The URL can be used to link to this page

Home My WebLink About15083-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z-16079 Date August 19, 1987 THIS CERTIFIES that the building ....~.B.O.¥ .E..G.R.O. ~p.D.. 8..~.I.~.~ I. ~.G.y.o. 9b .............. ~- 25335 Main Road Cutchogue, New York Locauon of Pro ert House No. Street Hamlet County Tax Map No. 1000 Section l 09 .Block .0.2 ........... Lot 01 I Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated July I0, 1986 15083 z ..................... pursuant to which Building Permit No ...................... dated .... Ju. ............. 1 y 11, I 986. ......... 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 ......... ABOVE GROUND SWIMMING POOL The certificate is issued to ROBERT HOPKINS ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO .... N 825408 N/A PLUMBERS CERTIFICATION DATED: Building Imp[ct;; ............. Rev. 1/81 lvORM NO. ~ TOWN OF $OUT~OLD BUILDING DEPARTM£NT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15083 Z Permission is hereby granted to: .....~.o.~.~.T......~../.,..,:~l.o~,...~.~.~... .... ...~.~..~.......~...~ ............................................ ...... .C..~~u~.t~.:.~......t.).~.~-- ,o ........ ~~~.~ ........ ~~.....~.~.....~.L.M~ ...~..~ ...................................................................................................................................... at premi.s ,~ated at ...~.~..~.~ ....... .~.~.~...~.~..~ ................................... ............................................................................................. ~vxc.~.~.~.t....~.:~.~ ...... c~.~ ~=~ ~=~ ~. ~ooo s,~,,o....l~.~ ......... ~,~ ...~..~ ........ ~, No..~..L~ ............. Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 I TO,',N CF SOUT~OLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m~ to the Building Inspec- tor with the following; for new buildings or new use: 1. FinaJ 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-6xisting" 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: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 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 Z,],.,~../.o~. - ' .~ '- 5.Updated C.O. $ 50.00 Date .... .~ ............ NewCons tpuc tion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property. ,o~.,~.~.. ...... ,~r'/~ ~'~'?~' House No. Street Owner °r Owners °f Pr°perty..~'~-~, ,~'~-. ,a~.-. ,~,. ,~/?~,. ~, ~r~,,~ County Tax Map No. 1000 Section/.~...4~...~1~ ....... Bloc!< ~L~ ........ Lot .... ~./~. ......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./~'~'~.., Date of Permit .......... Applicant ,~,~.~?,./~ifi~ $. ............... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ P~anning Board Approval ....................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted S. Construction on above described building a)~er~it me(~ts a~l al2plicable codes and regulations. Applicant ~.~ Rev. 10-10-78 t THE NEW YORK BOARD OF FIRE UNDERWRITERS 13~. BUREAU OF= ELECTRICITY BS JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT ~nd Rober~ W. Ropkins, Main Rd.- Box .,0, CrOWn ~..x.~i.~d on July 3 0, 19~ 7 a.dfou.d to be ~. complinnce ~' th the req.ireme.g* ,[ this Board. RXTURE RXTURES RANGES COOKING DECKS OVENS FANS 1 DRYERS MOTORS FUTURE APPtJANCE FEEDERS TIME CLOCKS DIMMERS SERVIC~ D~SCONNECT S E R V I C )THER APPARATUS: AWG. OF CC. COND AWG HI.LEG NO. OF NEUTRALS (Swi~ing pool)This certificate covers compliance at the date o~ i~spection only. Because of unusual environments it is advisable to have frequent test and/or repairs made by a qualified person. Jody Pumillo Pat Lane Mattituck, N.Y., 11952 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be id~n~ifiecd~by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ~/FINAL REMARKS: DATE ./ FIELD INSPECTION C~MMENTg FOUNDATION ( 1 st FOUNDATION (2nd ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ODE ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-180:a (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,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.., inspe'~dl~ns")l~. ~d~ ./~~, f r.: , . ..... ~ (M ailing addres§ of applicant) State whether applicant is_owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises.. ,2P~6~. '~e~./~..../..~5.d~.-J:..~... ~.//~,).~ .................................. / (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No.~-4S~.' ~'~~! (t~.*,~O~. ~ Plumber s L~cense No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. · ............... .... ................... ................. House Nmnber Street Hamlet County Tax Map No. 1000 Section . ~.~ .~.a .~.c:~ .-7./.' ./.. Block .................. Lot ................... 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 .... .~. ~..~..J~.. { .Q~.~.. b. Intended use and occupancy .. ~..~...~..~....~./~~'O~..-- ~'~t~.. ~6k4~: · ...... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition .......... Alterati~,,, ....' .... i~. Repair .............. Removal .............. Demolition .............. Other Work. · }~.d~ .I ........ 4. Estimated Cost.,....,~p .6. ?. ........................ Fee .~~/~2~'-~° (Description) · (to be paid on filing this application) 5. If dwelling, number o f dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify ~a.ture and extent of each type of use 7. Dimensions of existing structures if any' Front Rear ... .................... Depth...' ......... Height ............... Number of Stories ........................................................ Dimensions'of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... ' 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height .............. ~Number of Stories .......... >,. ........................ -- ................ 9. Size of lot: FrOnt .... .~ ~>. ..... Rear ~/Q e th ~. Date of Purchase /././~.. l ....................... ~' '~' .............. 10. · ....... ~.~ ................ Name of Former Owner ~.~ ~°.i ~C~ C O. ~. [t.~. r~ ............. 1 I. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ................. .. Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address .... : .............. Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No .~... · If yes, Southold Town Trustees Permit may be required. . PLO'r DIAGi~kM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate 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. STATE OF NEW YORK, COUNTY OF ................. S.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 manner set forth in the application filed therewith. Sworn to before me this ........... · //. :,~ · ...... day, of ¼...~/~...~ ......... ,19 ~..~ Notarymublic ..~ ~ ..~.~...~.. County TOWN OF SOUTIIOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. I 1971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of the following reasons. An application for Certificate of Occupancy is not on file. No Underwriters Certificate on file. The check is(outdated~not on f~i]o.) /~/ No Health Dept. Approval on file. No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit ~ ] ~ ~_ ~ _~ Z Building Dept. ***/Z/ No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 )