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Home My WebLink About19651-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Z-19703 February 4, 1991 THIS CERTIFIES that the buildin~ Location of Property 8305 COX LANE House No. County Tax Map No. 1000 Section 84 Subdivision ACCESSORY Street Block 3 Filed Map No. CUTCHOGUE, Hamlet Lot 1.1 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 1, 1991 pursuant to which Building Permit No. 19651-Z dated FEBRUARY 1, 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 ACCESSORY PRE BUILT COOLER The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A PRIME PURVEYORS, INC. Building' IJs~ctor ~ Rev. 1/81 FOli~ lqo. O TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ' SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~- 1 9~51 Z Permission is hereby granted to: ..y..~.~ ......... ~.....~~.. .................................................................... · .~...~..,.~.~.~"~'~-~....~~. ................................................................. ~n~ Tox nap No. ,000 ~ct,on.../...~ .......... ~,~ ....... ~.. ......... Lo, ~. ../.,....../. ......... pursuant to application dated ..... ~~."' ......... ./. .............. , ,9..~..Kond approved by the Building InSpector. F. $...Z.~..£..~..~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN ~ALL 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 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 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. B. 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. ~. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additiohs 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 . . . ~.....~...f..~. ................ Aew Construction...~'. ...... Old Or Pre-existing Building ......... ' Location of Property .... · House No. Street Hamlet Dnwer or Owners of Pro ert .. P Y County Tax Map No 1000, Section..~..~. ...... Block .... 3 .......... Lot .... ?.!../. ........... Subdivision .................................. · . Filed Map ............ Lot ...................... !leal thPermit Dept.N° ~..~.~.Approval ~' /' ~''' Date Of Permit. ~..-~% l.':..~, l o~l~v~' '~~~'~'~ · · . . .Applicant~ . . .......................... Underwriters Appr . .~~ . Planning Board Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $. ~...~/r 91l $. " .: .......... ............ ~.~ ~_ l~')O~ APPLICANT 70U~;DA TI O.U ~lst) FOU~;DATION ROUGH FRAME -?LUMBING (2nd) IHSULATION PER N. STATE ENERGY CODE FI;;AL ~./~. . ,. ' ADDITIO~L COMME~TS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHQLD.. LkL,¥ _ TEL.: 765-1802 Examined ................. 19. , Disapp?oved a/c .................................... (Building Inspector) APPLICATION FOR BUILDING PERIMIT BOARD OF HEALTH 3 SETS OF PLANs ''' SURVEY .......... CtIECK CALL ................ Date INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink &nd submitted to th~ Building IJmgaat~:, sets of p~, a~curat~ plot plan to scale. ~ ~o~ing to schedule. b. Plot pl~ showing location of lot and of build~gs on premise~, relationshfp to adjoining premi~e~ or public ~tre~ or areas, and ~' ' olvm= a det~led description of l~yout of property must be drawn on tha diagram which is pa~ of tMs apF Cadon. . · , C. The work covered by tMs application may not be Commenced befor~ ~ssuance of BuDd~g Pe~it. ~. Upon approval of this application, thc Building Inspector w~l issued a Building Pc~it shall be kept on the premises available for ~spection throu~out the work. to the appHc~t, Such peru e. No bulldog shall be occupied or used in whole oran part for any purpose whatever until a Ce~ificate ~hall have been granted by ~e BuildMg Inspector.- APPLICATION IS HEREBy MADE to the BulldOg Depmment for the issu~ce of a B~Iding Pe~it pU=uant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York. ~d other applicable ~ws, Ord~ces Regulations, for the construction of bufldhgs, additions The applicant agrees to Comply with all a~giica~le laws, or alterations, or for removal or demolition, as hereM deschbe: ordinances, bufldMg code, housing code, a~d regulations, . ( :~nature oI aPphcant, or name, If a Corporau~n~' . State whether applicant is owner, lessee, agent, ~chitect, engineer, general contractor, electrician, plumber or builder ,as on the tax roll or latest'~) .................... If applicant is a corporation, signature of duly authorized officer. Builder's License Ne ...... ~. j ........... Plumber'~ License No ................... > .... Electrician% License No..~.. ~ , Other Trade~ License No ..................... · Location of land on which proposed work will bc done; ..... ..... - llouse Number ' ' Street. ' ' ' ..... Hamlet ~ .............. Subdivision '' ' .......... Lot...Aq [ .... ................................. E/lcd Map No (Name) · Stzte e" .............. Lot ......... sis mg u~e and occupancy of premises and intended use and occupancy of proposed construction: A. Ex~st~ng use and occupancy ......................... , ~,. , B. Intended use ~,m ~ccupancy ...... ~.~<~.~.~ 3. Nature of work (check which applicable): Ne~v Duilding .......... Ad_4itian .......... ,%kcration ......... :'.'.':: ?mo?i ......... : .... D moli .......... poo ......... ,! ,.'_' ../accessory Buzlding...~'... .... Fence ....... OCher Wor~, ' 4. Estimated Cost ..../~./..~..~'~.~/ ! //-~/ /~ ~' ........... ',';' ............................. ~' ~'" t'~. , ')" : Fee .... ~x. ............................ 5. If dwelling number of d~vclling ~nits (La he paid on filing this application) Number of dwelling nnits on each floor ' If garaee n'umber of cars ............... ' .............. 6 If business ........................... COmmercial or mixed occupancy spec fy nature and ................................ 7 Dimensions of existingstruCturc~ if any FrOnt ' extent type ..... ofcich of use ............... Hcieht ', · ·, ............ Rear . Depth .............. Number o f Stories .............. Dimensions of same structure wifit alterations or additions: Front ...... Depth ' . ............... Rear ................. ! Height ' 8 ........................................... Number of Stories ..................... Dimensions of entire constnietion: Front · new Heiettt Number of Stories ' ' ' ' ............. Rear ............. Depth .............. 9 Siz~ of Io~: ............ ' ...................................................... · Front ...... $ Rear 10 Date of Purchase ................................... Depth ..................... Il'Zone ........... } .................Name of Former Owner .......... · or use district in which pre~nises are situated .................. 12 Does proposed construction violate any zoning law ............................................... 13. Will lot be regraded ~ , ,ardinance or regulation: ............................ 14 N f O ......... ~ .................. Will excess fill be removed from premixex: Yea .... '., f g k ' ~ Add ' ' · amc o wner o rcm es ... ~ .............. ,. rcs~ ................... Phone No ............... Nm'nc of Architect i Address ' Phone No ~rne of Co, tractor .... ~ - · .... t ........... . .....Address ................... Phon~No .... : .......... 15.l.s ~-b. is propert:y ]. e~Ced w~.l:hxn 3~ feet: o£ a tidal ver. l~nd? ~¥E$ .... NO .... *If yes, Southold Town Locate clearly and distinctly all property lines. Give street arid block interior or comer lot. Trustees Permit: may be required. PLOT DIAG RAM buildings, whether existing or proposed, and. indicate all set-back dimen:!on: umber or description according to deed, and show street amines and indicate v,.::::::. STATE OF NEW ~aKff'~/5~ { / ~- OU TV .... , .... (Name ofindividual ' ' ~ '" stgnmg cantract) above nam'ed· ~ is the ....................... o' ~ (Contractor, agent~~ ...... ~&~'~ ~'~1[ er crc ) I said owner or owners, ~d is dulYlauflmrized to perform o~ed the said wor~ and · applicaton hat al'statencnts conta~ed n this n)- /~, . . , ~ . , tom~e 1 , Work will be perforated in the m~ner }et forth in the application filed therewith. Sworn to before me this ................... day~f.~ ...... - to , . .... ..... ... Nora%, Public ~ ~79506 ' ' . Oualffl~ in 8fiff~k C~ ~ (Signature of applic~'.