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Home My WebLink About14582-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~RTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17402 Date OCTOBER 11, 1988 THIS CERTIFIES that the building Location of Property 4515 House No. County Tax Map No. 1000 Section ADDITION PEQUASH AVENUE CUTCHOGUE Street Hamlet 137 Block 4 Lot 5.2 Subdivision FLEETWOOD COVE Filed Map No. 1265 Lot No. 13 & 14 conforms substantially to the Application for Building Per~kit heretofore filed in this office dated JANUARY 12~ 1986 pursuant to which Building Permit No. 14582Z dated FEBRUARY 12~ 1986 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 ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED JAMES & JOHANNA CANCRO (owner, PENDING Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, No Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is herebK gronted to: County Tax Map No. 1000 Section .... J...~..-J .......... Block ..... .~....~ ......... Lot No ..... ..~..: .~.. ......... pursuant to application dated .....~..~~...J....~. ................. , 19..~...~.., and approved by the / / Building Inspector. Fee $..~..~.. :....~... ....... Rev. 6/30/80 BLDG. DE! T. 'tOWN OF SOUTHOLD FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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: 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 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: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res, 2.Sworn statement of owner or previous owner as to use, occapancy 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 iS10.00 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 4.Vacant Land C.O. $ 20.00 5 .Updated C.O. $ 50.00 Date ..... .~..~. ,~..Y.~..~.~' ........ NewCons truc tion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~..~../.~....-'~, .e.~. (J...~ .~..~....~ .L)..~. ..... .~..~.~..~.~..O.~. ?..~, ...... ~ f .~...~ House No. Street /'/am/et Owners of Property ~',~hl~.~ W- --~J~;~,~.~. ~ C,~A.~.cr Owner or ............................................ County Tax Map No. 1000 Section ........... 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 Cert f cate~ , x .......... Fna Certif cate ... ~ .................. Fee Submitted $., ~(~ .(..~../.~.~..~.. .... Constr~ction on abov~ described building and,permit meets all applicable codes and regulat ons. C,0~751-]~ ~ Applicant ~ ~ ~ · . .................................... Rev. I0-10-78 ~oo~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~'~' ~ BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 -- O("I'OB~':~ lq ~gP, f~ 3~g~6286/g6 N 041064118 ~te Application ~o. on fil~ THIS CE~IFIES THAT ~y t~ ~t~ ~uipme~t ~ ~ ~ ~ int~ ~ t~ ~i~t M~ on t~ ~ ~t~ numar i~ t~ ~s of (~ ~ ()~ F~ and found to ~ in compliance with the requirement~ of this ~ard. I bN~S }~1~ ~S I OVENS I M~ W~I~S IXH~ST F~NS B~ S ~ R V I C E J S~IIVICE DISCONNECT NO. OF 1 ~ 50 CB OTNIK, TUS: PANF,[,gOARDS:I-19 CIR. 150 STI*iPNOS K l FRANK 412 C bit ],F* NI':CR C(I'}'CHOGOE, NY, This ~fka~ m~t ~t ~ a~r~ in any ma~er; rmurn ~ ~ offi~ of t~ ~ard if incor~. Inspectors ~y ~ identifi~ ~ ~ cmdentia s. COPY F~ ~IL.DI~ ~RTMEHT. THIS COPY ~ CERTIFI~TE ~ST HOT BE ALTERED IN ~Y ~ER. · ~o~ ~o~ C_ A ^~c~O Memorandum from .... BUILDING INSPECTORS OFFICE TOWN OF SOUTHOLD Town H^LL, SOUTHOLD, N. Y. 11971 765-1802 FIELD INSFECTION 1. % FO O__N D A_T Ip_N -- (1st) FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-180:3 Examined ~.~3,~q~q~.&..~.., 19~. .~. Approved .~....~4,~,~4~.~., 19 ~.~ Permit No..~.q .~..~..&..'~-. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,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 throu~hout 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 necessaj~y inspections..~ ~r~ .//(Signatt~/e"of applicant, ~; name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, elec.trician, plumber or builder. ....... .............................................................................. Name of owner of premises .0 .~..~.a..~...~.'...~.'..~..~..C.~.O...).,..~..0..il..&..n.h. ~., .~......~ .,~...,,~..~..ff.o. ......... (as on the tax roll or latest 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. /¢ .~. (.5-.....~..e~.~..~..r.~...~.o..o7. ...................... ........................................... ............. .............. co?c4 House Number Street/7M O ~ ,Hamlet O ~' ~ County TaxMapUo. 1000 Section~Z~.~..-.-~. ..... Block ..~.~O~.~.~ Lot.j~0..~~ ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constrRction: b. Intended use and occupancy ....... /~ .................. ~~,..~.i ......................... 3. Nature of work (6iieck whiett~pplicable): New Building .......... Addition .......... ~teration .......... Rep~r .. ~ o.~.~. Ro~oval ...... Demolition ..... Other Work ............... 4. Estimated Cost~:¢.)~.~ ........................ Fee ...................................... ' : ' ~ (to bo paid on filing this application) S. If dwelling, number of dwelling units / Number of dwelling units on each floor· If garage, number of cars ....... [ ................................................................ 6. If business, commercial or mi~ed occupancy, specify nature ~d extent of each type of use ..................... 7. D~ensions of existing?mctu~es, if any: Front ............... Rear .............. Depth ............... Height .... P[.g~.~ ~.. N~mber of Stories . ~elY¢m... ~.~ PZq n~ J: ..... D~onsions,of same structure with alterations or additions: Front ................. Rear ................. Depth .... 2 ............. ~... HeiSt ............ ~ .......... Number of Stories .................... ' 8. Dimensions of entire new comtmction: Front ..... ~/~... Rear ............... Depth ............... n~;-ht N~mber of Stories 9. Size of lot: Front .... ~.O.~ ............ [e~ .... ~.O ........... Depth . 10. Date of Purchase ........ ~/.~ .*~/~ ~.g ..... Name ;f Fom:r Owne} ,. ~.O.~ ~ ~.Mt ~ ............ 11 Z d' 'ct' wh'ch~remise situat d . one or use lStrl m 1 s are e ..................................................... 12. Does proposed construction vi¢late any zoning law, ordinance or regulation: .... ~.~ ........................ 13. Will lot be regraded ...... ~.~ ..... , ........ .....Will excess fill be remgved from premises. Yes No 14. Nme of Owner of premises4~.~4.0o~g. O~ddress ~.C(~.~.~l~.~q~hone No. ~$¢n~.~ ~... Nme of Architect ........ ~ .................. Address ...... ~ .X .~:.{ ~... P~ hone No ................ Nme of Contractor~ .~[~.. d~5..~W2. Address [[ .... Phone No. . ~[ .... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and bloc~c number or description according to deed, and show street names and indicate whether interior o~ corner lot. . ~ STATE OF NEW ,YORK, COUNT',: OF. So · ..................... being duiy sworn, dePc~ses and Rays.thht h'o is the"applicant (Name of individual Signing contract) . ~, , above named. He is the . 1 .................... I ...................................................... .;... }. ~.. ...... i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d¢ly 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 ...~ ........... ~..'~. ..... day°f .... ~~ ...... ,197.~. Notaryeublic ..... ~..~:. ...... ~.~ ~t~-~ .... County ~l~lV~~ (Signature of applicant) 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING REMARKS= [ ] FINAL DATE INSPECTOR/~'''~ , OT~F¥, ~UILDING~, DEPARtmENT ' AT ¥ ~ 1802 9~Aa~ ~0 4: PM ~R THE t ~OUNDAr!ON ~OR~QUIREO ALL CO~:~TRUCTION ~ALL MEET [ ~HE~ ~UiP~MENTS OF~HE N ~ ~[~E~NS~RUC~iON~& ~ERGY ~E~IGNOR CONSTRUCTioN ERRORS, !' i ~OTIFy ~UILD~NG DEPARTMENT AT 765-1802 9 A~ TO 4 P~ FOR THE FOLLOWING INSPECTIONS: 1 FOuNDATiON '~WO ~QUJRED 3. INSULA F ~. FINAL CO":~TRUCT~ON BE COMP~ ETE FOR C,O. ALL CONsTrUcTiON SHALL ~EET THE REQUIF~E~ENTS OF THE STATE CONsTRUCTiON & ENERGY CODES, NOT ~S~NSIB[.E FOR r~F~iGN OR CONSTRUCTION ERRORS, OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY