The URL can be used to link to this page

Home My WebLink About12864-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No. Z12.293 Date February 23 1984 THIS CERTIFIES that the building .... deck - Location of Property 510 Holden A. ve. & 280 Dick's Pt. Rd. Cutchogue ~/~s~ HO'. .................................................. Streot Ill~r~/e~ County Tax Map No. 1000 Section . 110 .Block 05 ..... Lot 021 Subdivision ......... .X ..................... Filed Map No...X ...... Lot No..X. ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated February 7 198..4. pursuant to which Building Permit No. .12.8.64 Z · dated .... F..e.b.r.u.a..ry..9. ............ 198. .4., 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 ......... a deck addition to existinq dwelling: The certificate is issued to ....... ?.H.~L~ .i.P..H. :..a..L.A..U.R~...J. :..O.B.E.N..A.U.E.I.~ ................. {owner, te~e-o~'l~lant] of the aforesaid building. Suffolk County Department of Health Approval ..... ~./..R ................................ UNDERWRITERS CERTIFICATE NO ............. N./..R ................................ ' ' 'B~ilding i'hspector ' ' Rev. 1/81 FOI~dC NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF ,THE WORK AUTHORIZED) ~? 1256~ Z Permission is hereby granted~te~ · ..... ~.~.,~.~......~Z....Q~.~:~.,~ ..... £~...../.~... ........ ~z.. ...................... ........ .~~.~...~.~ ....... z../.~.~~ ,o ........... .G~.~./.~.~...~.~.....' ~..~.~ ~.~'~.---Z~c..... ~,~....~.~.... ..~...~'Z~.~.~ .......... .~.: ................ ~ ..................... ~ ................ .,. .................................. ~.....~ ....... ~ n tpre m ises Ioc a te/at ... ~ K~,...L~..Z~?~..,~..~. ~..~........~......'.~. ~C:?......~.../.~...~i....~ ' County Tax Mop No. I000 Section ..... Z'.i'./..~.. ....... Block ..... .~........~,,. .... Lot No..~..~... ......... Building Inspector. Fee $...~..~.. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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- lions, 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-ex'st'ng land uses: 1. Accurate survey of peoperty 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: Certificate of occupancy $5.00 1. Certificate of occupancy on pre-existing dwelling 2. 3. Copy of certificate of occupancy $1.00 land use --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date ~ - 7 - ~ ~ New Building ..... ~ ..... Old or Pre-existing Building ............ Vacant Land ............. (_.7. or: D,c s 4 fl.. Y .... ":.. Location of Property . .°.lJ.e.e · '(':' ;~ ~' ~'~'~' House No. Street Hamlet Owner or Owners of Property ............................................................ County Tax Map No. lO00 Section ./{~) Block ~J Lot Subdivision ......... ~. ....................... Filed Map No .... ~. ...... Lot No. Permit No. (~G~ Date of Permit ~ .Applicant ' ~' C~ Health Dept. ApprovaJ ........................ Labor Dept. Approval ........................ .~..~. "'~ Planni g Boa d App oval Underwriters Approval ........... ' ......... n r r ...................... Request for Temporary Certificate ..................... Final Certificate .... · .LYL/. · · .............. Fee Submitted $ ...... i .................... Con stru ctio n on above described building an~eetsf~plicable codes and regu ,atio ns. F!ELC~ IN~TECT~iON DATE COMMENTS FOUNDATION ~ (1st) FOUNBATION ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY Q,ODE ,.-~,..,z ., FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Exalnined . .~.~4.~e7.7 ....... , 19~. Approved .~.~../--2.''. ~' ........ ,19 .?./Z>Permit No.../.~...?. ~'/~.. '~ Disapproved a/c ...... ............... <7 ...... (Building Inspector) APPLICATION FOR BUll. DING PERMIT Received. A/~. .... 19d~ Date . .-R?i;'P..7. ~. .......... 19 :q4 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 co,~ered 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 S0'uthold, 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 neces~q4'y inspectj~ns. :..,/ /.,.-~/ (Signature of applicant, or name, if a corporation) · :. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 0'~"~]~ ~7' ........................................................ Name of owner of premises . .0.}~.c'75.'P:7~. · .1°.3~.5r$~[~p ~ a.~).d ;:.rF . ................... (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. · .-~.....~.~..t~.L~7... [ .~7.'. ..... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. House Number Street Hamlet County Tax Map No. 1000 Section ..... ¢~:Q ......... Block .... ~ ............. Lot .... 85. ............ 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 . ...O?.c:. b. Intended use and occupancy 3. Nature of work (check which applicable): New Building .......... Addition . .'[.)~9.k. ... Alteration .......... Repair .............. Rerqoval .............. Demolition .............. Other Work ............... ~'J'j,~:~_d '-- ~t ~ . (Description) ...... Ms' e i s. La'boy cyme' 4. ~sumarea cost. ': ......... ~ ....... ; ..... : ............ Pee ... ~ ................................. (to be paid on filing this application) 5. If dwelling, number of dwelhng umts . 3. · 5g ......... Number of dwelling units on each floor, gJ[~. 9~ .99K... If garage, number of cars ... ~. ~P.~r. [Sq,~'[~i.q. V~Xqt.?. )SqY?R .............................. 6. If business, commercml or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing stmctu~es, ifany:Front. 50 [ Rear 50 ~ . Depth . ?,vc'~. Hdght ~:mk ............ NuCber of Stories..939. .................................................. D~ehsions of same structure With alterations or additions: Front ... ¢DyilO ......... Rear . . ~¢b)~iO ........... ~epm ....... ~ .... ~ .... Num bet of Stories .... q q~ lap.. 8. Dimensions of entire new construction: Front ...~/~.., ..... Rear ............... Depth ............... Height ............... Number of Stories ................................. 9. Siz of ot: F o t..200...S7. ..... ...... ............. mpa . CP. .............. 10. Date of Purchase . .APf'74g~.,..~ 9.[.~ ........... Name of Former Owner .~:fP'P.q$~. ,[~79~..l~gP?.~ ...... 11. Zone~or use district in which premises are situated .... 2~f4'[r}O~k~5~¢~.. ................................... 12. Does proposed construction vi61ate any zoning law, ordinance or regulation: ,.[[O ........................... 13. Will 10t be regraded .~/A...~ .................... Will excess fill be removed from premises: N/A Yes No 14. N~e of Owner of remises ~hilSp Obey~az~or Clt'tchogue Phone Mo 7U4-606~ P . , ..... - ............ Address ........................ ~ ............. Nme of Architect . .. Y[~A ................... Address ................... Phone No ................ Nme of Contractor ... ~.' .................. Address ................... Phone No ................ 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 number or description according to deed, and show street names and indicate whether interior or corner lot. See al,t~ohed Uo~st;ruc-~io~ is of 0GA 't.,:'c:~:tod lumber, supp¢~'[;if~g;pof'~'l;s sre 4X6's v~]~ich are s~nk~ i~ tho ~f~roct~d 36" a~.d frilled wi2h concrete~ There a,z'e ton of these pos-ts spaced approximately 5~ framin(~ ~uderuoa~;h is o~ 2X5 oons'~ruc'~ion~ Tho surface o:? 'the deck is of 5/4 X6 c~ms-tr~c2ion. 'Oho railinE ia~ 28" hi,Th. The dock is appz'o:~J,raately 36" high a~ the eas~ end~ furSb, es% :Crora 'the l'~.ous~and a'box,~ ~0" t).i~uh: n,2 the ~.~osg end, ff~nr-tbesg Fmom ~he ho~xso. All bol~s joi~sin~; 2X6's ~o 4X6's are -~inch Eslvav, izod. ~ho deck is j"ined ~o thoh. oudo -~,,~i~h flashi'~g bohi~d a 2X~ ¥,rich i~ fosSened 'to -the house Wi'th. 5 "ga].vahized lag bo~ts. &IiL n~il~ u.~md az'o galL-~rna.i, zod. STATE OF NEW YORK ~'ct F:,c'o/_./c_ S S COUNTY OF ................ ' ., J: :: 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.) ef zai4, owner or owners, and is d~ly 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 flied therewith. Sworn to before ~ne this . ; 7 da f e~/~F ar' ..................... , Y9 "'~ ..... ~'"~ ....... 19... NOTARY PUBLIC, State of New Yo~ ~ -/'~ ~,<~[{' ~/ Qualified in Suffolk County tSlgnature of apphcant) Commission Expires March 30, OWNER: 7 · co: 'ZALT. ' · The ~e,,~age a~spoSa~ aha ~ter ~upply faoilltles for this loc~tion have ~een tnspected by this department ~d fouled ~at ' to · ~