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HomeMy WebLinkAbout17166-z FORM ruo. a , TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z-]7029 July 6, 1988 No . Date THIS CERTIFIES that the buildin ACCESSORY g Location of Property ..,?5650 Main Rd: & 2115 Moores Lane Cutchogue, N.Y. House No. Street ~~~~~~~~Hamlet County Tax Map No. 1000 Section ~ ~ 9.......Block 3...........Lot ~ 9........... . Subdivision ...............................Filed Dlap No. ........Lot No. . conforms substantially to the Application for Building Permit heretofore filed in this office dated June 24, 1988 17166 Z • • pursuant to which Building Permit No. . , . dated June 24 , 1988 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 PAGOTA AS APPROVED BY ZBA The certificate is issued to . , ,NORTH FORK COUNTRY CLUB owner,%$ski'v~~'t$a$t~.~ of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO N /A PLUMBERS CERTIFICATION DATED: N/A Building Inspect Rov. 1/81 iroaat xo. a TOWN OF SOUTHOLD ®UiLDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT {'PHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N ~ ~ ~ 71 ~ 6 Z Date .........~....sr~.~ 19.~ 0 Permission is hereby granted o~:~~ Q n r, f/^~ ........~n:!'n ~:!-!~:~r-t..!~,......!~.:.y.:... x.1...9. ~.5-.~A...... cam, ro ..~.oaro~A.~c,4.e..1~.....17~......Q,.~::(.......~?.../Yt.~.....Q-N........_._0_.dZ.~?~?~' of premises locoted of .asa~. lts~~....~~:>...1~ °'2./!.$.1...~/~rM.~; c:.. R'":4.. ~-t~.l' . . ...........................................................................qq.................................................................................... County Tax Map No. 1000 Section .......~.~..1....... 81ock Lot No....0..:1.. pursuant to application dated 19~~.., and approved by the Building Inspector. Fee $..a~ .........J .......................................r... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 71971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ 9~~r to the Building In~ec- torwith the following; for new buildings or new use: 1, Final survey of property with accurate location of alt 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), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 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 POOLS $25.00 ALTERATION $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 4.Vacant Land C.O. $ 20.00 7/6/88 S.Undated C.O. $ 50.00 Date New Construction,.XX, Old or Pre-existing Building Vacant Land Location of Pro ert 25650 Main, Rd, 2,115, Moores, La: Cutchogue, N.Y. P Y House No. Street Hamlet Owner or Owners ofPraperty NORTH FORK COUNTRY CLUB County Tax Map No. 1000 Section ~ ~ 9........ Block ~ 3 Lot , , .0 9 Subdivision .................................Filed Map No. ..........Lot No. , . Permit No. 17.1662 Date of Permit .6~.24~88,Applicant„NORTH FORK COUNTRY CLUB Health Dept. Approval N~A . .Labor Dept. Approval N/A Underwriters Approval NSA . .planning Board Approval N/A Request for Temporary Certificate . . .Final Certificate , , ,XX Fee Submitted$.,..1.0:00 Construction on above described building and permit meets all applicable codes and regulations. Applicant.. The North Fork Country~Club~ seg. io-io-7s RR,c.3H95~ e o 176~~1 l~l(6x ~s~-iso2 BUILDING DEPT. INSPECTION [ ]FOUNDATION iST [ ]ROUGH PLBG. [ ]FOUNDATION ZND [ ]'INSULATION [ ]FRAMING [~INAL REMARKS: ©a ~ , i DATE s INSPEOTOR ~5 FORM NO. 3 TOWN OP' SOUTHOLll ddUdLDING DEPARTMENT "rowN cdNERlc~s arr[cE SOUTdiOt,D, N.Y. N01'dCE OT' DISAPPRO(VA~L. ~~-Yp I=i]c No. . Date . \t~ U 19 . ..YYl. . . ~ x~.~ . I IR.~.~ . . ~.........y pP ' PLEASE "FAKE NO :that our a ligation dated ~ 19 . for permit to construct ~ at I' Location of Property Co S2~ ~.a~. . ,a,"?i ~.t~~.Y'a.....~.c~-~.c1G~?'ga.~R_. House No. Street Nonile County T'ax Map No. 1000 Section 9 131ock ......Lot .1~.3....... . Subdivision [~ilcd Map No. Lot No. . is returned herewith and disapproved on the tbllotving grouirds . ~-1~1..~~~..~`"' ~u-~.., ~ .~s....... ~ ~ _ Building Inspector nv vao 0 BOARD OF HEALTH 3 SETS OF PLANS . g a ~ FORM NO. 1 SURVEY . G TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC r•oart TOWN OFSOUTHOLD ~ TOWN HALL ~ .,OUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-1802 CALL MAIL T0: '~Examincd ~~?^€.z~.., 19~.g Approved .../~~.*-NS. Z~„ 19?3.2~Pennit No. ~.7 Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERPAIT Date ..~,cu!{?R..:?.T.., 19.~a.~ INSTRUCTIONS a. Tlils application must be completely filled in by typewriter or in 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 premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit 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 Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins ections. ( gnature t app leant, r6 nam , i a era-t3en) ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..Nl~'4-~.. ~ , (as o~ roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and tit]e of corporate officer) Builder's License No . . Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be one. , , , , , , , , , , , , , . • , , , , , , Ifouse Number Street Hamlet Q County Tax ibtap No. 1000 Section U B~bck Q. ~ , , , , , , , Lot Q. Subdivision Filed b1a No. . (Name) p Lot State existing use and occupancy ofpnreminses and intended use and occupancy of proposed construction: a. Existing use and occupancy . ~^(n~ ~ .q.~ Q ~ b. Intended use and occupancy . l~K~`. . • • , , , , , , ''a.x*~ ...;~~,w'3'~= . . ~ ti 3. l;et ~i of work (check which applicable): New Building , ~ ~M Ad'ditivoZl., ~ , anon P Removal . Demolition cr • • • • ~ • • • ,~4 • ' (Description} 4. Estimated Cosi ! , , , , , , , , r Fee' . cZ5.~. , r~,`~,~:E'rn r .~.~..t . . (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor . If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. ~~im}isions of existing stru NU~s, if any: Front . . Rear , . • . Depth . ber of Stories . Dimensions of same structure with alterations or additions: Front ~ ~ ~ • ~ ~ • ' ' ' • ' ' ' ' Depth....... Rear.................. • • • • • • • . • Height Number of Stories . 8. Dimensions of entire new construction: Front . Ileigltt Rear............... Depth Number of Stories . 9. Size of lot: Front ! • Rear............ p Depth ]0. Date of Purchase i ""'•"•r•••••••••••••....,NameofPormerOwner 11. 7.one or use district in which remises are situated ~ ~ ~ • ~ ~ • • 0 !3. Will tot be regraded , • • date any zoning law, ordinance or regu]ation : . . • • • • • • • • • • • . • . • Will excess fill be removed from premises: Yes No Name of Archrtcot structton vio 14. Name of Owner of remises P .................Address ...................Phone No........ . •+••••••••••••••...Address. .PhonoNo.. Name of Contractor . .....Address . • • ~ • • • • ~ ~ • ' • IS.Is this ro ert loc ••••••PhoneNo P P y ated with in~00 feet of a tidal wetland? *YES....NO.... *If yes, Southold Towri Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ''-¢-Q ~ ~j ~y,^, ~~J Z,("'*1 i~ r'.o-~;~ e~-~.,..~" '~I'~.-~•~ m.0.. k: c~~~,sr' c ~ . STATE OF NE1V YORK, COUNTY OF $'S • • • ~ • • ~ • • • • ' ' ' ' ' ' ' ' g ` • • • • • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant (Name of individual si niatg contract) above named. He is the..,,. ' •••••••.••.•.,.•,,•..•.(Contractor, agent, corporate officer,etc.)•.•,~•••~•~~•~••••~~••••••" of said owner or owners, and is duly authorized to perform or have performed the said work and to make and Gle this application; that all statements contained in this application arc .true to the best of his knowledge and belief; and that the work will be performed in the manner~,set forth in the application fyled thercwitlt. Sworn to before me this I Notary Public, , , , 1C.. pe , Yd'~r• , County ~KDEYO'fNwYMk . . NOTARY MI8414a $gq~le o1 ~pq Tere~Eit ~?M~reh30,1l...:../ (Signature of applicant) i u,~nun ~~r lir.:~i.rn (u ntt}IdvK ~ FORM NO. 1 ~r-~SSfr0 ~ ~ SURVEY . ~fil"g,~yygg TOWN OF SOUTHOLD BUILDING DEPARTMENT SEPTIC FORM TOWN HALL NOT (PY SOUTHOLD, N.Y. 11971 CALL. • • • • - 7EL.: 765-1802 - ~ ~ • • • • MAIL T0: Examined 19 Approved 19 Penns it No........... . Disapproved a/c .................~~;.1.,_ecx ''„-~~r,":~r~.... f~r~.. (Building Inspector) APPLICATION FOR BUILDING PERMIT ~ 1 ~ Cry J '~J ~j Date ....~.r.l.........., 19 .Q~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in 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 premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property ;must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit 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 Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk. County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signatur of applicant, o name, if a corporation) (Mailing address o pplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...............................................~.y.p............../~............................... Name of owner of premises ~ ~ ~ (,P • • ~ ~ • • • (as on the tax roll or latest deed) If applic t is a rp ation, signature duly authorized officer. (N e and title of corporate officer) A L CON ACTOR'S MUST BE SUFFOLK COUNTY LICENSED B ilder's License No . . Plumber's License No . . Electrician's License No . . :a Other Trade's License No. ~ ~ ~~~k .~o.~~ C-~S144~ 1. Location of land on which proposed work will bed ne. Q . ~ . Cz (y~ • . ~ P ~ House Number Street ~ Hamlet County Tax Map No. 1000 Section ~9......... Block .....d~ Lot ~ Subdivision Filed Map No. Lot............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy . (;ueo?Idde 3o am;euSlg) i ~ MME ~ . . ~ . 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