HomeMy WebLinkAbout19301-Z Unit 16 FORM N0. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22059 Date DECEMBER 24, 1992
THIS CERTIFIES that the building ALTERATION
Location of Property 22355 COUNTY RD. #48 (Unit 16) CUTCHOGUE, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 84 Block 1 Lot 26.2
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated JULY 30, 1990 pursuant to which
Building Permit No. 19301-Z dated AUGUST 6, 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 ALTERATION TO CONSTRUCT WORKSHOP & OFFICE AS APPLIID FOR.
The certificate is issued to PUDGE CORP.
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N-130236 - MAY 22, 1990
PLUMBERS CERTIFICATION DATED N/A
Bui ing Inspector
Rev. 1/81
1051[ N0. f
TOWN o>: souTHOLD
BUILDING DEPARTMENT
TOWN HAW.
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
[1~~ ~ 3 0 ~ j Dote .e:~^.......~............., 19.q>~
Permission is hereby gron...• to: ,
to ...~s»: s.~:.....~ ~'.......~,.....~r..~:~!-4.........
or premises I«ated at ~:.3;~SS......~;t1...Kta:
~~.SC....).rSI~J.'
County Tax Map No. 1000 Section .....Q.g.`~........ BI«k ......s?..~........... Lot No.....~.~P
pursuant to application dated 19.~.Q.., and approved by the
Building Inspector.
Fee 51.~.:...:~....
~ ~O-C
Bu Iding Inspector
Rev. 6I30I80
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
A. This application must be filled in by typewriter OP, 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 17, lead.
5. 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 $50.00.
2. Certificate of Occupancy on Pre-existing Euilding - $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 ...DHC:.9x.1992
New Construction........... Old Or Pre-existing Building
~"r.,;l~ 22355 COUNTY. ROAD #48 CUTCNOGUE~•NEW YORK
Location of Property.......
House No. Street Hamlet
Onwer or Owners of Property...... FUDGE CORPORATION „
County Tax Map No 1000, Section..... 84.......Block....~ ........Lot...26:?
Subdivision ....................................Filed Map............Lot......................
Permit No..,,~9301-Z,•,,,Date Of Permit., 8/6/90 „ Applicant..PUDGE.CORPQR~ITIQN,,,,,,,,,,
Health Dept. Approval ..Underwriters Approval.........................
Planning Board Approval ,
Request for: Temporary Certificate........... Final Certicate...........
Fee Submitted: 50;00 •
Q~ -Q.c... uI S 3 - JAMES, GRAY, SR .
APPLICANT
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c1ELD I;:S:'?C:IU;J ~~Un:n ~I COMMENTS
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ItJSULATZON PER N. Y. . • .
STATE ENERGY np
CODE
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ADDITIOPIAL COMMENTS: ~
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BO.~RD OF HEALTH
7 SETS OF PL.1NS
FORMN0.1 SURVEY - • • • - • -
TOWN OF 50UTHOLO -~-CIiLC[: • • • • • • • • • • • • • • • • -
BUILDING DEPARTMENT S1;'P7IC FORM • • • - • • • • • • • .
TOWN HALL -
• $DUTHOLD, N. Y. 1171 NOTIFY
~ TEL.:7G5.1802 CALL
~ MAIL TO
Examined . ~!+~e~....., 19y. _ • .
\ppravcd~~>:~~.`... 19~~. Pctinit No./.q3~.~ • , l ~t~ t • • . .
~ 6 9
Disapproved a/c 11,
~ )b - 61990
' BLDG. DEPT.
~r~°":~: TOWN OF SOUTHOLD
(Building Inspector)
APPLICATION FOR BUILDING PER141lT
Date ..:July.30........, 159,0 ,
INSTRUCTIONS
a. Tltis application must be completely filled in by typewriter or in ink and submitted to the $uilding Inspector, with ~
:cts of plans, accurate plot plan ttrscale. 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 aivin~ a detailed description of layout of property must be drawn on the diagram which is pan 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
zhall beJ:ept on the premises availabte 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
:hall 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
3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lativs, Ordinances or
?c;ulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
-lie applicant agrees to comply with all appiieabie laws, ordinances, building code, housin; code, and regulations, and to
dmit authorized inspectors on premises and in building for necessary inspections.
.Pudge. Corp:... . .
•(Signature of applicant, or name, if a corporation) -
_ • • • • - P.O. Box :1465 Southold : NY •11971 • • •
(Mailin~ address of applicant)
':ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.............................Owner..............................................................
:ameofowncrofpremises .......Pudge CorQ
(as on the tax roll or Latest deed)
• ~pplicant is a corporation, signature of duly authorized officer.
• . ~ • . • (Name and title of corporate officer) . • • • • •
Builder's Liccnsc No .
Plumber's Liccnsc No . ~ .
Electrician's License No .
Otltcr Trades Liccnsc No . .
Location of land on which proposed work will be dorc; Cox Lane Industrial Park Unit 4116
...........223~~ .GRUnxY..R4ad .4B........ Gu>:Gh9>oue s .1`IX .
(louse Number Street Hamlet ~
1
County Tax ,Alap No. 1000 Section ........$4 Black • • , , , , 1• • • , • • • • • , , Lot ......26 '
Subdivision F.il~d tap No. Lot
•O\l cure j .
State existing use and occupancy of premi~cs and intended use and occupancy oC proposed construction:
•T.i
~ New Structure (•Mattituck Glass•••••••••••••••••-
A, Existing use and occupancy.......
_ ~ Office Brl~l.~o~t
B. Intended use and occupancy•••••••••••••
Nature~of work (check «'hich applicable): Ne~v Uuilding Addition .Uteration .
Re air Removal Demolition ..............Swi;nnin; pool............
P
Tennis Court ~ Accessory Building........~Fenre•-,~•,,,.....Other lJork.
Estimated Cos~~:~? . Fec .f c???..•......
(to be paid on filing this application)
If d~vcllin„ nurnbcr oC dwelling units Number oC dwelling units on each floor .
If oarace. number of cars .
1C business, commercial or mixed occupancy, specify nature and extent of each typo of use .
Dintcnsions of existing structures, iC any: Front . Roar Depth . .
Hci^ltt Number of Stories . .
Dimensions of same structure with alterations or additions: Front Roar . .
Depth Height Number of Stories .
Dimensions of entire new constntction: Front Roar Depth . .
Hei_ltt Number of Stories .
Size of lot: Front Rca~...................... Depth .
Date of Purchase .............................Name of Former Owner
Zone or use district in whic}t promises arc situated . .
Does proposed construction violate any zoning law, ordinance or regulation : . .
1Vill lot be regraded \Vill excess fill be removed from premises: Yes . , No . .
Name of Owner of premises Fudge, ~AFP: , , , , ,Address . , $ox ,1465 ,Southold Pltone No... ,7,6$, 180. , , , , ,
Name of Architect ......Address .Phone No .
.
Name of Contractor Gray, Construction....... Address . $9x,1145 Southold ,phone No.... ,7,65.-.185D:... .
.Is this property looted within 300 feet of a tidal wetland? =Y);5....NO. X..
~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 dimensions from
:perty lines. Give street and block number or description accord_ino to deed, and show street names and indicate whether
:riot or corner lot.
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DATE , 0 6 T" t' L 9 30_~~
FEE ::^.!3 . L
NOTIFY St,11L.DINi 3: F'- - AT
765 t $(i? St F'~..' {E
FOR POURC-L~: i.~:~,:. ~Mq~
2. ROUGH FRaiUtiZc ~
3. INSULATION
ALL CONSTRUCTION SHALL M ! e r~~+ I a
THE REQUIREMENTS OF THE N.Y,
STATE CONSTRUCTION & ENERGY -
'~TG OF \ RESPONSIBLE FOR
U;1TY OF~S~ CONSTRUC'i~l ERRORS
M ~ ~ being duly sworn, deposes and says that he is the applicant
• . • .(Name oC•individual signing contract)
;vc named.
i;Iltc ~
(Contractor, agent, corporate officer, etc.).
:aid owner or owners, and is duly autltorizcd to perform or Itavc pcrformcd tltc said work and to make and Cile this
iration: that all statements contained in this application arc true to tJtc best oChis knowledge and bclicf;and that the,
k will be pcrformcd in the manner sot forth in tltc application filed therewith. t
~rn to bciorc me this i
.......day oC 19 9.~~.
//~~,p,, QQ
~ry Public, Yk~
..•.,L, , , , , County
EM K OEMOE '
race ?uc. Shot ai Ne. York
;78,So1foNtCaxttY ' (Signature o plicsrtt)
Term, s Motek 30.19-~.
- ,