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Home My WebLink About15279-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ...zrJs. 977 ...... Date .2.8.:. L98 ....... THIS CERTIFIES that the buflflmg . DECK ADD IT ION Locatlonofl~operty 660 Schoolhouse Road Cutchogue, New York House No Street Hamlet County Tax Map No. 1000 Section . 1.0.2 .... Block 0. 5 ........ Lot ., ! .2 ......... Subdlvmion ................. Fried Map No ...... Lot No ............. conforms substantially to the Apphcahon for Buridlng Permit heretofore fried in flus office dated September 2, 1986 pursuant to w~ch Bml&ng Permit No. 15 27 9 Z dated .S e.p t e .mb e r, .1.9.,. ~986 was issued, and conforms to all of the requirements of the applicable provisions of tile law The occupancy for which tlus certificate is issued ~s . DECK ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to .... WAYNE . &. ?I. ARY. M.O.T. T ............. (owner, I~gO~a~ of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO.. N/~ PLUMBERS CERTIFICATION DATED: N/A Rev 1/81 · o~ NO. · TO~H OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDIHG PER~,~IT (THIS PERAAIT k,~UST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 15279 Z Perm~ssron ~s hereby granted to. ...Q~-__~~ ~ :q........t!...ta.~.~.... at prermses located at .~..~..~.......~,.~.~ ..~....: ...... .~...~.~ ..... Count,/ Tax Map No lO00 Sect,on I .ID ~ Block ...... C~..~.. .... Lot No ..}..~ ........ pursuant to apphcohon doted ~'~.~'~'~. ~ - . .... , 19Y.(~., and approved by the Budding Inspector. Buildmg nspector Rev 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- ][802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be fdled m typewriter OR ink, and submitted == ~ to the Budding Inspec- tor with the following; for new buildings or new use 1 Final survey of property w~th 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, Muluple 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. For existing buildings (pr~or to April 1957), Non-conforming uses, or buildings and "pre-ex~sting" land uses: 1. Accurate survey of pzoperty show~ng all property lines, streets, buildings and unusual natural or topographm features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buddings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent mforma- t~on required to prepare a certifmate. C. Fees: 1. Certfficate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2 Cert~fmate of occupancy on pre-ex~st~ng dwelhng $ 50.00 3 Copy of certlfmate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 )7 5.Updated C.O. $ 50.00 Date ...................... ~' NewConstructIon ...... Old or Pre-ex,sting Bu fldtng ........... Vacant Land ............. Locat,on of Property .~..~..O. ............... 0.6./ ~t~,~;E ](~ ~ ~c~e~ ~ ~ House No. Street Hamlet Owner or Owners of Property ....................................................... County Tax Map No. 1000 Section ..../.~.7-. ........ Block d~" Lot .... Subdw~s~on ........................ Fded Map No ........ Lot No ............. Permit No./¢Z77 Z. Date of Perm,t ~/~-,~ -~Apphcant ~'/'~K .'~-.. ~ /~ ~' Health Dept Approval .................... Labor Dept. Approval ...................... Underwriters Approval ..................... Planning Board Approval ..................... Request for Temporary Certlhcate .................... Final Certificate ...................... Fee Submitted $... ~¢'" aO,~_, Construction on above described building and pe~eets all ~es and regulations. Apphcant ..... ~ . ....................... Rev 10 lO-Ta FiELD~INSI~CTtON DATE COMMENTS FOUNDATION ( 1 st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE ~O~lFf ~UILDING OEPARTMENT A 785-1~2 9 AM TO ~ ~ ~R THE ~[OWING IN~PECTION~ FOR POUREI~ ~OHt~[~- ' ~ 2 ROUG~ ~RA~iN(~ ~ ~LdMBING ALL CONS~HUCTION SHALL ~EET THE ~EQUI~MFNTS O~ THE N Y ~ CONStRUCtION · ENERGY ~DES NOT ~S~NSI~E ~R ~SIGN OR CC,~S~UCTION ER~RS 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~AL DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND I- ] INSULATION [] FRAMING [~FI~ DATE INSPECTOR~,~ 76S-XSOZ BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND I' ] INSULATION [ ] FRAMING X] FINAL REMARKS: Approved Disapproved a/c FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N Y 11971 TEL.: 765-1802 , 19~ , 19 ~ Permit No. ] APPLICATION FOR BUILDING PERM IT t~~.,,m ~,~ OF S~JTHOLD lqecea, ved ........... , 1 9 · Date ......... 19 INSTRUCTIONS a TI'us apphcatlon must be completely filled m by typewriter or In ink and submitted to the Building Inspector, witl 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 adjmnmg premises or pubhc stm, or areas, and giving a detaded descnptlon of layout of property must be drawn on the diagram which is part of this apl cation. c. The work covered by flus application may not be commenced before ~ssuance of Building Permit d Upon approval of this application, the Bmld~ng Inspector wril ~ssued a Buridmg Permit to the apphcant Such pert shall be kept on the premises available for mspechon throughout the work. e. No buriding shall be occupied or used m whole or m part for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector APPLICATION IS HEREBY MA~DE to the Buridmg Department for the ~ssuance of a Building Permit pumuant to t Builchng Zone Ordmance of the Town of Sou]hold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construct]on of buildings, additions or alteratmns, or for removal or demolmon, as hereto describ, The apphcant agrees to comply .w~th all apphcable laws, ordinances, building code, housing code, and regulataons, and admit authorized inspectors on premises and m bufldmg for necessary inspections. (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect Name of owner of premises ~/O~_..- -a- as on the tax roi1 or latest deed) If applicant is a corporation, signature of duly authorized officer engineer, general contractor, electrician, plumber or build, (Name and title of corporate officer) Burider's Plumber's License No Electrician's License No ..... Other Trade's License No Location of land on which proposed work will be done House Number Street County Tax Map No 1000 Section /O ~- . . Hamlet Block ~ ....... Lot / ~' ..... Subdivision . .. Fried Map No Lot . (Name) State ex,sting use and occupancy of premises and intended use and occupancy of proposed construction a Exlstlnguse and occupancy b Intended use and occupancy ...........-~:';~+~'~*'. ~, '~",, ......... 3. Nature of work (check which applicable): New Bmldlng ....... Addition ....... Alteration ...... · Removal ....... Demolition ......... Oth[r Work· .~-~m,~ ..... Repair '~ 'd t~' (Description) 4. Estimated Cost /..~..~?.~...09 ................... Fee... (to be pad on filing this application) 5. If dwelling, number of dwelling units .............. 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 Dimensions of exmtmg structures, ff any. Front .............. Rear ............. Depth ............. Height ........... Number of Stones ................................. D~menslons of same structure with alterations or additions. Front ........... Rear ............. Depth ............ Height .................... Number of Stones ................ 8. Danensions of entire new construction Front ......... Rear ......... Depth ............ Height ........... Number of Stones ......................................... 9. Sizeoflot' Front ........... Rear .................... Depth ................ 10. Date of Purchase ................. Name of Former Owner ...................... 11. Zone or use dmtnct in winch premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation ......................... 13 Will lot be regraded ....... ;/..:.. Will excess ~l be remov~r~,~,mq~premises' Yes. i~ 14. Name of Owner of premises tz-f. f-f'~ .~?t. ' .~..~-.'/f . Address ~o.6.w. 1'~!60." C' ~Jf.~' .~. Phone No ~.f..~. ~f'.~. ~.... Name of Architect .... Address ............. Phone No .......... Name of Contractor ................ Address .............. Phone No ....... 15. Is this property located wzthzntO0 feet of a tidal wetland? * Yes ..... No .~... · If yes, Southeld Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and dlstmctly all bufldmgs, whether existing or proposed, and, indicate all set-back danenmons irc property hnes. Give street and block number or descnphon accordmg to deed, and show street names and indicate wheth interior or corner lot STATE OF NEW YORK, COUNTY OF ......... S.S (Name of individual mgnmg contract) above named being duly sworn, deposes and says that he ~s the apphca 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 f'fle ti application; that all statements contmned m this apphcahon are true to the best of his knowledge and belief, and that t~ work wdl be performed in the manner set forth m the application filed therewith Sworn to before me this ..... ~. ..... ,...day of... ~ ..... Notary Pubhc, ~... ~...~. ~'..~..~. County ' '~' '~3 (Signature of apphcm