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Home My WebLink About20682-zFOPS4 NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Ball Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20910 Date AUGUST 3, 1992 THIS CERTIFIES that the building, ADDITION Location of Property 5370 NASSAU POINT ROAD CUTCHOGUE~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section lI1 Block ~ Lot I9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 2~ 1992 pursuant to which Building Permit No. 20682-Z dated JUNE 2~ 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 ADDITION TO AN ACCESSORY BUILDING AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HFALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 ROBERT FEGER & TERESA TAYLOR ~ / B~d~ng ~n~'pector l~m'a,~ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPJVtIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne-N? 2058J~Z Permission is hereby granted to: .... ~.?.~..~~. ...... ~: ............ ,/~.7.~__;__.~' ..~. ~..~...~. ............................... ...~~.,:...~....,..~. ::::::::::::::::::::::::::::::::::::: :.;::::::: ................ .... :': '.:'.....'"':.' .'.'::'"'..' :: ........ :::::::::::::::::::::::::::::: ........ ................................ ~ .................... ?.w.., J ..................... County Tax Map No. 1000 Section ....... ,/~./. .......... Block ....~.~.. ........... Lot No ....... /....~. ........... pursuant to application dated ................... ~./......~... ...................... , 19~...~..., and approved by the Building Inspector. /~ulldlng Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN RALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. 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: 1. Final sqrvey 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 1% 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: i. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed applic~tio~ 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 1. 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.- $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construct~on.....~..... Ol.d Or Pre ex~st~ngD~ '~' ..Z%..~.p.\.~.?..~. ........... Location of Property.. ~-~.~ .......... ~.~...~.~.~...~.~ ............. ~~. ..... ~ouse ~o. Street Hamlet Onwer or Owners of Property ............... County Tax ~ap ~o [000~ SectSon .......... Block .............. Lot ......... Subdivision ..................... ~ .............. Filed Map ............ Lot ...................... No.~..~..~.~.~..~....Date Of Permit ..~..--~.:.~...Applicant. ~..~. ~. ~. Permit Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate.....~...... Fee Submitted: $...~..~..~.~. ................. ~/~~~ . ~J~/~'~° , ....... C~ L~ ~OUNDA'TION (3st) ?OUNDATION (2nd) ~OUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FIX;AL ~DDITI~ ~L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION' [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ .1 FOUNDATION ZND [ ] INSULATION [ ] FRAMING DATE 'z./' INSPECTO 765-~802 BUILDI G DEPT. [ ] FOUNDATION ' 1ST i[ ] RouGH PLBG. ' FOUNDATION 2ND~[ ] INSULATION FRAMING 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [] INSULATION ~ ~,~,,,~ ~ ~ ~,,,,~, ~/~~*/ INSPECTO~ DATE .... · ~;~ ~'ii i~ TOWN OF SOUTHOLD ~!'" HAY 2 9t992 . I BU LD NGDEPARTMENT ; i~,'~ ' ~ .... " '! TOWN HALL iLi\~!~: .... - $OUTHOLD, N.Y. 11971 ~' ;·.~,¥¥; ,,' ; ,~, TEL.: 765-1B02 Disapproved a/c ..................................... BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ NOTIFY CALL ..................... MAIL TO: (~il~ng Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tkis 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 lhyout of property must be drawn on the diagram which is part of this appli- cation. e. 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 shali 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. ~ (Sig~lature of applicant, or name, if a corporauon) _ . (Mailing address of applicant) ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · -./ ......... 2~', ~-~- ........................................................... Name of owner of-remises ,~0/(~-t~.'.~. t/~"~?~-~'~-- ~ '~~ ~ ~ O~ ' ~ '~' ....... ~ ...... (~;h';d~';~';~i;;ilt;}t'5;;4'A~R~yg~A~'N~ ....... If appl~ is a co--re of duly authorized officer. ~c ~ .,% "~ ......... ~ o~;/) ..... ' ~s ~o~ ~ ~ m ~ .~ ~o. ~ FOR POURED CONCRETE Plumber's License No ......................... 2. ROUGH -,~RAMING & PLUMBING 3. ~NSUL&~TION Electrician's License No ....................... 4. FINAL ~ CONSTRUCTION MUST BE ~OMPLETE FOR Other Trade's License No ...................... ALL CONSTRUCTION SHALL ......... ' STATUE CONSTRUCT ON N 1. Location of land on winch proposed work wm Ge uone ................... ~.~.,,~?...-., .......... ~..~ .~Oy.. House Number Street Hamlet co,,t~,~x ~ No. ~00o s~lio, ..... t. (.( .......... ,~o~k ..... ~. ...... ~o~ ..... ~.~ .......... Subdivision ................................ Filed Map No ............... Lot ............... (H'~;~d) 2. State existing tzse and occupancy of premises an¢ intended use and occupancy of proposed construction: a. Existin8 use and occupancy / ~/ / ~ ~ ....... ' ' ' '~ ........ V .... ~:~D'.~,D~F~D .... , ............... b. Intended use and occupancy .../. ~.~.~[V /~?/dwz~M~,'t?,'~:'~ 3. Nature of work (check which a~plicable): New Building ..... ' ..... Addition ... Alteration .......... Repair .............. Removal .............. Demolition ............ Other Work ............... ~/..~/700,io~._ (Description) 4. Estimate'd Cost . . ~,,~ ~-- .....ql ..................... Fee ..................................... (to be paid on filing this application) 5. If dwelling, number of dwelling Bnits ............... N~mb.er af dwelli~ units on each floor ................ If garage, number of cars ... ~..~&..~~.~.~ ~...~. ~J~. ~R~ ............. 6. If business, commercial or mixed occupancy, spec~y n~u[e and extent of each tyce of use .................. 7. D~mensmns of e~st~ng structures, ff any Front .... ~ ~ ..... Rear ............ De~th . Height ...Z ~ ......... Number o f Stohes ....................... ../ ..................... y ......... D~ensions of same structure w!th alterations or additions: Front .... ~. ~ .......... Rear ...... ~ ........ Depth.. ~. ~ ............. ~.. HeiSt ...... 4 ~ 2; ......... Number,of S~ohes ...... ~.. / ....... Dimensions of entre new construction Front ~/ .. ~ear . ~ / '... Denth Height ..... ~ ........ Nm~ber of Stories ....... ~ ................................................ Size of lot: Front .... ~. · ?.fi& ~q~.. Rear ...................... Depth ...................... 10. Date of Purchase ~ ( ·. Name of Fo~er ~wner 11. Zone or use &smct ~n which prqm~ses are s~tuated ....... ~/.~& ............................... 12. Does proposed construction v~l~ate any zoning law, ordinance or regulation: .... ~ ......................... 13. Will lot be regraded ... ~/~i ......... ~ ..... ~... Will excess fill be removed from premises: Yes No 14. Nme of Owner ofpremi tess ................... Phone No ........... '~ ..... ~ '~4~] .......... Address ................... Phone No ................ Nme of Architect .~ .,., . Nme of Contractor . ~. ~9~1 ....... Address~q:~e~6~ ~ ...... Phone No. ~L~7.; ? ~7~. 15.Ia this property lees.ted within ]00 feet of a tidal ~etland? ~YgS .... ~0.~ · If yes, Southold Tow~ Trustees Permit may be required. PLOT DIAG~ Locate cle~1y ~d d~s~ncfly ~l bulldogs, whether existing or proposed~ ~d. ~nd~cate ~ set-back d~ensions from prope~y Hnes, Give street ~d block ~umber or desc~pfion accord~g to doed, ~d show stree~ n~es and ~dioa~e whether int~or or corner lot. STATE OF ~~ /J~ ] cou s.s . (Nam~ o f individual signi3g contract) above named. : t, corporate officer, etc.) of said owner or owners, ~d is dul~ authori~u perm or have perfo~ed the said work and to m~e and file this application; that all statetnents contagned ~ this application are true to the best of his knowledge and belief; and that the work will be performed in the m~ne~ set forth in the application filed therewith. Sworn to before me t~s ~ _ ~ . .............. ....... .... _ ./ . :::, ....... o~ ~ _ / ' [~gnature o~ appnc~r) 7G5-~.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING , [ ] FINAL DATE . INSPECTOR 76S-1802 BUILDING DEPT. C INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: "' INSPECTO~~.~..c~ DATE 7/~/'~ ~