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Home My WebLink About15678-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .. Z15.7~7~ Date ...... ~9y..2.6{ 1.987 .... THIS CERTIFIES that the bmldmg a.c..c.e.s, so..ry..s.h..e.d... ...................... LocaUon of PropertyI ......... S..tillwater Ave · Cutchogue 3'6' ~'OHouse ~lo .... ~t~t ................. hJt~le~ County Tax Map No.11000 Secnon ...1.3.7 .Block ...... .1. ..... Lot 13 Subdivision ' ' ' t ...... .X ....... Fried Map No .... .X...Lot No .... X. ....... conforms substantially to the Apphcahon for Building Permit heretofore filed m thas office dated · .. Febru~rT. 5.,. 1987 pursuant to wluch Building Permit No 1.5..6.7.8Z dated ..... Febr~arT. ll,.lR87 was ~ssued, and conforms to all of the requirements of the apphcable prov~slons of the law. The occupancy for wluch flus certificate ~s issued ~s ...... .. A. C ce s s.o.r.y, shed. FLORENCE & DANTE COLOMBO The certificate is issued to ........ {o~n'e),~~ ............ of the aforesaid building Suffolk County Department of Health Approval .. Iq/A UNDERWRITERS CERTIFICATE NO ....... N/A N/A PLUMBERS CERTIFICATION DATED: / Budding Inspector Rev 1/81 IvO~M NO. Jl 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~ 15678 Z Permission is hereby granted to: , .... · ..~~-.~..:.h..: ...... ~.~ ..... . ~, ,o...~ ....... ~....~.~.....~..~...~...¥~...~.. County Tax Map No 1000 Section ..... ~...~...?.. ...... Block ...... ...~....! ........ Lot No ...... /.3 ....... Building Inspector. Fee S. ~,.~,~,.:....~. Building Inspector Rev. 6/30/80 TOWN OF $~%'~ ~ -~ '~ ~ ....... ;=Southold, N.Y. 11971 765- [8O2 APPLICATION FOR CERTIFICATE OF OCCUPANCY FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Instructions A Th,s apphcat~on muSt be filled in typewriter OR ink, and submitted m ~ to the Building Inspec- tor with the folJowihg; for new buddings or new use: 1. F~nal survey of property w~th accurate location of all buddings, property lines, streets, and unusual natural or topographm features. 2.F~nal approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approval of electr, ical installation from Board of Fire Underwriters. 4. Commercial buildings, lndustrml buildings, Multiple Residences and simdar buildings and installa- t~ons, a cert~hcate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed rote plan requirements where applicable. B. For existing buddings (prior to Apml 1957), Non-conforming uses, or buildings and "pre-existing" land uses: , 1. Accurate survey of p~Operty showing all property lines, streets, buddings and unusual natural or topograph lc featu res. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any hous!ng code or safety inspection of buddings or premises, or other pertinent ~nforma- tlon required to p~epare a certificate. C. Fees' Additions $25.00 1. Cert~flcateofoccUpancv New Dwelling $25.00, Accessory ,$I0.00 Business $50.00 2 Certificate of occupancy on pre-existing dwelhng $ 50.00 3. Copy of cert~flcate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ....................... New C o n s t z-u c t · on... &. Old or P re-exlstln§ Budding ............ Vacant Land ............. Location of Property ................................... : ....................... House NO. Street m/et Owner or Owners of Property ....... ~..~..~. ~%...0~/~.....~.~::) .................. County Tax Map No 1000 Section ....~. ........ Block ....... 1 ...... Lot ..... t ~-~ ....... · Subdwm~on ............................ Filed Map No ....... Lot No .............. Perm,t No,/.5~-.~. .~..~ ~-' Date of Perm,t .~... . .Applicant .................................. Health Dept Approval ................ Labor Dept. Approval ........................ Underwmters Approval .................... Planning Board Approval ...................... Request for Temporary Certificate .................... Final Certificate ..... ~ ............... Fee Submitted $. (~. . .~.,. ,J!! .......... ~C ,"'~,%O 'nt~ ~-15'~9 7 ~)~O (O(~ , Applicant / .......... .~ ................ ......... Rev 10 10-78 OUNDAT!ON (1st) OUNDATIO~ (2nd) OUGH FRAME ?LUMBING iI NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION XST [ ] FOUNDATION 2ND [ ] ROUGH PLBG. INSULATION FRAMING [ ,:].,FINAL DATE NORTH FORK WOODDESIGN 43305 Mmrl Street, Southold, N Y 11971 ', !, ~hone ~516) 765-3090 Customer's Order No ..Shjpp,ng Date Time. Salesman OPTIONS' ' ~' "' SHELVING .......' VENTS ,., CUPALO ' , ' EXTRA DOUBLE DOORS' DECORATIVE SHUTTERS INTERIOR PARTITIONS FLOWER BOXES OPTIONAL SIDING CUSTOM COLORS ' " ' , , , ' SIZE . . '- ' ' '~"'~/r~' . . ' /', ~"~ , ~' ~ ' BALANCE - . ,' ~., NOTICE- .... ¥ 'r° ALL CUSTOMERS nI~FOR" YOU MAKE YOUR PURCHASE! /3 Can we drive directly to the ocabon you've chosen fo our shed wrshesorlntheeventnoonelspreseqt, wedonotassumer ~ ..~,,.,...,~._~[~rese~t'lnacc°r~ancewlththebuyer~ Wood, whenltlsexposed othee ementshasatendencytoshrmkandex and Be {~jforchlpp~ng crack ng m no[war n etc P ~u~ofth~s, wecannotacceptresponslbd~ty *BA~NCE OF PAYMENT CASH OR CERT F ED CHECK ONLyI ...... Signs r ....... ' ~ ' ,:' HAVE A NICE DAY Disapproved a/c .... FORM NO. 1 ~? TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL.: 765-1BO3 BOARD OF HEALTH 3 SETS OF PLANS SURVEY CHECK SEPTIC FORM NOTIFY CALL MAIL TO: FEB - 5 1987 JAN Z 8 t98"/ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS D ......... 19 a This application must be completely filled in by Wpewnter or in ink and submitted to the Bmldmg Inspector, with 3 sets of plans, accurate plot plan to scale Fee according to schedule. b. Plot plan showing location of lot and of buddingS on premises, relationship to adjoining premises or pubhc streets or areas, and giving a detatled descnphon of layout of property must be drawn on the dmgram which ~s part of tins apph- cation. I c. The work covered by tins apphcatlon may not be commenced before ~ssuance of Budding Permit d. Upon approval of thru apphcahon, the Bufldmg Inspector will issued a Budding Penmt to the applicant Such permit shall be kept on the premmes available for mspechon throughout the work. e. No budding shall be occupied or used in whole or in part for any purpose whatever untal a Certificate of Occupancy shall have been granted by the Buflciing Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bmld~ng Penmt pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the constructton o~dmgs, ad&hons or alterations, or for removal or demolmon, as hereto described The apphcant agrees_B> l;q~i~i~'l[apphcabIe laws, ordinances, budding code, housing code, and regulatmns, and to admit auth~l~'l~d~mt~fa'n~c[ II, building for necessary inspections (Signature of applicant, or name, ff a corporation) .................. ~i~e~ssg~ (Malhng address of apphcant) State whether~ agent, architect, engineer, general contractor, electncmn, plumber or builder. Nameofownerofprem~ses '%~.~q 4[) 7'/'~ ~::~(!p/_,..gg//d/~ (as on the tax roll O~Le' ~,r # ~ If apphcant m a corporation, s~nature of duly authorized officer /~ , ~:~![ --% ~r ,.-,- Rv, , ' . (Name and title of corporate officer) ,t ' .~C-5 {-' ,,,,-5 T(. ~ ~'I~ ~3R Humber's License No 3 "~' ' ~ r=, [Icctncmn's License No Other Trade's Lzcense No r'i~ .,'~: ' ';~'~,~ '~'~, 1. Locat~on ofland on whmh proposed work wdl be done ,~i{~.. I'.~.;;*~¥:~ > ~ · ................. Zv House Number Street Hamlet co,,tuNo o0o S ct o, . . g ..... Lot. Subd~vm~on , (Name) Filed M ~p No Lot 2 State ex~stxng use and occupancy of premmes and intended use and occupancy of proposed construchon .. ...... ...... a Exlstlng use and occupancy . b Intended use and occupancy t~ . .~' . ',... ~. ~.~ ..... 3 Nature of work (check which applicable) New Building .... Addition ........ Alteration Repair .. Removal ....... Demolition ....... Other Work. .-%-/7~./~?''' (Description) 4 Estimated Cost .......................... 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 . i ............................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ........... 7. DtrnenslonsofexlstlngstruCtures, lfany Frontr~M'~... Rear .....~..... DepthS..~..... Height ........ Number of Stones ............................... Dtmenmons of same structure with alterations or additions Front ......... Rear ............... Depth ............... Height ....... ~ .... Number of Stories ............... Dimensions of entire new construction' Front . /&/- ~..~. Rear ............. Depth . ./. ~.r....~>.. . Height ......... Number of Stones ............................... 9. Slzeoflot Front ......... Rear ............... Depth ............. 10 DateofPurchase .. . : ........ Name of Former Owner .................. i I Zone or use district in which premises are situated ........................... ..~. 12. Does proposed construction violate any zoning law, ordinance or regulation ./~. O' ................ 13. Will lot be regraded .~/{frO' .......... Will excess fill bg~rprt~oved fro. in premises Yes Name o f Owner of premlse~s~ a>Z ~,~r;> . Addr e ss .-~ .~. ~.O. ~ .~?.~'~.Y.tJ~/..4f~one No ......... 14 Name of Architect .. ,cr~" ....... 1 .~., . Address .~,. ~ p .... .~ . ~hone No ............ 15. Is this property located w~.thin 300 feet of a tidal wetland? *Yes ..... ~If yes, Southold Town Trustees Permit maybe required. PLO~r DIAGRAM Locate clearly and dmtmctly all bmldmgs, whether exmtmg or proposed, and indicate all set-back dzmenslons fro~ property lines Give street and blbck number or descnptlon accordmg to deed, and show street names and indicate wheth, mtenor or corner lot '-8 STATE OF NEW/'~iORK, . COUNTY OF S S ~7--'~.;' ~"'~- ~e ~ ~ .~ ~ .- -~ ...... ;: .~.. being duly sworn, deposes and saysihat ~ is the apphcar (Name of individual s~gmng contract) above named He is the ............................ '~" -9 ~' · :! (Contractor, agent, corporate ofhcer, etc ) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file th application; that all statement.S contained m this application are true to the best of his knowledge and behef, and that tE work wdl be performed in the manner set forth m the application filed therewith. Sworn to before me this ..... Notary Publlc,~/r~. _k~f~,~.. ~~ounty