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Home My WebLink About19880-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19997 Date JUNE 19, 1991 THIS CERTIFIES that the building ACCESSORY Location of Property 770 HIGHLAND RD. House No. Street County Tax Map No. 1000 Section 102 Block 08 Subdivision HIGHLAND ESTS. CUTCHOGUE Lot 34 Filed Map No. 6537 Lot No. 37 Hamlet onforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 17, 1991 pursuant to which Building Permit No. 19BS0Z dated MAY 22~ 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 BUILDING IN REAR YARD. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 THOMAS & THERESA REILLY Inspector I~OB, M ~o. o TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_ 19880 Z Permission iS hereby gmntec~o: ~ ~ 'F ~ ~~.~.~~ __~ ......... ...l.t..~....~ ......................................... :... ....... ~ .......... ~......~ .................. ~ ........ : .... ~ ~,...~.,'~.,o ...~...~....~~....~~.~..~....~ ~ ..... ....... ...................................................................... ~,,~,~,~ J J.x~...~~ ...... ~4., ........... ~~~~__ ............... Ma No. I000 Se tion .... C)..¥::... Rl~-k . ,~ Lo' ~'o ~LI County Tax p c . . ~L ....................... ee~ee. ............. . . ..~...~ ............... pursuant to application dated .... ..~.....~...!..~. ........................ , 19..~..I..., and approved by the Building Inspector. Bulld]ng Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTtDLD 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 building, multiple residences and similar buildings and installations, a certificate of Code Compliance from archiuect 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. 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 buildin§ $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing BuildJn§ - $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 ....... ~ ...... . ....................... {ew Construction ........... Old Or Pre-existing Building ........ Location of Proper my .... .~. Z ~. ................ 7~./.0..~..~-.~-. ~-.. House No. Street Hmnlet )nwer or Owners of Property..~.~%~..~.~h~..~.~_~.[.~. ....... ;ounty Tax Map No i000, Section ....... Block ............. t ..... bdivi ion //~/~:~/L/~/~/t'/P ;u s ............................ Filed Map ............ Lot ........ lermit No ~.~ ~. 2~/.~ ............. Date Of Permit ....... Applicant ......... [ealth Dept. Approval..~.~. .................... Underwriters ./~.~ .............. Approval ..... 'lanning Board Approval equest for: Temporary Certificate ........... Final Certicate..~.... .... ee Submitted: ................ /co z / ?yy? . FIELD FOUNDATION (lstl ~OUNDATION I 2nd I 2. ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-180Z BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ _] ~ATiON FRAMING [/--]'FINAL DATE ~~//~/~/'~ INSPECTOR ~ , , , ~ '"' ~ YOUNG o YOUNG .... RIV~RH~AD, NEW YORK FORM NO. 'l TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HAL/ $OUTHQLQ. [~L¥. 1.1.[171. TEL.: 765-1802 Examined..-~tT~).. ~....~..%., 19 .c[.[ ^pp,o,,ed.....'bm Pe, it No. ..... (BUd~mg Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTll ......... 3 SETS OF PLANs SURVEY .......... CIIEcK SEPTIC ' ' ............. CALL ........... · .... I'IA T L TO: INSTRUCTIONs a. Tiffs application must be completely filled in by typewriter or in ink ~nd submitted to the Building I~pector, wit/ sets of plus, accurat~ plot plan to scale, lace =CCordin. ~,~ .~.~o,~,, b. Plot,plan showing location of lot and o~ ,- ',L~' ........... . or areas, eno giving a detailed desert,.*;..- ~, · ouuumgs on premises, relationship to adjoining premises or public stm: cation.. . -.~-,m ct myout of property must be drawn on the diagram whichis par~ of this ap.~ ¢. The Work covered by this application may not be commenced before issuance of Building Permit. 'd. Upon approval of this application, thc Building Inspector will issued a Building Permit to the applicant. Such perrr shall be kept on the premises available for inspection throuo_hout the Work. ¢. No building shall be occupied or Used in whole or~n part for any purpose whatever until a Certificate oFOccupa~m shall have been granted by the Building Inspector. · APPLICATION IS HEREBY MADE to thc Building ~,~q~.tj~:, .for the cous:~ct,on o~ ~u.d~ s add;' olk Coun~. Ne,~ Vor~, ~d othe~appI~:a~le · amir autho,~eff inspee~o,~ o[('r~'~iie~"aappl'°able laws, ordinances, building code, h"ou°s~ ~mo?tlon, a~ hereto describe~ · P nd in building for necessa-.: .... · n.. coae, and regulations, and t . tol~natlLc Ct applicant, or name, if a-~o~por.-lt~') ' ' .(Mailing address of applicant) State Whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Ifappllcant is a corporation si---,--- ,-~ . _ (as on the tax roll or latest deed)r`. ................... :- - [ , ts,,,~,uic olauly authorized officer it o o oral er) Plum bet's License No ....................... Electrician's License No.. Other Trade's License No ...................... 1, Location o£Iand on which proposed work will be done: llouse Number Street. r: ...................... .~ .cj. 3 .0..% Hamlet ............ County Tax Map No. I000 Section ~.~..~ , ............. Block ~51~ ' Subdivision . . .t. '.cl. P2~..Eilcd Map No. · State e" ' (Name) .............. Lot ...... . x~stmg use and occupancy of premises and intended use and · oCCUPancy of proposed constrflction: '~. d. ..:'. A. Existing use and occupancy ........g.~..l. B. Intended use and qccupancy ........ ' ' 3 N f rk(h k h happli abl }aN ildi '/dr ti · stere o wo cec w lC e e ew Bu ng .......... Aflditian .......... era on . ., ..... Re r'. ...... ~ .....::. mval .............. DecoCtion ..... Sw z.'ma pool .......... A :: Tennis Court .... Ccessory Building ..... Fen ..... Other ork; ......... ,. ........................ ..................................... · i , , (ts hc paid on filing this application} numberofcar, .... z ....... :.::.m.b. 7.°.f.Y.7':g:Tt?°.".7.?:.°?::: ": 6. If business. COmmercial or mixed occupancy specify..na ~re and ]f an Front ~ xtent of eaci] type of use ~ ' ~ 7. Dnensonsore.xsin~ '' . ~ / e .&".lg.,[.~...'Y .............. ~.' ..... · t ,. structures, y Rear Depth I% __, ................. Number of Stories X' ............. ' '' i ' ' Dimensions of same structure ..................................................... with alterations or additions: Front Rear Depth ' Height ..................... ........................................... Number of Stories 8 Dimensions of entire ' ...................... · new constmcnon: Front /' "L- Rear Depth H ei,.'ht ............... Numg,r or 9. s= octet: Fron /, .... '-... .e.'F..,i ....... lO, Date of Purchase .'.//'/'fO' /f.,~.i~t'-l-~Z~.~'- 0 ~. ....... ................. Name of Former Owner ................ 11. Zone or use district in which premises are situated .... ,~.zA.O. ......... 12. Does proposed construction viol t,' any zoning law, ordinance or regulation: ...,~.O. ........................ 13. Will lot be regraded ...... /'.~.d .. ' · ' ~ .... r ,-, ..... '7-,cr--~"' .~':--=: .......... Will excess fill be removed from pre..mL~: ~. Yea .... 14 ......... ,..Jwner ot premises ,.~ .~c ~/. '...0..~'./..X~. / .... Addre~'7.Ze.~./&~.Ze~.o. ~ Phone No. 7.~.%~..2~ Name of .Architect ....... ! ' ' · · ~ ................ Address ................... Phon~ No ................ Name of. Contractor ......... ~ ....... -' .. .......Address ................... Phon,e,.No .... '- .......... I~.Lm P-kx~ property Located withxn'~o0 feet of a tidal wetland? '-YES .... HO..'~.. ' ~Tf yes, Southold Townl Truzteem Permit may be required. PLOT DIAGRAM Locate cle:~rly mud distinctly all buildhugs, whether existing or proposed, and. indicat~ all set-back dimen;!o:.; :': property linex. Give ~treet and block umber or description according to deed, and show street names and indicate interior or comer lot. STATE OF NEW YO.RKt~. __ COUNTY OF .... .~..~i 5.~.~.~.. S.!S ....... ~.~....~7.:. ~ ' '" ' ' ~ '~nt .............. being duly sworn, deposes and says that he is the applies:. · . (Name o£lndlwdual sign age ract} above named. He i~ the . ~ ~ ' , (Contractor corporate officer otc ) , ) agell[~ , . of said owner or owners, and is duly authorized to pe.rform or have performed tim said work and to make and file application: that all statements contai 'ed in this application are trne to the best of his knowledge and belief; and that WOrk will bc performed in the manner set forth in ti:-' application filed therewith. Sworn to before me this ·. t .~..."~.. ay of.~...'~...'['{~'"~" ' Nota~, Public ......... · County · · · ' ~ .~ . · ......... NO, 4725089, Suffolk Co )PJ~ w { bfi~nature of applican: · Term Expires NI~¥ iii1, 19~------ . '