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Home My WebLink About16421-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N Y. Certificate .0[ Occupancy No Z-16164 Date . September 15, 1987 TIllS C[' R JIF[ES that thc budding Deck Addit zon Locatton of Property 285 Emory Road Cutchogue, New York House ~to ............ 'St/eof ................. County Tax Map No 1000 Section 103 Block 04 Lot 38 Subdivmion ..... Fded Map No ..... Lot No ...... conforms substantlaliy to the Apphcanon for Building Permit heretofore filed in this office dated Sept ember 4, 1987 pursuant to which Budding Permit No.. 1642 I z dated September 4, 1987 was issued, and conforms to all of the requirements ot the apphcabte pravmlons at thc law. '[lie occupancy for wlucl~ tiffs certificate m issued is . DECK ADDitION TO EXISTING ONE FAMILY DWELLING The certificate Is issued to ROBERT & CARON DzMARTINO ..... /oh.e; '~'~'~ ............ ot the aforesaid building Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO . PLUMBERS CERTIFICATION DATED: N/A N/A / B~ldmg Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) County Tox Map No. 1000 Section ,..,..~...~ ...... Block .~.....~...~ ....... Lot No .... .i ....... pursuant to application dated ....,~;~.~.~J~....~ ........ 19..~..~.,---- and approved by the Budding Inspector. F. ,..~.~.:...../... ...... .......... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Buildmg Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled m typewmter OR ~nk. and submitted m~,,-,.,-,,- to the Building Inspec- tor with the following; for new buildings or new use: 1. F~nal survey of property with accurate Iocation 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). 3Approval of electrmal installation from Board of Fire Underwriters. 4. Commercial buddings, Industrial buildings, Multiple Remdences and similar buildings and installa- tions, a cert~fmate 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 ex,sting buddings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses' 1. Accurate survey of property showing all property hnes, streets, buddings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancv and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- lion required to prepare a certificate. C. Fees' Add~tions $25.00 1. Certif|cate of occupancy New Dwelling $25.(10, Accessory ~$]0,00 Business $50.00 2. Cerhflcate of occupancy on pre-exist~ng dwelling $ 5 0 0 0 3. Copy of certlfmate of occupancy $ 5,00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .,V/.f.O./.~.~. ............. New C °ns t r uc t ~ on..¢~... Old or Pre-exmt~ng Budding ........... Vacant Land ............. Location of Property . ~:~.~..~...~?(. ~. ~..~..~ .~.../~.,. ~...~.¥~./~.O..~. ¢.~~. ........... No. Owner or Owners of Prope~y .~.. ~ ~ ,~ ,~-, 7-- County Tax Map No. 1000 Section ...~ ,~. D ....... Block ...,~//. ......... Lot.. D..~. ........ Subdivision .............................. Fded Map No ......... . Lot No ............ . Permit No../~.¥.c~ ./..~. Date of Permit .~./¥/~.Apphcant ~..o~.~,.,.,.,.,.,.,.,.,.~...~..~..~..~.~.4..~4../~.t~..~.~./.z'J 0 Health Dept. Approval ,0/../4. . .Labor Dept. Approval ./.~././~. Approval .... .~./~. ............. Planning Board Approval . ./~.//~ ............... Underwriters Request for Temporary Certificate.. ~- ........... Final Certificate ~ Fee Submitted $. .. : ..................... Construction on above descmbed budding and permit meets all apphcable codes and regulations. Applicant ................................. Rev 10 10-78 FOUNDATION {1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE COMM£NTS FINAL ADDITIONAL COMMENTS: FORM NO 1 TOWN OF SOUTHOLD BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL SOUTHOLD, N.Y 11971 TEL.: 765-1802 CALL ................ MAIL TO: Date Approved~..~. ~ , 19~'l Permit NO ~ q,~.~ ~ Dmapproved a/c ............. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Ttus application must be completely filled m by typewriter or in ink and submitted to the Building Inspector, w 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 st or areas, and giving a detailed descnp~n of layout of property must be drawn on the dtagmm which is part of this c. The work covered by t~p~at~~emmenced before issuance or Building Pemit d Upon approval of tt shall be kept on the pr~ ~~~ou~out the work. e. No bufldm~' ~r ~[h~hole or m p~t for any purpose whatever untd a Cemficate of Occup shah have been ~, Building Zone Or~ ~ld, Suffolk County, New York, ~d other apphcable Laws, Ordm~c Regulations, for th~o~ ~ ~d~s, addmons or alteratmns, or for removal or demolmon, as~rem descr apphcable laws, or&nances bufl~-c~e, ~Umng code, and rCgulahons, The apphcant agrees~ ~1~ t~ses ~d m buddmg for necessa~ ]n~ectio~ admit authorized mspe~n (SlCature of ap~h(a~t, or~ame, if a ~poratlon) (Mmh~g address of apphcant) State whether apphcant Is owner, lessee, agent, architect, engineer, general contractor, electnman, plumber or bul Name of owner of premmes ~k'~'~i~lC~g'T~40 ~"~- '}-~0~ ~ h~~ (as on the tax roll or late~ ~ ~ ~ ~L~- ,2~ If apphcant is a corporation, mgnature of duly authorized officer (Name and title of cort~ora~e officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's L~cense No Plumber's License No. . . Electncmn's License No Other Trade's L~cense No I Location of land on which proposed work will be done. House Number l County Tax Map No 1000 Sechon Subdtv's'°n ~n ti1 ~O~ne) Street IGq&I , NOTIF~ BOILD~N~ OEP$,RT~F'NT 765-1~2 9 A~a co ~ ~ ~M TME FOLLOW'NG {N~PEC DO~ ALL (,ONq~U~ T~O~ ~ ,L. ' . ~l Ham~ Block 5/ ... Lot 3 ~ FdedMapNo Z23 ) . Lot . /~ . · State existing use and occupancy of premises and ~ntended use and occupancy of proposed construction a Exmtzng use and occupancy .... b. Intended use and occupancy ~ ....................... 3. Nature of work (checkwhlch applicable) New Bmldlng .. Addition ..... Alteration__ L, . Repair ...... Removal ...... Demoht~on ........ Other Work . . ~ Estimated Cost .... , ............... ~ee ........ ~ (to be prod on fihng th~s apphcahon) 5. If dwelhng, number of dwe~ng units .... Number of dwelling umts on each floor ...... If garage, number of c~ .................................... 6 If business, commercml or m~xed occupancy, specify nature and extent of each type of use ... - .... 7. Dm~ensmns of exmtmg structures, ff any: Front .. . Rear .......... Depth ....... Height ........ Number of Stones ,. ' ............ : .............. D~enstons of same structure with alterattons or addtttons. Front ........... Rear Depth .......... He~t .............. Number of Stones ............... 8 D~mensmns of entire nef constmctmn Front ~.~ ..... Rear . ~r ....... Depth . ~6 ~r .... Har,ht -' }~t' · N m~r of Stones ............................... 9 S~zeoflot Front . . ~¢.~ ........ .Rear . /~ ........ Depth ~ ..- ....... 10. Date of Pu~ .../~B ......... Name of Fom~er Owner .................. 11 Zone or u~ msmcrln which premises are mtuated .... /~ ........................ 12 Does prop~d cu~tmctmn violate any zoning law, ordinance or regulation .... ~.~ .......... 13 Will lot be regraded . .. ~ ........ W~I1 excess fillbe remo~d from premises. Yes 14 Nme of Owner of prem~ses ~a~f~a~, ~A~&s .. ~*r p}. r~,JT~t~neNo.~& Name of Architect ............... Address ......... ' ~hone No ........ Nane of Contractor ............... Address ........... Pho~ .. No ........ [5. Is this property located within 300 feet of a t~dal weCLand? *Yes .... · If yes, Southold To~ Trustees Permzt maybe requzred. PLOW DIAG~M Locate clearly and dmtmctly all buddings, whether exlstmg or proposed, and ~ndmate all set-back d]menmons fro property hnes G~ve street and block number or descnptmn according to deed, and show street names and indicate wheth intoner or corner lot. STATE OF NEW YORm- . ~ __ .:_.~~'m~*~'b ..~, ..... bmng duly sworn, deposes and says that he ,s the apphcar (Name of ~n&v~dual mgnmg contract) above named tie ~s the ............... (Contractor, agent, corporate officer, otc ) of smd owner or owners, arid is duly author]zed to perform or have performed the smd work and to make and file th apphcahon, that all statements contmned m th~s apphcahon are true to the best of hm knowledge and behef, and that tl~ work wdl be performed m the manner set forth m the apphcat~on filed therewith. Sworn to before me thru .... f .... ml~M~day°f '' ~/!~"'' ...... '19~r7 /''~' ~" ~r~e~ Notarymubhc, .~-~, K .~."~.. County ~ ~' . I~,.BIKI~ V~ . . . . ~707878, Suffolk Countl~;.o (Stgn