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Home My WebLink About16029-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southo~d, N.Y. Certificate Of Occupancy No Z-15840 Date June I I, 1987 THIS CERTIFIES that the budding DECK ADDITION Locat~on of Property 505 Custer Avenue Southold, N.Y. Hou~e 'No .......... 'S't/eei ................. County Tax Map No 1000 Sectlon . 7 0 ..... Block . 8. ......... Lot 2/4 Subd~wslon ..................... Filed Map No ...... Lot No ......... conforms substantially to the Apphcatlon for Building Permit heretofore filed m this office dated May I I , I 9 8 7 pursuant to wluch Braiding Permit No 1 6 0 2 9 z dated . Jun e 5,. I .9.8 7 was issued, and conforms to all of the requirements of the apphcable prowsions of the law. The occupancy for winch tins certificate is issued ~s .... DECK ADDITION TO EXISTING ONE FAMILY DWELLING HAROLD WINTERS The certificate m msued to ......... ?o.,ne;, .............. of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO N/A N/A PLIJMBERS CERTIFICATION DATED: '~Bu~Idm~ In;~;c'to; .......... Rev 1181 Folr, H No. · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 16029 z ~ County Tax Map No. I000 Section .....~.~..~. ....... Black ....... .(~.~ ....... Lot No....c~.~. .......... pursuant to application dat~ ...... ~..%...~} .......... '9.J~., and approv~ by the Building Insp~tar. 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 ~n typewmter OR ink, and submitted m~ to the Building Inspec- tor with the following; for new buildings or new use: 1. F~nal survey of property w~th accurate location of all buddmgs, property lines, streets, and unusual natural or topographm features. 2. Fmal approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrmal mstallat~on from Board of Fire Underwmters 4. Commercml buildings, Industrial buildings, Multiple Residences and similar buildings and installa- t~ons, 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 (pmor to Aprd 1957), Non-conforming uses, or bu~ldmgs and "pre-existmg" land uses. 1. Accurate survey of pzoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees' 1. Cert~f~cate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2 Certificate of occupancy on pre-exmtmg dwelhng $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20 00 5.Updated C.O. $ 50.00 Date 3une ] ], ]987 NewC°nstructlon ...... Old or Pre-ex~stmg Bulld~ng ........... Vacant Land ............. 505 Custer Avenue Southold, New York Location of Property ................................................................ House No. Street J-;am/et HAROLD WINTERS Owner or Owners of Property ............................................................ County Tax Map No 1000 Section 70 Block 8 Lot. 24 Subdwlmon ......................... Filed Map No .......... Lot No ............ 5/ 1/87 George Terry Custom Blder. PermltNo 16029Z Date of Perm~t ........ ADp~cant Health Dept. Approval .................... Labor Dept. Approval ........................ Underwriters Approval ............... Planning Board Approval .................... x Request for Temporary Cert~fmate ................ Fmal Certificate ..................... Fee Submitted $ ..................... Construction on above described buddmg and permit meets all apphcable codes and regulations. Apphcant .... H aY o 1;~' 'W ~' h t'e'C ~ ....................... Rev 10 10-78 OUNDATIO.U ( ls t) OUNDATIO:~ ( 2nd ) OUGH FRAbIE & FLUMBING NSULATION ?ER N. Y. STATE ENERGY CODE ADDITIO~A'L CO~ME~;TS: , Approved ~ , 19~ Disapproved a/c .... FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL., 765-1802 Permit No°IR: (Buddmg Inspector) APPLICATION FOR BUILDING PERMIT Rece~.ved ........... ,19... Date ...... 19.~. t INSTRUCTIONS a. Tins application must be completely filled in by typewriter or ~n ink and submitted to the Bufldmg Inspector, w~th 2 sets of plans, accurate plot plan to scale. Fee accordmg to schedule b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or pubhc street. or areas, and giving a detailed description of layout of property must be drawn on the thagram which is part of this apph cation. c. The work covered by thas application may not be commenced before issuance of Bufldmg Permit d Upon approval of tim application, the Bmldlng Inspector will issued a Building Permit to the apphcant. Such permi shall be kept on the premises avmlable for mspection throughout the work e. No bufldmg shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc,. shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depaxtment for the issuance of a Bmldmg Permit pursuant to th. Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, ad&tlons or alterations, or for removal or demohtton, as hereto described The applicant agrees to comply w~th all apphcable laws, ordinances, budding code, housing code, and regulations, and tt admit authorized inspectors on premises and m bmldmg for necessary ~l~sp~ctmns (Signature of apphcant, or name,Tf a corporation) (Mailing address of applicant) State whether apphcant is owner, lessee, agent, architect, engmeer, general contractor, electrician, plumber or builder .. W. .i , / ................................ Name of owner of premls/~.: ~ . .O-fPc-~ ~/~ ..... (as on the tax roll or latest deed) If apphcant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builder's L~cense No [ .7 Plumber's License No Electrician's L~cense No . Other Trade's License No... Location of land on which proposed work will be done --CO 5-' House Number Street County Tax Map NO 1000 SecUon . '~ ~. Subd~ws~on ...... (Name) Block Fded Map No Hamlet ... Lot...c~ .~. Lot 2 State ex,sting use and occupancy of premises and intended use and occupancy of proposed construction a. Ex~stmg use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable) New Budding . Addmon~Z) .~.C'...~... Alteration Repmr [ [ ut~moval ....... Demolmon .... Other Work ........ (Description) 4. EstnnatedCost .~?J-.'-.,;'O,~.~.-~ ............... Fee .-,2.3.~...-'~--. .................... (to be prod on filing thru apphcation) 5. If dwelling, number of dwelling umts. ~ ...... Number of dwelling units on each floor. -- ..... If garage number of cars ~ 6. If business, commercxal or mixed occupancy, specify nature and extent of each type of use ...~ ......... 7. Dunenmons o~ ex~stmg structures, if any. Front . .'7. ~ ..... Rear 71 .'~ ....... Depth. '47 .... Height I q ..... Number of Stones . I. Dunensions of same structure with alterations or additions Front -~ 1-- ......... Rear ........... Depth .t/.-/ ............ Height ! ~] ........ Number of Stones....] ............. 8, Dunenmons of enhre new constructmn' Front .-1 ~ ....... Rear . 7/.2~ ........ Depth ~..] ..... Height . .~ t~ ........ Number of Stones .~ .................................. Slzeoflot Front ~ ~,.OO? . Rear. J.O.q,.Ls3 ......... Depth [j~.e.{., .O..~. i ..... Date of Purchase ............ Name af Former Owner ................. Zone or use d~stnct m which premises are mtuated q ~.~; t.~.~ ~.~3.~. ~ .~., ................... Does proposed construction violate any zoning law, ordinance or regulation !M..O ..................... Will lot be regraded ~.~.. ~. ....... ~... Will excess fill be removed from premises Yes ~ Name of Owner ofpremlses~a'? ~ [~'r.~l,Jes~-t~,.¢ Address~h~l~'Je-.q-~ ~..~ .. Phone No..~ q ~..'7 ~* q.(*. f Name of Architect . ~ ........... Address'cl..~ ........ Phone No 2. ....... Name of Contractor .~.: ~...~'"1 ....... Address . -~o~q. ~,.~ }0 .... Phone No. D6.5 :~. ~...q .'~'I.. 9 10. 11. 12. 13. 14. PLOT DIAGRAM Locate clearly and &stmctly all bufldmgs, whether ex~stmg or proposed, and, indicate all set-back dunenmons fron property lines. G~ve street and block number or descnptmn according to deed, and show street names and in&cate whethe interior or corner lot. ~ ~'~ ,- . . .~te~.,~--~r~. . . being duly sworn, deposes and says that he ~s the apphcan (Name of m&vidual signing crertitract) above named He m the ~'~/'~ ~.'~a'e~g]o~ ................... (Contractor, agent, corporate officer, etc.) of smd owner or owners, and ~s duly anthorged to perform or have performed the smd work and to make and file thr apphcat~on, that all statements contained m thru apphcatlon are true to the best of hm knowledge and behef; and that th~ work will be performed in the manner set forth m the apphcation filed therewith. Sworn to before me th~s dayof ...... NotaryPubhc, ........ '~: .~.~'~i~tA- County .i 'g "I IIO,O 14At,OLD iV!,Aw,,,,o,,~- PIJOPE""" D. ~ NAI2CELLA F. AT E. MOMUHENT