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Home My WebLink About14277-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14016 Date November 21 ................. · ................................ 19.85.. THIS CERTIFIES that the building ....~,~¢¢~.s.Q~;y.. ................................. Location of Property 7~Q Little Neck Rd. Cutchogue House No. Street Hamlet County Tax Map No. 1000 Section ..... 9.7 .....Block ....... .7. ......Lot ...... .2.6...~ ...... Subdivision Little Neck Properties Filed Map No. 6048 .Lot No. 5 conforms substantially to the Application for Building Permit heretofore fried in this office dated .... .A. qgu~.t..2.~ ...... ,19 .8.5. pursuant to which Building Permit No. 14277Z dated .... .S.e.p.t..e.m.b.e.r...1.3. ......... 19 .8.5., 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 ......... Accessory building. The certificate is issued to ............... .H~..I~..N...~, .~.B.O..O.K~..I.L..I.~. R /owner, ~ ............ of the aforesaid building. Suffolk County Department of Health Approval ......... .N./A ....... UNDERWRITERS CERTIFICATE NO ......................... .N .,~. ..................... Building Inspector Rev. 1/81 I~OR~ NO. f~ TO~'H OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14277 Z Permission is hereby granted to: .~..~.~........%..~~... ..~.~...~..,~....~.~....~.d., .................. ...~..~.~....~.:H. .,.....LL.~..~.-... ..... ~~ ,...~...~..~ ~ 0~...~ .... ,o ........................................................ ~ ........................ ~ .............. ~_~ ............. ~ .......................................... :~.: ................ : ............................................... ..:,. ................................... et premises Iocoted ~t ..,-/.!.,,~...... ,~-,~....,.~,,,~,,,,~.,,,... ,,~,.,,.; ............ ~,.~~ ............. c,o,..,,ty Ta× Map No. mOO s,~o~ ..... ~.~.~ ....... B~k .....~ .......... Lot No....~.~.:g..o..~..~. pursuant to application dated .~.~...~..........~.....~. ............ 19.?..~...'~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG. DEPT, TOWN OF SOUTHOLD Instructions This application must be filled in Wpewriter OR ink, and submitted m Iii. II 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 nam ral or topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pm3perty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of Occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date ......................... New I~h~i~g ~.7~.~-~ ~'~.C~ Old or Pre-existing Building ............ Vacant Land ............. Location of Proper~..'~Z~Z~4~.~-~/~.~..~~-~/.. '''''"'''''''' ~ ~ .... ~;~/e; Hou~ No, ~- Street Owner or Owners of Property ~~ ~. ~. ~.. ~-. ~~+.~ .......... CountyTax Map No. lO00Section ...~?. ....... Block "7 ........... Lot.~.~,c~.. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No,' ...... Date of Permit .......... Applicant .. ~ ....... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....~... ............... Fee Submitted $..~..'~::...~.:~.. ¥~.~...~...~. ...... Construction on above described building and permit meets all applicable codes and regulations. '-~--0..~, ~'~. ~o)~-~-1~7 Applicant .... ~G~..~.. ~ .................. Rev, 10-10-78 iELD INSPECTION COMMENTS OUNDATION (2nd) OUGH FRAME & PLUMBING ~SULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N,Y. '11971 TEL.: 765-1803 ~,pproved 757.~ .~.., 1.~., 19 8..~. Permit No. )isapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ~19... I INSTRUCTIONS i a. This applicatlon must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relatiouship to adjoining premises or public streets r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. c. The woi'k covered by this application may not be e~6mmenced before issuance of Building Permit. d. Upon approval of this applicat_'~the ~lcl. ing~l~e~ctor will issued a Building Permit to the applicant. Such permit ~all be kept on the premises availabl~'t~]'n~'~ t~*~iout the work. e. Nobuildingshailbcoccufl ~t~i~fl'w~-in part for any purpose whatever until a Certificate °f Occupancy mllhave been granted by the I~ ~g APPLICATION IS HE~k~ ~1 ~o~;~ing Department for the issuance of a Building Permit pursuant~to the ~uitding Zone Ordinance~4 le q ~0f~b~oJ~uffolk County, New York, and other applicable Laws, Ordinahces or '~e~ulations, for the ~¢ [~ %~lc~_,~6ns or alterations, ~r for re,oval o~ demo?ion,? he~e~ ~h~ applicant agre~o~ ~ ~p~la~vs, ordinances, building code, housing eoae, ana regmanons, ana to dmit authorized ~to~ ~ ~iId~g for neCessaw inspec~ ~ ~ m~ .,, ....... i ~ ~ "' [~i~;ature of applicant, or na~':, if ;cOrporation) (Mailing address of ~plicam~ gtate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. qame of owner of'pre~nises ' · · · · : ............................. (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officer· (Name and title of corporate officer) ...... Builder's License No. Plumber's License No ............. ' ............ Electrician's License No ....................... Other Trade's License No ............. Location of land on which proposed work will be done ........ ~...~..~.u ~ ...... ·" . ........... l{ouse Number Street County Tax Map No. lOOOSection ...~.:~ ......... Block ''7 ............. Lot~/~.-,~ ....... Subdivision L [.~yFJ.~/~:d.~ .J:,~.~,t'k.~:/.2/Aq_J .... Filed Map No. [;~..~.~ ..... Lot ..~ ........... (Name) State existing use and occupancy of premises and intenCed use and occupancy of proposed construction: a. Existing use and occupancy . ~/. fl.~. ?~q~ffff ................................................... b. lntended use and occupancy ~ . ............... ~ .:;~'~ ;'~, ~ ~4'~%'~: ~ .... ~' ' ' Nature Of work (check which a Repair .............. Rerr ?plicable): New Bu'flding Addition .......... Alteration . oval ........ ., .... ;:~ Demolition .............. Other Work ...... ' :' "'~ ~. (Description) 4 Estimated Cost ' " Fe ~' ~' (to be paid on filing this application) 5, If dwelling, number of dwellin units .......... . ..... Number of dwelling units on each floor ............... If garage number of cars ...................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................. 7, Dimensions of existing structures, if any: Front ............... Rear .............. Depth .............. Height ............... Nulnber of Stories ....................................................... Dimensions of same structure With alterations or additions: Front ................. Rear ................. Depth ................... !... Height ...................... Number of Stories ............. ,; ....... ... Rear .. ~. ........... Depth /~?- .. 8. Dimensions of entire new consiruction: Front .. d/Z~./. ... /, / ............ Height . .~../ ....... ... Nu~horneSton'os ....... ; ......................... ','~ .............. 9. Size of lot: Front ./.~r/i2.~...~. ~-. ~}....'~. l~;ar, iZ ~.~.. f. ............ Depth ~ ~.'&:.~ ............ 10. DatiofPurchase .......... j ................... Name of Former Owner ............................ .... h p: ' ' 11. Zone or use &strict ~n wh~c rem~ses are s~tuated.. .- ............................... 12. Does proposed construction violate any zoning law, ordinance or regulation' 13. Will lot be regraded .../.'~..~.,, .................... Will excess fill be removed~.from premises: Yes N 14. Name of Owner of remises ~J/'/lq //- .L~- ~ .. Address-~/,~.d'/',rT'Z~/F).~'''''' P ..... ;' .' .... ..v ~.;..,~,~ 5;% ............................... Name of Architect ......... i .................. Address .~.~z.c..~;p'{-~: ./,f..~... Phone No .............. Name of Contractor ........ i ....... ' ........... Address ................... Phone No .............. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fro property lines. Give street and block number or description according to deed, and show street names and indicate wheth. interior or comer lot. ' S.S STATE OF NEW YORK, COUNTY OF ................. ............................ : ..................... being duly sworn, deposes and says that he is the applicar (Name of individual sighing contract) above named. I% is the ..................... ................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is drily authorized to perform or have performed the said work and to make and file th application; that all statements contained in this application are true to the best of his knowledge and belief; and that tk work will be performed in the manffer set forth in the application flied therewith. Sworn to before me this ............. '.!.~- . day~f ..~/~ .......... 19 ~5'"' ~ ' (S~g'~'nature of applicant