The URL can be used to link to this page

Home My WebLink About16945-zFORM NO. 4 TO~N OF BOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17073 Date JULY 13~1988 THIS CERTIFIES that the buildin~ RAMP Location of Property 27245 MAIN RD & 120 HIGHLAND RD. CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 109 Block 02 Lot 17.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 9, 1988 pursuant to which Building Permit No. 16945Z dated MAY 9, 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 CONSTRUCT RAMP FOR HANDICAPPED. The certificate is issued to CUTCHOGUE PRESBYTERIAN CHURCH (owner, of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATE NO. N/A Building Inspector Rev. 6/88 FORM NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, t4. Y. BUILDING PF.R~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N 16745 z Permission is hereby granted to: - nt premises located at ...~....~.~....~..~....,....~.".~;.ii~/i..:~..., ......................................................... .................................................. ~ .... /'-;~' ....................... f~' .......................................................... County Tox Mop No. I000 Section ....... ~..~...~.. ..... Block ...... ~, ........... Lot No ...... ./...~..:../., ..... pursuont tO opplicotion doted ...... ..~.../.../~ ................................. , 19.~.~., ond opproved by the Building Inspector. oo Rev. 6/30/80 DUNDATION (1st) )UNDATION ( 2nd ) )UGH FRAME & PLUMBING 'SULATION PER N. Y. STATE ENERGY CODE FINAL % ADDITIONAL COMMENTS: ? 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 Wpewriter OR ink, and submitted m Imammmm 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- 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: I. 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, occapancy 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 $25.00 1. Certificate of occupancy New Dwelling. S25.00, Accessory ~$I0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50-. 00 3. Copy of certificate of occupancy $ 5.00, DYer 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .................... NewCons%ruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property Hou.~e No. Street Ham/et Owner or Owners of Property . ......... County Tax Map No. 1000 Section ..../.~..~. ....... Block ..... ,~ ........Lot..../Z', ,/ ........ 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 an~,it meets all_~plic, able codes and regulations. ¢., ¢~-'~*~'~"'· ~= ....... ' '~'"' 't SETS OF PI,AN,q ....... · ¢ ; -. . , FORMNO, 1 SURVEY ........ * ~¢~ ~¢~ TOWN OF SOMTHOLD CllECK - o''d~Orc~ BUILDING DEPARTMENT SSrTIC TOWN HALL NOTTFY SOUTHOLD, N.Y, 11971 CALL ................ TEL.: 76U-1802 Examined ........... 19 Approved . .~ ......... , 19~Pe~it No ............ Disapproved a/c ..................................... ............................. ..... APPklCATIO~ FOB B~IkDI~G 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 inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) ~essee, agent, architect, engineer, general contractor, electrician, plumber or builder. State whether applicant / CWu,ec>l Name of owner of premises .................................................. ~ .................... £' (as on the tax roll or latest deed) If ~p'-~t!j~*n~t is a corporatio,n, signature of duly authorized officer. .... 7 ? (Name and tiffe-of corporate officer) ' ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Ttade's License No ...................... ~ "7 ~ 1. Location ofland on wlfich proposed work will be done. . . 4(47-(--~ House Number Street Hamlet County Tax Map No. 1000 Section ..... ~..o..q. ....... Block ....... ...2--. ....... Lot'....~.7.,..i ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constrnction: a. Existing use and occupancy .... .~.../~../~'r~..~f.~ ..................................................... t! b. Intended use and occupancy .................................................................... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition . ! ........ Alteration,~ ....... . . Repair .............. Removal .............. Demolition .......... i. · · Other Work . . . .Zz~..t~.,~.> .... i (Descrlpllon) 4. Estimated Cost ,. ............ Fee....~$Y..~.[ ............................ (to be; paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling un!ts on each floor ................ If garage, number of cars ........................................... i. ............................ 6. If business, comme!-cial or mixed occupancy, specify nature and extent of each tylpe of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ...... [ ....... Depth ...... ......... Height ............... Number of Stories ........................... I ............................ Dimensions'of same structure with alterations or additions: Front ........... i ..... Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front .......... . ..... Rear ....... i ....... Depth ............... Height ............... Number of Stories ........................... i ...... ; ..................... 9. Size of lot: Front ...................... Rear ...................... i Deptli ...................... 10. Date of Purchase ..... ........................ Name of Former Owner i ............................ 1 1. Zone or use district in which premises are situated ........................ i ............................ 12. Does proposed constructio~-violate any zoning law, ordinance or regulation: '-.I ............................ 13. Will lot be regraded .. ~/(/~ ..................... Will excess fill be remov{d from premises: Yes ~__~ 14. Name of Owner of premises ~'7, ................. Address .............. ~ .... Phone No ................ Name of Architect ff/~,~.~...7~.,~g'A.Y.Z, ./%4tb:/ ........ Address/~../?./.~..A°..~. ~..~d'.:a.~fl..&"Phone No ................ Name of Contractor Address ' 15. Is this property located within 300 feet of a tidal wetland? *Y~s .. · If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, i~ldicate 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. iTA'I'E OF NEW y~l~( ~q ~ ' OF.. Y · .: .... .~.: . .,,~..,.../~..g./.~..~.~..._/~. :Zr..~--...,~../~ ..~...C.'..~.... being dttly sworn, deposes and (Name of individual signing contract) :bo~e named. says that he is the applicant le ~s the ............................................ ,,~.-:?~...-'r~-~...').. i .................... (Contractor, agent,~,,prporate offlce, r~c.) i ~f sa,d owner or owners, and is duly authorized to perform or have per ol~6~{ted the smd work and to m~e ~d file this pplication; that all statements contained ~ this application are true to the best of hislknowledge and belief; and that the york w~l be performed in the manet set forth ~ the application filed therewith. ;worn to before me this ............... /~ay of.~.. ~ .;23~;~9 .~ ~~.__ ~ ...... ~~ (Signature of a2an,) .I OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY A~P$OVED AS NOTED 765, 1802 9 AM TO 4 PM FOR THE FOLI OWING INSPECTIONS: 1. FI IUNDATION - 11AIO REQUIRED F~ ~R POURED CONCk~:;~= 2. R )UGH - FRAMING & PLUMBING 3. I~ ~ULATION 4. F ~AL - CONSTRUCTION MUST B i COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENT~ OF THE N.Y. STA~;, CONSTRUCTION & ENERGY CO~,;S. NOT RESPONSIBLE FOR DES GN OR CONSTRUCTION ERRORS ~i ko~ // I ,C: ion L. ~VAT- Ioll",,[