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Home My WebLink About20901-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20947 Date AUGUST 18t 1992 THIS CERTIFIES that the building Location of Property I850 HIGHLAND ROAD House No. County Tax Map No. 1000 Section lQ2 Subdivision Filed Map No. ADDITION TO ACCESSORY Street Block 8 CUTCHOGUE~ N.Y. Hamlet Lot 29 Lot conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 18r 1992 pursuant to which Building Permit No. 20901-Z dated AUGUST 18~ 1992 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 DECK ADDITION TO AN EXISTING ACCESSORY INGROUND SWIMMING POOL ~ BUILT. The certificate is issued to JOHN F. & LINDA M. COOK (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 - // Building Inspector FOR~ NO. ~ TO~N OF SOUTHOLD BUILDIHG DEPARTMENT TOWN HALL $OUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°N? 20901Z ........... .............. ...~ ...... ~....~.....~..~ ............. ~ .... ¥ .... ./ ............................. ~ ........... ~~_...~.~ .............. z~.~ ....................... County Tox Map No. 1000 Section ....... /...~.. ......... Block ....... ..~...~.. ....... Lot No ...... ...~.../~.. .......... pursuant to opplicotion doted ................................................ , 19. , and approved by the Building Inspector. Fee $....~...~.. ..... //Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 ,,TOWN OF SOUTHOLI) "' APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of i% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements.' For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees l. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $t0.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ................... ~'~ew Construction .... ~.. .... Old Or Pre-existing~uilding. o a ion of roperty:. ..... ', House No. Street Hamlet Dnwer or Owners of Property...~.°~..~....F.'..~./.~..Z.l[.~V~.~...-./~.';...(.~?..~. .................. . . . %ounty TaM. Map No 1000, Section.,.¢/{)~ .Block...O.~D., lubdivision ..................... ~ .............. Filed Map ............ Lot ...................... 'ermit No ................ Date Of Permit ............... Applicant ............................. lealth Dept. Approval ........................... Underwriters Approval ......................... 'lanning Board Approval lequest for: Temporary Certificate ......... Final Certicate...-./. .... 'ce Su .... omltteo: ~ ...................... . . FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c .................................. BLDG. DE~. APPLICATION FOR BUILDING PER~IT BOARD OF 3 SETS OF PLANS ......... SURVEY .................. CIIECK ................... SEPTIC INSTRUCTIONS a. Tlds application must be completely filled in by typewr[ter or in ink and submitted to the Building Inspector, with 3 2ts 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 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 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 hall 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 aall 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 uilding 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. he applicant agrees to comply with all applicable laws, ordinances, builtding code, housing code, and regulations, and to Jmit authorized inspectors on premises and in building for necessary i~sl~e, ctions. ... ........ (Signature of applicant, or name, if~a corporation) tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ;amc of owner of premises . .'~...(~... ~/~....~...o.,...~.'..~.O>..`...C~..~...,..~O~ .%.. ~"~[" ~."~[" ..... (as on the tax roll or latest d~r~F/¢~u~,c....__ .' applicant is a corporation, signature of duly authorized officer. E' ~ ................................. ~; ....... 765-1802 9 AM ~ 4 PM FOR THE (Name and title of co~orate offic r ~ . IS UN WFUL 1. FOUNDAT~N - ~O REQUIRED Builder's License ~o ............... FOR POURED CONCR~E Wi f0UT CERTIFICATE . Plumber's License No ......................... . INSU~ON 0[ OCCUPANCY .. Electrician's License Nb ............. BE COMPL~E FOR C.C. AkL CONSTRU~ON SHA~ ME~ OtherTrade's License No ...................... THE REQUIR~EN~ . . ~ s co ~o m ~ v ~k .~-- ~ x ~ ~ ~,. ~ ~ ~ DESIGN OR CO~~RRO~ .... XX SS ............................. IIouse Number Street Hamlet County Tax Map No. I000 Section ,~... .......... Bock ~ .................. Lot...~, ~ ............ (Name) State existing use and occupancy of premises aad intended use and occupancy of proposed construction: a. Existing use and occupancy . ._[ ...................................... an, F .t .............. Repair .............. Removal .............. Demolition ................... *OtherWork (Description) 4. ]Estimated Cost ...................................... Fee .................................... (to be paid on filing this application) 5. If dwelling, number Of dwelling units ............... Number of dwc~lling 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: F. ront ............... Rear .............. Depth ............. Height ............... Number of S~f0ries:..'.7 ................................................. Dimensions of same structure with alterations or additions: Front ................. Rear ................ Depth ...................... Height ...................... Number of Stories .............. '.. ..... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............. Height ............... Number of Stories ............................................. : ........ 9. Size o£1ot: Front ...................... Rear ...................... Depth I0. Date of Purchase ............... : ..... ......... Name of Former Owner ............................ 1 I. Zone or use district in which premises are situated .................................................... 12. Does proposed construction violate ~ny zoning law, ordinance or regulation: ................ . 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes N 14. Name of Owner o£premises ..................... Address ................... Phone No ............... Name of Architect ........................... Address ................... Phone No ............... Name of Contractor .......................... Address ................... Phone No ............... 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... *If yes, Southoid Town Trustees Permit may be required. PLOT DIAGRAM Locate dearly and distinctly all buildings, whether existing or proposed, and. indicate ail set-back dimensions fror, property lines. Give street and block number or description according to deed, and show street names and indicate whethe interior or comer lot. STATE OF NEW ~QR~rwt t~ S.S cou ¥ OF.. .... ........ b.~'~../~ ,', ~ ............ being duly sworn, deposes and says that he is the applicanl (Name of lndMdual signing contract) ~bovc named. Heis thc ..... ~~ ................................................................. · (Contractor, agent, corporate officer, etc.) ff said owner or owners, ~d is duIy authorized to perform or have perfo~ed the said work and to m~ and file thli ~pplication; that ail statements contained ~ this application are trne to the best of his knowledge and belief; and that the york w~l be perfonned in the manner set forth in the application filed therewith. ;worn to before me this ................ day of .......... , 4Ota~ Pu ~ ~, 8m~ of N~ Yo~k ........ ~. 52491~39 (Signature of applican(