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Home My WebLink About16591-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17381 Date OCTOBER 6~ 1988 THIS CERTIFIES that the building Location of Property 645 HOLDEN AVEN~JE House No. County Tax Map No. 1000 Section 110 Subdivision ACCESSORY CUTCHOGUE~ N.Y. Street Hamlet Block 5 Lot 51 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 30~ 1987 pursuant to which Building Permit No. 16591-Z dated NO~EMBER 5~ 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 ACCESSORY BUILDING AS APPLIED FOR The certificate is issued to MARY LOU CA~SIDY (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED ' Building Inspector Rev. 1/81 FO]~M NO. ~ TOWN OF SOfT'OLD B~JILDING DI~PARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No- 16!~91 Z County Tox Map No. 1000 Section ....... ,~.~..,~.. ........ Block ....... .,0.....~'.., ..... Lot No....~..~.] .............. ...... .~..~......~... .............. , 19.~...~., and approved by the pursuant to application dated Building Inspector. 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 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: I. 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 o{ Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approvat 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: I. Accurate survey of property 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 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling.$25.O0, Accessory,.$]O.00 Busi~ess $50.00 2. Certificate of occupancv on pre-existing dwelling 3. Copy of certificate of occupancy $ 5.00, over 5 years $I0.00 4.Vacant Land C.O. $ 20.00 /.~./~/.~...~ 5.Updated C.O. $ 50.00 Date ................ New Cons t r uc t i on Old or Pre-existing Building Vacant Land Location of Property ........ ~.~..~7 ................ /~.~..~..~.....~.-~.,.................... House No. Street f'lam/et Owner or Owners of Property ...... /~ .~. r .u. .................................... County Tax Map No. 1000 Section ...... //..~ ..... Block .... ~. ......... Lot ..... .~../. ....... Subdivision....~. ..... [ ...................... Filed Map No ........... Lot No .............. Permit No.../.~. ,)".~../... Date of Permit .///..~.~ .... Applicant../~ ~,~... ~OU ..~¢'~.L,P~ ............. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .. Fee Submitted $ ..... /. ~ f ~ ............. Construction on above described building and permit meets all applicabJ~codes and regulations. .... ..... TOWN 0I" SOUTIIOLD OFFICI'; OF BUILDING INSPECTOR ILO. BOX 728 TOWN HALL SOU rllOLl), N.Y. 11971 TEL. 765-1802 To Whom TI]is May Concern, h'e are unable to complete your Certificate of Occupancy because .of the folio'wing reasons. /_~/ An application for Certificate of Occupancy is not on fil~,. ~,~' /'_~// :lo Under;.;riters Certificate on file. -//_~_~ The check is(~/not on /~/ l.;o r, Iealth Dept. Approval on file. /_--_/ No final inspection has been made. Please contact: our office on Thank you for your cooperation/ Building[ Dept. ~. */_-/ this matter. ~Io Plumber Solder Certificate on file. ( all permits involving plumbing being .ts ~ued after April 1,19~4 ) 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. REMARKS: FOUNDATION 2ND [ ] INSULATION / FRAMING [~/FINAL INSPECTOR~ 7GS-J.802 BUILDING DEPT. INSPECTION [.]/~/FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ,r. ] FINAL REMARKS: DATE FOUNDATION FOUNDATION (2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL ADDITIONAL COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY ......... · CHECK .......... SEPTIC FORM · NOTIFY . CALL '''''~' ~' '~: .... MAIL TO: Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date..../fl/~..O ....... 1 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. 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 inspec~f.i~??..,..f ~...~.. ~ .. (Signature of a,p'plicant, 9~'name, if a corpo, r~tion) .........~v(,,..,.:... . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............. ,e¢. . - ....................................................................... Name of owner of premises . ~..~ ( ?..~..., .C~..~. .~.4 .f~..'./', .................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) . ALL CONTRAI~TOR~S MUST BE SUFFOLK COUNTY LICENSED Builder's License No ...... .%'.&..a~.T., ............ 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. .Y. .5 ................... ........... C .............. House Num her Street Hamlet County Tax Map No. 1000 Section .... /.//..dP. ........ Block ..... .~ ........... Lot..~.7/. .............. 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 .................. , .............. .,/, ......... /I .... 3. Nature of work (check which applicable): New Building ....~.'..... Addition. ......... Alteration. .......... Repair .............. Removal .............. Demolition .......... .... tJtner worn .,~. 5',qeep · · (Descrip.tion) 4. Estimated Cost ....... ~...~/?.o..,. ~ .................. Fee ......... ~ ............................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling ufiits on each floor ................ If garage, number of cars ........................................... i ............................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7 Di i f isting tructu if any Front Rear D pth · mens OhS o ex s res, ; ..................... , ........ e ............... Height Number of Stories Dimensions of same structure with alterations or additions: Front .................. Rear .................. Depth ...................... Height ...................... Number df Stores ...................... Dimensions of entire new construction: Front ..... ].~ ........ Rear ../~..! ........ Depth /.~.7./-/r.~.'.~.n.~(¢ Height ..... /..~. ....... Number of Stories .... / ...................... i ............................. 9. Size of lot: Front ...................... Rear.. i ................... i' Depth ...................... 10. Date of Purchase .... {/.~. ? .................... marne of Form er Owner i C~/~'[5 ~rJT. i.. ~ .~.c'f'ff ............ 11. 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 ...................... ; ..... Will excess fill b~ removed from premises: Yes No 14. Name of Owner of premises/~ ./~./.(,0.4 .C.~ .~5.'./fi/. Address .~.rf.~./'~-a~ .°~..t~.~. Phone No. ~.~.tFY7 .~.~.'.q/~.. 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. PLO-T DIAGRAM Locate clearly .and distinctly all buildings, whether existing or proposed, and. :ndicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY ~ ........ .-~..,/~ . ~ .-~ ....... ofi~ icii .......... being duly sworn, deposes and says that he is the applicant above named. He is the ........................................................... ~ ......................... ~ .... (Contractor, agent, corporate officer, et'cO of said owner or owners, ~d is duly authorized to perform or have perfo~ed th~ said work and to m~e and file t~s application; that all. statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~ner set forth ~ the application filed therewith. Sworn to before me this ........................ day of ...................... Nota~ Public, ~~ .~: ............ County Te~ Ex~ March ~,