The URL can be used to link to this page

Home My WebLink About7070-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-22546 Date AUGUST 23~ 1993 THIS CERTIFIES that the building ACCESSORY Location of Property 3080 STILLWATER AVENUE House No. Street County Tax Map No. 1000 Section 136 Block 2 Subdivision Filed Map No. CUTCHOGUE~ N.Y. Hamlet Lot 14 Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 29r 1974 pursuant to which Building Permit No. 7070-Z dated FEBRUARY 5r 1974 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 STORAGE BUILDING The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ESTATE OF WILLIAM M. SMITH //~/Building Inspector Rev. 1/81 TOWN OF ~O~THOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~OUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7070 Z Date ........................... ~.eJa ....... .~ ............ 19.~.. Permission is hereby granted to: ~/:l. llJ,aa..i~JaLt~ .................................................... ........ ~.f~ll~&~..A~. ..................................... ............... .~A~cJao~me .......................................... to ....but id,.. ~,e¥..p~ ~,.v.a.te.. ,o~e ~so~y... ( s $~e~,e~ge ~.. ~eu.l-t&~ n~ ......................................... at premises located at ~,o.t,~.,~:~.~.8.....FL,8~l~al:~..~uJa ................................................................. ............................. ,~,~ll~&t e~...~e ............... Cu.t. eimag~a.....~.,.~'.,. .............................................. pursuant to opplicotion dated ..........................~.....~.~. ............. , 19'j.bx ..... and approved by the Building Inspector. FORM NO, 6 TOWN OF SOUTHOLD · Building D~partment Town Hall Southold, N.Y. 11971 765- 1802 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. 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 [he 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)o Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pzoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or prevlous 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 $25;00 -- ~,US[RES$ $50.00 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 5. Updated C.O. $"$0.00 Date .,J.u~Y.~.3~ ............ X Shed NewCons truction Old or Pre-existing Building Vacant Land Location of Property ...3.q8.q .S. tJ.l.l.w.a.t.e.r..A:v.e...,..C.u.t.c.h.op.u.e.,..N.Y .............................. Hou~ No. Srr~ut Ham/or Owner or Owners of Property . .E.s.t.a.t.e. ,o,f,.,W,~,],l,¥,m, .M....S.rn.i.t.h ................... '.*: ............ County Tax Map No. 1000 Section ...1.3.6...0.0 ....... Block . .0.2~ .0.0 ......... Lot .Q[4. ,QQQ ........ Subdivision ................................. Filed Map No. Permit No ........... Date of Permit .......... Applicant .................................. / Health Dept. Approval ........................ Labor Dept. Approval ........................ Request for Temporary Certificate ..................... Fin,~'~ertiflcate .~.. . 25.00 Fee Submitted $ ......... ' .......... ............ Construction on above described braid,n§ and permit m 3ppli le codes end re;~uladons. Gary'Fla~nef O~s~n'. Esq. n,v.~o.~o.~a P.O. Box 706 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLEKK'S OFFICE SOUTH~LD, N. Y. ........................................ ...... ................................ APPLICATION FOR BI~LDING PERMIT ///~:: Application No ................................. Date ................................................ , 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter oe in ink and submitted in triplicate to the.Building Inspector, with 3 sets of,plc~qs, accurate plat 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 areas, and giving a detailed description of layout ofprOperty must be drown on the diagram which is part of this application. 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 perm t shall be kept on the premises available for inspection throughout the work. ~J 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. ^PPLICATION IS HEREBY MADE to the Building Department for the issuaAce of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New ~.~/and other oppl cab · Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations,.~ar"for removal or demolition, as herein descr bed The applicant agrees to comply with all applicable laws, ordinance~s/'~uilding code, housing code, and regulations, and to admit authorized inspectors on premises and Jr) buildings for .neeessa.~y inspections. .~ (Sigr)al~r~e of applicant, or name, if a~e~rporation) (Address of applicant) '~ ...... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name o{ owner of premises ........................................................................................ 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 ............................................... 1. Location of land on which_oroposed-work will be done. Mop.,~lo.: ............ ,~ ......................... Lot No...~....~...~...~. Street and Number ...... ........ ~..~...~...~ ........ ~ ........... L_) Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. ExisJting use and occupancy .......... ~.~ ............................................. b. Intended use and occupancy .............................................................................................................................. '3. *Nature of work (check which applicable): New Building. ..................... Alteration ............. '...~,'* Repair .................. Removal .................. Demolition .................... Other Work ................................................ . ..... ..'T...../...v.A."~ "~*/'~..~. [0 ~ (Description) 4. Estimated Cost Fee ............. (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ...... ~ ............... If garage, number of cars ............................................................................................................................................. 6. if business, commercial or mixed occupancy, specify nature 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. D mens ons of ent re new construct on: Front .............. ~..r. .............. Rear ......... ..~...~. ............ Depth ...... ..~.... .. Height .................... Number of Stories ....................................................... Size of lot' Front /'~J~ ./..~. R~nr /~'/'/(~' Date of Purchase ........................................................ Name of Former Owner ........................................................ Zone or use district in which premises are situated ..................................................................................................... Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ Will lot be regrade~ ........ ~ .......... Will excess fill be removed from premises: ( ) Yes ( ) No Nam~ of Owner of premises .................................................... Address ................................ Phone No. ...................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, Whether existing or proposed, and indicate all set-bock dimensions from to deecl~ a0d show street names and indicate 10. 11. 12. 13. 14. property lines. Give street and block numbe~' 0r d_escriptior~ac_~;ording whether i~terlor or comer lot. STATE OF OF (Name of individual signing contract0 above named. eing duly SWorn, deposes and says tl~2t he is the applican! 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 ~gtements contained in this application are true to the best of his knowledge and belief; and that th~work will be per, f~r/ned in the manner set forth in the application,filed therewith. Swonl"~ be~re me this/ /_ ry P p' , ....... ty ............................. ..................... ..... ' // ' ~ '~ - ~f - ,~ ' (Signature of applicant)