The URL can be used to link to this page

Home My WebLink About14919-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z;146~_ 5 Date ..... .J.u.l.y.. 9 ............... . ..................... i9.8.6. THIS CERTIFIES that the building deck addit ion Location of Property 3040 Skunk Lane Cutchogue, N.Y. 11.9.35 House No. Street Hamlet County Tax Map No. 1000 Section . 9.9.7.. ....... Block ..... 0.8. ........ Lot....~.2. ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .M.ay..~7~ ...... ,19 .8.6. pursuant to which Building Permit No...1.4..9.1.9:~z. ........... dated .... ~Y._.29, ................ 19..8.6, 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 ......... .... Dm.ak. a~ldit iP~. t o..~ is.t.i~g. P. nev ~ i ~Y..clv/¢~J~in. g, ..................... The certificate is issued to ...... Cha. r. les. ~,. &. D. oro.t.hy. J....Mcg~l~n ................ (owner,~..;~ of the aforesaid building. Suffolk County Department of Health Approval .......... .N/.~ ....... ] ............... UNDERWRITERS CERTIFICATE NO .................. 2,I/. ~ ............................ Building Inspector Rev. 1/81 ~oIt~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMEhlT TO~ HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14919 Z Permission is hereb/granted to: .c~.~.~~..~.,...~ .... ,,.ao...~.~,,..,~,~.,~..,.~ ................ .... ~.o~,_......,p,...:.V..,....u.~..a~... ........ o, prem,,e, ,ocot~d at...~...O...~..O.....~....~,..~. ......... .C_,~Z'.~~ ...... County Tax Map No. 1000 Section ..... ..(~...~...~. ...... Block ..... ..~..~ ....... Lot No ..... !...,.~,. ............ pursuant ,o application dated ...... .~.~..~ ....................... 19.~..~., and approv~ by the 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 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 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 sifnilar bui[dings 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 (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~'operty 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 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 5.Updated C.O/ $15.00 Date .......................... New Building V/ Old or Pre-existing Building Vacant Land Location of Property .Z~.~.~... House No. Street Ham/er Owner or Owners of Property . .~--,~/~. ¢:./.e..~...~.:..0/-...~. ~.1~...o.' .~..V..~.-~-'.....(~..5~.~.. ?...L:..r~. ~ ....... Countv Tax Map No. 1000 Section .... (~.c].~. ...... Block ...~).~. ......... Lot.. / ~ ' Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo. ~.~. 9,/..~. Z Date of Permit vC/~/~(~Applicant ............................. Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted ................... Construction on above described building and permit meets all applicable codes and regulations. ................ FIELD INSPECTION FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL Ye ADDITIONAL COMMENTS: 0 ~ >4~° 0 ~o~ -q XXXXXXX ~ OZ TOTAL RISE (DECK HEIGHT) -% 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. ~.OUNDATION 2ND £ ] INSULATION FRAMING [ ] FINAL R[MARKS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~°OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined...~5~"~ .~...°1..., 19 ~.~'. Approved . .~.. ~..o~.~..., 19~..(¢. Pa=it No.! .~..~.! .~..~.. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,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 {~ 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 inspections. . (Signature ofgpplScant, ~r name, if ~orporation) · rt.. &o..mo.. ......... .... ..... · ~-- ~aiii~'address ;5,,~applicant) . State whether applicant is o~lessee, agent, architect, engineer, general contractor, electrician, plumber or bmlder. Name of owner of premises ...~/..7.~..~.....~7..c< . .~....~m~...5'~: . ?.. -~..~ ............................. (as on tlfe tax roll or%atest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) 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 ................................................... ..... ......... .. . House Nmnber Street County Tax Map No. 1000 Section c'/'~ '~ _ ~7 Block . ............. Lot.../. '%¢~. ............. 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 · · 3. Nature of work (check which applicable): New Building .......... Addition . L'~ Alteration Repair .............. Removal ............. Demolition .............. Other Work ............... (Description) 4 Estimated Cost - I (to be paid on filing this application) 5. If dwelling, number of dwellinglunits ............... Number of dwelling units on each floor ................ If garage number of cars 6. If business, commercial or m;xeld occupancy, specify nature and extent of each type of use ..................... 7.. Dimensions of existing structures, if any: Front ....... ........ Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions~of,:sam~e structure With alterations or additions: Front ............. Rear .. . Depth ................... :... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height .. ) 2 ........... Number of Stories ............. ........................................... 9. Size of lot: Front .......... ~'. ........... Rear ...................... Depth ...................... 10. Date of Purchase ... i..... ............. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed constructinn vinlate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ..................... ~. :,,¥...... ...... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ...... Address ................... Phone No..~. ~. ~.-~ ~.o. ~..~-4. Name of Ar hitect Address Phon N ' Name.' of Contractor ........ i .................. Address ................... Phone No .............. 15. Is this property locatedI withinli00 feet of a tidal wetland? * Yes ..... No ..... · If yes, Southold Town Trustees Permit may be required. I , PLOT DIAGRAM Locate clearly and distinctly"all buildings, whether existing or proposed,' and, indicate all set-back dimensions from property lines. Give street and block number or description according to deqd,~ and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUN~r~Y' OF --~ S.S ,.. ~ .¢. '..~..q-.~ ~ .............. being duly tworn, deposes and says that he is the applicant (Nam~ o~ndividual si!ning contract) above named. He is the : ' ., : (Contractor, agent, corporate of said owner or owners, and is duly authorized to perform or have peri application; that all statements contained in this application are true to tl work will be performed in the manner set forth in the application filed thru Sworu to before me this : ................. · ~ ~...dayiof ...... ~0~.~..~.~.. .........19 .~.¢ $otaryPublic, . ..... .~....i~. .~/:..D.U. .. County ~fficer, etc.) ~rmed the said work and to make and file this .e best of his.knowledgg-and belief; and that the- ;with. (Signature of applican,t)