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Home My WebLink About15492-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Zil. Sl.89.. Date January 9, 1987 Construct Carport to existzng accessory THIS CERTIFIES that the building ' ~ ~'r'a g e'. ............................. 4605 Stillwater Avenue Cutchogue, New York Locatmn of Property ........................................................... House No Street Hamlet County Tax Map No. lO00 Section .Block ............ Lot .............. Subdlwszon ....................... Fried Map No ....... Lot No ............ conforms substantmlly to the Apphcat~on for Building Penmt heretofore filed ~n tlus office dated November 5, 1986 . pursuant to wluch Bml&ng Permit No. z 154.92 dated N o v e mb e r.. 13 ,.. ! 986 , was msued, and conforms to all of the requirements of the apphcable proms~ons of the law. The occupancy for wluch tlus certificate is assued is ....... CARPORT TO EXISTING ACCESSORY GARAGE. PAUL & CHARLOTTE GALGAN The certfficate ~s ~ssued to ............................................. (owneqr~2qg.~ff~Ilt~ X X X of the aforesmd building Suffolk County Department of Health Approval N / A N/A UNDERWRITERS CERTIFICATE NO ............................................. PLUMBERS CERTIFICATION DATED: N/A Rev 1181 rOB,~ NO. I* TCI~VH OF $OUTHOLD BUILDIblG DEPARTMENT TOWN HALL SOUTHOLD, I%1. Y. BUILDING PERJ~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) County Tax Map No 1000 Sect,on . I"~.~ .... Block ....(~...'~... .........Lot No ...... .t~.~..: ....... Bufldlng Inspector. Building Inspector Rev 6/30/B0 Ao Bo FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- [802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This apphcat~on must be filled in Wpewnter OR ink, and submitted I~ to the Building Inspec- tor with the following; for new buildings or new use. I. Final survey of property with accurate location of all buddings, property lines, streets, and unusual natural or topograph m featu res. 2. Final approval of Health Dept. of water supply and sewerage d~sposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and s~milar buildings and ~nstalla- t,ons, a certificate of Code compliance from the Architect or Engineer responsible for the budding. 5. Submit Planning Board approval of completed s~te plan requirements where applicable. For existing buddings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property hnes, streets, buildings and unusual natural or topographic features 2. Sworn statement of owner or previous owner as to use, occupancy and condition of build,rigs. 3 Date of any housing code or safety inspection of buddings or premtses, or other pertinent informe~ t~on required to prepare a cert~ficate C. Fees: 1 Certificate of occupancy $5.00 2. Certlhcate of occupancy on pre-ex~stmg dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ~-~ 5. Updated C.O. /- $15.00 Date ....................... / NewCOns %ruct ion.. ~. ~ Old or Pre-ex~stmg Building ........... Vacant Land ............. Location of Property .......... .~.~..c~. f ......... , ....... .~y..~. ~ .................... House No, Street Ham/et Owner or Owners of Property ............. County Tax Map No. 1000 Section .............. Block ............. Lot ................ Subd~ws~on ................... Fded Map No ......... Lot No ............ Permit ........... Date of Permit ...Apphcant ................................ Health Dept. Approval ....................... Labor Dept. Approval ........................ Underwriters Approval ...................... Planning Board Approval ...................... Request for Temporary Certificate ............. Final Certificate ....................... Fee Submitted $ ........................ Construction on above described bu~ld~all appJ~able codes and regulations. Rev 10-10 78 310f¢-I 15145 OUNDATION (1st) OUNDATION (2nd) OUGH FRAME & FLUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 7GS-XS02 BUILDING DEPT. INSPECTION [ ] FllAMING REMARKS: FOUNDATION XST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FINAL >Z P~ Examined l0 .~o~,j.~, Approved Disapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL: 765-1803 )~, 19~G Penmt No } t~'~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Rec~3_ved[ ........ :.% 19... INSTRUCTIONS a Tlus application must be completely filled m by typewriter or in ink and submitted to the Bmldmg Inspector, with 3 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 streets or areas, and glvmg a detmled description of layout of property must be drawn on the diagram which is part of thru apph- cation c. The work covered by tlus application may not be commenced before issuance of Budding Permit d Upon approval of this application, the Building Inspector will issued a Braiding Permit to the apphcant Such perrmt shall be kept on the premises avadable for inspection throughout the work. e No budding shall be occupied or used m whole or in part for any purpose whatever untnl a Certificate of Occupancy shall have been granted by the Bmldmg Inspector APPLICATION IS HEREBY MADE to the Bmldmg Department for the issuance of a Bmlding Permit pursuant to the Bmld~ng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or Regulations, for the constructmn of bmldmgs, addltaons or alterations, or for removal or demoht~on, as hereto described The applicant agrees to comply with all apphcable laws, ordinances, bu_j~rg~e, hous~l~ code, and regulations, and to admit authorized inspectors on premises and m building for necessa spections ~_~~ (Signature of applicant, or name, if a corporation) (mail~ng address of applicant) State whether apphcant is owner, lessee, agent, architect, engzneer, general contractor~ electrician, plumber orbm erld (as on the tax roll or Iatest deed) If applicant is a corporation, signature of duly authorized officer (Name and txtle of corporate officer) Bmlder's License No ..... Plumber's LmenseNo. Electrician's License No Other Trade's License No Location of Iand on which proposed work wall be done House Number Street County Tax Map No 1000 Sectmn /~.7... Block Hamlet OO ..... Lot.. ...... Subdivision. .. Filed Map No .... Lot (Name) State existing use and occupancy of premises and ~ntended use and occupancy of proposed construction a. Exmtmg use and occupancy dPeX. ~.t~. y'...Z.-~.~, f.~.~..~C..~7'' .............. b Intended use and occupancy //~ ~'~q..?~...~..~..~,~r~.~( .~.-~.~ .C°..O~.. (..22~.. ?~..~.). ,~O~. 3. Nature of work (check which applicable) New Budding Repmr .... Removal .. 4 Estimated Cost 5. If dwelling, number of dwelling umts ..... .. Addition ...... A~teratlon .... Demohtion ..... Other Work ........ (Descnptlon) (to be paid on filing th~s application) ·.. Number of dwelhng 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. Dlmenmons of existing structures, if any Front . ~ &' .., Rear .......... Depth..../?. ...... Height d"/ Number of Stones . / Dnnenmons of same structure with alterations or additions Front . .*-70. .... Rear Depth . /~ ' .. Height ~' Number of Stones 8. Dmaenmons of entire new construction' Front ...... Rear ............. Depth ..... Height ........ Number of Stones .................................. 9. Size of lot Front Rear ......... ./r/.'!:~.z?De~?'"'~//"~..'"21 '' 10. Date of Purchase .~,~. ?~.z/r-. ~. i i i ...... Name of Former Owner 1 1 Zone or use d~stnct in which premises are situated ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation . ....~.0. ..................... 13 Will lot be regraded .................. Will excess fill be removed from premises Yes No I4. Name of Owner of premases . Address ~/~8~.cc .~..,pr~... Phone No. Name of Architect .............. Address .......... Phone No ............. Name of Contractor ........... Address ............. Phone No ......... 15.' Is this property located within 100 feet of a tidal wetland? * Yes ..... No : ..'.'.~. · If yes, Southold Town Trustees Permit may be requmred. PLOT DIAGRAM Locate clearly and distinctly all bufldmgs, whether ex~stlng or proposed, and. indicate all set-back dmaenslons from property hnes G~ve 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 OF ....... (Name of individual signing contract) above named being duly sworn, deposes and says that he is the applicant ...... /.~. ...... day of Xlotary Pubhc ....... ~...~- N~ 4~ ~k ~ He Es the ............................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly anthonzed to perform or have performed the smd work and to make and file tins application, that all statements contained m thru apphcatton are true to the best of his knowledge and belief; and that the work wall be performed m the manner set forth m the application filed therewith. Sworn to before me this .~..~/..t"~.. Count.:l' ~~.~..,..._~. ........ (Signature of applicant)