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HomeMy WebLinkAbout11841-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate O[ Occupancy No. z-15875 Date June 24, 1987 THIS CERTIFIES that the building DECK ADDITION Location of Property 1030 Horseshoe Drive Cutchogue, New York House No. Street Hamlet County Tax Map No. 1000 Section 95 . .Block 4 .Lot 18. 17 Subdivision..M./.o..O.r.e.$o.n..yi.e.w..E.s.[s.: ........ Filed Map No. 6241 .Lot No. I7 conforms substantially to the Application for Building Permit heretofore filed in this office dated Hay 17, 1982 pursuant to which Building Permit No. 11841Z dated August: 5, 1982 ............................ 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 ......... DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR JAMES P. & BARBARA W. ANDERSON The certificate is issued to ..................... [old, n.e,r,.le,TsfCroS:~g,~.~X~ .................. of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N / A N/A PLUMBERS CERTIFICATION DATED: Rev, 1/81 Permissior~ is hereby granted TOWN BUILDING BUILDING PERN[iTt~ (THIS PERMIT MUST BE KEPT ON i~H,E PR[~IS COMPLETION OF THE WORK AUTH,~RIZED) I' ~ UNTIL ~ULL ty, :' T~X Map No. lO00?Section p;ur~uant BullJ~ing / F~O $ ........... , ........... :0 application:' dated ~spector. }~pproved by the FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY HAY 6 I 'i' BLDG. Ok:PT. TOWN OF SOUYH©LD Instructions A. This application must be filled in typewriter OR ink, and submitted I~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of properW with accurate location of all buildings, property lines, streets, and ~musual natural or topographic features. 2.Final approval of Heatth Dept. of water supply and sewerage disposel--(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-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic featu res. 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: Additions ~ ~¢~ - 1. Ca~ificataofoccupanc¥ New Dwelling $25.00, Accessory ,$I0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancv $ 5.00, over 5 years $}0.00 4.Vacant Land C.O. $ 20.00 ~/]4~[t/ .... .Updated o.o. 5o.oo Date NewC'°nstruction ... Old or Pre-existing Building ............ Vacant Land ...... Location of Property.. .... ~, .)~,,~,~,, ~:~.~,, ,~, .......... .... House No. Street Ham/et Owner or Owners of Propertv ./.~. f:..(.....~ ............. .~'.~. ............................ 'County Tax Map No. 1000 Section .............. Block .............. Lot .... · Subdivision ~¢~) ~'~ ~.~Ff~7~S .Filed Map No. ~/ .LotNo.. Permit No.J ~ .~..q.~l .~... Date of Permit .......... Applicant ................................ .. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ..._/, ................ Request for Temporary Certificate ..................... Final Certificate ..................... V/ Fee Submitted $ ......... ,~,~,~?f ,0,, .~, ........... Construction on above described building and permit meets all a, ppl~able codes and regulations. 15t7 COMMENTS FOUNDATI©N (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE ADDITIONAL COMMENTS: FOIr, M ~rO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIClE SOUTNOLD, N. Y. Exemined ..................... ..................................... ,9 ........ Permit No...77..~F. VS:..~2...:..~,~ Disapproved a/c ................. ~ ......................................... Application No. / / ~/~// // ?~/~_~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or. 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. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stree[s o~ areas, and giving a detailed description of layout ofproperty must be drawn 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 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 hove 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, air 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 i~ buildings for necessary inspections. ~.. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . ................................... Name of owner of premises ..~.~..~.~'....B.....~I~......~.,/~"~........~..:....~....~.~'~,~.i~.. ......................................................... If applicant is a corporal, signature of duly authorized officer. ................................ l.4. ............................................. (Name and title of corporate officer) Builder's License No .................... ~.l-z]. ........................ Plumber's License No ............... ..,~..l.~ .......................... Electrician's License No ........... ~'h .......................... _ Other Trade's License No .............. Z~.h ........................ ~/,/'/~ S u b cl ±v J-s ±o~ 1. Location of land on which proposed work will be don,e. Map No.: ..... ~...~:~.~...~..I ................. Lot No.../.7 ................ Street and Number .L~.....~.......l~p.~.l~-~.......~.~.i.~/~.. .................. ~.(,.~...~.b~.~l~.. .............................................. ' . Munlcipality 2. State existing use and occupancy of premises and iDtended use ahd occupancy of proposed construction: a Ex s t ng use and occupancy .si l . ,.. . ............ b. Intended use and occupancy ~'~ .~...).~.~, Count,¥ Tax Hap No. DZst,. 1000 Sect,:Lon q5?' B:Lock ~ ~o~ 1¢,/7 3, Nature of work (check whidh, applicable): New Building,· ................. ~.~...~..~,...... Alteration ................. Repair .................. Rernoval CL Demolition .................... Other Work $..~.'~.I. IL .~ J/~I.P~....I.6....~,/~, ~, : ~ ( ~ ~ ~ (Descrip~/on) · ............. .L.o.....~.~.'..q ..................................... 4. Estimated Cost .......................................................... e ................. ~ (to be paid o~ filing this applicati~) 5. If dwelling, number of dwe!ling 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 ...... ~./.,,X/ .............. 7. Dimensions of existing structures, if any: Front ..,...~..~.,'.~.....~.t ....... Rear .....c'J. Jg.:..~....~..'~.: ........ Depth ...~...~..:~... ,~.. · ' Height ...... ..~..~.....~.:... Number of Stories ..... .1.y~ ............................................... ~ ................................................. Dimensions of same structure with alterations or additions: Front ........ ..~..,~..:.~....~.~.: ...... Rear ...../~...~.t.~.....~.."g. .... Depth ......... ,~,.0...~.~.:. [Height .....~.,.~...~..~.: ........... Numbe~ of Stories ........[.!k~.'~._. .............. 8, Dimensions of Lentire.new construction: Front ............ L~...,~.~...~JF4I¢.. Rear . !.~...~ .~.eR.k. Depth ..,[.~/' Hei hr. ~..,~.~e¢l(Numb;rofStorie,~e~..~.~.ct+;If.4,¥.t~[~ ~ ' x: z'~ ~'~Jec~:~'t~k g .......... :... s .C, ....................... !~ ......... L~..~...,....I .............. ,. ......... ,.., ....... ~_.. Size of lot' Froht [~,~'~.OO .~..¢..~..~.. Rear c~D~'~0"~c¢4~ no,,,l~ 10, Date of Purchase .~.~4. Lk/.:~.9. [~.'l.? Name of Former Owner ...... -.b/.¢~..: .................................. 11. Zohe or use d.str.ct in whici~ premises are situated ........ J~,C~.k(~J.~[. .......................................................... 12. Do~s proposed construction yiolate any zoning law~ ordinance or regulation: .......... /~.1~. ....................................... 13. Will lot be regraded . ....... ..~..,O. .............. Will excess f, ill be removed from premises: (.~' Yes ( ) No ha f ne ' :::]'/~ P- ~ J~ee'~'~ ~ ,' . ..................... 14. 4 meo Ow rot prem.ses...,,....~.~. ....... [ ................................ Address ....C~..~.~,..~.S~.~.'~.' Phone No. Name of Architect /J.~/.~.. .. Address ....... ~ ........ Phone No ...... Name of Contractor i .Q(~ .~.~P' Address ~-' Phone No. i PLOT DIAGRAM Locale clearly and distinctly ~11 buildings, whether existing or proposed, and indicate oil set-b~ck dimensmns from property lines, Give street and b'lock number or description ~according to deed, and show street names and indicate whether interior or corner lot, , r · ,,~^ -- /~--,- STATE OF NE%Q-'"'~RK, . /,~' COUNTY ~.,'.,.r f °'°~ ................ ..~/~.~.'~.~,.~..~..t...*..~...0J...,~...~.. .... be ng duly Sworn, deposes and says that he is the applicanl (Name of individual signing contract) above named. He is the ....................................... i ......................................................................................................................................... I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dOly authorized to perform or have performed the said work and to make and file this application; that oll statements contained in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth in the application filed therewith. Sworn to ~cfore me this ........ ./.~.. ......... day of ..... ..~,.....-~ ....................... , 19...~..~.. ~ /~ (Signature of applicant)