The URL can be used to link to this page

Home My WebLink About20754-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No. Z-20847 Date JULY 10g 1992 THIS CERTIFIES that the building. Location of Property 5055 PEQUASH AVENUE House No. County Tax Map No. 1000 Section 110 Subdivision ADDITION CUTCHOGUE, N.Y. Street Hamlet Block 4 Lot 3 Filed Map No. Lot No. conforms substantially to the Application for Building Per~it heretofore filed in this office dated JUNE 22~ 1992 pursuant to which Building Permit No. 20754-Z dated JUNE 23~ 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 EXISTING ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to MILDRED C. ENGL~-ND (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED PENDING - JULY 2, 1992 //~uilding 'InSpector Rev. 1/81 IPO'nM NO. S TOWN OF SO~THOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT {THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NgN? 2075~Z Permission is hereby granted to: ..... ~:.~ ~.~.L~.~..~.~ ............... ,o ..... ~~. ~.....~./.~...~..~.... ~ ~ .~......~~/ .......................... ..........."~'~'"'"~"'~' ..................... ~i ...... ~':i ................ ~:'/'" .................. ~"'"~- ~ at premises located at ........... ~...-~ .~....~....~ ....... ../~..~.~'.~...~.. ...... ~ .......... ~....~ .............................. :~,i i' ~' ........................................ .~//~. ~ .~.~. .................................. ,,~ i County Tax Map No, I000 Section ,,,,/.,/.,,~,,/ /, ........... Block ,,,,,,~,, ,~,L ......... 4LL°t No ..... ~,,~,,,,,,,:~:~:,:~. pursuont to opplicotion doted .................. .~'.~-.~/..~.. ........................ , 19../.../'~..~ and approved / Building Inspector, Fee $ ........................ Building Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD . Bui dimi Department Town Hall $outbold, N.Y, 11971 705 - 1802 T ........ APPLICATION FOR CERTIFICATE OF OCCUPANCY In~tructlons A. This application must be filled in typewriter OR ink, and submitted I ea.a.~a to the Building Inspec. lot with tiao following; for new buildings or new use: 1. Final survey of prope~!.¥ with accurate location of all buildings, property lines, streets, and unusua 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 bu'ld~ngs, Multiple Residences and similar buildings and installs. ,t. ions, a certif,icate of Code compliance from the Arc ' - · 5.Submit Planmng Board approva of - ~ , . h~tect .or Engineer respons b e for th building, -omp,ate~ s~te p,an requirements where applicable, e B. For existing buildings {prior to April 1957), Non-conforming uses. or. buildings and "pre-ex~sting" land uses: , . 1. Accurate survey of p3.~Operty showing all property lines, streets, buildings and unusual natural or topograph ic 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 tion requir, ed to prepare a certi[icate, buildings or premises, or other Pertinent informa- C. I ecs. 1. Certificate of occupancy $25;00 -- BUSINESS $50.00 2. Certificate of occupancy on Pre-existing dwelling $ 50.00 3, CopY of certificate of occupancy $'5;'00, over .5 'years $I0.00 4.Vacant Land C.O. $.'20.00 5.Updated C.O. $"50.00 Date .... June i, 1992 NewCons tPuc~ion ...... Old or Pre. existing Building ........... Vacant Land ............. Location of Property ....... .5,0,5,5,,P,e,q,u,ash 'Avenue, Cutchogue NY HO~'~e/Vo. '''''''''' Owner or Owners of Property .. ,Mildred C. England bdlVl Ion, ,, , , , , Fil0d Ma o ........... Lot No ............. Permit No. -~,0.7 ~5. ;J,-~. Date of Permit .......... Applicant ............ Health Dept Apprmal · ' ' ....................... Labor Dept Approval Underwriters Approval ........................ Planning Board Approval Request for Temporary Certificate ........... .. , .......... r m. aFue~fflcate ........... ' ouDm,tteo%;.....~.. _..,.D,u-O m ~se~aJJap.p-I~/a~l s/nd Construction on above described building and permit e cod; re' ul uary ~lanner'O/sen, Esq. . ''~-' ...... a-.~e-,o.~e P.O. Box 706 Cutchogue~ NY 1~935 E×a~&~a ;': ': 7.. :... ....... 19, .. Approved ......... ~ ....... 19... Permit No ............ Disapproved a/c .... ;,..,. '% ."~:'. :~'.' ..................... FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971' TEL.: 765-1803 g0Ago OF HEALTII 3 SETS OF pLANS SURVE~ ................... SEPTIC POgtl APPLICATION FOR BUILDING PERMIT Date ...... INSTRUCTIONS a. This app~icat~n mUst b~ c~mp~te~ ~ed i{~ by typewffter ~rin ink and su~mitted t~ the Bui~ding ~nspect~r~ 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, relaBonship 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 this application may not be commenced before issuance of Building Permit. dj' Upon approval of tiffs 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 e.' No building shall be occflpied 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 D6partment for th~ 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 ~:emoval or demolition, as herein described. the applicator agrees to comply with ail applicable laws, ordinances, building code. housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ~ (Mailing address of applicant) State whether applicant is mPner, lessee, agent, architect, engin,~r, general,contractor, electrician, plumber or builder. ..... ~. i~¢~.~ ............................................................................. Name or owner or premises .... ~.~ ~.~.~.~?~...C........~... d<~..z. ~4~o~. .......................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly auth, orized officer. · (Name and title o£ corporate officer) Builder's License No. , ./~..~ ..~.~<.~...~..A~. ................. Plumber's License No ......................... ~ Electrician's License No. ~¢~ ......... Oilmr Trade's Lkense No ...................... I. Location 'of land on which proposed work will be'done .... ~~ .............................. ..... · .. ~ ~ .......... ~ ~z~ F~. ~u~ .......... .~&'~/~ ....... ~.~. ~. ........... llouse Number Street Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision ..................................... Filed Map No ............... Lot (Name) ,.,' ..... . State existing use and occupancy of premises and intended use an~ occuppncy of proposed construction: a. Existing use and occupancy ~ ~, . ~ b. Inlen~ed use and occupancy ... ¢ G . '~ ~ ~ . .'.. 3. Nature of work (check which applicable): New Building .......... Addition ...../~f~..... Alteration .......... Repair .... ~ .......... Removal .............. Demolition .............. Other Work ............ 4. EstimatedCost../~]~.¢/'Aq.~..(../..~.~..~.'. ,' .............. Fee .,~, ............ (Description) (to be paid on filing this application) 5. Ifdwelling, numberofdwellingunits ............... Numberofdwellingunitsoneaph floor ................ · If garage, number of cars ........... 6. I£ buslness, c°mmereial or mlxed occupancy, specify nature and extent o f each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... ~umber of Stories .................... .~ .......... Dimens ~ns ~ s~me stm¢tur~ with altera~i~ns ~r additi~ns: £r~t 5?e..e. .~/.~:z q.. //~(¢~Rear '"i;ii;iii .... Depth ...................... Height ...................... Number of Stories ......... 8. Dimensions of entire new construction: Front .......... Rear ............... Depth .. Height .............. / Number of Stories ............ £ ...................... 9. Sz~oflot:Front ..57.0 ............... Rear...£P ................ Depth 10. Date of Purchase .... ./~Tfl..7 ......., ..... ......... Name of Former Owner .~:.°d: .e. ..................... 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordnance or regular on' (I;"~ , 13. Wil otberegraded /g'/t:> Willexc .......................... ........................... ess fill be removed from premlses:~ . Yes 14. Name of O~/ner of premises x4/44~,.,.,.,.,.,.,.,.,.~q..,~. ~.~.4'4:/.~..&:. Address ,~z .~.v77.~.c/9.4 ...... Phone N .c~_./Y~3,.q ?/; Name of Architect ........ Address ................... Phone No ................ Name of Contractor. X ~,~4~ 12~.' ~oi~ ~.'/.'¢i ...... Address .O..~,4-&?br .~. ...... Phone No ....... 15.' ,Is this property within 300 feet of a tidal wetland? ~Yes ........ No...J<~. .... *If yes, $outhold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& indicate all set-back dimensions from prope[ty lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. gTATE or~, . COUNTY OF .,,~...~.~.IC' ........ S.S .......... ' ...................... ~ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~bove named. le Js the ..... .................................................................................... (Contractor. agent, corporate officer, etc.) ,f said owner or owners, and is duly authorized to perform or have performed the said work and to make m~d file this pplicatinn; that all statements contained in fifis application are true to the best of his knowledge and belief; and that the ~ork will be performed in the manner set forth in the application filed therewith... , . ,worn to before me this .ore, Public. ~/~, ... County ~ . ~ .... ., -- , [~ n ~0 ~d*ub*~d~f*~ } .... ' ........ . .............. ~ .......... ' ........ 7.. ~aVoL ~ -' ~ :'- ,. .: : , (Signatureofapplicant) ..... ?....: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ~ ,.~ REMARKS INSPECTOR"~/~/~ TO DATE SIGNED GARY FLANNER OLSEN COUNSELLOR AT LAW P. O. BOX 706, MAIN ROAD (516) 734-7666 FAX: (516) 734-7712 MES sAGE Town of Southotd Building~Dept~ Town Hall - Main ROad' Southold. NY 11971 ........ June 2. 1992 DATE Re, Messner to en land f~"~ ~'~:~ ~',~F;'~-;',, n,~, ril~ ~ 53 6 ~~I ~'~{<~-~ i:~ Enclosed please find the foliowing: JUN- 3 1. Application for pre-existing CO. ~ ~' ~ 2. Cbnsent to Inspect.' * ................. = 3. Check in the sum Of $100.00. 4. Survey. Pleas6 contact Bili K~Iiy of BuYt beWis to make arca~gements to ~n~p~ct ~e ~uS~ (298-4600). SIGNED GFO:lmk THIS COP'Y FOR PERSON ADDRESSED ~. ~ ' ' TOWN OF SOUTHOLD // SURV.E.¥ ................... , ....... BUILDING DEPARTMENT/ CII£CK ................ ' .... ,. JIJNZ2]:..i!)~; TOWNHALL ~ SEPTIC FORH .............. :.~ ,: ' SOUTHOLD, N.Y. 11~1' , ,; TEL.: 765-1802 ( _ . , //~ 0~. ~ C~L~ ................... ..................................... ....... ................. - ....................... . .......... ... ............... .- . (B~Iding Inspector) Date . .~Z~ .......... 19~ INSTRUCTIONS a. This application must be completely filled id by typewriter or in ink and sub'mitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scales 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. e. 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 w6rk. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shaLi have been granted by the Building Inspector· APPLICATION IS HEREBY MADE to the Building Department for ';he issuance of a Building Permit pursuant to the Building Zone Ordinance of the'r..own of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or aiterations, or for r'emoval or demolition, as herein described· the applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins~,pections. ~ - ' ....e: '4 .5 .... (Mailing addreZss of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder, Name of owner of premises .... .Xl,~./.L. '7~).Z,.~.<e:~...(,~' .,.....~.....(p'..(~..~. ,~7x//?~. FEfi?~)~'~/' · - · (as on the tax roll or latest deed~OTlFY I~UII.DING ~£P~RIMEI~' AT If applicant is a corporation, signature of duly authorized officer. 765-1802 9 AM TO 4, PM Fq~THE FOLLOWING INSPECTIONS: /.MSE IS UNLAWFUL Builder's License No. /.~ ./~..~..Zkrf 3. INSULATION .... ~ 4. FINAL * CONSTRUCTION MUST~ ?¢¢I. OUT CERTIFiCAtE Plumber's License No ................ ALI. CONSTRUOTION SNALI. MEET Electrician's License No..~/.,.qz~,'~.'?/.-.'~.,~¢r00CUPANCY T.E .... STATE CON$TRUCT1ON CODES. NOT RESPON$ffiUE FOR. Other Trade's License No ...................... DESIGN OR CONSTRUCTION ERRORS · Location or]and on which proposed work will be'done .... .,.-~-. ,Z,~ ~:~/.'...~.'..~?'r:. ................... .................. ~ / c/~,-- House Nmnber Street Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision ..................................... Filed Map No ............... Lot .. (Name) · State existing use and occupancy of premises and intended use anU occupancy of proposed construction: " a. Existing use and occupancy.... ~ ./'X~. .... C%~;::.CC'. .~-....... , ............. bl ddu d ~..If-'. ]'/.ff. _(:~7 ~.4~-~.I'' · nten e se an occupancy ... . ...... 3. Nature of work (check which ap!plicable): New Building .......... Addition ...... . oration .......... Repair .............. Removal. ............. Demolition .............. Other Work ............... 4. Estimated Cost ,f~.~.D~.~... (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 busine'ss ..... [ .................................................................. commercial or mixe4 occupancy specify nature and extent of each type of use 7'. Dimension's of existing structure~ if any: Front' Rear 'Depth ................... Height ............... ~umber o~ Stories ........................................ Dimensions of same structur,, with. alterations or additions: Front ~.~.-e..x4./.o:~.. -~. ~..~.z'..,,gRear ................. .............. Depth Height Number of Stories 8. Dimensions of entire new construction: Front . .............. Rear ............... Depth .............. He~oht .............. / Number of Stones .............. 9. Size of lot Front .. P'7..° .............. Rear ................. ;57.~ t .......................................... Depth ../~..f~f ............ 10 Date of Purchase ./¢.~.../7 i : ' Name of Former Owner x'~..°.,4.: ¢. 1 I. Zone or use district in which premises are situated ........................ 12. Does proposed construction vmlate any zoning law, ordinance or regulation: F/f. ¢. ................... 13. Will lot be regraded ,/Jf..~. ! · ~ . ....... + ................. Will excess fill be removed from premises:_ - Yes N['~o5 14. Name of Owner of premises .,df./S?~.,~-~',~. ~-.4,.~'.~4,??..Address //..z-/.~ /~.~ ,,~ ,,/&,_l/ ..... ,,~ Name of Contractor . ~ oiteq. J~/.,~. p.o...~../.~ ....... Address . .~4~/Fe¥¢/x...~'... ;... Phone No ................ i5. Is this property within 300 feet of a tidal wetland? ~Yes ...... Trffstees Permit may be required. ~If yes, Southold T~wn ·. No..L<'7. .... PLOT DIAGRAM' Locate clearly and distinctly all Cuildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block ~umber or description according to deed, and show street names and indicate whether interior or corner lot. / gTATE OF~, coum'v S.: ........ :" .... . ..... /fl'~/'~'Df~.~.'/~...~....~../qf.~./.-~..'{'~9. being duly sworn, deposes and says that he is the applicant (Name of individual signin~ contract) ~bove named. , le is the / i (Contractor, agent, corporate officer, etc.) ,f said owne? or owners, and is duly a.uthor, zed to perform or have performed the said work and to make and file this ppi/cation; that hll statements contaim /ork will be performed in thc manner se .worn to before me this · .......... /.~, ........ day of. ~i'~ 10 ~Md subscribedbefal'~ ~ ,,~ . ~ayof~ in this application are true to the best of his knowledge and belief; and that the forth in the application filed therewith. 2..i NOTARIAL SEAl.. , ,, Iq ~_~ / NANCYL SCHRUM. NotawPubrlc ........ ~ ..... / Cl~y of York, York County iViv Commission Expires Dec '18..1995 (Signature of applicant)