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Home My WebLink About12368-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z-16469 December 11, 1987 No .................. Date .................................. Construct Deck Addition THIS CERTIFIES that the building ................................................ 415 Glenwood Road Cutehogue, New York Location of Property ~t&Js~ ~]o~ ........................................................ Street Hamlet 137 05 016 County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision M/o Ravitone Realty ...Filed Map No. 539 .Lot No. I6 conforms substantially to the Application for Building Permit heretofore filed in this office dated May 1 I, 1983 pursuant to which Building Perrnit No. 12368 Z June 6, 1983 dated ............................ 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 ......... CONSTRUCT DECK ADDITION TO EXISTING ONE FAMILY DWELLING EDWIN & JOAN RUETTIGER The certificate is issued to ........................................................... (owner, TeY~z,d~ Year, DX of the aforesaid building. Suffolk County Department of Health Approval N /A UNDERWRITERS CERTIFICATE NO ................ .N./.A. .............................. PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 ~OF,~ NO. 2 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) N? 12368 Z Permission is hereby granted to: ~ ~<~ ...... ~..~..~.,.~...~:.....~~ ....... ~.~.=.~/.. ...... ./..~.~.~..~...~........~....: ~- ..,...~~.~//~...~..,.z/~- ,o ..._~.~...~~...~~..~..~ .................... ...... ~.~.~...~~~ ................................... ~ ........................................ o,~,m'~e,'~t~a ~, ......... //~ ............ ~~~....~~ .............................. .................................................................. ~~ ~.. ~ ~ ......... . ................................. ~/ -- ~,~. / ......... ....... ............ co,,~ T~x ~ ~o. ~ooo ~e~,on ..~Z~ ...... ~ ...~.~ ......... ~o, ,o..~.~ ........... Building Inspector. Fee $..~ .~...~....; ;';~.... Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Finat survey of property with accurate location of all buildings, property lines, streets, and unusuat 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. 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 / , Date ..... P...~./?./~.~. ........ / / New Building ............. Old or Pre-existing Building ............ Vacant Land ............. ................. . Location of Property .~/~ ~ ~ ~o0~,, .~: ~;;e;; .... House No, Ham/et Owner or Owners of Property ~.~.W~.~.~,, E~,~//~.. ~. ~. ~ .~. ~/.~ ~ .......... County Tax Map No. 1000 Section I% 7 Block ~ Lot /4 Health Dept. ~p~roval ........................ kabor ~e~t. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. Rev, 10-10-7e --' TEL. 765-I 802 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR sour.oLD, N.Y. ,,97, ,.~.~.'/~"'" 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 - net on f le. /--// NO Underwriters Certificate on file. /~/ The check ~s(outd~ted/not on file.) ~ ~.~ ' ~)-7--~'~'~-~~~~ '~ /_/ ~o f~nal ~nspect~on has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit ~ ~ 2 ~ ~ ~ Z ~ Building Dept. ***/~/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FIE~D I~SPECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING {2nd) INSULATION PER N. STATE ENERGY 4. FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .Z'&'.~'...~ .... , 19J,~ -~' Disapproved a/c (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No../. J,f..( .~..~.. .... a. Tins 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 inspectio~[~L,,~,~, / (Signature o f apptica~?~o; ~~:a't~Tr~) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises ...~..O. ~ ..~..~...~. ..... ~...~..~..~..]..~7. ff...~. ................................ (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.... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ...q.l .4T ........ ....... .d. q. v .......................... House Number Street '-~Hamlet County Zax Map No. 1000Section [.1.~.,~.. Block ~" Lot /b Subdivision ?:6k~,~--,0 [~ . . .~..T Filed Map No ~'-'3 .~. Lot (~ 2. State existin;'dsl 'a~;' ~;~d~a~'~iXl'o~;i~'~iill i~; ;~ie~;'use and occup~nc;'~; ;;~:s~;'/ ~nstruc;i~: ........... a. Existing use and occupancy 4.U .~..~.~,2~./~ bO/l,//~ ,~Otlt~{/t~..~ l&.~..t~,l~t~l.~..~l).~ ~.eFO~ b. Intended use and occupancy /~/~.. O..cQ'7~'.ID. '~...1~..~..~./~.. ~. [/I/..c,. ~../t~.k/./7.~.~..~.t~...~..~.. t,~ /t Jo/,~ 3. Nature of work (check which applicable): New Building .......... Addition ... Alteration .......... Repair .............. RemOval .............. Demolition .............. Other Work ............... 4'. Estimated Cost ..... ~,...o'..~../.~.O ............... Fee .................................... (to be paid on filing this application) 5. If dwelling, number of dweliing 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. Dimensions of entire new construction:, Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ Size of lot: Front ........... i ........... Rear ...................... Depth ...................... [)ate of Purchase ........... .................. Name of Former Owner ............................. .... whi h p e it Zone Or use &strict~n c r raises are s uated ...... Does proposed construction violate any zoning law, ordinance or regulation: ... ~..O ......................... Will lot be regraded ....... ,. ilJ~O.... ~ ............. Will excess fill be removed from premises: Yes No Name of Owner of premises z~. ~ .0..~.l[F/~./~Address 6.~M~.o.~0../~0..~..t~.~. Phone No. ~.~. ~.'-. ~,. ~.o. ~. Name of Architect ....... 2...t. ............... Address ................... Phone No ................ Name of Contractor ' Address Phone No 10. 11, 12. 13. 14. PLOT DIAGRAM Locate clearly and distinctly all. buildings, whether existing or proposed, and~ indicate'all set-back dimensions from property lines. Give street and block ~umber or description according to deed, and show st.r~et names and indicate whether STATE OF NE~JORK, '/~ ~ ~ COUNTY ~ ...... ~'~ "' ...~n~ ~d. nf'.e.,~... ~. ~:6/g~-c-~>~.'~f_~.. being duly sworn, deposes and says that he is the applicant (Name of individual sig~i~ ~ontract) above named. He is the ................ .Ah~c.c,,~Ak~ ....................................... (J , ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ authorizedV .. --- 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' .....~..c~. ~ .... ,19..~ Notajy/Public, ........ >-s. · . ~ounty c/ N0~q, St.te of Ne,~ No. 52.81258~0, gu[folk gottt~- (Signature of applicant)