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Home My WebLink About16594-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail $outhold, N.Y. Certificate Of Occupancy No. Z16376 Date November 6, 1987 THIS CERTIFIES that the building A d d i t i o n Location of Property 585 Mechanic Street Southold h3ds; hiol ....................... 's'~/e;i ....................... h;r3/ol County Tax Map No. 1000 Section .... 6. ! ...... Block 4 .Lot 39 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated 0 c t o b e r 9, 1987 pursuant to which Building Permit No. 1.6594 z dated ...~o. y.e.m.b.e..r..5 .... J ,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 ......... Deck addition with roof to an existing one family dwelling~as apglied for. The certiTicate is issued to VERNA P. FITZPATRICK ..................... ?o¥,~'e;, Y;gdffX~'~&~XX' ................... of the aforesaid building. Suffolk County Department of Health Approval ....... .~/.A. ............................... UNDERWRITERS CERTIFICATE NO. N / A PLUMBERS CERTIFICATION DATED: N/A / Build]iig Int~6ector Rev. 1/81 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPAI~ 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 featu res. 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: I. Accurate survev of p~'operty showing ail 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. Cert[ficateofoccupancv New Dwelling.$25.O0, Accessory ,~10.00 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 ............. New C OhS ~cuc f~ i on..w'~.... Old or Pre-existing Building ............ Vacant Land ............. House No. Street / Ham/et Owner or Owners of Property ....... ~., .-~.. .T. [~.. l CountyTax Map No. lO00Section ..... ~./ ....... Block ....~. .......... Lot..~...~ ........... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ...................... .. Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .... o~ ~ .................. Construction on above described building and p~?.~/tmeets all applicable coders and regulations.. ' '¢ Applicant .... ,~'.~... ,t~/.. , . ,~, ,/~/~ '~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1802 ...... .. / - .., ,~,~,,d . ~ . ~ . ~ ..... Disapproved ~/c ..................................... ................................ ' APPLICATION FOR ~UILDING PERMIT BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. : NOTIFY CALL ................ MAIL TO: Date / O ....... , ...... INSTRUCTIONS a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 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 stree' or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app] cation. c. Tile 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 perm 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 Occupant shall have been granted by the Building Inspector. APPLICATION IS HEREBY MAI~E to the Building Department for the issuance of a Building Permit pursuant to t? Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws. Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe, The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and in building for necessary ~p~;C~ctions. ~ .... r. ~/~...~-,... ~:..~'~~ ...... (Signature of applicant,or dxta~a4, if a. corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Nmne 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: ................................................ ...~. ~. : ............... ,....m..~.c4.,a ~. .&. ~:~. ....... .~. .o. ~r:a a~.b~. ~. iI~t(. . . House ~uln her Street Hamlet ~ County Tax Mal, No. I000 Section ...... .~. [ Block ~ Lot ~ f Subdivision .................................... '. Filed Map No ............... Lot: ............. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............................ ~ ...................................... b. Intended use and occupancy .......... ~......Cu~..: ...................................... 3. Nature of work (check which apphcable): New Building .......... Add~tmn .......... Alteration .......... Repair .............. Removal .............. Demolition ............ Other Work.. t~Cg-~.: ..... : (Descriplion) 4. Estimated Cost ...... ~07~ ~i .0~. ........................ Fee ...................................... : " (to be paid on filing this application) 5. If dwelling, number of dwelhng umts ............... Number of dwelling units on each floor ................ If garage, number of cars ..., ..................................................................... 6. If bqsiness, commercial or mixed occupancy, specify nature and extent of each type of use .......... ' ....... 7. Dimensions of existing structdres, if any: Front ............... Rear .............. Depth ............... Height ............... Ngmber of Stories ........................................................ Dimensio~ns!q~ sa~e~i~tmcture i with alterations or additions: Front ................. ~ Rear .................. · Height Number of Stories Depth Dimen'sions of entire new construction: Front .......... . ..... Rear ............... Depth ............... ~ Ho. ~ht '. N0mber nf Stnri~s Size of lot: Front ' Rear Depth Date of Purchase ......... i .................... Name of Former Owner ............................. Zone or use district in which premises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ..... ..,i .................... Will e2~cess fill be removed from premises.'_ Yes No Name of Owner of prem~sesV~J~qt~. Name of Architect ............................ Address ................... Phone No ................ Nmne 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. -.i PLOT DIAGRAM Locate c/early and distinctly all buildhngs, whether existing or proposed, and, indicate all set-back dknensions from :k number or description according to deed, and show street names and indicate whether 10. I1. 12. property lines. Give street and blo~ interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................ ..................................... ............ being duly sworn, deposes and says that he is the applicant (Name of individual s!gning contract) above named. He is the .................... . ..................................................................... (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 this 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 manner set forth in the application filed therewith. Sworn to before me this