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Home My WebLink About13774-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ....... Z~579.~ A.. Date ............. .~.a.¥..2.6.:..~.9.8.7. .... THIS CERTIFIES that the building ....... a.c..c.e.s.s.o..ry..s.h..e.d. ........................ Location of Property .....6980. Skunk Lane Cutchogue ,ou~ No. ' .................... County Tax Map No. 1000 Section ..... 1. 0..4 .... Block ........ .5 ......Lot 8 Subdivision ........ X ............... Filed Map No....X. .... Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated March 12, 1985 13774Z ...................... pursuant to which Building Permit No ...................... dated March 22, 1985 ............................ 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 shed in rear yard.. The certificate is issued to GERARD M. CONROY ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO N/A PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 IPOB,M NO. 0 TOWN OF SOUT~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 13774 Z Permission is hereby grant~L~to: /%, ...... ....... Ca~nt~ Tax Mop No. 1000 Section ..... l...O....¢ ....... B,o~k ....... ~--.. ......... ~ No ...... .~. .............. pursuant to ,ppllcotion doted . .~.~ ....... /.....'~... .............. , 19.~..~..,'~and approved by the Building Inspector. '~~:Buildlng Ir~:mc~cr4~ ................................ Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 BLDG. DEPT. TOWN OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY ~ Instructions ~/~'1/~) 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-(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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property 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. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate 0f occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... New Cons truc t ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~ ~7~ ~f','~Z~,4,/.,~. /~,~/~5 ~.¢~. 7~'C-,/',/~'-~ E HouseNo. ¢;._/?//,- -~ ~. ~. ?S. rre.~. . .~. f ./r~'__ Ham/et Owner or Owners of Property '~ County Tax Map No. 1000 Section . . ?.~'2~.., Block ..~. Lot. Subdivision ................................. Filed Map No.,, ......... Lot No. Date of Permit .~./~l~,.~..Applicant .¢~..~.'.~..~.~ ' '"'~ Perm it N o. i ~'~.'). ~. ~'.. Underwriters Approval ........................ Planning Board Approval ..................... . Request for Temporary Certificate ..................... Final Certificate .. Fee Submitted $. J0. ! .0-~,.,· .~..~5-'~ ............ ... Construction on above described building and~ ~~ applicable c~fes and regulations ,.,~,.~. ~ (~ AppJican,....~, .~. "~ .................... Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise you that the job under building permit no. ~ issued to Gmrmrd ConrOy on --3/22_L~5___ for Ac~mmmory is completed a final inspection has ( ) has not ( X ) been done. and In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $10,O0'payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. Please help us to clear up this matter so that legal action does not have to be taken. Thank you for your prompt attention. Very truly Victor Lessard Executive Administrator VL:gar I . ~JGT~D NOTIFTM ~ ~'l -,,~ ' ' ..... . ,¢ ~Ep^RZi:-,Tv, I',FN~'~-'~'"~ 7dS-bm'? 9 4M ~Q 4 PM FOR THE ' 1. FP[~,'~,,!~N . TWO REOUIRED F~ ..... q 'q CONCRETE 2. ROLf~': FRAMIN~ ~ p~ 3. I~cl~' t, ~mN ' ' N ,",~ UST ALL '~' : STA~r Cm~IcrRUCTiON & COmEs' N~T RESPONS~f ~Fq GN Qn CONSTRUCTION r~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-180:~ Examined...~ 0,A,r.~..~.~.., 19tb'~ Approved ., 19~.. Pe~t No ........ Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ):'arch1.2 .......... 1985. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 gets 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 tiffs 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 1S 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 coustruction of buildings, additions or alterations, or for removal or demolition, as herein described. l'i~e applicant agrees to comply with all applicable laws, ordinances, building code, liousing code, and regulations, and to admit authorized inspectors on premises and in building for necessary il~spections. .... ................. (Signature of applicant, or name/if a corporation) · .gq~,O .Skunk .~ane~ ,Cu%chogue .N .~r .11935 ....... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architecL engineer, general contractor, electrician, plumber or builder. Name of owner of premises . -Oom, o,r -,- .~anand l~ ~..~ifa ............................................... (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 ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. l.ocation of land on which proposed work will be done...6qS0.Skunk .Lane ................................ ...... 6%8.0 ................ Skunk .Lane .......... ~utahc~'asr .N .Y.r .1195¢ ......................... tlouse Number Street Ha~nlet County Tax Map Iqo. I000 Section ..... ].Oh .......... Block ..... [ ............ Lot ...~ ............... Subdivision...Broad~qat, ers .¢e.~ .................. Filed Map No ............... Lot ............... (Name) 2. STate existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... R~8:l.~erl(le ................................................... b. Intended use and occupancy ........ S%o]C~,g~ ..................................................... 3. Nature of work (check which applicable): New Building ...gl['. .... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost ...................................... Fee ...................................... °' (to be paid on filing this application) 5. If dwelling, number of dwelling 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. Di~nensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ' Nmnber of Stories Dhnensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front .... J~O..: ....... Rear . 213. ;! ......... Depth ...9..: .......... lleigbt ... 6.; ......... Number of Stories ..... on. ............................................... 9. Size of lot: Front .. lb.5..: ............... Rear . .lb.5..~ ................ Depth .. ,1,50 .: ............... 10. Date of Purchase . ~,/2/.76 ...................... Name of Former Owner .. d. g. ~..e.~,l.s ............... 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... rm ......................... 13. Will lot be regraded ........ n~> .................. Will excess fill be removed from premises: Yes x No 14. Name of Owner of premises fi. £4 B. 3.or~.oy ........ Address69.8.Q 3.k.u,n.k..I~ ........ Phone No.73.1&-.~Sh.3 ........ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor s~lI~ . Address as abov~ ... Phone No. n PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S 2OUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) .~bove named. He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........................ day of ..................... ,19... Notary Public, . ................................ County (Signature of applicant) FIELD INSFECTION COMMENTS FOUNDATION FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: THE LOCATION OF WELLS AND CESSPOOLS ~ OWN HEREON ARE FROM FIELD OF HEALTH SERVICES APPLICANT: ~ ADDRESS ~ TEL ..... ~VO TE ** 0 "PIPE VIATEt~ SEBVI~E -' P~IVATE Vl~l~ NEABEST PU~IC WATEB MAIN-* 5 MILES REVISIONS DEC. ~.~/9 JAN./0, YOUNG & YOI SURVEY FOR: ~ND GERARD M. CONROY ~9 BARBARA C. AT GUARANTEED FO: EAST CCITCHOGUE TOWN Of SOU THOL D