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Home My WebLink About20437-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20552 Date FEBRUARY 27~ 1992 THIS CERTIFIES that the building. ALTERATION Location of Property 660 SCHOOLHOUSE ROAD CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 102 Block 05 Lot 12 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 12~ 1992 pursuant to which Building Permit No. 20437-Z dated FEBRUARY 19, 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 ALTERATION TO CONVERT EXISTING ATTACHED GARAGE TQHABITBRT.~ SPACE IN EXISTING ONE FAMIL'f DWELLING AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. PENDING - 2/24/92 PLUMBERS CERTIFICATION DATED N/A WAYNE J. & MARY O. MOTT Rev. 1/81 TOWN OF SOUTHOLD BUILDZNG :DZ:PARTJ~4ENT TOWN HALL SOUTHOLD, No Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) NO_ 20437 Z Permission is hereby granted to: ~..~._.2...=~:..:~.%...¢.~ ................... .. ~..~.~ ............................... ,o_..~~.....~...~~;.~......:~..~.~~ ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: County Tax Map No. I000 Section ......... ./..~.......~... Block......................~l-~-- Lot No ...... .~.....~.. ......... pursuant to application doted ......... ~ ............................. , 19..~....~--end approved by the Building Inspector. Fee $....~.,~ Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT~ TOWN HALL 765-1802 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: 1. 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 1% lead. 5. Commercial building, industrial bu%lding, multiple residences and similar buildings and installations, a certificate of Code Complianca from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. ~ B. For existing buildings (prior to April 9, 1957) non-conforminguses gs and '.'pre-existing" land uses: 1. Accurate survey of property showing all property lines, stree unusual natural or topographic features. 2. A properly completed application and a consent to inspect sigr nt. If a Certificate of Occupancy is denied, the BuildingInspector~l ~ate' reasons therefor in writing to the applicant, · C. Fees i. Certificate of Occupancy - New dwelling $25.00, Additions to dwell{~g ~$25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory buil':~ing $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 Date ....~/.~.././..~..~... ........................ . New Construction ........... Old Or Pre-existing Building ................. Location of Property ............................................ . .. ... . ...... . House No. Street Hamlet Onwer or Owners of Property .... ........... County Tax Map No 1000, Sectlon.../.~.~: ..... Block...........~- .....Lot....,/,.J~. ....... ...... Subdivision .................................... Filed Map ............ Lot .................... . . Permit No..~.?.~.~..~...~....Date Of Permit ............ Applicant .......................... 'Health Dept Approval Underwriters Approval Planning Board Approval ......... Request for: Temporary Certificate ........... Final Certica ...... Fee Submitted: $ ............................. , 3s s .. ......... .................... qO~ 2 0~_~ APPLICANT :'iELD ~ .......... i IIDA?E il fOUNDAtION ~OUNDATION ~OUGH FRAME & (1st) -PLUMBING (2nd) iNSULATION FERN. STATE ENERGY CODE FI:IAL ADDITIONAL COMM£ UNDERWRITERS CERTIFICt,,TE REQUIRED FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved ......... , 19 .~.~. Permit No ............ Disapproved a/c ..................................... BOAKD OF HEALTll SURVEY . . Cil _C ::: ..... SEPTIC FORH .............. .7.5.~. ~-.55 CALL ................ MAIL TO: . (~ildi~spe'ctor) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application 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, 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..T. pe work covered by this application may not be cbmmenced before issuance of Building Permit. d. l.]pon 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 hall 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 luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or {egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply, with ail applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspections. -- " (Signature of applicant, or name, if a corporation).. , . .&. . 7. :.. . .. (Mailing address of applictffnt) /]O..~ ;tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. or or,,emi, , . ¢.(( .................... (as on the t~ 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 ........ ' .. ...... &/:.o., ............... ouse Number Street /;/ Hamlet County Tax Map No. 1000 Section .../.¢..~'. ......... Block ...~. 0./'/ ........... Lot..../..°?'7. ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy o~:intended_use and occupancy of propose/C.co.~J~jac_ti~_' / ~ a. Existing use and occu,,anc,, ~ ..... __ _-_~Z ~/zT/'E/¢0::-~--{ ~-~/d'"a"/j~.-v~/ ] ~' '" ............... - ............. ~-. -~, · ...r~-.- - ....... ,-' ' .. · *, ....... b Intended use and occupancy c~ ..4M~ ,,Z.O-Zrk~..~ 3. Nature of work. (check which applicable): New Building .......... Addition .......... Alteration .... Repair ............. Remo~,al ............. Demolition .............. Other Work ............... I . (Description) 4. Estimated Cost '~' ~ ~ · : ~ (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 ...... If business, commercial or mixedioccupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structuresl' if any: Front .... ./ .......... Rear .............. Depth.' Height ............... Numl?er of Stories ..... /. ........................... ' ............. Dimensions of same structure witlh alterations or adfiitions: Front ...... /.~a ......... Rear .... /t .(,o ......... Depth :2-~. .......... i Height .... ~:~ ................. Nmnber of Stories ..... 8. HDimensions of entire new construction: Front ..... ; ......... Rear ............... Depth ......... , eight ............... N.umber of Stories . . ./. ...... ; ...... . . 9. Size of lot Front [OO. Rear ~ . ' ......... ;,' ' ;,' ' ' i~.'N ?;J.',' ......... ....... ~ .......................... L~ prn .. 1~.'1.9>. .......... I0. Date of Purchase ............ i ........ ' ........ Name ofFormerOwner ~/~..~. 11. Zone or use district in which prernises are sitnhtocl ...... ~.~g) , ' ~q;~ ......... 12. Does proposed construction violaie any zoning law, ordinance or regulation' /,,} 0 . . . 13. Will lot be regraded ,/,j~. ~ .......... ' ' ' j ;. .................... ~ ..... - - I' ' - .............. wm exc,ess ua oe removeu zr~om~remises:- Yes ('No 14. ,N, ame of Owner of premises~'~.~...1'.~..,~.~.~ ./~...07~ddress .~'.C, .~.c/.~. c/,r~, /~b, C~"~o/nY*e~l~o. marne of Architect ^,~ .............. .,~ ........................ ,~uuress ................... rnone rqo ................ Name of Contractor .O. CV./O~ .~.. Address ph,,.,~ 1.5. s this property w~thzn 300 feet of a tidal wetland? *Yes ........ No.. *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all huildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or descriptio~i according to deed, and show street names and indicate wh~ther interior or coruer lot. APPROVED AS NOTED FEE' ..,~.~ o~ GY: ~ Nb~lFY 8UII:D'I~IG DEPAR'~Ei[~ AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING iNSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2, ROUGH - FRAMING & PLUMBING 3. INSULATION 4, FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS ;TATE OF NEi,V--VO~R-K~ (Nam~ of individual signing ;contract) ..... being duly sworn, deposes ~d says that he is the applicant bore named. ' ,i (Contractor, agent, corporate officer, etc.) said Owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e ~d file this ~plication; that all statements containe~ ~ this application are true to the best of his knowledge and belief; and that the ork will be perfomed in the m~ner se~ forth in the application filed therewith. .yom to before me this - Qualified in Surfak Coun~ ~ ~ -- / (Signature of applicant) ~mmi~ion E~ires Oe~m~r~8, 19 ~ '