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Home My WebLink About19533-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19917 Date MAY 20, 1991 THIS CERTIFIES that the building~ Location of Property 1295 HIGHLAND ROAD House No. County Tax Map No. 1000 Section 102 Subdivision ACCESSORY CUTCHOGUE~ N.Y. Street Hamlet Block 8 Lot 4 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 26~ 1990 pursuant to which Building Permit No. 19533-Z dated NOVE4X{BER 26~ 1990 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 STORAGE SHED AS APPLIED FOR. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A FRANK & ELIZABETH MELE Rev. 1/81 I'Oll NO. Il TOWN O~ $OUTHOLD BUILDING DEPAKTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PRF_ARISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~- 19533 Z Date ......~?...~ ................. , Permission is hereby gronted to: ~ .... ~ '~ ............. ..... ~.~ ...... z.~.~ ......................................... ~~~......~..:..~..: ....... .,..,..~..~..~= ..... ..z~.~=... at premises located at .....~ ..... .-~ .......... ..x,y~.~;~....~ ............. County Tox Map No. I000 Section .../...?......~=... ....... Block ..... .(;~ ............ Lot No ............... pursuon, to opplicatlon dated ..... ~...~~.....~...~. .......... , 19.~[.0.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 Form No. 6 TOWN 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. 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. 6. 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 i. Ce~tificate of Occupancy - New dwelling $25.'60~ 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 few Construction ........... Old Or Rre-existing Building ..... ,ocation of Property ..... ~. .................. .. , ~ . House No. Street Hamlet )nwer or Owners of Property.. ' .~..~. ~ ~ ....... ~ .... ~/J-~ ...... ........ 7. ...................... :ounty Tax Map No i000, fiection..../~..~. ...... Block ...... ~.~. ....... Lot ..... . ................. ubdivision Filed Map Lot ermit No ............. ... Date Of Permit ..... Applicant ......... ealth Dept. Approval ......................... · Underwriters Approval ........................ . lanning Board Approval ........................ eqoest for: Temporary Certificate ........... Final Certicate ........... ee Submitted: $.. C~-.~. ~ H I ........... ' COZ Iq ~/7 PP ICAN ' ' .... FOUNDATION ( ls t) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: INSPECTION DATE INSPEGTOR ~ N~)REY 81.1~LDING DEPARTMENT AT 765-~802 9 AM TO ~)LLOWING INSPECTIONS: FOR POURED CO~" : ROUGH . . :~:*, F~TT¢ RESPONSIBLE FOR ' ::;¢G[~ O~ CONSTRUCTION ERRORS % '-.,, ____lYOUNG ~ YOUNG A~.~, , FdVE/~AO, NI~ YORK as 1295 Highland Road, Cutchogue, N,Y..~ Provided no default exists under the terms of this note or the mortgage' which secures this note, this note may be prepaid at any'time without penalty. This note may not be changed or terminated orally. FORM NO. 1 TOWN OF $OUTHOLD BUILDING DE?ARTMFNT TOWN HALL · ~OUTHQLD.. LLL¥. 1.1.9.71- TEL.: 765-11302 Disapproved a/c ... ................ (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH .......... 3 SETS OF PLANS .......... SURVEY ................... CtlECK ..... NOTIFY ~ CALL INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to th~ Building I~peetar, wit2 sets of plan& nec~rat~ plot plan to scale. [:ee aCcorrting to schedule· b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre,~ or areas, and giving a detailed description of lfiyout of property must be drawn on the diagram which is part of tkis apl: cation. ¢. The work covered by this application may not be commenced b ' -cl. Upon approval of tins application h~ r~.:,.,: .... efore ~ssu~nce of Building Permit. · t.~ o-.umg inspector will ~ssued a Building Permit to the applicant Such perrr shall 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 Occupan~ shall have been granted by the Building Inspector· ' APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bu/lding Permit pm'xuant to t,~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances r Regulations, for the construction of buildings, additions or alterations, or for i:emoval or demolition, as herein describer The applicant agrees to comply with all applicabqe laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and in building for necessary inspections. ign t re' ., applica t if State whe'ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of Owner of premises ... '~'--' ~ ..... ' (as on the tax roll or l~te~t ~ee'd) ' If applicant i~ a corporation, signature of duly authorized officer. title of corporate officer) Builder's License No .......... '.~.. Plumber's License No ....................... Electrician's License No ...................... Other Trade's License No .............. 1. Location o£1and on wliich proposed work will be done; ouse Number Street, : ..................... Hamlet .............. County Tax Map No. lO00 Section .... ~ ..... Block ................. F, ilcd Map No. (Name) .............. Lot. (~..~. State c.',isting use and occupancy of premises and intended use and occupancy o£ ro o~ed co ' ' · ,/ P P nstrnctlon: Repot'. .......... t.. RpmOva~ .............. D,'molition ........ I.~..~mv,-~ ~..[~ ... Tennis Court ~ ........ 'Accessory B~ilding .......... Fence Est'mated " O~ ' 0 0 4. , Co~t... ~ ...... ~ .......................... r~ ....... ~:.. ~ (~a ha para on nnng'~ 5. If dwelling, number of dwetling~ units ............... Number of dwelling units on each floor .~ .............. If garage number of cars ' 6. If business. Commercial or mixqd occupancy, specify nature and extent of each type of use ................... · 7 ' ' ' ' ' if any:Front Rear Depth . Dmmns~ons of ax~stmg st~ctur~a, .......................... Height NuO~berofSto~es ~ [ ~' ' ~ ~ ~ ..... Dimensions of same structure With alterations or additions: Front Rear Depth ................... ~.. HeiSt ............. Number of Stories 8. Dimension~entire new consth~ction: Front .... [~ Rear t ~ r Depth .......... ...... Height ..~ ........... Nu~- ........ ' ....... 9 .Size of lot: Front ~ Rear Depth 10 Date of Purchase , ' · ........................ · .. · Name of Foyer Owner .............. 1 I. Zone or use district in which pr~emises are situated 12. Does proposed construction vidlate any zonin~ law or~;~a ..... , , ,' · .. 13. Will lot be regraded ........ ~ .....' ~, ~ ~ , ~ . .~y. ~.~..~ .... Will excess fill b~ r~oved f$om pr~: _ Ye: ...... 14. m~emUwnerof rem~es. ~ ///'~/~ 2~ ~, g, ~ ~ ~q P -'~q~. ......... ~ddre~ .(,..~... ff. ~2..~. a. Phone No ............... N~e of ArcMtect ......... , .................. Address ................... Phone No ............... N~e of Contractor ~ ' ; hk' "iifi' ................... .... .... : ...... ~ yea, Sou~ho~d Tow~ ~rustees Permit may be required. PLOT DIAG ~M Locate cle~ly md dist~ctly dj bu~d~gs, whether existing or proposed, ~d. indicate fll set-back d~en:io~: property lines. Give street and blocl interior or comer lot. number or description according to deed, and show street names and indicate w::::: STATE OF NEW YORK, COUNTY OF ................. i S.S ............................ ~ ..................... being duly sworn, deposes and says that he is the applies: (Name of individual s'gFing contract) above na~cd. , ~ is the I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to pe.rform or have performed the said work and to make and file application; that all statements con!ained in this application are true to the best of Work will be performed in the manner set fort ~ in the application Qled therewi'th. Sworn to before me this County ' NOTARY PUBUC, ~at~ of New Ym'k / ..... {P' ......................... No. 4707878 ~uffolkCountY~, (SignnTure of appii¢''m'