HomeMy WebLinkAbout19418-Z (Unit 12) FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-22064 Date DECEMBER 24, 1992
THIS CERTIFIES that the building ALTERATION
Location of Property 22355 COUNTY RD. #48 (Unit 12) 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. 19418-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 APPLIED 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-160246 - NOVEMBER 9, 1990
PLUMBERS CERTIFICATION DATED N/A
1~~
uilding Inspector
Rev. 1/81
I}O7t![ N0. f
TOWN OF SOUTHOLD
tU1LDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
tU1LDING PERMR
CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N ! 9 41 ~ Z Date s1~-Y. ~-!a:... ~ 5....., 19.3.:c>
Permission Is hereby granted to:
1 .
ro ....~i.!T1E4sA.....Gk+n....l~.~el~.C.it.....4p......~~.,p~ ....................~.5?Z........
..............................................................[D.~.............................0 .UOu...........................................
~ gyp.........
at premises located at ..ZZ.3SS,...... G ......................S.~F?N.::gM..~:z......
County Tox Mop No. 1000 Section .....Q.~.T...... Block ....~.1.......... Lot No....C~..IIW.A..l
pursuant to applicotion dated ...S.R.p..llA:rn.~v.....~.~..........., 19~~..., and approved by the
Building Inspector. Y
Fee sl.~... /
. ~ s~w:.
..Bu' dire ~ Inspector
Rev. 6/30/80
Form No. 6
• ~ TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTII'ICATE 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 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 $15.00
Date ...DEC:. 9t. 1992
New Construction........... Old Or Pre-existing Building
'U~r,,~M~2. 22355 COUNTY ROAD ;48 CUTCHOGUE~.NEW YORK
Location of Property.......
House No. Stree[ Hamlet
Onwer or Owners of Property...... PURGE CORPORATION
County Tax Map No 1000, Section..... 84. ......Block.... ........Lot...26:?
Subdivision ....................................Filed Map............Lot......................
Permit No...~~4~$.$......Date Of Permit.. 3/,~~/,~Q......Applicant..PUDGE,CORPORAT~QN,,,,,,,,,,
Health Dept. Approval ..Underwriters Approval.........................
Planning Board Approval
Request for; Temporary Certificate........... Final Certicate...........
Fee Submitted: SU:00 .
~.uc.. N s 3 ~g - ......?mss cxnY , sR .
APPLICANT
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FOUtiDATION (1st) °t'Y
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STATE ENERGY
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ADDZTIOPIAL COMMENTS: x
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r _ BOARD OF HEALTH
~~f-' ~ 3 SETS OF PL.\NS
n ! FORM NO. 1 SURVEY • • . • • ' • • . • - • . • .
U TOWN OF SOUTHOLD -r~tleci;
4 jC}Q,. ~ BUILDING DEPARTMENT S1;~PT'IC PORri
TOWN HALL - S"
$OUTHOLD, N. Y. 11'J71 . NOTIFY'c ~~5
Q
BLOt,. ~ TEL.:7G5.1802 CALL
ExaTQWl~1Ur;,,, >~r~, 19.4 MAIL TO:......•.•..•....•.•.•.•...•.•.•.
Approved .~'~~:.r,.G:~: 19 9v. Permit No............ .
Disapproved a/c
. (Building Inspector)
APPLICATION FOR BUILDING PERMIT Q
Date ~.1.~ 15
INSTRUCTIONS
a. Tlus 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 ttsscale. Fee according to schedule.
b. Plo[ 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
3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Zc;ulations, for the construction of buildings, additions or alterations, or for iemoval or demolition, as herein described.
Clie applicant agrees to comply with all appiicable,laws, ordinances, building code, housing code, and resulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
PudBe ~4~P.•....
(Signature of applicant, or name, if a corporation) ~ -
, , , , , , , ,P ;0 ; Box ,1465 , , Sout}io~d,,, ~I,Y , ,l,iy7~, , , ,
(Mailing address of applicant)
:late tivhether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, piumber or builder.
........................Owner..................................................................
:ameoCownerofpremises ........Pudge,~qrp;,,,,,,,,,,,,,,,,,,,,,,,,,,rQe1G~.~.,U~~'4 U ~1~.
(as on the tax roll or latest deed)
"applicant 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 . .
Other Trade's License No . .
Location of land on which proposed work will bc• doge; Cox bane industrial Park Unit. # ~a-
zz355. !?DUR1=Y. 8pad.48.......Cutchogue, .N`~ . •1.1935.... .
llouscNumbcr ~ Street. Hamlet~••
• : i
County 7'a~ Alap No. 1000 Section 84, Block ........1 Lot 25....... ,
Subdivision Filed i\!ap No. Lot .
(IJame)
State rxisting use and occupancy of prcmizcs and intended use and occupancy oC proposed construction:
l~ 1ff .13F'. 7
A. E:xistin . NeW. BZTUC1=Ut€. ~?Yrv~?~ ; ~ ~ i ;2 ..a1S~:A .
g use and occupancy • • • • • • •~+l~.•.\~,#'cr1 • ,~1rPN.
Office Buildout M*'t'^'1 ra,' b: ":~*z+?` •
B. Intended use and occupancy .................................4LA.~•ste:>~:iie_,%wr++,.,~~:+'1
which applicable): New Building Addition . • • •
Nature-of work (check ' • ~ ~ • Swimnin; pool.... ,
Repair Removal Demolition •I. ,
Tennis Court Accessory •Building..: ; Fenre•-; ...0[her IJork.. •..:::174.... ~ .
JVY ~ a
l{f~ Fee
Estimated Cost l • • • • • • • • • • ' ~ '
(to be paid on ding this application)
If dwcllin„ number of dwelling units Number of dwelling units on each floor
IC garage. number of cars
. if business. commercial or mixed occupancy, specify nature and extent of each type of use .
Dimensions of existing structures, if any: Front . Rear Depth . .
Hci;ltt Number of Stories . .
Dimensions of same structure with alterations or additions: Front Rear . .
Depth Height ......................Number of Stories .
Dimensions of entire new constnuction: Front Rear Depth .
Hci;lti Number of Stories .
Size of lot: Front Rear Depth
Date of Purchase .............................Name of Former Owner .
Zone or use district in whiclt premises arc situated . .
Does proposed construction violate any zoning law, ordinance or regulation : • . • • • . • • • .
\Vill lot be regraded \Vill excess fill be removed from premises: Yes . No . •
Name of Owner of premises . Pudee. G4~& s • . • • Address .$0~4 146, , $ogp)ip~~l, Plione No..I6~-)$~Q . .
Name of Architect ...........................Address ...............Phone No................ .
Name of Contractor Gray. GQL<StXq~>son , , , , , ,Address .$o~. ,11,4, $ouxizp).tl• .Phone No...765.-1854 .
..Is this property looted within 300 feet of a tidal wetland? *YCS....NO..R•
*If yes, Southold Town Trustees PLOT DIAGRAM a required.
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
~perty lines. Give street and black number or description according to deed, and show street names and indicate whether
prior or corner lot.
AlaPl?OV((1 Qu (~GazC
DATE, 9 ~ 0 3.P 11 .!4~ Y Lam.
~~Q 765 130L c, a _ .
vg~C. ,~.~C ~QP~ ~ F i~~NO~~~~~~ .._T{' . ,
t.~ ttJt4C~~ ~ c
~OG 2. Fc0s1GH . FRA~,yt~;r, ~ ~~_.;n,5:;~;
3. INSULATION
4. FINAL - GO~ISTE~t1CTlf,aN M1.lST
t3E COMPLETE Ft)Fi C.p
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS t7F THE N.Y,
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE I.OR
DESIGN OR CONSTRUCTION ERRORS
'.TL• OF \fi\Y YORE, S.S -
LINTY OF
, , , , , d":.:-:: ~ , being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
we named.
isthc C~w:~............. ~
(Contractor, agent, corporate officer, etc.),
:aid owner or otvncrs, and is duly autltorizcd to perform or Itavc performed tltc said work and to make and file tltis
lication: that all statements contained in this application arc true to the best of his knowledge and belief; and that the,
k will be perforntcd in the manner set forth in the application fifcd therewith.
~rn to bcto11rc me this ~ ~
........1.. .da~of 19
l ~ ;
ary Public, ~ ~~~`n. • .,L..... County
Mow11
(Signarure applicant)
Owe!~b^ ~