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Home My WebLink About14520-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-]5287 Date February 19, 1987 THIS CERTIFIES that the building One family dwelling & garage with attached · ' f~b'dd ' ab'dR ................................... Location of Property 3050 Itighland Road Cutchogue, New York House No. Street Hamlet County Tax Map No. 1000 Section 10 2 .Block 08 ..... Lot 0 2 3 Subdivision MID Highlaud gstates .Filed Map No..6.5.3.7 .... Lot No. 26 conforms substantially to the Application for Building Permit heretofore filed in this office dated December 6, 1985 pursuant to which Building Permit No, 14520z dated January 30, 1986 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ONE. FAMILY DWELLING & GARAGE WITH ATTACHED WOOD DECK The certificate isissued to DAVID A. & DONNA M. COOK ..................... ' ;dbFg.xg T x x ................... of the aforesaid building. Suffolk County Department of Health Approval 85- S O- 169 N793808 UNDERWRITERS CERTIFICATE NO .................................................. January 5, 1987 PLUMBERS CERTIFICATION DATED: / B2~ffding Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMI$£S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 1~? 14520 Z Permission is herebt gronted to: .... :~..~z~ ~.....rZ... ~ ~....~..~ .... .,~.~...~...~Z~.~z/~.-z...i~ ......... .... .q:.xr~.~B...~...-....V........~<.~_~..~ ,o ........ ~.~.. ~Z../Z..~.~.~.........o.~...e....~?...~/.~..~.....~.~c./.~c.~ ......................... ......................................................................... .L~x,x-x~.~.~,... ~......W....... :.~..,~L/.~..~r..~.~L~..iii~.~.x...i ................ ..z.~- ' ~..~..~ ........... County Tax Map No, 1000 Section ,.../~,..~...~.. ....... Block .... ..~....~, ........ Lot No....,,(~.,~.. ,~.. ....... Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ,~ ~--.~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--iS-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. Bo For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~"operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 / 5.Updated C.O. $'50.00 Date ........... NewConstruction ...... Old or Pre-existi.g Building . ........ Vacant Land ............. Locat on of Property ........... ~.. ~4.. ~; ..................... ~ C. d~¢~.. ~ Owner or Owners of Property ......... 1 ...... ~ ...... 0.C~C7.~ ........... ~ (~ County Tax Map No. 1000 Section ../~ ....... Block.. ~ ........ Lot..~ ......... Subdivision./~d ~¢~<Z&. ~¢~;~¢/~ .Filed Map~N°'~ ~ .Lot~)sN°' ~ ¢ ........ ~ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $.. o ................. Construction on above described building and i:~git meets~t~icable,codes a~c~ regulati~s. ~ ~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner ~/~C2/~ ~ ~/<~ (please print) Plumber ~/~ ~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) Sworn to before me this ~-day of ~ , 19 · Notary Public,~ County Notary Public NOTARY PUBI.IC. State of New Yo~k No. 4n7878, Suffolk Countyo Tefra Exl~ms M~mh 30,19'/~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 3~0~0 BUREAU OF ELECTRICITY B5 JOHN STREET, NEW YORK, NEW YORK 10038 ".t. Vebruar¥:~2,z9~7 ~..,,...o.~....z.. ~3~3/~ N 793808 THIS CERTIFIES THAT o~y the electrlcaJ equipment ~ ~scribed below a~d int~d~ced by t~ appllca~t ~med o~ the a~e application n~mber i~ the prem~es of David A. Cook~ 3050 Hi~h]and Rd., Cutcho~ue, N.Y. ~s exatnlned on Febru a-i?y 9 ~ 1 9 8 7 and found t~, be irt corttplia.ce u' th the req reo[e.ts qf this Board. EXHAUST FANS DRYERS FURNACE FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: T-Smoke Detecto]- $ E *[o R V I C E 3/0 Truman II, Cook Bo× 44 ChampuD Placa Gre.nport, N.Y., :[1R44 lic. ~743E GENERAL MANAGER p,~- 11 This certificate must not be altered in any manner; return Jo the office of the Board if inc6rrect. {nspectors ma), be identified by their credentials. COPY FOR BU!LDING DEPARTMENT. THIS COPY OF CJ:I,~ flFICATE MUST 'NOT BE ALTERED N ANY MANNER FIELD~INSPECTION~ COMMENTS FOUNDATION ( 1 st ) FOUNDATION (2nd) 2 o ROUGH FRAME & PLUMBING INSULATION PER N. Y, STATE ENERGY C,ODE FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST [ ] ROUGH PLBG. FOUNDATION 2ND ~INSULATION [ ] FRAMING [ ] FINAL REMARKS: INSPECTOR 7GS.'1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION DATE / ? INSPECTO~ BUILDING DEPT. INSPECTION FOUNDATION 1ST ~ ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION []FRAMING []FINAL 'REMARKS: DATE ~//~ ~a'~' INSPECTOR 76S-1802 BUILDING DEPT. SPECTION _ ..~,~IOATION 1ST [~ ROUGH PLBG. FOUNDATION ZND [ ] INSULATION DATE /~///~~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ].ST ~.~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS:~//~, [ ] FINAL Examined ...xY ............ ,19... 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ............................. .~ ....... (Building Inspector) APPLICATION FOR BUILDING PERMIT l~ BLDG. DEPT. [ TOWN OF SOUTHOLD Received Date .................. , ] INSTRUCTIONS . a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building c,,~te, housing code, and regulations, and to admit author/zed inspectors on premises and in building for necessary~spectio,~s//~ ~ /] /? n (Signature of applicant, or name, if a corporation) (Mailing address of applicant) [[~'~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................................................. Name of owner of premises · J'~/~.~]~ ~[2~.. ~/~ o...~'~.~..~..~.....~.., iDO.'.~/.j.~.'/~- · · . t~.o... ':~..'~. '.~.'.~.' ;-. ........... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ..... Plumber's License No ......................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ......................... n ........... · House Number Street Hamlet County Tax Map No. 1000 Section .... 2~'~. · ........ Block .... .~.~. .......... Lot...~...~. ............ Subdivision.///. '~f..~//~/~.~....~..~.,¢~..~.S .... Filed Map No...~..~. · .~...~. · · · · Lot..~ ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use aaa occupancy ~-~l./-~.~/.,~...~....~ ¢:¢.T.. ............... b. Intended use and occupancy 3';- Nature of work (checl/which applicable): New Building ....... 'Addition .......... Alteration .......... ' Rembval Demolition Other Work Repair ........................................... : . .: · t , (Description) 4.~ '~Estimated Cost..~:~. ,z...~...Q ~ ...................... Fee ................................ '~" ....... · ~ (t g thi ppli ) : · : o be paid on illin s a cation 5. If dwelhng~ number of dwellingmn~ts .... i ......... Number of dwelling units on each floor ................ If garage, number of cars .... ~ ~ .................................... 6. If business, commercial or mixed, occupancy, specify nature and extent of e~use . . .~:-.. ................ 7 Dimensions of existing structures if any: Front .--7. ..... : \ Rear ~. Depth - -- ~ Number of Stories ~ - . Height . , . .' ....-:: Dimensions of same structure With alterations or additions: Front ~ Rear Depth ... ~ ....... ... Height ....... ~...~ .......... Nunlber 9f Stones...-~-:. ..... ..~ .,,~ ..~ ~,~.. 8. Dimensions of e[ttire new consthaction: Front . .: ~.~.'. ...... Rear . .~.~. ~. ........ Depth ... ~'(t, .~.~. :'... Height , ~. ......... Nt~,~ber of Stories . .l. ~o~ ....... '.,, ..... ! .................... , .....~r .......... 9. Size of lot: Front ..... l~.., ........... Rear ..... / ....... 10. Date'ofPurchase ....... .~/.;~-/.~.~;.~ .......... ~ Name of Fonner Owner ~.~.~/~a~-~t}/~)~ .~.~t~.C~t~0. ¢...; i 1. Zone or use district in which p~emises are situated../'5'. ................................................ 12. Does propos, e.d constructitln violate any zoning law, ordinance or regulation: ~]. ~ ......................... 13. Will lot be re}raded ../~. ~.:~ .................... Will excess fill be r~moved,from premises: ,t _ Yes 14. Name,of Owner of premises ~U[~I~. ~*..(~' Address~./~/~q~.' .~.'~hone No..~. ~.77/~.~.~... Name of Architect ......... ~ .... Address ........... Phone No ........ Name of Contractor ' Address Phone No PLOT DIAGRAM . Locate clearly and distinctly afl buildings, whether existing or proposed, and, indicate all set-back dimensions from i property lines. Give street and block number or description according to deed, and sho.w street names and indicate whether interior or coruer lot. STATE OF NEW YORK, S.S COUNTY OF ............ ............................ ~ ..................... being duly sworn, deposes and says that he is the applicant!. (Name of individual signing contract) above named, j : He is the (Contractor, agent, corporate officer, etc.) of smd owner or owners, and is duly authorized to perform or have performed the said work and to make and file this apphcatmn; that all statements contamed m th~s apphcat~on are true to the best of his knowledge and belief; and ~hat th~ work will be performed in the manher set forth in the application filed therewith. Sworn to before me this ......... . cou2 (Signature of applicant) D~VlD ~. COOK & DONNA M. COOK ~FFOLK COUNTY DEPARTMENT OF HEALTH SERVICE~ LOT 26, "HIGHLAND ESTATES" AUG. 20~ 1985 AT CUTCHOGUE O~TE FEB. 24, 1985 FOR APPROVAL OF CONSTRUCTION ONLY ~N ~ SOUTHOLD SCALE: I"=~O' DATE HS - ~ SUFFOLK COUNTY, NEW ~RK No. APPROVED ~ .coe~[s ~ m~s s~vE~ NOT ~n~ ~H[ L~aO CHICAG~~C~OMPANY = STA~E ~ RIVER~AD, NEW YORK ONAPR. Z6, 1977 AS FILE NO. SS~T. AND LAND SURV[YOR N Y-S UCENS/ NO. HOWARD W. YOUNG, LAND SURVEYOR / . 0 SURLY FOR ~ NO~ 21 ~. , - ~_ DAVID A.'CO0~ & DONNA M. COOK JAN. 27,1986 ,~ --~ ~ /~ LOT'26, "HIGHLAND ESTATES" NOV. 26,1985 AUG. 20~ 1985 ~T -.CUTCHOGUE O~TE, FEB. 24, 1983 ~N ~ SOUTHOLD SG~LE~ 1"=40' DEC ~ 19~ SUFFOLK COUNTY, NEW ~RK NO. I'~:~'~P ~ 0F N~UTH~IZEO ALTERATION OR ADDITION ~ ~lS GUARANTEED TO: "~ ~V SURVEY = A VI~&TIONN[w YORK STATE E~CATION~ SECTIONLAw 7209 ~ THE DAVID A: CO~ C~ ~ /C~ ~ COPIES ~ mis S~VEY 'NOT ~AR~G THE LAN~ CHICAGO~E~~MY SURV[~R'~ INKEO ~[&L OR EMBOSSED SEAL $H~LL FOREM~T HEALTH DEPARTMENT-DATA F~ APPRO~L TO C~STRUCT ~[ ~ ~R WHOM THE SU~EY 15 PREPARED t YOUNG 8 YOUNG ~ = STAKE 8ET SUBDIVISION MAP FILED IN THE OFFICE OFTHE C~ERK OFSUFFOLK COUNTY ALDEN W. YOUNG~ PROFESSIONAL ENGINEER ON APR. ~6, 1977 AS FILE NO, 6e~7. AND LAND SURVEYOR N.Y.S. UCENSE NO. 12845 HOWARD W. YOUNG, LAND SURVEYOR w ~ L~ ~ ~L(W), ~PTtC ~ANK{ST)e C[~OLS(~) ~N ~ N.~ S~ LI CEN S E NO. 45893 If copper lubing is used for water disfributing sys em; piping shall be of types K or L only PLUMBER CERTIFICATION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY SOLDER USED IN WATERT 'PPLY SYSTEM CANNO ~XGEED 2110 oj' 1% LEAD. AP,~R~VED AS NOTED r NOTIFY BUILDING D~-PA'R'T/'AENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION ~ TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULAT!ON 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C, O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. 15'5" -I. 477-0400 ~ Mai. Re'ad %¸. 'ir - H- 0'0" ,'4 Fu'rdFE