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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
Date: 02/25/08
NO: Z-32900
THIS CERTIFIES that the building
ACCESSORY
Location of Property: 16300 CR 48
(HOUSE NO.)
County Tax Map No. 473889 Section 101
CUTCHOGUE
(STREET) (HAMLET)
Block ~ Lot 11.1
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
fi1ed in this office dated
MARCH 13, 2007 pursuant to which
Bui1ding Permit No. 32795-Z
dated
MARCH 13, 2007
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 ACCESSORY GREENHOUSE IN THE REQUIRED REAR YARD AS APPLIED FOR.
The certificate is issued to ROBERT L HUBBARD
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPAR'l'MENT OF HEALTH APPEOVAL
N/A
N/A
ELECTRICAL CERTIFICATE NO.
N/A
PLUMBERS CERTIFICATION DATED
~h~
Rev. 1/81
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
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APPLICATION FOR CERTIFICATE OF OCCUPANCy
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 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 I % 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 Planlling 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:
I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant. If a Certiticate 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, Rusinesses $50.00.
2. Certificate of Occupancy on Pre.existing Building. $ I 00.00
3. Copy of Certificate of Occupancy . $.25
4. Updated Certilicalc "fOccupancy. $50.00
5. Temporary Certlticalc of Occupancy. Residential $15.00, Conlllercial $15.00
Date.
New Construction: __'___'-_ Old or Pre-existing Building:
'-_~_ (check one)
________~:t C ko ~__
mlll~t
Location of Property: ___
House No.
. 'U'~(J (j ({2. y'i,
Street
Owner or Owners of Propeliy: . Po J. ...-",""t" .1. Ii/A i<"A. rei
Suffolk COllnty Tax Map No 1000, Section _ ..lo I. Block
;,)
Lot
II- 1
::::~~~:n :3 ;) ~ q ~... ~ Date of penIl1t~\B \ '1
'h:>'i""'-, W {o
Health Dept. Approval: __ Underwriters Approval:
Filed Map.
Lot:
Applicant:
Planning Board Approval: _
Request for:
Temporary Certificate
"iFinal Celiiticate: L___ (check one)
Fee Submitted: $ ____..d"LQO
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Applicant Signature
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FORM NO. 3
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)
PERMIT NO.
32795 Z
Date MARCH
13, 2007
Permission is hereby granted to:
ROBERT L HUBBARD
16300 COUNTY ROAD 48
CUTCHOGUE,NY 11935
for :
CONSTRUCT ACCESSORY GREENHOUSE AS APPLIED FOR. THIS PERMIT
REPLACES BP 26799.
at premises located at
16300 CR 48
CUTCHOGUE
County Tax Map No. 473889 Section 101
Block 0002
Lot No. 011.001
pursuant to application dated MARCH
13, 2007 and approved by the
Building Inspector to expire on SEPTEMBER 13, 2008.
Fee $
35.00
ORIGINAL
Rev. 5/8/02
3 'J-77S-z
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING [] FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTAucnON [ ] FIRE R ISTANT PENETMTlON
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INSPECTOR ~~
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PLUMBING
SOLATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
J-OH ~ 10/-2-1(.r
O~ER STREET /
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FORMER OWNER N
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LAND
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Tillable
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House Plot
Totol
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TYPE OF B ILDING
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REMARKS
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FRONTAGE ON WATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
,1020
d-)O/
LOT
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Porch Basement Full Floors 6~ 1\ K,
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Porch Ext, Walls Interior Finish LR.
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Breezeway Fire Place Heat DR.
Garage Type Roof Gd. b l-e Rooms 1 st Floor b BR.
Patio Recreation Room Rooms 2nd Floor FIN. B
O. B. 1.2. .smA L (.. JH'ED...... .so Dormer Driveway I
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FORM NO. J
TOWN OF SOUTHOLD
;BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 1]971
TEL: 765-]802
3Ji1s
Exanined................., LO.... ~
"t I~ 'V-~ . ~
Approved......!!.........., .... PeIlDlt lb.. . .........
Disapproved alc ..................................
r I'~'-' rii~~iilli 'i !. ,
D' Lt~ !.~') .~~. 'l '
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! lfUl AUG 2 9 2000
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L-._______-J
[;..[?'::'1, ce'^(,
TOWj\i (;i~ so~;.,_':~~:_;-.
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORM ...................
DEC ...........................
TRUSTEES ......................
~~in::...? $. V. :-.~ .~.?Y
MAIL TO:....................
....................................
...................................
..................................)2;..... ...........,
....~....
. (lbilding
APPLICATION FOR BUILDING PERMIT
Date. . . . . . . . . . . . . . . . , 20. . . .
INSTRUCTIONS
a. This application DUSt he ~letely fill~ in by typewriter or in ink and sulmitted to the Building Inspector wi,
3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of hIildings on premises, relationship to adjoining premises or p.IDlic
streets or areas, and giving a detailed description of layout of property 11lJSt he drawn on the diagr1lll .t.ich is part of
this application.
c. The work COII'ered by this application may not he COlll1enced hefore issuance of Ibilding Pennit.
d. Upon approval of this application, the Ibilding Inspector ,rill issue a Ibilding Pennit to the applicant. Such
pennit shall he kept on the premises available for inspection throughout the work.
e. lb hIilding shall he occupied or used in .t.ole or in part for any "(1JrpOse wtever \lOtil a Certificate of
lkcupancy shall have been granted by the Ibilding Inspector.
APPLlCATIlJl IS IEREBY MAlE to the Ibilding Ilepartment for the issuance of a Ibilding Pennit J11rsuant to the
Building Zone Ordinance of the Town of Soothold, Suffolk Camty, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for rellDlTal or daoolition, as herein
described. The applicant agrees to ~ly with all applicable laws, ordinances, hIilding code, housing code, and
regulations, and to adoit authorized inspectors on premises and in hIe:.w necessary inspections.
I ................iI::k~................
(Signature O~?}icant, or /r" iJ a :frporation)
. ~ 16}ooC. ~ '..&I...if.tr.~Q.q.0::f.
,,-=(~1ing address of applicant) /iJf it tr 3}
State >t.ether applicant E ~essee, agent, architect, engineer, general contractor, electrician, plllliler or hIilder
..................................................................................................................................................................................
N1IIIe of ~r of premises .........Ro6.{t..J":"..H!:h.4?k.4.~.cl....~..0f..........................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
/
......................................................................................
(N1IIIe and title of corporate officer)
Ibilders License lb.
Pllllilers License No.
..................................
........ -............................
Electricians License NO. .....................
Other Trade's License lb. ..................... R
I. Location of land on .t.ich prO\X>Sed work will he dooe...1.!f.? ~.'?. .~p.~.~,. ....~. ~.~ .t........ ....
....~~~...~~....~!~~~......................................~;~............~..............
Camty Tax Map lb. UXXl Section ....LQ.\....... Block .....~........ Lot ....l1.J......
Subdivision ...................................... Filed Map lb. ............... I.ot ...............
(N1IIIe )
2.
State existing use and """'P"'lCY of premises and intended use and occupancy of proposed cons~rJ,'lion: .L
a. Existing use and occupancy ......tJ..JU.,..m.~..j('.<JJ.~.r-/){.0.a.....sr./.eL
( (' ({ l ( \y L ~
b. Intended use and occupancy .............................................................................
.~
3.
"'",ture of work (check ...lid. applicable): New fuilding .......... Addition....~ 7L' Alteration..........
Repair............ Raooval ............. IlenDlition ............ Other Work .-<J le~................:....
Si ; (Description)
Estimated Cost ......... ~o. rr.......... fee ..............................................
(to be paid on filing this application)
If Welling, rurher of Welling .mits ............ tUJber of Welling lIDits on eadl floor ................
If garage, lUliler of cars _~ ........_. .... ... .0..................
If business, conrercial or miJ.ed occupancy, specify nature and extent of eadl type of use......................
Dimensions of existing structures, if any: Front...... .':1. v.... Rear...... ,:-!.l,.i... Depth.... .~.~......
l1eight ......................... tUJber of Stories ......................
Dimensions of sare structure with alterations or additions: Front............... Rear...............
Depth .................... l1eiw.t .................... tUJber of Stories ...............
Dimensions of entire new construction: Front.... .1. L...... Rear.. j l~........ Depth ..............
l1eight .... J. .). . . . . . . . . . .. .. .. tUJber of Stories ..................... I
Size of lot: Front ..n.!?'............ Rear .J]p.~........... Depth ...??-.!{P...T....
I1ate of Purdlase ..................... Hare of l'orner O.mer . .ttUJ./.C}cj;. TLf..+.f.l(.I..............
4.
5.
6.
7.
8.
9.
10.
II.
12.
13.
14.
Zone or use district in ~idt prBDises are sitlJated ..0..................................................................................
Does proposed construction violate any zoning law, ordinaoce or regulation: ........................
Will lot be regraded ... 'to.........J.. will "lk1b~;J. be ramved fran premises: YES N) I (
NaIl>s of O.mer of premises ..~.r:t.~...~~~....... Address ~:~.li:t-0V;;i3(llione &7~if~~'1.':f.
NaIl> of Architect .................................... Address.............................. llione &. ..............
NaIl> of Contractor ................................... Address ...............................Phone &.
15. Is this property within 300 feet of a tidal ""tIand? "YES.......... N)..........
"IF YES, 9:IJ\lUD n:m TRIlS\F.E.,) PEIMIT MIIY BE RIlQJIRIID.
PLOT DIAGRAM
locate clearly and distinctly all buildings, \ot1ether existing or proposed, and indicate all set-back dimensions
fran property lines. Give street and block rud>er or description acCOrding~o and show street nares and indicate
\ot1ether interior or corner lot. >< ~
~~ '\ D'AS~D..
. - .------ .- aLl DA:' :;I...~/O:B.P.# ~mc_
I 3';;" BY: ~~
BUjLDING DEfSARTMENT AT
765.1802 !l AM TO 4 PM FOR TH!(
FOLLOWING INSPECTIONS: J:(.,L
1 FOUND~TION .~IIU>
FOR P~RED CO ~
2. ROUGH - FRAMING BING
3.INSI,l ON
4. FINAl. \. CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL C~~TRUCTION SHALL MI:ET
THE REQ~IREMENTS OF THE N.Y.
STATE CO~STRUCTION S. ENERGY
COD-ES;1'lOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
Lf~
OCCUP~ OR
USEyls.lTNLAWFUL
\~OUT CERTIFI~ATE
OF OCCUPANCY ;g
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STAlE IF l\I~, J?L. //_
mJNl~ r....:YJ..IT9.1.5.\/"l s.')
t: ofu,f- L f1Ct b&vd. . .
.. h...... ...... h. ...................................... .belng duly sworn, deposes and says that he IS the applicant
(NaIl> of individual signing contract)
above named,
. G v./YL.e. V
11e 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 aU stat"""nts contained in this application are true to the best of his knowledge and belief; and
that the ""rk will be perfonned in the mam1er set forth in the application filed therewith.
C-cul\~ :;<0<
Sworn to be~?,t:':. this
.......2r.':1.::./t o/}I-.~...... .....?!l.~'?.
&taryPWli~.. .
.~..~.~~.
ClAIlIli \. GLEW
IlaWY~JI"1<! 01 NewYorl<
No 01 GLA879505 -
aualWI8d in Suffolk couq~)
eammla8lon Explr.. Dec. 8, .
(Signal"re of Applicant)
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FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT
COMPLETION OF THE
2> 'J. ---Y1:; "('--1'\
PERMIT NO. ~. Z
ON THE PREMISES UNTIL FULL
WORK AUTHORIZED)
Date SEPTEMBER 28, 2000
Permission is hereby granted to:
ROBERT L HUBBARD & WF
16300 CR 48
CUTCHOGUE,NY 11935
for :
CONSTRUCTION OF AN ACCESSORY GREENHOUSE IN THE REQUIRED REAR YARD
AREA AS APPLIED FOR.
at premises located at
16300 CR 48
CUTCHOGUE
County Tax Map No. 473889 Section 101
Block 0002
Lot No. 011.001
pursuant to application dated AUGUST
Building Inspector.
29, 2000 and approved by the
Fee $
... . u_3.5..Jl.Q
~
Authorized
ORIGINAL
Rev. 2/19/98