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Home My WebLink About17931-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19276 Date AUGUST 7, 1990 THIS CERTIFIES that the building REPAIR Location of Property 28350 MAIN ROAD CUTCHOGUE, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 10-2 Block 6 Lot 16 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 16, 1989 pursuant to which Building Permit No. 17931-Z dated MARCH 17, 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 RECONSTRUCT A CHIMNEY TO EXISTING DWELLING AS APPLIED FOR. The certificate is issued to WILLIAM J. SMITH (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A B ilding Inspector Rev. 1/81 roaas xo. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 50UTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) njo 017931 Z Date .......~.~:~'1....~...? 19..rJ.~ Permission es hereby granted to• ta .~1..1Z.-.4~!Y`.y'°~.V'-K:S.~.:.... 44~...~'X:4s!.:~t~•::1•'•'r:( ~R ..~1....~:r~...~~ruJ.!~:x-~-!MA 1 ct premises located nt .~~',.~!~5?.....!..'1.~?^^~..(4:R ~4K..7:4J.~,.,...~.:.~r. . . a8"35o . . Caunty Tox Map No 1000 Section ~ ~ pBlock Q.Q. ..`.q Lot No ...~..~P.... pursuant to opphcation dated 4 ~ 19.R~, and approved by the Building Inspector Fee 9:..~~. ilding Inspector Rev 6/30/80 Form No. 6 ` 1 ` 1 nn /~j {1 TOWN OF SOUTHOLD tl fl I lJ'~" C ~ U BUILDING DEPARTMENT ' l x ~J f~lv ~ ~ ~ 765N1802L BLDG. DEPT ~ , TOWN OFSOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY 1. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: far new building or new use: 1. Final survey of property with accurate location of all buildx.ngs, 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 lz lead, r S. 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. 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 $SO.OO. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 L. Cpuated Ceruiicate of Uccupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ....AUGUST. 7, .1990 :;ew Construction....... Old Or Pre-existing Building.....X........... Location of Property..2~.3(gfl.MA.ZN.RDARa.~UTCHOGUEi.h. Y• House No. Street Hamlet Onwer or Owners of Property.~ILLIAM d:.SMZTH.._. County Tax Map No L000, Section....l 0 ~:.....Block...~...........,Lot..~f4 Subdivision ....................................Filed Map............Lot...................... Permit No 17431Z........Date Of Permit. 3f~.Z~S~9 ......Applicant... WII'ls'~~.~r.wS~~T~...... {ealth Dept. Approval ..........................Underwriters Approval................_..., Planning Board Approval . Request far: Temporary Certificate........... Final Certicate...X....... , Fee Submitted: .~Q - . (dec.. 0 aa~ icAxx . TLL. 7G5-1802 S~FF~LKc op : OGy TOWN Or SOUTIIOLD i? ~ OFFICE OF BUILDING INSPECTOR =;t5 ,kt~'~' rn P O BOX 728 , ~ ~ TOIVN IiALL ~y,4,o1 ~ ~ap~ SOUTIiOLp, N.Y. 1 1971 August 7, 1990 Mr_ William J. Smith P.O. Box 1238 Cutchogue, N.Y. 11935 To 4Jhom This May Concern, t We are unable to complete your Certificate oL-- O/ccupancy because of the following reasons. /v/ l~n application for Certificate of Occupancy ' is not on file. (ENCLOSED) o Underwriters Certificate on file. /?J Tlic check is (A~ISg2fll+ikl~&/not on file. ) $25.00 No ilcalth Dcpt. l.pproval on file. No final inspection has been made. Please contact our office on this matter. Thank you L-or your cooperation. puilding Permit 17 9 3 1 Z (HOUSE) Iiuildinc7 Dept. No Plummer 5olcier Certificate on file. ( all pcrcniLS involving plumbing being tissucd afLcr April 1,19B4 ) •1 i :1::LJ ~..:;.L .i~:~ ~~Je,.c ~ ~~M~~ICNT° .9 t. 3 n H ~~'7 H r'OUNDATI0;1 ( tst) - - c FOUIJDATI0:1 (2nd) m 2. 0 ROUGH FRAi'1E & PLUMBING 3. ~ r~ n I1ISULATION PER N. Y. STATE ENERGY CODE I _ _ y lvy~ J FI;IAL ~ o ADDITIOPIAL COMMEPITS: x x ^o H . 9 H H O Z m a r _ S a m H BOARD OF HEALTH 3 SETS OF PL.1NS FORM NO.1 SURVEY TOWN OFSOUTHOLO CHECK BUILDING DEPARTMENT SEPTIC FORM ' TOWN HALL ~ SOUTHOLD, N.Y 11971 NOTIFY sr_ h • TEL.. 7651802 CALL .~3.`/r.SL~°.~...•~~,~.~ Examined .~.~-X1.(.1.., 19~°I. MAIL T0: \pproved .~5~^t4~I . ~ ~ . , 19 Pcrmtt No.I ~ 9. ~ • ~ ad Disapproved a/c ~ ~ (6 ...'t L~u0.t, . ^ . BLDG. DEPT. (Bwldm, Inspector) TOWN OF SOUTHOLD APPLICATION FOR BUILDING PERMIT Date 15 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relatronship to adlommg premises or public stree or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app catron. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Bwldmg Inspector will issued a Budding Permit to the applicant. Such perm shalt 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 Buildmp Inspector. t APPLICATION IS HEREBY MADE to the Buildmp Department for the issuance of a Bwlding Permit pursuant to ti Buildtng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Reculations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees Td cbmpliy with all applicable laws, ordinances, budding code, housing code, and regulations, and admit authorized'Riu'sl~~tozsop.pr~mises and m building for necessary lnsp~s~,~/ • ignature or phcant, or name, if a corporauon) (S/r 4'f, ~f h+' • (Mailing address of apphcant) State whether applicant is owner, lessee, agent, architect, engtneer, general contractor, elecf~tcian, pltimli ~ q)• hudde • .ru Nameo£ownerofpremises .C~`1':`.!`°.".'.?. .5.'.~;r7H......... (as on the tax roll or latest deed) !f 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 . . Other Trade's License No .:~.i(~tat1.T...... . 37 3~ 1. Location of land on which proposed work will be done. . ttRtA1y •/x.f!~n C,v''Z4M!!< r ~..~y ,fl4.~S 1{ouse Number Street Hainlct +t County Tai htap No 1000 Section ../,Q~ . Block Lot . ~ . Subdivision Filed T,lap No Lot . (Nance) State e~isung use and occupancy of premises and intended use and occupancy of proposed construction a. EYisting use and occupancy f{~a'E b•Intendeduseandoccupancy .SR"•"•~•••••••••••••••••••••••••• 3. Nature of wo k (check «hich applicable): New Building Addit,on • • • Afteratfon . Repair Removal Demolition Othec \Vork ~ H+~ v,~P~ (Dcscnpuan; 4. Estimat~d Cost d ' Fee . (to he paid on filing this apphcatfon) S. If dwellin„ nurnber of dwelhng units Number of dwelling units on each floor . Ifgara;c,numbcrofcars 6. If business. commernal or mired occupancy, spectly n~ture and extent of each tyke of use ? ~ , , 7. Dimensions oC ceutmg structures, tf any Front Rear ....d.5....... Depth .1.~.......... . Hcigttt Number of Stones . Dimensions of same structure with alterations or adddions. Front ~~b1.f,.......... Rear S,".~.C, , , . Depth ~nwE lIcight $?f?~... Numhcr of Stones ..~t.~:'i.. , , , . , , Dimensions ~ cntirq~tew consttuction Front ~~k Rear . „~R":~.......... Depth . ~C; y+~, , , , , , , _ Hci;ht ....lr?~:~....... Number of Stones .....Saab 9. Size oflat Front Rear... Depth 10. Date of Purchase . d~.`x~S~ .....Name of Former Owner .~fi.4+~rKf•. kl:'-(~.... . 1 I. Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation .......IvtiO . 13. Nt111ot be regraded , h.4 Ntli excess fill be removed from premtses: Ycs ~ 14. Name of Owner of premtses tr3+.cN^!' Y.S rlirH...... ,Address . ~i.,S paF?? . petc:..~; Phone No..~(~:5~?~.... . Name of Architect•~ .Address ...................Phone No.... . Name of Contractor . tf.Q.~,lt+~u :QC~~?~ Address .~(tf:~a~4E !~Wr`ft`~: Phone No..'.~.~.~~f~ . ]S.Is this property located within 300 feet of a tidal wetland? *YES....NO.... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dunensions fro property lines. Give street and block number or descnptton according to decd, and show street names and indicate wheth, intenor or comer lot. ~ / APPROVED AS N07ED OCCUPANCY OR GATE ~-Y4_-e.P ~ 1~t ~ - USE t~ UNLAWFUL FEE s-~. ~ BY V. iMtTNOU~~'a CER~[FfCATE NOTIFY BUILOfNG OEPARTMEtdT MT - OCCUPANCY 785.1802 9 AM Tf) q °M FOR TNF_ FOLLOWING 1NSi'EC"~1qw~ 1. FOUNDAT40N - T1iJ~t F,E(IU:RkD 1~~~~ FOR POURED CONCRETE / 2. ROUGH . FRAMING ~ PLUMEfING .~`6` 3.INSULATKIN ~ S,. h'"'F ~ . 4. FINAL - CONSTRUCTION MUST ~d,~„ BE COMPLETE FOR C.O. ~ ALL CONSTRUCTION SHALE MEET THE REQUIREMENTS QF THE N Y. STATE CONSTRUCTION 8 ENERGY COOES. NOT RESPONSIBLE FOIE f DESIGN OR CONSTRUCTION ERRORS ~ ~inµ A vV y{aJf T J t STATE OF \EN YORK, S.S COUNTY OF . • L'~1~!9n. S..Slki!N.. being duly sworn, deposes and says that he is the apphca (Name of mdmdual signing contract) about named. ` Eieis(fte....yJw?IrC- (Contractor, agent, corporate officer, etcJ ~f said owner or owners, and is duly author¢cd to perform or have performed the said wort. and to make and file tl -pphcauon, that all statements contained m this application are true to the best of lus knowledge and belief; and that t: work will he performed in the manner set forth m flit application Glcd thercwrth. ~ Sworn to before me thu ~p~ e%/~~`,- {.(F. day of .tM~;Rc,41 19 ,p, rotary' Public, <!...~.'t! tt: V.~..... County t f~~.''~ . HELENKDEVOE ~ (SignatureoCapphcar NOTARY PUBI{GState o/New Yolk t Na 4707878, Suffolk Couatri ~ Term Exp~rea Mucfi 30,1