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Home My WebLink About44412-Z Town of Southold 11/18/2019 s P.O.Box 1179 0 53095 Main Rd JA �ao� l` Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40866 Date: 11/18/2019 THIS CERTIFIES that the building AS BUILT ALTERATION Location of Property: 985 W Creek Ave., Cutchogue SCTM#: 473889 Sec/Block/Lot: 103.43-12 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/6/2019 pursuant to which Building Permit No. 44412 dated 11/14/2019 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: "AS BUILT"BATHROOM IN AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to Brooks DJ Dec of Trust of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED )&4e Signature o�su ��co TOWN OF SOUTHOLD BUILDING DEPARTMENT z TOWN CLERK'S OFFICE o . SOUTHOLD, NY - BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 44412 Date: 11/14/2019 Permission is hereby granted to: Brooks DJ Dec of Trust 917 S Catherine Ave LaGrange, IL 60525 To: legalize an "as built" bathroom as applied for. At premises located at: 985 W Creek Ave., Cutchogue SCTM # 473889 Sec/Block/Lot# 103.-13-12 Pursuant to application dated 11/6/2019 and approved by the Building Inspector. To expire on 5/15/2021. Fees: AS BUILT- SINGLE FAMILYON/ALTERATION $416.80 CO TERATION T WELLING $50.00 Total: $466.80 wilding Inspe Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 1%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 Planning 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: 1. 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 Certificate 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial$15.00 Date. �o lC New Construction: Old dor,Pre-existing Building: V (check one) -- Location of Property: House No. 1Street Hamlet —" Owner or Owners of Property:IcN,"N .4, � r Suffolk County Tax Map No 1000, Section 10 �j Block /3 Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept:Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: f/ (check one) Fee Submitted: $ Applicant Signature Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) I,CQ I I �_ aej��$residing at q (Print property owner's name) (Mailing Address) /,e, do hereby authorize Nee l ga-X-C (Agcnt) to apply on my behalf to the Southold Building Department. 40--1�--tg (Owner's Signature) (Date) QAI�zj & S (Print Owner's Name) ho�,Of SOGlyo6 F # # TOWN OF SOUTHOLD,BUILDING° DEPT.- ��yco,,,m ' 765-1802 _ I-N-SPE,_cTION , [ ] FOUNDATION 1ST [XROUPLBG. FOUNDATION 2ND ° [ TION/CAULKING FRAMING/STRAPPING [ [ ] FIREPLACE &CHIMNEY- [ ] FIRE SAFETY INSPECTION [= ] FIRE-RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)- [ ] CODE VIOLATION [ ] PRE C/O REMARKS: DATE INSPECTOR o t _ ► �- k^! FIELD INSPECTION REPORT -DATE COMMENTS *o FOUNDATION (IST) y ------------------------------------ ' C FOUNDATION (2ND) CIO z o H ROUGH FRAMING& PLUMBING y ' d r b r INSULATION PER N.Y. y STATE ENERGY CODE FINAL ADDITIONA L COPdMENTS O Z m Q H x d troll H i TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying9 TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 ( / (�(�jr� Survey Southoldtownny.govPERMIT NO. `( -ll w(( 11 Check Septic Form 7 N.Y.S D.E.C. i Trustees f C.O.Application ' Flood Permit Examined 2 ht\ Single&Separate , Truss Identification Form Storm-Water Assessment Form E.<<y Contact: Approved ,20 Disapproved a/c Phone: -a�a—qQ(7-J40-3- Expiration 403- Expiration 20A.-<(A— /_ .i`� 4EA �� F� B i g Inspector 'tel 7_77 q o�9 APPLICATION FOR BUILDING PERMIT Date 40—;La , 2011T INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 waterways. 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 Building Permit to the applicant. Such a 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 what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after;the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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 colistruction 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) fooC� 3 )a-yet oma. State-whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises !!00p ®�'�",��'t �� Co l�'� �2� o-�' ��•x (As on the tax roll or latest deed) ` If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. -- 1. Location of land on which proposed work will be done: wesi- C r,"II/ N VOI House Number Street Hamlet County Tax Map No. 1000 Section 'd 3 .Block _'''t'`''.J ' ',''' Lot. Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy . 3. Nature of work(check which applicable): NeyzBuilding Addition Alteration Om Repair Removal: E,� Demoliti•on Other Work (Description) \71slei'n ost f- •� :. Fee 6?rri5 (PM paid on filing this application) number of dwelling units Number of dwelling units on each floor umber,of cars commercial or mixed occupancy, specify nature and extent of each type of use. of existing structures, if any: Front Rear Depth Number of Stories Dimensions of s e str tune with alterations or additions: Front Rear _ Depth Height Number of Stories Dimensions of entir new construction: Front Rear Depth Height Number of Stories /D6--',Dateof t Rear Depth e Naive of Former Owner rict in whichpremises are situated onstruction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NOill excess fill be removed from premises? YES NO L--' 14. Names of Owner of premises U`U2 �` ®Q�Addd es 9 S5 Nes+Cre.&KPho e No. o�- Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale,with accurate foundation plan and distances to property lines. 17. if elevation at any point on property is at 10 feet or below,must provide topographical data on survey: 18. Are there any covenants and restrictions with respect to this property? * YES NO� * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) CIO 1[teN being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the ��e.v✓ (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 20 /G/ OFFICIAL SEAL ` IDAN Notary Publit NOTARY PUBLIC-STATE OF ILLINOIS Signature of Applicant MY COMMISSION EXPIRES JUN 20,2020 1.. za ,�,' I - v Y 00 w to U.) b N C DC .p 41) y .,T Cr r i t r',L i3VV^11 r jr.. 'i o , CG iF:i.'+ J 1rc `U�i }` l,`.:. ° C':. i�,.PLY WITH ALL CODES 0,= N: ,,Y YCRK STATE & TOWV CODES AS Fig 1UIRED A u i I i F N _ j__.._..iY� 411 O b S01 „,w ml r tr„,,, OARD �= s F I S Luvv, i , TEES F� v 6 ,CATION o r 242e:1U E_ TENT BEFORE C Its,^.TE OF OCCUPANCY _DER USCD liv �.. .TF._R cn D qn LU PLUMBING 24 l-laL�l�11 - Imo'FL F.LL PLUMBING WAST` 271 I ' TES T"vG H70' E COVEIII G . . �rr _ r► Z u � lily Till 2 3 L 2 N co TO,b p p201/r 14 F,6Lrl4 OF � � .. Z ? Y CO4Ey- loll - w � 3- D Z ID) Z 4 SSR - �',