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Home My WebLink About16621-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z. 1. 6. .4.1.8. ......... Date .. N.o.v.e r~b.e.~:. J .8.,.. ! .9 .8.7 .......... THIS CERTIFIES that the building A d d i t i o n 700 Skunk Lane Cutchogue Location of Property $k;~s~ h/o] ............... Street Hamlet County Tax Map No. 1000 Section 97 .Block 03 .Lot 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... I~ 9Y....9., . .1.9.8. 7. .... pursuant to which Building Permit No. 1662IZ dated ...N. qv.:..1.2. ,...I .9.8.7. .......... was issued, vmd 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. ~]~e certificate is issued to RICHARD A. SHENK & PAUL D. FREDA ..................... × ................... of the aforesaid building. Suffolk County Department of Health Approval ....... N../.A ................................ UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED: lq/A Rev. 1/81 FO~w NO. O TOWN OF $ODT~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, hi. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 16621 Z Permission is hereby granted to: ..... .,.~....,-..**x. ...... .~ ................................................... . at prem,se~'ocated at...n.~.....~.~ ....... ~..~ ....... ~~ .......................... County Tax Mop No. 1000 Section .... ..~..~l...-J .......... Block ....... .~...~ ....... Lot No...J..O ................. pursuant to application doted ...... ~L~..~...../....O. ......... , 19..~...~., and approved 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 OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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- 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 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: Additions $25,00 POOLS $25.00 1. Certificate of occupancy New Dwc].]Jng $25.00, Accessory ,$]0.00 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.Vaoan . andC.O. 0.00 { 5.Updated C.O. $ 50.00 Date ..f.(.. (,P ............ NewC°nstructi°n ...... Old or Pre-existing Building ~ Vacant Land Location of Property .~..~..0, .... County Tax Map No. lO00Section ....~.?. ........ Block Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept Approval ' Labor Dept Approval Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ~..~'.~,.e..o ................ FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [] [ ] FRAMING REMARKS: FOUNDATION 2ND [ ] INSULATION [ ~I~L ? INSPECTOR _~~~ ~ t~.) 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined · .~. · .°~X~L~. · · .~. · J..a'., 19 ,'8..'7 Approved .A)..~-*~... J.~.., 19'~.7. Permit No..L .~..~.0./. ..~ Disapproved a/c ................................ ii~. (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. NOTIFY CALL ................ MAIL TO: INSTRUCTIONS a. Tkis 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 ap,.plicant agrees to comply with all applicable laws, ordinances,,,,~ding code, hous_'mg code, and regulations, and to admit auth°rized inspect°rs °n pren~ises and in building f°r necessal¥ ~i~ ~ (Mailing address of applicant)~ ( ~ ~, $> State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED 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~ ~-J,.,~tc. t'kO -~ ' . ........... .. 7.9.9? ........ c,4 .,. House Num bet Street Hamlet County Tax Map No. 1000 Section .... ~./7 .......... Block ..... .~..~. ........ Lot ..... ./.~.. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premise~and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ f/~2./.d/ff-~'~....~ . .~'~/~' .~'~.-/~...~/,~.~/,,&?~t).~. ....... b. Intended use and occupancy ..... .~.~..7'.~/...~..,42..~7.....~.,.~?.~?/....~..d~. ~.4 .L./...~.. ~ ............. 3. Nature of work (check which applicable): New Building .... ' Addition .......... Alteration ....... [.. Repair .............. Removal .............. Demolition -i ....Other Work ............... ~,,3~)~ (Descrip~tion) 4. Estimated Cost ..... O. ~ e o Fee ....... (to b~ paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling ufiits on each floor ................ If garage, number of cars .......................................... ~ ............................. 6. If business, commercial or mixed occupancy, specify nature and extent of each t~pe of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ..... i ........ Depth ............... Height ............... Number of Stories .......................... ~ ............................. Dimensions of same structure with alterations or additions: Front .......... i ...... Rear .................. Depth ...................... Height ...................... Num. b~er of Stories ...................... '--8. Dimensions of entire new construction: Front .. ~... ' ..... Rear . ./. {[~.. [ ........ Depth . t..'t-~-. .......... Height Number of Stories 9. Sizeoflot: Front ...................... Rear ..................... i Depth ...................... 10 Date of Purchase Name of Former Owner 1 11. Zone or use district in which premises are situated ....................... i ............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ..[ ........... - .................. 13. Will lot be regraded ............................ Will excess tilt be remoyed from premises: Yes No 14. Name of Owner of premises .................... Address ................... Phone No ................ Nmne of Architect ........................... Address .................. Phone No ................ Name of Contractor .......................... Address .... : .............. Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? *%es ..... No ..... *If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. red,cate 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 signing contract) '~ above named. , ! He is the .......................... :' ~ .~. (Contractor, agent, corporate officer ~c~.g of smd owner or owners and ~s duly authorized to perform or have performed the~sax.m,y0~l{-~d ~&nl'ake and file this apphcatmn that all statements contamed m th~s apphcatmn are true to the best oi'.his kn0~l~dg~ Irll~t behef and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ' ~ ~t~!tOIr (Signature of applicant) . .3t~17878, Suffolk Ceunty~.~} lenn Ex,res March 30.1~