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Home My WebLink About18098-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 218062 Date MAY 30, 1989 THIS CERTIFIES that the building ADDITION Location of Property 1605 PINE TREE ROAD CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 098 Block Ol Lot 7.7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 3, 1989 pursuant to which Building Permit No. 180982 dated MAY 5, 1989 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING. The certif a.cate is issued to LOUIS & RARRARA LA GRAND (owner, } of the aforesaid build~.ng. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A B aldanq Inspector Rev. 1/81 roam xa s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT t,TH15 PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N 8 0 9 8 Z Date 19. ~ g Permission is hereby g%ts~~o~~' , . ...1~....~.~.... ~.I.!..~ . to ..~:sar-~.'...g....sit:c.~....s~,~.r~1.,~C:N,r~..~.:~...~1....,~%~-q~....<•:-~ ..1M~!-, . . at premises located of ..J..~P. ~.~.....a.. ~c-n?~:......~':~-....~ . ~ ....~:...~.~~.~4--~........~ . County Tox Map No. 1600 Section 09.x...... Block ......~?..I........ lot No .1....+... . pursuant to application dated ......~.G4A..1.. ~ 19.~.~., and approved by the Building Inspector. 6 Fee 3`~~:..~.. Bu ding Inspector Rev 6/30/80 - + `~,~L, FORM NO. 6 ~ TOWN OF SOUTHOLD iL Building Department ~ Town Hall ~j; , Southold, N.Y. 11971 ' , r i APPLICATION FOR CERTIFICATE OF OCCUPANCY ~ ;rU- # _ i lip y, 1 Instructions A. This application must be filled in typewriter OR ink, and submitted ~ to the Building Inspec- torwith the following; for new buildings 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 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 buildings, Multiple Residences and similar buildings and installa- tions, acertificate of Code compliance from the Architect or Engineer responsible for the building. 5 Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Nonconforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property Imes, streets, buildings and unusual natural or topographicfeatures. 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 buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees Additions $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory 10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5 00, over 5 years $10.00 9.Vacant Land C.O. $ 20.00 ,7i1 r~4'O S.Undated C.O. $ 50.00 Date 1 NewConstruction .Old or Pre-exist~n wilding Vacant Land Location of Property ~~°.°.5.........y !.J C~ ~`2v~tt...'.'??.... ~o`t ci-1a S ~ House No. Street / Hamlet Owner or Owners of Property ? ~ . ~ iz"~" ~ . . County Tax Map No. 1000 Section ~ 4.S.r Block ~ Lot . Subdivision .Filed Map No~.........Lot No . . Permit No 4. ~ Date of Permit ! .Applwant ..'.`.'.a ~ ~ ~ ~ Health Dept Approval ........Labor Dept. Approval Underwriters Approval _ .Planning Board Approval . Request for Temporary Certificate Final Certificate ~ . Fee Submitted $ „ . _ _ , . . Construction on above described building and pe/r~~/m~"i-t-meets a I p-lacable\codes and regulations a~ mm~s C o Z /p(`Jr~ ~ ~L 3 ~3 sy 1~LD I,.s: ~....ut+ ~~D„.i; ~ ~~dw~tl.ur~ i _ L`C 1. m a H _ H OUt1DATI0"] ( 1st ) ~I ~ c POUNDATIOt1 ( 2nd ) m 2. z o s ?OUCH FRAME & ~ G PLUMBING F ~ ~ 3. a ; m n r I1dSULATION PER N. Y. 'j STATE EPIERCY CODE _ a. S 3 ~ ~ y FIilAL Q S o ADDITIOPIAL COMh1E1JTS: °7 S 4 Q r r l ~ . x w H • A H H O m } , c' H x 0 m H 5~~~~ ~ q 2~ ~ `l'n Z 't' ~ ~ /-L` ~ V S P 7 ~ a ~~~~o~ / ~ IL ~ f LO ,sr ~~-o t' MAY 191989 : , r~i..~ ; U~~T TU:": IV Ur SOUiHULO ~;T I rss-iso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [~INAL REMARKS: ~ C~ DATE ~ INSPECTOR BOARD OF HEALTH 3 SETS OF PLANS 1 I .•-~-.~.t~ FORM NO 1 SURVEY . U ~ ~ ~ TOWN OF SOUTHOLD CHECK • • - - ,'I ~ BUILDING DEPARTMENT SEPTIC FORM t eL,G DEiT # TOWN HALL NOTIFY t-'~ SOUTHOLD, N Y 11971 'j S' - 2 f.-l CALL Tdt~~N OF SGitlHp;p 111 TEL 765.1802 MAIL TO Examined 5 , 19~~ Approved .rte , 19~~ Permit No ~'8 Q9 ~ Disapproved a/c ~ . ~K.it V-4 ` ' (Building Inspector) APPLICATION FOR BUILDING PERMIT p Date ~ t. , 197 INSTRUCTIONS a This application must be completely filled m by typewnter or m ink and submitted to the Building Inspector, 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 premtses, relationship to adjoining premtses or public streets or areas, and giving a detailed descnptton of layout of property must be drawn on the diagram which is part of this apph- cation. c. The work covered by this apphcatton may not be commenced before issuance of Building Permit d. Upon approval of this apphcatton, the Butldmg Inspector will issued a Building Permit to the applicant Such pennrt shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used to whole or to pazt for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Butldmg Depaztment for the issuance of a Building Permit pursuant to the Butldmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o, Regulatrons, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnbed The appltcant agrees to comply with all applicable laws, ordinances, building code, housing co nd regulations, and to admit authonzed inspectors on premises and in building for necessary inspections. (Signature of a phcant, or name, tf a corporation) (Mailing address of applicant) State whether appltcant is owner, lessee, agent, architect, engineer, general contractor, electnctan, plumber or builder. C-, ~ ,.A . ~m -r ,L Name of owner of premtses ~ S ~ 3A-t~- `'3'4'2'A' La C.~ ;t.A.a .a . (as on the tax roll or latest deed) If applicant is a corporatton, signature of duly authonzed officer (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE S~TFFOLK COIINTY LICENSED Builder's License No t'?-•`;~-} t ~-4 I Plumber's License No Electnctan's License No Other Trade's License No . . 1 Location of land on wlitch propJo~/gyed work^w~ill be done . ~ ~ O s . 1 ~ V'. 1~Z. tlti' 1\V eJ `t CFk1 (.~J~,~• House Number Street Hamlet County Tax Map No 1000 Section ~ ~ Block ~ Lot . Subdivision Filed Map No .Lot . . . (Name) 2 State existing use and occupancy of premises and intended~ujse and occupancy of proposed construction a. Existing use and occupancy ~"`"''.7 • . b. Intended use and occupancy S~"`'t`"° - ~ a ~ C..7a u n l..n-. tG. 3 Nature of work (check which applicable) New Building .Addition Alteration , Repur Removal . , . Demolition Other 1Vork , (Dg~piton) ISuo w 4 Estrmated Cost -Fee - - ' (to be paid on filing this application) 5. If dwelling, number of dwelling units . J Number of dwelling units on each floor ,1 , , If garage, number of cars . - . . - . . 6. If business, commercral or mixed occupancy, specify nature and extent of each type of use . . . 7. Dunenstons of existing structures, rf any Front Rear Depth , , Height Number of Stones Dunensrons of same structure with alterations or additions Front Rear . . Depth Height . Number of Stones . . 8 Dunenstons of entire new construction Front Rear . .Depth . Height . Number of Stones . 9 Size of lot Front ~ ` ~ Rear .l. ~ . Depth Z ~ 10 Date of Purchase Name of Former Owner . . 11 Zone or use district in which premises are situated 12 Does proposed construction violate any zoning law, ordinance or regulation 13 Will lot be regraded ~ h~... Will e~ess fill be reriywed from premises. Yes_ No 14 Name of Owner of premises~..a~r s . C ~ Address i ~'~a .T2"" , ^ GK'S Phone No ~l'! - Name of Architect .Address Phone No. Name of Contractor.~^^~.~-"`.~:"r':~s?"~. Address~~'O.?' S!!t.~AY.?5!^r-PhoneNo.~~-`.~-~"~'~.~... 15. Ys this property located within 300 feetyyof a tigidal wetland? *Yes No *If yes, Southold Town Trustees PermitPLOTDIAGKAMed. Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dunensions from property lines Give street and block number or descnptron according to deed, and show street names and indicate whether ntenor or corner lot r T~ n 5. yI y ' 4YL ~V..'-'i F~f-.1 N• ?V M ~ (U f; } ti ~ ~ NI-u f ~~l t ~ Z ~ ~vt. lC O C 4a ri t. X 1 r- .q t ; . L~.cR6 304- ~'o lglac~ ti' Lltl.. yY , Ui ~ ~ j`"~ r' ~ ~ ~ h ~ r 1 i f~l 11 1. ~ ~r4 iTATE OF NEW YORK, S S ~OUNTY OF . - being duly sworn, deposes and says that he is the applicant (Name of mdnndual signing contract) above named 3e is the . . (Contractor, agent, corporate officer, etc.) ~f sard owner or owners, and is 'duly authonzed to perform or have performed the said work and to make and file ttus ipplicaton; that all statements contained m this application are true to the best of his knowledge and belief, and that the Nork will be performed m the manner set forth in the application filed therewith. iworn to before'me'this q day of 19~~./ . . p U~ . . lotary Public, 4 dew.. County ~'C `"`~`-~1` HELEN K DE VDE ~ • ~ " " ~ ~ ~ ~ ' . NOTARY PUBLIC, State of New Yak (Srgnature of applicant) Na 47D7978, Sutlulk Cou~Y9 - Tum Ecpues Maroh 30,18_