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Home My WebLink About16309-zFORM NO. 4 TOWN OF BOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-25935 Date: 09/02/98 THIS CERTIFIES that the building ADDITION Location of Property: 185 HOLDEN AVENUE CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 110 Block 2 Lot 12 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 27, 1987 pursuant to which Building Permit No. 16309-Z dated AUGUST 3, 1987 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. The certificate is issued to KEVIN M. & CORINNE A. MACDONALD (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Building Inspector Rev. 1/81 FOU~ NO. B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. Permission is hereby granted to: ...~..~ ~-..~. 0~. ........... , ,o ..~~....~....~.~......~..~........~......~...~ .......... at premises Iocated~at .../....~....t~......~....~.:......~~..~ ................................. County Tax Map No. 1000 Section ....... I.[.,~,, ........ Block ....... ,,~,,.,,'~,. ...... Lot No .....[..J. ................ pursuant to application dated ....... ...~r.&~,......,~..,.~ ................... , 19,.~,..'],, and approved by the Building Inspector. Fee $..~....:..~.... Building Inspector Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the buildin~ inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(s-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildiD and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. / For existing buildings (prior to April 9, 1957) non-conforming uses, or ~uildings an qpre-existing" land uses: ~ 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildinz - $i00.00 3. Copy of Certificate of Occupancy - ~ .25~. 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date ...... ~./. ~.~. .................... New Construction ........... Old Or Pre-existing Building...~-../....... i Location of Property.. ~..~.. ..... ~.~..4~... ~.'~. ............. .~..Of~..~.~j.t~.~_~ ...... House No. Street Hamlet Onwer or Owners of Property.../~..~.~-~-..~..~..~.~.,'/~'~' .... ..~..~6~....~...A~.~.~ .......... County Tex i000, Section.../20 ....... ........ Lot...Af ..... ........ Subdivision .................................... Filed Map ............ Lot ........... ~ ....... Permit No...t..~.~.?.~.-.~...Date Of Permit ................ Applicant ................... i~ ....... Health Dept. Approval ......................... · Underwriters Approval ........................ Planning Board Approval ....... Request for: Temporary Certificate ........... Final Certicate .......... f_co, · · · ......... · Fee Submitted: $... UNDATION ( 1 st ) UNDATION (2nd) UGH FRAME & FLUMBING SULATION FER N. Y. STATE ENERGY CODE FINAL ADDITIONA'L COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING ROUGH PLBG. I N/s~L~TI ON ~FINAL [ ] FIREPLACE & CHIMNEY DAT~//~Y INSP AUG 3 - 98f , ~FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined...~..1~.?~..~.., 19 .~.? Approved . .C~'x /~.~/..~..., 19~. ?. Permit No..~..~..~.O. ?. 5 Disapproved a/c .............................. ................................ .... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. NOTIFY CALL ................ MAIL TO: 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, buildi, a~ code, housing code, an¢~egulalions, and to admit authorized inspectors on. premises and in building for necessary insp, gdIilSns. . -/ ,/ /l/ (Signature 9f applicant, ornal3~, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .............. ~. ................................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co,orate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY Builder's License No .......................... LICENSED Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done2 ................................................. .... ............ · ........... ...................: ............. House Number Street Hamlet //. ,, Jt County Tax Map No. 1000 Section ..... O Block ~ ~-- Lot. 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.. ~.~~, ~t C'""x,. '~'-~"<~~*, ' {.~]~ .......... ,;,4, .... ,''_, ''" b. Intended use and occupancy, ii}'AML.. ~.~.[~...%~...~....c~A~.. 7..J~ J.. ~~ ....... 3. Nature of work (check which applicable): New Building ..... ' ..... Addition ......... Alteratig.n ......... Repair .............. Ren~oval .............. Demolition .............. Other Work . .~../..d... ¢2g-' i ~ '~ ' (Description) 4. Estimated Cost..~,~ ........ i .......................... 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 *-. $. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ....... . ................................................. 9 Size of lot: Front Rear ' ' · Depth 10. Date.of Purchase .......... i ................... Name of Former Owner ............................. 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction vi61ate any zoning law, ordinance or regulation: 13. Will lot be regraded ........ .................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ..................... Address ................ Phone No. Name of Architect ......... ~ .................. Address ................... Phone No ................ Name of Contractor . I . Address .... ; .............. Phone No ........ 15. Is this property located' within 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town TrUstees Permit maybe required. PLO"I' 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. STATE OF NEW YORK, S.S COUNTY OF ................. ~ ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual sigmng contract) above named. He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du y authorized to perform or have performed the said work and to make and file this application; that all statements cont ~ined in this application are true to the best of his knowledge and belief; and that the work will be performed~in the manta r set forth in the application filed therewith. Sworn to before me this ........................ day oX ...... .......... , Notary Public, ....... , ......... County , ~E'LEN It. DE VOE, ~ PUSI.IC, State of New York (Signature of applicant) _ _4707878, SuffolkCountyF-~? , - ferm I:xpires MBrch 30, SURVEyEL, CERTIFIED '0, KEVIN M. / CO~RtAItF ~, , oCDONALQ rile O/~4E ~AV/NGS ~ANIC OF IV.Y. /c_qB L,AWYERC3 TiTL6 INSURANC£ CORP. MiDWOOD /.=z~O ' ~ GE~ q-O lO W .~EpUTZF-.D N/FLY MA 50~J FREDERICK R, POKORNY S, URVEy Og TAX LO? I~ BY 7D~N ~ ~OU~OL~ ~UFKO~ CO? N. ~ LAND SURVEYOR HUNTINGTON NEW YORK