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Home My WebLink About16493-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-16232 Date October 1, 1987 THIS CERTIFIES that the building D E C K A D D I T I 0 N Location of Property 540 Cedar Road Cutchogue, New York House No. Street Hamlet County Tax Map No. 1000 Section ...1.0.9. ...... Block 5 .... Lot 017 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated July 15, 1987 pursuant to which Building Permit No. 16/493 z dated .... September...............30, ......... 1987 . wasi~sued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to EDWARD F. & DIANNA SCHILLER ..................... ....... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO... N/A PLUMBERS CERTIFICATION DATED: N/A / z~ltuilding Inspector Rev. 1/81 FOK~ NO. 0 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) N~ 16493 z Permission is hereby granted to: ..... ~~~./...; ................. ~ ,o..~~....:~~.....~_~;/.,,~ ....... ~. . ~~.......~..,. ..~..~,~......~,~..~ ............................................... ~....~ ................................ ,t premises located at ....~..~..~... ...... ~..~.~......~... .~...~...~~...~..~x~.y .... County Tax Mop No. lO00 Section ......... ./..f~....~.... Block ...... ~ ........ Lot No ....... .~.~...,/..Z ...... ...~...~Z.,,~.. ................................. , lg...c?.~,~.~ end epproved by the pursuant to application doted . Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765- 1802 APPLICATION 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 featu res. 2. Final approval of Health Dept. of water supply and sswerage 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 showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and CO_Q.~,ition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepareta certificate. C. Fees: Additions $25.00 1. CeFtificate of occupancy New Dwelling $25.00, Accessory',,$i0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5/00, over 5 years $10.00 5.Updated C.O. $ 50.00 Date ................ NewC°nstructi°n ,..~,, Old .... or Pre-existing Building . .-~/...~= .... Vacant Land ........... ;. Location of Proper..... ... .. .......... t .............. ,,...... · House No. Street ~-~x Ham/et Owner or Owners of Property .... County Ta× Map No. 000 Section ..... ..... mock .... ........ Lot ..... O.4'Z ...... Subdivision ................................. Filed Map No ........... Lot No .............. Perm it N o./~. ~.~..~...~-~. Date of Permit ~.~. 8/~..)..A pp licant .... . .-~r~.. ....................... r--- J Health Dept. Approval ........................ Labor Dept. Approval ......................... / ., Underwriters Approval .... ,,................./ .Planning Board Approval ................ , ..... Request for Temporary Certificate ..................... Final Certificate ....... ~ ............ Fee Submitted $ ....... '~'~, .,...'777.. ............. Construction on above described building an~eets all~desand regulations.. Applicant. Rev. 10-10-78 ~ ~ 353o Co II, Examined ............... , 19fi7 BOARD OF HEALTH ...... 3 SETS OF FLANS ....... 'FORM NO. I SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. : TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 TEL.: 765-1803 CALL ................ MAIL TO: ' ....... /(Build, fig Inspector) APPLICATION FOR BUILDING PERMIT 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 oFa 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~.igousing code,j%3dTregulations, and to admit authorizeS inspectors on premises and in building for necessary, inspect~~- ~~. ~ .....---- ----- ~~ '. ~Signature of applicant, or name, if a corporation) (M ailing add/~ss of appli~nt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... d-.-~O..r--~..~.~./9.../....~.*.~/~ .~'... ~C.C~t'cJ~-ocq._ ............... (as on the tax roil or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .... ' ~-' ,2;>'~L,~ ........... 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. ..... ..... o .... .c.s..o ........................... House Number Street Hamlet County Tax Map No. I000 Section /t9 ~ Block '-~ Lot 0 / 7 Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and b. Intended use and occupancy .... 0 CO vi .... l.l .~. . .,~ ........... . : %/~ ". 'i~?.~. .'~'i'. .... 3. Nature of work (check ~vhich abplicable): New Building ..... ' ..... Addition .~-~-.~.. Alteration ~.~. '.4' '':' ' Repair .......... Rempval ........... Demolition .............. Other Work .... ~, ....~---- G.~ .. 4. Estimated Cost ........................... 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 c~s 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing stmcturos, ifany: Front...~ ........ Rear .~'f ....... Depth...~. ~ ...... Height .~..( ........... Number of Stories ....... ~.t/~ .................................. ~ ......... D~ensions'of same structure With alterations or additions: Front ....... ~ ....... Rear ..... ~. ....... pth ~ ~ ' Hight f St De ................... :... e ...................... Number o ofies ................. ' 8. Dimensions of entire new construction: Front .... ~{.. ..... Rear ..... ~t. Depth .... ~ / Height ........... '.... Nether of Sto~es ........................................................ 9. Size of lot: Front ........ [.~.. · .~ ........ Rear ....... /2O ........... Depth ......... ~O~ ....... 10. Date of Purchase ........ A~ ....... Name of Foyer Owner ........................ ~ 1. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~ ..................... 13. Will lot be regraded ........ ~0 ................. Will excess fill be removed from premises: Yes 14 Nam~~ m~i~ ~.. ' . . Address Phone No .... ~~ect ~?~. '~aNOTI~ .............................................. .... ~.~. ~ ................. Address .................. Phone No ................ ~~~t~ ~.~ ~ ~ ~ ~ ....... darers . ' Phone No .... ~ ......... 15.~~~y~ ~0 feet of a tidal wetland? *Yes ..... No ~-' ~{~~~ ~ Permit_~a~ ~ ~e~q~ed. ~ ~ ~: :~u2 9 AM ~ ~ ~'f/~u I T AT PLOT DIAG~M ' [~~~;~ ~-~dNgs, whether existing or proposed~.md~t~l,~¢~c~ensions from ~prgpemali~s~e~ ~ber or descfivtioa a~ordin~ to deed. [~g~;~[e~n~ l~cata whether ALL CO~, , ~' ~ -- ~,~o~UCTioN ~m~$' NOr .... .... ~ ~. O. &b .... ~?. ~ { 5~ ~.~ ........... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the ..................... d ~,~ E~ gO~ ~. : (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his knbwledge and belief; and that the work will be performed in the m~n~r set forth in the application filed therewith. Sworn to before me this ~/ ...day of 19 ~ ? ~~ ~ ~N°talTmublic ............. ~ ....... County.......~~. .....,. ,.' ~w ~bl~ 8~ N~OF, ~ (signature of applicant)]