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Home My WebLink About16089-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-16173 Date September 16, 1987 THIS CERTIFIES that tbe building REPLACE EXISTING PORCH WITH DECK ADDITION 865 Track Avenue Cutchogue, New York Location of Property ....................................................... House NO, Street ' ' 'l:¢Jr~ie;~ County Tax Map No. 1000 Section .. ,] .3.7 ....... Block 0 I ..... Lot 24 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore flied in this office dated May 28, 1987 pursuant to which Building Permit No. 16089 Z dated ............................June 18, 1987 . was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... REPLACE EXISTING PORCH WITH DECK ADDITION AS APPLIED FOR PAUL E. HARBEN The certificate is issued to ..................... ?oWn'eL'l'~_.l~'~l~t~:'~'~'X .................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO .................................................. N/A PLUMBERS CERTIFICATION DATED: Rev. 1/81 FO~l~ NO. ~ 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) No- 160~8~2 Z Date ~ 19.~...2 Permission is hereby granted~ ~ ~......~.~ ....... .~. ........ ~ ............................... ...~.~.~i...~ .~....~.....~..: ........................... ~u. , // ~ o, ,oco,.~ o,. ~ ~ ~...ff~......~. ~ premises ........................... ~: ....... ::.;= ........................... County Tax Map No. I000 Section ..... ~....~....~ ......... Block ....... .~..J ......... Lot No ......,~..~. ............ Building Inspector. approved by the Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink. and submitted ,~ ~ 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 p~13perty 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 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 1. Certificate of occupancy New Dwelling. S25.00, Accessory",$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 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 ............... NewConstruction ...... Old or'Pre-existing Building f.-.~x,f~./,9 Vacant Land ............... ' Location of Property .......... '.'~.-.~-..-.(~.~...~.¥.~ ..... ~.~, .~-.~; .~.l~ .. -- House No, Street Ha/n/et Owner or Owners of Property ..... ~. ~', ?..~¥~':.. ~..~.'~. ~...?... #. ~.r{ ~ ~?.~. ................... County Tax Map No. 1000 Section .../.~.;~7. ....... Block .... ~ .[ ....... Lot... ¢~../~. ......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. {/.~.O..~'.~'.~. Date of Permit /. ~.',~.~..~.?.Applicant ... ~.~.~.. Health Dept Approval ' Labor Dept Approval Underwriters Approval ........................ Planning Board.Approval ................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .~.~. Construction on above di~seribed building and permit meets all applicable codes and regulations. Rev, 10-10-7S 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: ~ DATE INSPECTO~ OUNDATIO.U (1st) OUNDATION (2nd) OUGH FRAME & ?LUMBING iNSULATION PER N. Y. STATE ENERGY CODE Fi. AL ~DDITION~L COMMEHTS: TOWN OF SOIJTItOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because ,of the following reasons. /_~/ An application for Certificate of Occupancy is not on,file. /--/-' No Underwriters Certificate on file. /----~/ The check is(outdated/not on-file.)~.O0 /~/ No Health Dept. Approval on file. /~/ No final inspection has been made. Please' contact our office on this matter. Thank you for your cooperation. Building Permit tt ~ _~ _~ ~__~' Z Building Dept. ***/~/~No Plumber Solder Certificate on file. .( all permits involving plumbing being issued after April 1,1984 ) : Occupancy or use is unlawful without a Certificate of Occupancy. Clear up this matter as soon as possible so that legal action does not have to be taken, Thank you .for your prompt attention. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 ~ ~l~.g~_N To Whom This May Concern, We are unable to complete your Certificate of Occupancy because ,of the following reasons. /_~_/ An application for Certificate of Occupancy is not on file. /--~' No Underwriters Certificate on file. /Z~// The check is(outdated/%kq~~.)*~.o~ /~/ No Health Dept. Approval on file. /5/ NO final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # _L _~ O ~_ .~ z Building Dept. ' ***/~/ No Plumber Solder Certificate on file. { all permits involving plumbing being issued after April 1,1984 ) Occupancy or use is unlawful without a of Occupancy. Clear up this matter as soon so that legal action does not have to be taken. Thank you for your prompt attention. Certificate as possible BOARD OF HEALTH S gETg OF PLANS FomNo. SURVEY TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORH ............. TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1B03 Approved .... jr-PAul. ! .~.., 19j. .g. Permit No..~.o..~ c~ ~. Disapproved a/c ...................................... NOTIFY CALL ................ MAIL TO: APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date . ~./.~. ~. .......... 19~.~. a. This 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. Up'On 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 applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to. admit authorized inspectors on premises and in building for necessaw insp~otiOf/~,~ ,v 6'~ // ...... ............ (Signature of applicant, or name, if a corporation) (Mailing address'of aPPlicarJt) 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 co~orate officer) - ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No ..... (~).~V.N. ,~./~ ......... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ltouse Number Street Hamlet (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 3. I~bqture 0fwork (checkwhicha)plicable): New Building' Addition .......... Alteration .......... Repair .............. Ren~ oval .............. Demolition .............. Other Work~e~?d.c~¢. 0:]~ .... '/ (ffge n ) · (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 .... : .................................................................... 6. If business, commercial or mix6d occupancy specify nature and extent of each type of use ....... ' .............. 7. Dimensions of ex4sting structurgs, if any: Front ............... Rear ..... ......... Depth .'. ............. Height ....... , ........ Number of Stories ........................................................ Dimension~ of same structure with alterations or additions: Front ................. Rear .................. Depth .................... i. · · Height ...................... Number of Stories ...................... -' 8. Dimensions of entire new c0ns~ruction: Front .......... ' ..... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front .......... i ............ Rear .... ................... Depth ...................... 10. Date of Purchase .......... i ................... Name of Former Owner ............................. 1 1. Zone or use district in which p~emises are situated ..................................................... 12. Does proposed construction vi61ate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ i .................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . .~ .................. Address ................... Phone No ................ Name of Architect ......... ~ .................. Address ................... Phone No ................ Name of Contractor ........ .................. Address .... : .............. Phone No. ' ............... 15. Is this property located: within 300 feet of a tidal wetland? *Yes ..... No ..... · If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and blocg number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW counTY OF ............... ]~."J{.~/..k-..~..~..~.~.~ ~ ~ .......... 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, etc.) of said owner or owners, ~d is d~ly authorized to perform or have performed the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be perfo~ed in the m~ner set forth in the application filed therewith. Sworn to before ........... .... ..... . ..... Nota~ Public,...~~.. ~unty