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Home My WebLink About15651-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate THIS CERTIFIES that the building Of Occupancy Date January 30, 1987 DECK ADDITION Locat~on of PropertyI 2675 Stillwater Avenue Cutchogue, New York County Tax Map NoI 1000 Sect,on 103 Block 0.8. ...... Lot 7 .............. Subd~wmon . ~ Filed Map No ...... Lot No .......... conforms substantially to the Apphcat~on for Bmld~ng Permtt heretofore filed in this office dated January 29, 2987 pursuant to which Bmldmg Permit No 15651z dated . . J a.nupry. .29.,. 19.8.7 ,was issued, and conforms to all of the requirements of the apphcable provm~ons of the law The occupancy for which this certfficate is msued m ..... DECK ADDITION TO The certificate Is issued to .. of the aforesaid bmldlng EXISTING ONE FAMILY DWELLING JON R. CHITUK Suffolk County Department of Health Approval N / A N/A UNDERWRITERS CERTIFICATE NO.. PLUMBERS CERTIFICATION DATED: N/A Rev 1/81 FOZt, M NO. II 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~ 15651 Z cou.~ Tox Mop No 7000 Sect,on..k:".t~.... ,,o~k ..... .C,.~ ......... ~ ,o.....~ .'7... pursuon, to opplicotion doted ..~~.......,~...cj ......... , ,9.'~.7, °nd opproved by the Budding Inspector. 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. Th~s apphcatIon must be filled ~n typewriter OR ~nk, and submitted I ~ to the Building In~pec~ tot w~th the following, for new buddings or new use 1. Final survey of prbperty w~th accurate location of all buddings, property lines, streets, and unusual natural or topographm 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 Commercia~ buildihgs, ~ndustrial buildings, Multiple Residences and s~mi~ar buddings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the budding. 5. Submit Planning Board approval of comp eted rote plan requirements where apphcable. B. For existing buddings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: I 1. Accurate survey o? p~Operty showing all property lines, streets, buddings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condk~on of buddings. 3. Date of any houm~g code or safety ~nspect~on of buddings or premmes, or other pertinent reforma- tion required to prepare a certlhcate. C. Fees' 1. Certificate of occupancy New Dwellzng $25.Q0, Accessory ,$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwe[hng $ 50.00 3- Copy of certificatelof occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date. Jan 30, ~987 NewConstructzon .., ,X.. Old or Pre-exmting Building .......... Vacant Land ............ Locat~on of Property 2675 Stillwater Avenue Cutchogue, New York House No. Street Hamlet JON R. CHITUK Owner or Owners of Prope~o/ ........................................................ 103 08 7 County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subd~wmon ........................... Fded Map No ......... Lot No ............. Perm~tNo. 15651Z Date of Perm~t . 1/29/87. Jon R. Chituk ................ App Icant .................................. Health Dept. Approval N/A N/A ....................... Labor Dept. Approval ........................ Underwriters Approval N/A Pianmng Board Approval N/A Request for Temporary Certificate .............. Final Certificate .. XX Fee Submitted $ 5...0.0 Construction on above descmbed building and permit meets all apphcable codes and regulations. Applicant ........... 3. ON..~. CHITUK Rev 10 10 78 00 ~. 15230 OUNDATION { 1st) OUNDATION (2nd) OUGH FRAME & PLUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.. 765-1802 (Budding 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 co~npletely filled m by Wpewriter or in ink and submitted to the Budding Inspector, with 3 sets of plans, accurate plot plan to Icale. Fee according to schedule b. Plot plan showing location of lot and of buddings on premises, relationship to adjommg premises or pubhc streets or areas, and gwmg a detmled descnphon of layout of property must be drawn on the dmgmm which is part of this apph- canon. c. The work covered by tbas apphcation may not be commenced before issuance of Budding Permit. d. Upon approval of this apph~ation, the Building Inspector will issued a Budding Permit to the apphcant. Such permit shall be kept on the premises available for inspection throughout the work e No budding shall be occupied or used m whole or in part for any purpose whatever untal a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Bmldlng Permit pursuant to the Budding Zone Ordinance of the T~wn of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction df buildings, additions or alterations, or for removal or demolition, as herein described The applicant agrees to comply with all apphcable laws, ordmances, budding code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary mspectl~l~. ' (Slg/r~re of apphcant, or name, if a corporation) (Mating address of'ap~l~ant) .... State whether applicant is owner,1 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 m a corporation, signature of duly authorized officer 2 (Name and title of corporate officer) Builder's License No Plumber's License No Electrlclan's License No ....... Other Trade's License No Locatmn of land on which proposed work ~i-~xdon~ ................................ ...... ........... County Tax Map No 1000Sectlon .(~'~, Block .... .~.~ .... Lot . .C~. --7[. .. Subd~v~mon ........ Filed Map No ...... Lot .. . (Name) State exm,ng use and occupancy of premises and lntel~te,4use and occup,ancy of proposed construction 3. Nature of work (check whmh applicable) New Budding .. Addition. ~. . ... Alteration * Rep'mr .... I Removal ...... Demolition . .. Other Work ...... (Description 4 Estimated Cost l ~.~ ............ Fee .~. I " (to be paid on filing this application) 5. If dwelbng, number of dw~elhng units .......... Number of dwelling units on each floor .......... If garage, number of carsl.. ............ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............. 7. Dimensions of exmtmg structures,, ff any Front. . .. Rear ........ Depth .... Height ..... I Number of Stones . .. Dmqens~ons of same structure' with alterations or additions Front ...... Rear .......... Depth . . .. ..... Height ........ Number of Stones ............ 8. Dimensions of entire ' ' Front ... Rear ...................... ~ new 9onstructmn ........ Depth Hmght .......... Number of Stones 9 Size of lot Front I ...... Rem: ............. Depth 10 Date of Purchase .......... Name of Former Owner 1 I. Zone or use district in which premmes are situated 12. Does proposed construction violate any zoning law, ordnance or regulation ....................... 13. WflI lot be regraded .. I .............. Will excess fill be removed from preimses Yes 14. Name of Owner of premises ......... Address .............. Phone No ....... Name of Architect ..... I . . i i ....... Address ........... Phone No .......... Name of Contractor I ............. Address ............ Phone No ........ 15. Is th~.~ property located w~.thin 300 feet of a tidal wetland* *Yes ..... No ..... *If yes, Southold Town Trustees Permzt maybe requzred. PLOT DIAGKAM Locate clearly and distlnc!ly all bu~dmgs, whether ex~stlng or proposed, and indicate all set-back dimensions fr property hnes Give street and block number or mtenor or corner lot. description accordmg to deed, and show street names and indicate whet STATE OF NEW YORK, S S COUNTY OF ... (Name of individual signing contract) above named being duly sworn, deposes and says that he is the apphc He is the ............................................. (Contractor, agent, corporate officer, etc ) of said owner or owners, and m duly authormed to perform or have performed the said work and to make and file apphcat~on, that ail statemer~ts contained m this apphcat~on are true to the best ofhm knowledge and behef, and that work will be performed in the manner set forth m the application filed therewith. Sworn to before me this ...... o~ ~. .... dayof .... ~ ...... 19 ~..7 Notary Public, ~ .~, ~.e~..~.~....(/. County I1~0~ 1~1~ ~tl~ ~1~ :, (Signature o f apphc~ Tena Ex,res M~rch 30,19