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Home My WebLink About9473-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.-Z-q!.~-5?B-:.i .... Date December 23, 1987 THIS CERTIFIES that the building. ACCE S SORY BUILDING Location of Property ...6.4.5...L.~.~.t.I..e Peconic ,Road Cutchogue, New York County Tax Map No. 10'00 Section 1.-! .1 ......Block 11 .Lot 9 Subdivision ............................... Filed Map No ........ Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated September 28, 1977 pursuant to which Building Permit No. 9473 z dated September 28, 1977 ............................ 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 ......... A'CCE S SOR¥ BUILDING SAUL & SUSAN ROSENSTRETCH The certificate is issued to ................................... of the aforesaid building. Suffolk County Department of Health Approval N /A UNDERWRITERS CERTIFICATE NO... N / PLUMBERS CBRTIFICATION DATED: 1/81 FORM NO. 2 TOWN OF $OUTHOLD BUILDING 'DEPARTMENT TOWN CLERK'S OFFICE SOUTH~LD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION, OF THE WORK AUTHORIZED) 9473 Z Date ...................................... Permission is hereby granted to: c~ ~ 7~CCE/~fST~ tC° A~ .~/Zk:.~ ....... 2....Z .................. : .............................. at premises located at ......... k2Z....2LT~. ....... gursuant to applicdtion dated ................................. ~.k..'..L.....~, 19Z~..., and approved by the Building Inspector. Fee $.....L.~ .............. Building Inspector FORM NO. 6 -TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - I802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate !ocadon of all buildings, property lines, streets, and unusual natural or topograph~ features. ~_Fi,aJ epprov..akof Health Dept of water supply and sewerage disposal-($-9 form or equal). 3i,'\5.'~r,,';. ;:1 of ~l.=c[rici~l ::~st~l,'.~t!on from Board of Fire Underwriters. 4. C., n ........... ~. ~1 ..... m !, str;a~ huiid[ngs, Multiple Residences and similar buildings and inStalla- tion:, a cer.'i[ica!.'; ()~ Ccda corr~)li;,:ca from' the Architect or Engineer responsible for the building. 5.Subm~t~ P~annln~ Board approval of completed site plan req~uirements where applicable. B. For existing buildings (prior to April 1957), Nomconforming uses, or buildings and' "pre-existing'" land uses: 1. Accurate :su~ey'of p=operty showing all property lines, streets, buildings and unusual natural or topogr~dhic features. 2.Sworn s~atement of owner or previous owner as to use, occupancy and condition of buildings. 3. Da~e of any housing code or safety nspection of bui dings or prem ses, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS S25,00 1. Certificate of~occupancy New Dwelling $25.00, Accessory ,$ 10,00 Business S50.00 2. Certificate of o~cuDancy on pre-existing dwelling $ 50.00 3. Co~y of certificate of occupancy $ 5.00, ove~ 5 yea~s $10.00 4.Vacant Land C.O. S 20.00 5.Updated C.O. S 50.00 Date .......................... NewC°nstruc%io~ ...... Old or Pre-existing Building ............ Vacant Land ............. 645 Little Peconic Road Cutchogue, New ~ork Location of Prooerty ................ House No. Street l-lam~et Dr. & Mrs. Saul Rosenscreich Owner or Owners of Property .... County Tax Map No. 1000 Section ... ] ] ] Block I ] Lot 009 Subdivision ................................. Filed Map No ........... Lot No ............... 9/28/77^ . Saul Rcsenstreich Permit No. 9473Z Date of Permit . ......... ~ppdcant Health Deot. Aoproval ...... N / A · Labor Dept. Approval N / A N/A N/A Underwriters Approva~ ....................... Planning Board Approve,' ...................... ~equest for Temporary Certificate ..................... ~inal Certificate ....................... Fee Submitted $. 10.00 Construction on above described building and permit meets all applicable codes an? regulations. FO~ NO. ~ , ' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~ .~ SOUTNOLD, N. Y. ~ ~ / '~ ~ ~x~med .................... ~.., ........ , ~ ........ ~pfi~a~ ~. {DUIIQI~g I~p~Or) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ in ink and submitted in triplicate to the Building . Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule.' b. Pldt plan showing location of lot and of buddings' ' on premises, relationship to adjoining premises or public, streets. - °~?~' areas, and giving a detailed description of layout ofproperty m Jst be drawn on the diagram which is part of this apphcatlon.~ 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 issue a Buiiding 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~g;~ sh~all 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 demdlitlon, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building ced.e,, housing cede, and regu arians, and to admit authorized inspectors on premises and in buildings for necessary 'jnspecti6~s~ ~ Ga ...b. .................................. <Sign %r of oppi,cant" ', or , me, ,f a eorpor , i ........ (Address of applicant) j ! State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... r , d Nome of owner of premises ............. .~CLLb~%.~.L...~'~...£..,f,x....~;......=,..?.Z ........................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Locmion of I~d o~ which proposed work will b~ d~e. M~p No.: .......... ~ ...................... ~ ...... o ........................ Street and Number ........ ~.~.~.~:.. ¢ Municipali~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use aqd o~Upancy ,,., ............. b. Intended use and occupancy ..,..~ ....... ~¢,~.~ ......... ~.~..~'.,~..~.~: ....... ~.~ ........................... 3. Nature of work ¢check which applicable): New Building~. ................. Addition .................. Alteration ............. Reoa~r .................. Removal .................. DemoJitior ..................... Other Work ................................................... ~ ~c (Description) ,/ 4. Estimated Cost .................................. ..~'.'.'~.Lt.i ....... '....Fee (to be paid on filing this application) 5~ I{ dwelling, number of dwelling units ............................ Number of dwelling units on each floor ..... ~ ...................... If garage, number of cars 6. if business, commercial or mixed occupancy, spec]fy nature and extent of each type of use ............................ 7. Dimensions of existing structures, ~f any: Front ............................ Rear ................................Depth ................... · Height ....................... Number of Stories Dimensions of same structure with alterations or oad't'ons Front .................................... Rear ........................... Depth ................................Height ............................ Number of Stories 8. Dimensions of entire new construction: Front ! u Rear ................................................................ Depth ........................ Height /~ Number of Stories 9. Size of lot: Front ~' ' ~ Rbor ~ Depth ' ............ I~. Date of Purchase ........................................................ N:me of Fo~er Owner ............. ~ Zo~ or ~ district i~ whi:h ~e~i~ :~e sit~at~d ..................... :..e{i:h~..~}{.!.L{}?, ........................................... 12. Does proposed construction violate any zoning law, ordinance or regulatiom ........... 13. ~i[I lot be 'regraded ........................ Will exce~ fill be removed from p~mises ( ) Yes ( 14. Name of ~ner of ~rem ses ...... ...... Addre~ ...6~ZI?¢~.~.Z.. ~hone Name 'of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Addre~ ................................ Phone No ....................... PLOT DIAGRAM ,ocate deafly and distinctly ail buildings, whether existing or proposed, and intimate ail set-~ck dimensions from prope~ lines. Give street and bbck number or descr]Dtio~ according to de~, and sh~w street' names and indicate ~hether inter[or or corner bt STATE OF NEW YORI(, Z'~ ~ :': COUNT~_ __'OF .................. ; ............ ............ .~.i:l..r. .......... :h.:.~.~.:f:..~..:......::'..'2.._L .................. being duly sworn, aeposes a,c s~ys that he is the applicem (Name of individual signing contract) ~bove named. He is the ..... ' ................... .;,..~: ............................................................................................................ ~ ......................... (Co~tractor, agent, corporate officer, etc.) of said owner or owners, a~d is duly authorized to ~efform or have performed the said work and to m~ke and file this application; t~t all statements contained in this application are true to the best of his knowledge and belief; tha~ the work will be performed in the manner set fo~h in the application filed ,the~ewit~. Sworn to before me this ~ ~ , ~,~ //~ fizz,'~ .................. :.;... day of ................................ . ~';YF:""~'(~_19 ........ ~~F ~, ~ [Nota~ r~7~c, . ................................................... ~oun~ ................. ~ ................. -- ~ .................................................... ~OTARY~U~IC, State of New York No. 52~643~21, Suffcl~