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Home My WebLink About16809-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z.I.6.7.4.4. .......... Date March 29, 1988 THIS CERTIFIES that the building ..... A. g..r.i.c.u. 1..t .u.r.a..l..b.u.i..1 .d.i.n.g... ................. Location of Property 5100 Cox Lane & 22290 Ct. Rd. #48 Cutchogue House No. Streat Hamlet County Tax Map No. 1000 Section 084 ...Block 04 .Lot 003 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ,...14.a.r.e..h..6.,. I 988 pursuant to which Building Permit No. 16809 z dated .... Ma........r c h 14, ....... 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 ......... Agricultural nursery shade structure. The certificate is issued to PLANTINGS BY THE SBA, IgC. ..................... ?o;;,n'e;, '~'~'~ X .................... of the aforesaid building. Suffolk County Department of Health Approval ......... ~/..A .............................. UNDERWRITERS CERTIFICATE NO ................. ~./..~ .............................. N/^ PLUMBERS CERTIFICATION DATED: Rev. 1/81 ~tt~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-°16807 Z Permission is hereby granted to: . __ ~ j ..2~..~~....~.q.,...u...~..~.~5 ~, ^ ............. at premises located at .~.L...~.....~~~[~....~...~...~ ...... ~..~~. Counh/ Tox Mop No. 1000 Section ....... ,.C~,..~...~. ..... Block ...... ..0...~.. ........ Lot No......~.?...~ ......... Building Inspector. Fee $ ~. ........ and approved by the Building Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- ].802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted l~ to the Building Inspec- tor with 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 supp{y 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, a certificate of Code compliance from the Architect or Engineer responsib{e 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 sllowing 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 1. Certificate of occupancy New Dwelling $%5.00, 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 5.upd. ated C.O. $ 50.00 Date ....~.,-.,Z'..~.,"..~..~. ......... NewCons truction ...... Old or Pre-existing Building ............ Vacant Land ............. ......... ............ ...... Location of Property ~'/0o ............. ~-., 7¢ ¢.~.9o ,, ¥~' House No. Street Ham/et Owner or Owners of Property t/~¢-,~ld-rl~$ ~' 'r~-~ &-~-~,~c~ County Tax Map No. 1000 Section 0~'%/ Block .O~: Lot 0o3, Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. /..~.8..O?.... Date of Permit .3,..-! ?.-.~.~...Applicant..,~../'.~.~.7.L~. ~¥...~.~ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. ~--o ,o o Construction on above describedApplicantbUilding and p ~mee/~llj_.~ .~.-.-~../---/z/----- .//a~d~s and re~ns. Rev. 10-10-78 FOUNDATION ~ (,1st) FOUNDATION I 2nd ) ROUGH FRAME & .?LUMBING INSULATION ~ER N. STATE ENERGY CODE FINAL ~DDITION~L COMMENTS: Examined...~ .~-~....1.~...,19~..~. Approved·..~...o~..~... !.t{ .... 19~.~.. Pe~it No.J.~.~.~ . . Disapproved a/c ................................... ~ ...... [ IO~ O~ ~OUmO[~ INSTRUCTIONS BOARD OF HEALTH 3 SETS OF PLANS L~...'. 'FORM NO. I SURVEY .......... TOWN OFSOUTHOLD CHECK --~- ...... BUILDING DEPARTMENT gEPTIC FORH ............. : TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL ................ MAIL TO: 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 p~blic 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 btspections. (Signature of applicant, or name, if a corporation) · ¢-. Y..- ....... (Mailing address o~' applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............. .......................................................................... Name of owner of premises .../?/~..ff..~/.~.~,~....~..'~.4.~...~.~..~.t.d.~..C-'.: .................................. (as on the tax roll or latest deed) If applic~'~s a cor3~ratior~, sjgnatur_e of duly.~uthorized officer. ..... .... .... (Name and title of corpo"r~e officer) - ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No../~ .~.~.~. -Pl. l ....... Location of land on which proposed work will be done....~./..D.O. .... .~..~..~.ff.....~..~...~ ..................... House Number Street Hamlet County Tax Map No. 1000 Section ....D?..~. .......... Block .... .0.5(. .......... Lot...0..0.5 ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ./.~.~ fT(~.t4_../.~(<I..~..c%../... ~ .~..~..f.~..t(..~. .......................... b. Intended use and occupancy ~./4~' b ~ .-~'7~q ~4 ~''F'ct ~ -~ 3. Nature of work (check which apphcable): New Building .......... Addition ...... Alteration ........... Repair .............. Remoyal .............. Demolmon .............. O t her Work .,~. a..~ .,~..~..~. ~:~ ! (Descriplion) ( 4. Estimated Cos . . .,'T. ....................... Fee ...................................... i · (to be paid on filing this application) 5. If dwelling, number of dwelling qnits ............... Number of dwelling units on each floor ................ If garage, number of cars .............. 6. If business, commercial or m~xedi occupancy, specify nature and extent of each type of use ~:.~.~..~.% A,,.,.t.s'~ ... 7. Dimensions of existing structures, if any: Front..Kq .o. ~. ........ Rear ../.o.q .t ....... Depth. ~.' !. i i ltlt Number of Stories Height ....................................................................... Dimensions'of same structure wiih alterations or additions: Front ....z.o. :.. Rear z.o' Depth i Height Number of Stories -- 8. Dimensions of entire new constraction: Front .../.o..o.q Rear . ./.o. 9.'. Depth R.o. !... Height .... /.o.t. ........ Number of Stories ........................................................ 9 Size of lot: Front ~ Rear Depth 10. Date of Purchase ........... i ............... .~. Name oz[ Forjner Owner .... ...' ...................... I 1 Zone or use district in which premises are situated..,ffd~T.t+.~./7~.~PT/ ..................... .., ........... 12 Does proposed constructionv~plvi l'te any zoning law, o~inance or re ulation' ~]q . ~1~t ~ '.~ . . · ~ g 13. Will lot be regraded ...... .~.~t~ I; .... . ........ ; .... Will excess fill be removed from premises: Yes 14. Name of Owner ot~premises !f.~..'Ff~.~.a'. .~t.~fi~,g*"Address . fi..q~:..~.~.q.~ ....... '. Phon~ No. Name of A]~ fitect\. ......... i ................ Address ................... Phone No;: .' ...... "...,..' .... Name of Co! tractor~. ...... .5'.~, .~.~. .............Address .... : ...... ~ Phone bio 15. Is this p~ ~perty~g. oeated x~±th±n 300 feet of a t±dal wetland? ayes ..... (~ ..... *If yes, 8¢ thold ~wn TruStees Permit may_ _ ' ~- -- Locate clem and distinctly all buildmgs, whether existing or proposed, and~ indicate all set-back dimensions from property lines, f;ive street and block ~.umber or description according to deed, and show street names and indicate whether interior or corner lot. STATE,~OFNEW,YQRK, .S coo ?... .' ............. (Name 'of individual signiltg contract) above named. being duly sworn, deposes and says that he is the applicant He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulyI authorized to perform or have performed the said work and to make and file this application; that all statements contel'ned in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner!set forth in the application filed therewith. Sworn to before me this day of ! 19 Notary Public ' County (Signature of, applicant)