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Home My WebLink About16237-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z16175 Date ..... Sept. 16, 1987 THIS CERTIFIES that the building .... A. d..d .i.t.i.o..n ................................... Location of Pro-ert' 2055 West Creek Ave. & 1225 Midwood Road, Cutchogue v Y h3ds~hid ....................... 's't/o;i ....................... County Tax Map No. 1000 Section .. ! ! .0 ....... Block 02 .Lot 09 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated July 10, 1987 pursuant to which Building Permit No. 16237 Z dated......J u 1 y ..... 19 ,'. .... 198.......7 ..... 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 addit'ion to an existing one family dwelling. Tile certificate is issued to BARBARA CHRI STENSEN ..................... ?oh;.'o; ;k~'a' g.~ ...................... of the aforesaid building. Suffolk County Department of Health Approval N/A N/A UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 ZeO~ NO. S 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) Permission is hereby granted to: ............. at premises located at ~..o..~.~....~....~..?....~M~....~....~...J...~...~...~......~. ~...~..~..a....~.f~A'"~-~-fJ ' - ...... ~. ........... Lot No ......................... Counw Tox Mop No. I000 Section ...... ~.~..~ ......... Bilk ~ O ~ pu~uont to application dat~ ...... ~.~.....'.~. .................... , 19.~..]., and approv~ by the Building Inspector. Fee $.~... ................ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 ~ APPLICATION FOR CERTIFICATE OF OCCUP~ O DEPT. TOWN oF soumpm Instructions This application must be filled in typewriter OR Ink, and submitted -, laaa=,a~a to the Building Impec- 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 sev~erage 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- tions0 a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan re(luirements where eppl{cable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pm3perty showing all propertv lines, streets, buildings and unusual natural or topographic features. 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: 1. Certificate of occupancy New Dwelling.$25.00, Acce.~sory ..$10.00 Business $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 $ 50.00 Date ... ~p.~;~r~.b.e.r. 1.0.~ .1~.?.. 5. Uodated C..O. 6. Alteration' $25.00 New C on s t. r u c t; i on Old or Pre-existing Building Vacant Land Location of Property . 20.~.5 .We.s~. Crg.a~. A.v.a .&. ~22~. Mi4wpp. d. ~p.~cl....~ch.agu~ ..... Owner or Owners of Property , ~ b ~.~. C E~.~ ~ ~ e ~ ~ ........ ; ........................... f County Ta~,Map No. 1000 Section ............................................ ' ' ' Filed Map No Lot No Subd~wsmn .......................................................... ~3.%~.. Date of Permit...~Z~Appticant Permit No. Health Dept. Approval ........................ Labor Dept. Approval......., ............... Unde~riters Approva] ........................ P~anning 8oard Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..... ~ ................. Fee Submitted $..~5,~.0, ..................... AppliCant ~', .~. ~,~..~i~9.n~ ............. UNDATION (1st) UNDATION ( 2nd ) UGH FRAME & FLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: interior or comer lot. ~1~, 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 _? A roved n ~ ~. ., . . . Permit No. Disapproved a/c .............. : ........ ;. -- · · · · --f~) ......... , ....................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Bl. Do, ,- ' . LD WN OF $OUTHO Received ........... ,19... Dat? ....J.u.~.¥. 3.Q,. ..... , 19 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 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 inspections. ...E.av. ir o.o~o n.~, Zias J~.,..Iac .................... (Signature of applicant, or name, if a corporation) d' 3075 In lan Neck Lane · Pe.c.o ~f¢.,..NY. 11958 ......................... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . .B. arb~r.a...0kr, iske.rlso r~ ................................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Pre sident (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. O.ovnor..of. 2~35~. We-st. C.~eok..AYe. &. ........... 1225 Midwood Road .C.u..~9.h. qg.u.e' House Number Street Hamlet ~ - County Tax Map No. 1000 Section . .$.1.0 ............. Block ....2 .............. Lot ...... .7 ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... S.i..ng.l.e...f.a?.i.~.¥..dy.e. ~..Z.i. qg ....................................... b. Intended use and occupancy Single family dwelliag~ with.deck a.ddi~ion 3. Nature of work (check which a~plicable): New Building ..... ~ .....'Addition . .X ....... Alteration .......... Repair ... t.,: .'.U. [ .,J~ Removal ........... Demolition ........... Other Work .............. :~ (Description 4. EstimatedCost...,~..~0.0.0o0.0 .................... Fee ................................... ~ ~' (to be paid on filing this application) 5.If dwelling, number of dwellinglunits ...... 2. ........ Number of dwelling units on each floor ............... If garage, number of cars .... i ................................................................... If business commercial or mixed occupancy specify nature and extent of each type of use ..................... .... ' · , " ' 6" ' ~ OY Dzmens~ons of ex~stmg structures, ~f any: Front .. 3 2..~. . Rear ~ ~ .... Depth ..~ ........ Height ...2[[! ......... Number of Stories ...... 2, ....................................... Dimensions of same structure with alterations or additions: Front . .[Y(~...'!...~t (~I'... Rear i... i i~.! 5!'i ...... Depth .................. i.. Height ..................... Number of~tories .......... Dimensions of entire new constrUction: Front . .~11-! .......... Rear ... ~.~.(~[~ ...... Depth . .2.~.~. .6~.~ ........ l-leight .... NO .... Number of Stones ........... .R.Q ............................. ............... 9. Sizeoflot: Front .......... ~ ........... Rear ...................... Depth ...................... 10. Date of Purchase .......... ~ .................. Name of Former Owner ............................. 11. Zone or use district in which pr~mises are situated.. Ro.~J.~t.e.rlti:l,.¢.~ ...................................... 12. Does proposed construction vie,late any zoning law, ordinance or regulation: .l~.0. ............................. 13. Will lot be regraded . ~.Q .... ,l .................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ~"i' .q~,.5.s.g.e..n.s.e.r). Addressl00 Devoe . . .PhoneNo.922[.23g. Name of Architect ......... ~ ................ "--~ ~ [~i~'~[ ' ~t{~'~, ' ~ ' ·. ,~uuress .............. ..... Phone No ............... : Nam e of Contractor E nvi r o rims rz ~. E a s ~.,.. I rte..Ad dress 30 7~..I ~Ct £~. fl. Ere .c.k Phone No..7.34,' .7474 .... Peconic, NY PLOT DIAGRAM Locate clearly and distinctly sll buildhlgs, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and blo¢l~ number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ! S.S COUNTY OF ................. ............................ : ..................... being duly sworn, deposes and says that he is the applicant (Name of individual si~ning contract) above named. 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 fiI;'~this- application;that all statements cohtained in this application are true to the loest 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 /0 .. ............... ~ ...... day.Of...),/~. NOTARY POBLIC, State olNew York ' No. 4707878, S~ff~lk Coun~,~ Term Expires Ntarch $0,