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Home My WebLink About15723-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16859 Date May 12, 1988 THIS CERTIFIES that the building Add i t ions Location of Property 10230 New Suffolk Ave. Cutchogue House No. Street ........ County Tax Map No. 1000 Section I 16 .Block 6 .Lot 4 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 2, 1987 ..................... pnrsuant to which Building Permit No ..... 1.5. .7.2.3.Z. .......... dated ............................ Ma r ch 2, 1987 . was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which tiffs certificate is issued is ......... 2 dormer additons to an existing one family dwelling (non-habitable) The certificate is issued to ADRIAN C. HC CALL AND ANOTItER ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. NIA PLUI, IBERS CERTIFICATION DATED: N/A Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL PULL COMPLETION OF THE WORK AUTHORIZED) N~ 15723 Z Date~ ~ .. .... ....~.. ............................................ , ~..'7. Permission is hereby granted to: ..~.~.;~....~...Y: ......... ! ............................ ~... ~ '"~'~'~'~""~";'~'~'~'":"~"'""'-'""l~r';;': ..............,~ . , '--.-,~, ,o ~....~.......~.......~.~..~.....~.....~.......~....~ ~~..~.~..~..,....~...~....~ ..................................... ~t pmmtso~ ~t~d ~ ........................................................................................................................ Coon~ r~ ~p uo ~00o s~t~ ........ ll.~ ........ ~k ....... ~.h ...... c~ ~o .h.~. ...... Building Inspector. Buildln~ I~tor Rev. 6/30/80 -- BLDG, OEPT · mwa o~ sou~Ho~,? FORM NO. 6 TOWN OF SOUTHOLD Ruild~ng Department Town Hall $outhold, N.Y. 11971 765 - 1802 ~PLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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-iS-9 form or equal). 3. Approval of electrical mstaJlation from Board of F~re Underwriters. 4. Commercial buddirlgs, Industrial buildings, Multiple Residences and similar buddings and in~alla- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approvat of completed site plan requirements where applicable. B. For existing buddings (prior to Apml 1957), Non-conform~ng uses, or buddings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property hnes, streets, buildings and unusual natural or topograph lc featureS. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any housing code or safety inspection of buddings or premises, or other pertinent mforma- t~on required to prepare a certificate. C. Fees: ' Additions $25.00 POOLS $25.00 ALTERATION $25.00 ].Cer~ficateofoecup~ney New Dwellzng $25.~0, Accessory ~$10.00 Buszness $50.00 2. Certificate of occupancy on pre-exmting dwelling $ 50.00 3. Copy of certlf~cate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 ~../,~..~.~..~. 5.Updated C.O. $ 50.00 Date ................ NewConstructzon /Old or Pre-existing Budding Vacant Land .. Location of Property .... ',. ......................................... - ............. Owner or Owners of Property ................. County Tax Map No. lO001Sect;on ............. Block ............. Lot .............. Subdwm~on ............................... Fded Map No ........... Lot No ............. Permit No ........ D~te of Permit .......... Applicant ............................ .... . . Health Dept Approval ........................ Labor Dept. Approval ..................... ... Underwriters Approval ....................... Planning Board Approval ................. Request for Temporary Cer~hcate .......... ...........Final Certificate ... ................. .. . Fee Submitted $ ........................... Construction on above descmbed budding and permit meets all apphcable cocl~s and regulations. Apphcant ..................... OU~DAT!O.U (1st) OUNDATIO~ ~ 2nd) OUGH FRAME & ?LUMBING NSULATION PER N. Y. STATE ENERGY CODE FI;~AL ADDITIONAL COMMENTS: Exammed /7. [ct~e.~.. ~ , 19 Approved .~' '~t,r.~ . ~ .-, 19~'7 Permit No /.~.7..~ .~. (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO. 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL NOTIFY F, OUTHOLD, N.Y 11971 TEL 765-1802 CALL ................ MAIL TO: Date . ,-- ,19 INSTRUCTIONS a. This application must be completely filled in by typewriter or m ink and submitted to the Buildmg Inspector, w~ sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showmg location of lot and of buildmgs on premmes, relahonsh~p to adjomlng premises or pubhc str or areas, and glvmg a detmled descnphon of layout of property must be drawn on the diagram whmh cation. c. The work covered by this application may not be commenced before issuance of Bufldmg Permit. d. Upon approval of this application, the Bmldmg Inspector will issued a Buildmg Permit to the apphcant Such pet shall be kept on the premises available for inspectmn throughout the work e. No buildmg shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupa shall have been granted by the Bufl&ng Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Budding Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordmance Regulations, for the construction of bmldmgs, ad&tzons or alterations, or for removal or demolmon, as hereto descnl The applicant agrees to comply with all apphcable laws, ordnances, buddmg code, housmg code, and regulations, an, admit authorized inspectors on premises and m bufldmg for necessafT..inspechons (Signature of applicant, or name, if a corporation) (Mailing address of applicant) Il State whether applicant is_ owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or brai, Name of owner of premmes !¢~'~ ~ !¥3~'''~ ~?F'~.~ ~.(_.. ; (as on the tax roll or latest deed) If am>hcant is a corpo-m.hon, smnature of duly authorized officer (Name and title of cprporate ALL COI~,TRACTOR'S MU, ST ~BE SUFFOLK COIJNT¥ LICENSED Builder s License No . J ~'~oc 44[ Plumber's License No Electrician's License No Other Trade's License No Location of land on which )roposed work will be done House Number Street County Tax Map No 1000 'Section [ ~. ~.. Block Subdivision . Filed Map No i (Name) Hamlet Lot. .... Lot State ex~stmg use and occupancy of premises and intended use and occupancy of proposed construction a Existmg use and occupancy . .. ~... b. Intended use and occupancy .......... 3. Nature of work (check which applicable) New Building . . Addition .. . Alteration Repatr ......... Removal ......... Demolition ....... Other Work 7~ 4 Estimated Cost 5. Ifdwelhng, number of dwelling units.. (Description) · . ........ . .. Fee..... . .. .... .... . ... ... ... ' (to be paid on filing this apphcatlon) ·.. Number of dwelling units on each floor ...... 6 7 Dimensions of existing structures, if any Front Height ........ Number of Stones Dunenmons of same structure with alterations or addmons Front Depth ............ I' ' Height ..... 8. D~menmons of entire new construction Front .. If garage, number of cars .. , ......................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use ........... Rear .. Depth. .. .... Rear ......... Number of Stones .............. Rear ........ Depth ......... Height ......... Number of Stones ........................................ 9. Size of lot Front ...... Rear ................. Depth ................ 10. Date of Purchase .............. Name of Former Owner ................. 11. Zone or use dmtmct m which premises are situated ................................ 12. Does proposed constructmn vmlate any zoning law, ordinance or regulation' . ................... 13. Will lot be regraded ............... Will excess fill be removed from premises' Yes No [4 Name of Owner of premises ............ Address .............. Phone No ............ Name of Architect ............. Address .............. Phone No ......... Name of Contractor ................... Address ............ Phone No ........... 15. Is this property locatedlwithln 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and d~stmctly ali buddmgs, whether exmt~ng or proposed, and indicate all set-back dm~enslons from *roperty hnes Give street and block number or description according to deed, and show street names and indicate whether ntenor or corner lot I ;TATE OF NEW, YORK, ~OU, NTY OF ~ · ~ [~.,~,. tr,.~¢.;2.~ o,~ ~ c~.x~.r.,~l~M.l~l. ....... being duly sworn, deposes and says that he is the apphcant (Name of individual signing contract) bove named. te la the ........ 1 ...... , (Contractor, agent, corporate officer, etc ) ff said owner or owners, and is du)y authorized to perform or have performed the satd work and to make and file flus pphcatlon, that all statements contained m thru application are true to the best of his knowledge and behef, and that the cork will be performed in the manner set forth m the apphcatmn filed therewith. ,worn to before me thru 4otary Pubhc, . .................... Count~ UNDAJ COOPER (Signature of apphcant) Iqotary Public, State of New Yor~/ No 4822563, Suffolk County)?~ USE IS UNLAWFUL ~'~?THOIJT CERTiFiC,~t ~-,, OCCUPANCy