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Home My WebLink About16142-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certi[icate O[ Occupancy No. z16253 Date Oct. 6, 1987 THIS CERTIFIES that the building P o o 1 Location of Property 385 Cottage Place Southold County Tax Map No. 1000 Section 062 .Block 03 .Lot 17 Subdivision ................................ Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... 3[ u ~ e.. 1. 6,..1.9. 8 7.. pursuant to which Building Permit No. 1 6 14 2 Z dated June 2 6, 1 9 8 7 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 ......... Above ground l~ool and fence as applJ, ed for. The certificate isissued to JOHN E. & JEANNE C. WALTERS ..................... X .................... of the aforesaid building. Suffolk County Department of Health Approval ........... .N./.A. ........................... UNDERWRITERS CERTIFICATE NO. N 833900 9 / 24 / 87 PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 TOWN 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) N~_ 16l~2 z Permission is hereby granted to: ...'.~.z~..._~...~..~~ .............. ~.~ ...... ~...~.:.....U..~.~...~ ............ r, ...... .............. at premises located at ...~.~.. ........ .~~..s~.~,..O~...~ ........ ~.~ ................. County Tox Map No. 1000 Section ..... ..C~...(~....?... .... Block ...... .~....~ ...... Lot No .... !..~. ................ pursuant to application doted ..... ..~..~..~..7 ......................., 19.?..~.., and approved by the Building Inspector. Building I~tor Rev. 6/30/80 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY NEW YORK, NEW STREET. ~ £859)~/7 JOHN YORK 10038 ~a-.~-,~ Z4, ~4979/~7 THIS G~RTI~I~$ THAT only the el~tr~ ~uipment ~ ~cribed bebw and int~uc~ by t~ ap~icant ~med on the a~ application nu tuber in the prem~es of in the fottowing location; ~ B~sement ~ Iht Fl. ~ 2,d Fl. Section Bilk Lot u~s exatnined on ~~ ~ q ~ ~ 9~ 7 and found to be in con~pliance with the requirements ~f this Board. FIXTUEE OUTLETS RECEPTACLES SWITCHES FIXTURES RANGES :COOKING DECKS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS OVENS DISH WASHERS EXHAUST FANS TIME CLOCKS UNIT HEATERS MULTI.OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C E OTHI~R APPA~RATUS: / ' '-%~t~f~t MANAGER ~.-ut. hold, ~¥ 11971 Lc~82-.~ ~..' \ 11 This certificate must r~ot be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPA Instructions BLDG. DEPT. TOWN OF SOUTHOITD' A. This application must be filled in typewriter OR ink, and submitted m ~ 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. ()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 CCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.~ 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .... .*..c.'..~..;.'~.[ ........ NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. '" - I c,V/ ...... Location of Property :q.~ ..:~ . ,4 .~. ¢'~~. ................................. ~ ........ House No. ' Street ( ..~ ' Ham/et Owner or Owners of Property . ,_-~ .o. Y~.,'.~. ~. ~..,-~...~ .~ .~'1 ~4..(~... ~-~;Q%. ( ..J~. F. ~ .................. County Tax Map No. 1000 Section :~¢. ;-& .......... Block ... ,*~ .......... Lot...\ .~ .......... 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 an.d perrf~it meets all applicgble codes and regulations. Applicant ... ¥.>.~ .%...~ . .~, ,.'~.~ ........................ Rev. 10-10-78 UNDATION O'c,~ co UNDATION (1st) UGH FRAME & PLUMBING (2nd) SULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 F ×amined. 5 19 .7 Approved . .~,,~.4,4,X~..,~'.~.., 19~...'/. Permit No.! .~../.~..~..~.. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...... 3 SETS OF PLANS ..~ ..... SURVEY .......... CHECK .......... SEPTIC FORM ............. : NOTIFY S- - 27- ..... MAIL TO: u uL ......... TO~,,'N GF SOL~iHOLD Date .................. 19.. 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 scliedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public street: 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 code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ~ F- ...... ) ................. (Sig~a~ture 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. ·. ~"'.-.~,.,.,.n.g.~ ................................................................................... Name of owner of premises . .-.~. ~:'' h ,~...~.-., :~.-...,~-..~.C~..~.O.~..Q~.L~.~.q=. 3.4.,?..~A ........................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) - ALL COlqTRACTOR~$ 1.111ST BE SUFFOLK COIII~IT¥ LICEltSI~.D Builder's License No ............... ........... Plumber's License No ......................... Electrician's License No .... .,/. ................. Other Trade's License No .......... ............ Location of land on which proposed work ~'ill be done .................................................. ltouse Number Street '-~ Hamlet County Tax Map No. lOOOSection ..g..'~.. ........... Block ...~ .............. Lot..]7 .............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ~..?..-!c~.q~.-... d>. c9;' ~-~-~'~,t'. .'~ .c.)~ .j ..................................... b. Intended use ~qrld oc'~'i~p~qncy Repair .............. emoval ............. Demolition .............. Other-r)V°rk'' ' '~'[~'~' ~ r' (Descripli~ff)-' 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. Dimensions of existing St~C~tures, if any: Front ..... .. o ........ Rear .............. Depth ............... Height ............... Number of Stories .......... '...'. ~ ................. '..; ....... ' ............. Dimensions of sar0e slcacture with alterations or additions: Front ................. Rear ...... ' ........... Depth ......... '. ~ :..~. ........Height ...................... Number of Stones ...................... Dimensions of entire new construction: Front .......... · ..... Rear ............... Depth ............... Height .............. Number of Stories .......... ~:. ~ ...................... J.& o°. .~- 47 ............ 9. Size oflot: Front ..~].~.~ ................ . Rear...'~.,'..,....~ .... ....... Depth ..[.~J,C. L6.'.' ........... 10. Date of Purchase ............................. Name of Former Owner . ...~. J ..... l 1. Zcne .or use d:,strict in which premiaes are :~tuatcd ..................... · ............................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . !12\ .......................... 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes Nc 14. Name of Owner of premises .................... Address ................... Phone No ............... Name of Architect ........................... Address ................... Phone No ............... Name of Contractor .......................... Address ' Phone No ............... 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ,~... · If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions fron property lines. Give street and block number or description according to deed, and show street names and indicate whethe interior or corner lot. STATE OF NEW YOIg~, COUNTY OF..,5..,~...M~..'/.lc., .... S.S ............ ~ .~..'~..~.../x?/9..~..'77~:.~..~.' ....... being duly sworn, deposes and says that lie is the applican~ (Name of individual signing contract) above named. He is the ..................... .C/...c~...(~...~.~_ ..................................................... (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 thi: application; that all statements contained in this application are true to the best of his knowledge and belief; and that tht work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ... .....c~.~. .............. day of. ~ ............. 19~. Notary Public ............. ~ ...... County . ...... ............... Not~ Publio, Stm~ ot I~l~n ~/~c/ ~x,J (Signature of applicant) No. 4822563. Surf. o~k...Cou. ~1~/<::~ Term Expires December ~s~,