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Home My WebLink About20257-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20803 Date JUNE 18~ 1992 THIS CERTIFIES that the building Location of Property 30635 MAIN ROAD House No. County Tax Map No. 1000 Section 102 Subdivision ALTERATION Street Block 2 Filed Map No. CUTCHOGUE, N.Y. Hamlet Lot 22 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 31~ 1991 pursuant to which Building Permit No. 20257-Z dated NOVEMBER 6~ 1991 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 ALTERATIONS & RAM3S TO EXISTING BUILDING AS APPLIED FOR. The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N-237782 PLUMBERS CERTIFICATION DATED CDTCHOGUE UNITED METHODIST C~URCH - JIFNE 5~ i992 N/A ~u{ilding Inspector Rev. 1/81 ]~OB~ NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 20257 Z Permission is hereby g~,ted to: ~ .~ ~, . . , , ,/.~ _ ~..// /. ~/ ~~:.~ .:~...~~. ~~~~ ...~..:~...~~~....~....~ ..... ~~.....~..:....~~;.....~ .................................................. C~n~ Tox Mop No, 1000 ~ctlon ...... /~..~,.. Bilk ......... ~ ...... Lot No ........ ~ ............. pu~uont to application dat~ ....... ~. ................................. , 19.~, and opprov~ by ~e Building Insp~tor. Rev. 6/30/80 Form No. 6 TONN OF SOUTIIOLD 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. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 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 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 $15.00 Date .... ~/./..~/?..~. ........................ New onstruction ........... Old Or Pre-existing Building ................. Location of Property .......................... /-.~z~../.~..~.. . ....... .. ~/~..~-~.~f2~.f.~'~.. ......... House No. Street Hamlet Onwer or Owners of Property.~7~.~.~f./;z~-Q(~.~4.~... ,/~..4f..7-~-./$~f'..9..2~/..~7/~.0~.~2~. ......... County Tax Map No i000, Section .... 7.~...~. .... Block ..... ~ ...... Lot. ~ ~ Subdivision ......................... Filed Mnp Lot No..~.~ ~,~ Da t e Permit Of Permit .... f../.. Ap p icn n t .ZC_. Planning Board Approval ........ Request for: Temporary Certificate ........... Flnal Certicate ......... Fee Submitted: $..~. ,5~. ~-~ ........ q 0~0~ O_~O ................... APPLICANT ~eee34s THE NEW YORK BOARD OF FIRE UNDERWRITERS ~'AO~. ~. BUREAU OF ELECTRICITY /'~ BS JOHN STREET. NEW YORK, N. EW YORK 10038 0,,~ JUHS e5,1992 ~pplicazlonNo. onfit~ 77042992/92 ~ 237782 THIS CERTIFIES THAT CU?C~OGU~ E~THODI~ C~RCH, N/S OPPOSI~ S~ILL~A~ER AV~, CU~CHOGUS, N.Y. GOODALE ~L~C?RIC 7355 HAIH ROAD LIC.#383-E MA??I?UCK, NY, 11952 OENE~A£ MANASER 11 Per... ~/ ?his certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentlols, INSPECTORS Victor Lessard Principal Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance Inspector Robert Fisher Assistant F/re Inspector Telephone (516) 765-1802 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD HAY 4, 1992 KENNETH S. HILLER 17525 COIRqTY ROAD 48 CUTCItOglIE, NY 11935 RE: CUTCHOgUR UNITRD HRTHODIST CHORCH To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is ~not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 20257-Z Please contact our office on this matter. cooperation. Thank you for SOUTHOLD TOWN BUILDING DEPT. INSPECTORS Victor Lessard P~incipa~ Building Inspector Curtis Horton Senior Building Inspector Thomas Fisher Building Inspector Gary Fish Building Inspector Vincent R. Wieczorek Ordinance InSpector Robert Fisher Assistant Fire Inspector Telephone (516) 765-1802 SCOTT L. HARRIS, Supervisor Southold Town Hall P.O. Box 1179, 53095 Main Road Southold, New York 1DT1 Fax (516) 765-1823 Telephone (516) 765-1800 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD M&Y 4, 1992 KENRETH S. MILLER 17525 COUNTY RoAD 48 CETCROGUE, NY 11935 RE: CUTCHOGIIE UNITED IdETItODIST CltURCH To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) No Underwriters Certificate on file. The check is ~a~/not on file.)$25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT ~ 20257-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. ~,l. ,.~ FOU:;D^ TIO.~; (1st) FOU:~DATION (2nd ) ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE Fi:;AL ~DDITIONAL COMMENTS: 765-t802 BUILDING DEPT. INSPECTION [).]~OUNDATION 1ST [ ] ROUGH PLBG [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL ~~REMARKS: ~ ~ .- FORM NO. 1 % TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 Exa,ni,ed .//.~..~ , 19 .f/ TEL.: 765-1802 Disapproved a/c ..................................... ........................... APPLICATION FOR BUILDING PERMIT BOAKD OF HEALTIt 3 SETS OF' PLANS SURVEY ................... CIIEcK ................ SEPTIC FORH .............. CALL ................... HAlL TO: 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 tlie diagram which is part of this appli- :ation. c. The work covered by this application may not be cbmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit .h~ll 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 ]uilding Zone Ordinance of the Town of Southold,.,Suffolk County, New York, and other applicable Laws, Ordinances or {egutations, for the construction of buildings, add{tiohs or alterations, or for removal or demolition, as herein described. ['he applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and regulations, and to :dmit autlior/zed inspectors on premises and in building for necessary inspections., ~. - ' (SigBature of applicant or name, ifa corporation) · .1.7.5.2.5..C. qu. qt.y. Ad. ?.~,..C.u.t.c.h. og.u.e.,..iq.'/...1.1.9.3.5 ..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor Name of owner of premises . .C .u .t g .h p g .u .e . .U .n .i t e d Methodist Church (as on the twA roll or latest deed) it' 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..7.8.3. E. ................. Other Trade's License No. 10517111 · Location of land on which proposed work will be done..' ....................................... ' ......... 30 ~g5 Main Road Cutchogue llouse Number Street Hamlet Count~; Tax Map No. 1000 Section . /0.~ Block -~ Lot 2 .2 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 ..... ,,.~ , :~,f ~,, :~ b. Intended use and occupancy ....................................... ~ ~ ~'~ ~' , .~,; ¢~qr~.%:.C' ''" ' . . ..... 3. Nature of work (check which dpplicable): New Building ..... Addition Alteration ...... ... Repair .............. Re oval .............. Demolition OtherWork Coneret~e 4. Estimated Cost .,~..c~..~./~ . tY~ Handi-cap ramp (Description) ' (to be paid on filing this application) 5. If dwelling, number ofdwellin~ units ............... If garage number of cars ' Number of dwelling units on each floor ................ 6 If business commercial or mixed ................................................................... · , occupancy specify nature and extent of each type of use 7 Dimensions of existing structures if any: Frgnt Height ' Nmnder of Stories ............... Rear .............. Depth ............... Dimensions of same structure " ' ....................................................... with alterations or additions: Front Depth I Height ................. Rear .................. 8 ................... t ......................... Number of Stories · Dimensions of entire new construction: Front ..................... Height Number of Stories ............... Rear ............... Depth ............... 9 Size of 1~: ............. I ..................................................... · Front 10 Date of Purchase ..................... Rear ...................... Depth · ' ......... ~ .................. Name of Former Owner · 11. Zone or use district in which pr6mises are situated ......... ' ....................... 12. Does proposed construction vioiate any zoning law, ordinance or regulation 13. Will lot be reeraded i ,.. : .............................. ....... ' .............. wm excess fill be removed from premi X Yes No 14. Name of Owner of premises Mal:h~d~l:. 12h~rcb. ~... '.:Address .. ~,4t.e.h. qgye' . .. Phone No. Name of Architect i .................... ............................ Address ................... Phone No ................ Name of Contractor . Kenneth S Miller ....................... Address Cutcho~ue . Pro,No..7.3.4.-.7.0.2.1. 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No../t ..... *If yes, Southold ~own Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block humber or descriptioh according to deed, ~d show ~treet names and indicate whether interior or comer lot. rATE OF NEI{~YOI~alT)- /Z~ S'S · 'OUNTY . .rZT. . g.L &. . ' i ' ' ...... ..... bein t e of individual signing contract) ..... duly sworn, deposes and says that he is the applicant' e is the !..~;.... ........ '. gent~ cor~o;ate o'ffic;;, 'e't~.,') ............................ ~ said owner or owners, and is duly author tlz-e0...Lg_p~form or have performed the said work and to make and file this ,plication; that all statements containdd in this application are true to the best of his knowledge and belief; and that.the ork will be performed in the manner se!t forth in the application filed therewith· yom to before me this ........... ., .19../.aY o,.f i . )tary Public,..--..._.--r,.~ ~.~?.i... V. ,~.r,_..ArX,... County ~ ~ .~. .. No. 4879508 1 _ vauallfl~ in Suffolk COunty C.p'-~ ~- I (Signature of applicant) 4" c.o~,.~. I%a4p o? q ( PL~ ~q 4 Pf~d~ 4 ~, l~d- ....... ~7