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Home My WebLink About16846-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17659 Date January 9~ 1989 THIS CERTIFIES that the building Location of Property 31035 MAIN ROAD House No. County Tax Map No. Subdivision ALTERATION CUTCHOGUE Street Hamlet 1000 Section 102 Block 02 Lot 23 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 17, 1988 pursuant to which Building Permit No. 16845Z dated MARCH 22~ 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 INSULATE EXISTING ONE FAMILY DWELLING. The certificate is issued to_ JOHN G. SCOTT, III (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N040557 OCT. 18~ 1988 PLUMBERS CERTIFICATION DATED WILLIAM TUTHILL NO¥. 16~ 1988 Rev. 1/81 Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17660 Date JANUARY 9~ 1989 THIS CERTIFIES that the building Renovation Location of Property 31035 MAIN ROAD CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 102 Block 02 Lot 23 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 17, 1988 pursuant to which Building Permit No. 16846Z dated MARCH 22, 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 CHANGE & RE-FRAME WINDOWS AS APPLIED FOR. The certificate is issued to JoHN G. SCOTT, III (owner, ~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 ' Building Inspector FOBM NO. ~ Tov~rN 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) County Tax Map No. 1000 Section ..... I...Q....~T.. ....... Block ..... .,~.....~.. ....... Lot No....."~.....~.,. ............. pursuant to application dated ..... ~.Ok41~.~....t...~. .............. , 19.~...~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FOItM NO. O 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) Permission is hereby granted to: ........... .....~.~.~...~.¥ ............................................... ,o at premises located at ..;~..~...~....~...~..........~....0~...~...... ............. .Qd~~ ....................... County Tax Map No. 1000 Section ...... /..~....~.. ....... Block ....... .0..,,'~. ..... Lot No...,~...~ ............ pursuant to application dated .... ....~.~.,..~.~ ...................... , 19..~...~..., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Insoec- 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 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, a certificate 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 p~operty 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~~ 1. Cerfificate of occupancy New Dwelllng $25.00, Accessory '$10.00 BusLness $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.Updated C.O. $ 50.00 Date .......................... NewCon~ tz~uc tion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .... . ."~..~. ~. ..................... 7$;r'e;/~ 'i ......................... House No. Ham]er: Owner orOwners of Property .... J;' . . County Tax Map No. lOOOSection . /~Z__ Block .~_~.. Lot. Subdivision ................................. Filed Map No ........... Lot No .............. ~ ~.~, L~r'~Date of Permit Permit No ................... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ...................... .. Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant . . ~..~.. ............................ Rev, 10-10-78 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 f., TO~'' O~ SOUTHOLD 765 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions A. This application must be filled in typewriter OR ink, and submitted ~ 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 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- lions, a certificate 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 featu res. 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 $25.00, Accessory ~$~0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.00 3. Copy of certificate of occupancy $ 5,00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewConstructi°n ...... O]d or Pre-existing Bui[ding ............ Vacant Land ............. Location of Property . .'..?~..~./.~...u??.' ~We~, ~ Owner or Owners of Property --~ c, · County Tax Map No. 1000 Section /~/2~ Block ~ Lot ...... ?~..'-4~. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.. Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building a,~er~mit meets all applicable codes and regulations. App cant Rev. 10-10-78 FOUNDATION { ls t) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CQDE FINAL II~ATZ I1 :' -- ~. ' , 7~ ~ ~ '~ ADDITIONAL COMMENTS TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner ~-~0/~ (please print) Plu~er ~. ~ ~ ~ Lk (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) Sworn to before me this 3~day of ~~ Notary Public ,~County Notary Public Not~b~ Pt'/.'% 5~ ;[o cf N~w York Qua~;ficd in Suffolk County Comrr ~s::ion F;<p~ros 12-3l-~ FOUNDATION I 1st) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING IHSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST i- ] ROUGH PLBG. FOUNDATION 2ND ~SULATION FRAMING [ ] FINAL REMARKS: THE NEW YORK BOARD OF FiRE UNDERWRITERS THIS CERTIFIES THAT o~{y t/~ ,~ctn~e.{ ~ulpm,nt .Xn~l PiXTUIII$ OV~S FANS S~OKE DETgCTOR:-I I - , ! OCCUPANCY OR USE iS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY APPROVED AS NOTED NOTI~ ~UILD~NG DEPAR~ENT AT ~65.1~0:, g ~ TO 4 PM ~R ~E APPROVED AS NOTED ~EE~ ~'~ · ~ BY' NOTIFY BUILDING DEPARTMENT AT "~5-1802 9 AM TO 4 ~ ~R ~E FOLI OW~N~ INSPECTIONS: ~OU~ION TWO REQUIR~ ~0~ o~URFO CONCRETE ~[~[~H =~MiN[~ ~ PLUMBI~ ~ ~. ~ ~ ~ ~ ~t~C ~ON MUST ,~.. '~ ,~ALL MEET ~ ~ ~ ~-~ '~ ~ , ~ · .... ~: ~'~,~t~LE FOR uv~,U?ANCY OR ~SE IS UNLAWFUL ~ViTHOUT, CERTIFICATE OCCUPANCY 1 · FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined i .YT/?~Q.,M(~x..~-~..Z..., 19 .~.. Approved . . .~..0,4~..~,..-%.., 19~.~.. Permit No ~ G ~"b~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. : CALL ................ MAIL TO: Date .................. , 19... INSTRUCTIONS a. This application must be cmnpletely 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 tiffs 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. C.-~ignature of applicant, or name, if a corporation) (Mailing address of apphcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. of owner of premises .~.~...'Y~..; .~f'~..'. ~). · · .~. ~. · ............................................. Name (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY Builder's License No .... O. ~,e.,M ~. ~ ........... Plumber's License No .... Electrician's License No. LICENSED Other Trade's License No ...................... 1. Location of land on which proposed work will be done~ ................................................. .............................. ............. ........ ............. House Number Street Hamlet County Tax Map No. 1000 Section .... /..o.~. ......... Block ..... '.~ ........... Lot ..... '.d-.~ ........... 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 ~ oa .~'. ~...~7. .~')?q~q ~ ~. ............. b. Intended use and occupancy ........................................... 3. Nature of work (check which apphcable): New Building ' Addition .......... Alteration .... Repair .............. Removal .............. Demolition .............. Other Work ............... i ~ (Description) 4. Estimated Cost "'/~ c.4-~,,~ Fee~..~ ~.~.7 %. ~ (to be paid on filing this application) 5. If dwelling, number of dwelling ultits ............... Number of dwelling units on each floor ................ If garage number of cars 6. If business, commercial or mlxedJoccupancy, specify nature and extent of each type.of use ..................... 7. Dimensions of existing structuresi if any: Front ............... Rear .............. Depth ............... ight .... He .......... Number of Stories .......... .. Dimensions of same structure wi{h alterations or additions: Front ................. Rear .................. Depth ..................... i. Height ...................... Number of Stories ...................... "8. Dimensions of entire new construction:. Front .......... ..... Rear ............... Depth ............... Height Number of Stories 9 Size of lot: Front ...........I Rear Depth ...................... 10. Date of Purchase ! Name of Former Owner 1 1. Zone or use district in which premises are situated ..................................................... 12 ' ~ ' g 1 lati · D )es proposed constructlon violate any zonm aw, ordinance or regu on: ................................ 13. Will lot be regraded .......... ; .................. Will excess fill be removed from premises: Yes No 14. Nmne of Owner of premises .~..?.~.~.."~. ,..~.q~..T(. ~'~.. Address Phone No..~.. $.q.: N~une of Architect ........... . ................ Address ................... Phone No ................ Nmne of Contractor ... i Address .... : .............. Phone No.. 15. Is this property located ~ithin 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permit maybe required. PLOW DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and block n ~mber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. ~.S .............................. : ................... being duly sworn, deposes and says that he is the applicant (Name of individual signing 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 file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manneriset forth in the application flied therewith. Sworn to before me this NOTI~ PU~I. IO, State of I~w Yolk .................... ~ No..47078?J[ Suffo kCounty~c~ (Signature of applicant) lerm ~xpires J~irch 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y. 11971 TEL.: 765-1802 Approved....~.O~2~..z...~.., 19 .lt.~. Permit No. I .~..~. ~.~..~-. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... gEPTIC FORM ............. : NOTIFY CALL ... ~.~ Date ................... 19... 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 in~peqctions. , (..~nignature of applicant, or name, if a corporation) .. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of prem ises..~...o~-7.. ~., .f'..~..~>~ ....... .~.~ ............................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .... F~..~..~.~ .~'.. ........... Plumber's License No .... .~7 .~./]. 7 f ........... Electrician's License No... ~?...2~. ........... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street ' __l;i " County Tax MapN0. I000 Section ..... .f/0]& ........ Block ......... &. Lot ...... ?.? ........... Subdivision ....... ...'~.; ......................... Filed Map No ............... Lot ............... · :~ (Name) 2. State existing ff~e.and occupandy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~.... .. ... ~.~.~...-~.. ... .~.7(?. ~.~?_-~.~ .. ............... b. Intended use and occupancy ~.gu/u ~/z~ . .~.~./---~ ~' 3. Nature of work (checl~which applicable): New Building ..... ' ..... Addition .......... Alteration .......... Repair .~.~..o.d..~.'71~o..~ Rem o~al ...... Demolition .............. Otl~qr lWork.. 4. Estimated, Cost . ¢. .......................... Fee ................................ " (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 c~rs ..... i/~..o ............................................................... 6. If business, commercial or mixed: occupancy, specify rlature and extent of each type of use . .~.~. .... 7. Dimensions of existing structures, if any: Front.../.~' .......... Rear ..tq¢ .......... Depth.: Height ..... ~ ! .... Number of Stories D~rnensions'of same structure wiih alterations or'additions: Front .... ~.~.m.~ ..... Rear . 27~.,~.~ .......... Depth ...... ~' '~' ~ ....... I · Height ...~,~w.. ¢,2- ........... Number of Stories .... .'FY. ~O. ............ '" 8. Dimensions of entire new construction: Front .......... . ..... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...........! .......... Rear ...................... Depth 10. Date of Purchase .... /.~..'~.~....: ........... ': .... Name o.f Formez_Owner .O~.~.*.t~..° ......................~.~.qO .~.q .~.~..,,%1~.. 11. . · . . i. . Zone or use d~stnct ~n which pre~mes are situated ..... .q~Cq ~. K .¢~..~t~. ........................... .~.... 12. Does proposed construction violate any zoning law, ordinance or regulation: .....~..~. ......................... 13. Will lot be regraded ........ tVO... . Will excess fill b~ removed i'rom premises' Yes 1 4. Name of Owner of premises . ~ f,h~ ..'~.,: ~. ~ .~i~. Ad dress .~r~,?..~f,l... ~. ~... Phone No ................ . Name of Architect ...... ~9.~.? ~__.. ............. '. Address ................... Phone No ................ Name of Contractor ~¢,t~ ~. ............. . Address . .,~...... Phone~ .................. 15. Is this property located within 300 ~eet of a tidal wetland? Yes ..... ~2~ ..... · If yes, Southold Town Trustees Permit maybe required. ' PLO'r DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block r, umber or description according to deed, and show street names and indicate whether interior or corner lot. STATE,OF NE~ Yg, P~K,/ i, S.S COUNFI Y OF .~,hC)~.~.c) l}Sx ...... ...,:~...c.,.k. ri.. ~ ................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ................................................................................. (Contractor, agent, corporate officer, etc.) Of said owner or owners, and is dulyl authorized to perform or have performed the said work and to make and file this pphcatton; that all statements contmped m th~s apphcat~on are true to the best of his knowledge and belief; and that the work will be performed in the manner?et forth in the application filed therewith. Sworn to before me this , SUSANJ. NAO¥ ~ ' ~ ~ Noisy Publi~, State ~, New York .......... /.?. ......... day of .i./~.~' ~.. (' ........... 19 Notary Public, ?..~.~ ~~ ..... Qudifi~ in Suffolk Count'/ . County ~..- ~/// . (Signature of applicant)