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Home My WebLink About16487-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No- Z16432 Date November 24, 1987 THIS CERTIFIES that the building .... A d d,i.t. J, p .n ................................... Location of Property 3680 Stillwater Ave. Cutchogue House No. Street Hamlet County Tax Map No. ]000 Section ....1.3.7 ...... Block ·..0..] .......... Lot ] 3 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..8.e. p .t ....2. 5. ~. 1 9 8 7 pursuant to which Building Permit No. 1 6 4 8 7 z dated ...8.e.p..~ :..2.8..,..1.9.8. 7. ......... 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 ......... ·. A. coy. e~ed..p.o r ch..~..a.p.p .1 .~.e.d...f 9.r.. ......................................... The certificate is issued to .....D.AI~T.E. &..Y.LORENCE COLOMBO ..... ?oYn'o;,~g~'~;,~'~ ............... of the aforesaid building· Suffolk County Department of Health Approval Iq /A UNDERWRITERS CERTIFICATE NO.. N8 3 6 0 5 2 1 0 / 5 / 8 7 PLUMBERS CERTIFICATION DATED: N/A ........... Rev. 1/81 FO~ NO, 1S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT fi'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No- 16437 z Permission is hereby granted to; .~.~..v......~...~.:.~..,....!.L.~...:~ . ,o .~~....~....~....~.~......~....¥~...~ .............. ~,t premises located ot ........... : ................. ............ ................ 2:' ......................................................................................... County Tox Mop No. 1000 Section ...... I.,~..'J .......... Block ....... ,,~.~ ........ Lot No.....~.,~. .............. to application doted ....~..~..~....~.~. ....... , lg.~."J.., and approved by the pursuant Building Inspector. Building Insl~ctor Rev. 6/30/80 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 BLDG. IDa:Fr. 765 - ,802 TOWN OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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-(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 property si~owing att property lines, streets, buildings and unusual natural or topographic featuros. 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: A~ditions $25.00 POOLS $25.00 1. Certificateofpccupancy New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of Occupancy on ~,r,e-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years 4.Vacant Land C.O. $ 20.00 / /~?. 5.Updated C.O. $ 50.00 Date ..... 9; 'Z~. NewCOnstruct~ on ...... Old orPre-existing Building ............ Vacant Land Location of Property ............................................................... House No. Street Ham/et Owner or Owners of Propertv .... - . ~vt . .. County Tax Map No. 1000 Section ~ '~ 7 Block 0 ] Lot ..... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ~'~'~' ~'7 '' Date of Permit .(~/.o~,/, ,~, .Applicant .... ,~,,D,t:(i~..~,;,.,~,~J~, Health Dept. Approval ' Labor Dept Approval Underwriters Approval ........................ Planning Board Approvat ...................... Request for Temporary Certificate ' Final Certificate / Fee Submitted $ ....... Construction on above described building and permit meets all applicable c~des and regulations. ....... ."~' .......... r ...... ? ........... FOUNDATION (1st) ?O~J~DATION { 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOK P.O. BOX 728 TOWN }{ALL SOUTIIOLD, N.Y. 11971 TEL. 7654802 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 /5/ No Underwriters Certificnte on file. /.~ The check is (outdated/no.__t_. o~!_~~. ) /5/ No Health Dept. Approval on fileo /ii/ No final inspection has been made° P]ease contact our office on Thank you for your cooperation. this matter. Building Dept. ***/i/ No Plumber Solder Certificate on file. all permits involving plumbing being issued after April 1,1984 ) 1 IOl 'ri:LAC. lC: ~, Scale.. 5o'::I" · ..4 JOHN C. BORN BUILDER BOARD OF HEALTH ...... 3 SETS OF PLA.~S ....... 'FORM NO. 1 SURVEY TOWN OF SOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL ?B.OUTHOLD, N.Y. 11971 NOTIFY TEL.: 765-1803 CALL . .'~.'~.~-,.'".'~'~..~r... MAIL TO: Examined .~'. ¢'~L'~..~..~., 19 ?.'/. ApprovedC~Y.tl~?. ·~ ......... .~..~., 19~7. Pe~it No. ~.¢.~.~ ................................ ........ (guilding Inspector) APPLICATION FO~ BUILPlN~ Date ................... 19... INSTRUCTIONS 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. Upon 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 necessary inspecticms. (Signature of applicant, or name, if a corporation) .. ¢..0:, .¢?~. ?. ?.s.., ~.~.~...~.~.~:o., ~7!/!,t~3.,,. (Mailing address of applicant) State whether applicant is~ owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... .~..~.~?~....~.,...~.....~.L..o.~.~..~..r~....f~. ?.o..¢4..i}?. ............................ (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 ...... (~ ~ ~ ~...~ ........ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .... · ~. ~..~.o. ................... ~7~ .~-..~.../~v~ ............... ~ ~..~¢.~..~. ................... House Number Street Hamlet County Tax Map No. 1000 Section ..... /..~. 2 ~.:.. ;..-<. Block ......... i ......... Lot ...... /. ? ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... .~.~.6.....¢./~.. (~. ........ .,~. ?,~ ;,;~ ',-~,,X/~ .......................... b. Intended use and occupancy ~bO "' ~ -~a ~RC , . , J 3. Nature of work (check which applicable): New Building .... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............. ' (D rii~ti ) ~ ese on 4. Estimated Cost .~.) O~) 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 .... : ..................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front .... '.3.q~ .o~' ..... Rear ..... ~0 .' ...... Depth... ~.Z. ?7 7. ..... Height Number of Stories 0~ ~- Dimensions of ~amq.$l~)cture With alterations or additions: Front ................. Rear .................. Depth ...... :~.~.~ ...... i. · · Height .................... -. Number of Stories ...................... ....... -' 8. Dimensions of entire new construction: Front ...... ~i .~i ' ' ' i Rear ............... Depth .. o" Height ............... Number of Stories .................................................. 9. Sizeoflot: Front .......... , ............ Rear ............ Depth ...................... 10. Date of Purchase .......... i ................... Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .. ~oo 13. Will lot be regraded ........ , .................... Will excess fill be removed from premmes. Yes 14. Name of Owner of premises .0 .~..4 ~o~.~. ..... Address . .S.Tj .~.~r~ ~l~,q~..' Phone No ............... Name of Architect ........................... Address '"4 ................. Phone No ................ Name of Contractor .Q..~..q: .~.~.~.~. ......... Address '.. ~.. :~.~rl~.~ d ....... Phone No .~...2.3.. 7 .~..~.~. ~... 15. Is this property locatedlwithin 300 feet of a tidal wetland? *Yes ..... No ...~.. · If yes, Southold Town TrUstees Permit maybe required. I PLOT DIAGRAM ~ Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block'numbar or description according to deed, and show street names and indicate whether. interior or corner lot. , STATE OF NEW ~//;~/~.: cS ~?.U..N~. Y. ?;~~g contrac.t) being duly sworn, deposes and says that he is the applicanti above named. He is the ..... i Czo~.r~. ~.~rt~r~ ..................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file thisi application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mannor set forth in th~ application filed therewith. Sw°rn t° bef°re me t~I .~. Notary Public,...~. ~'~-~.~. ( y .... .............. ~ %1~o.; IIl~t~ ~ na~¥~ (Signature of applicant) Cornmiaston Expir; December 8, 76S-1802 BUILDING DEPT. INSPECTION ~N IST [ ] ROUGH PLBG. ~.j~ION'2ND [ ] INSULATION [/-3~FRAMING []FINAL REMARKS: ~, ~ ~~ ~*~-/