The URL can be used to link to this page

Home My WebLink About14682-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. Certificate Of Occupancy No. Z16160 Date September 14, 1987 THIS CERTIFIES that the building . .A. 1. t..e.r..a..c .c.e.s.s..o .r.y ............................. Location of Property 4515 Stillwater Ave. Cutchogue House No. Street Ham/et County Tax Map No. 1000 Section 137 .Block 03 .Lot 04 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .M.a.r.c..h..I.9. ,...1.9.8. 6. ..... pursuant to which Building Permit No. 14682z dated.....March .20' 19...86 .... ... 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 ......... Alter and add to existing ~ara~e & add second car area & 2nd stor2~ The certificate is issued to ...... .R.O.~.E..~.Z..~.. 49y.C.~...V.~.~?. ~..~.~.~y .Z ....................... (owner, ~t!~,YpX ~lgl,1~JX X of the aforesaid building. Suffolk County Department of Health Approval ............ ~1 / A ........................... UNDERWRITERS CERTIFICATE NO. N802750 April 9, 1987 PLUMBERS CERTIFICATION DATED: Robert Kowalski 7/23/87 Building Inspector Rev. 1/81 ~gOU~r NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, iq. Y. BUILDING PERJ~,IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14682 Z Permission is hereby gronted to: ~.~-~. ~....~~......~..; .c~..~.~...~.:..~.,.....u.~...~.~C.. ~o .....C~k~,.~..~..,,~._...~._..~_~.~.,,....~..:~....~...~. ~...~...~...;~.,~.a.....~.~......~~..~.~....~...~.....L.~ o~ ~,e~,~e~ ,~ote~ ot ...~..~-.~..,.~.....~..~.~...~.~......~~~... County Tax Map No. 1000 Section ...... .J....~..~.. ........ Block ...... ..0.....~ ....... Lot No ..... ..k]. ............... pursuont tO opplication doted ......~.~...~...~ .................... , 10.?...~.., ond opproved by the Building Inspector. Builcling Inspector Rev. 6/30/80 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW ~Q~,~9~8 N 802750 THIS CERTIFIES THAT o~y ~he electrlcol equipment ~ ~scrlbed be~w and introdaced by t~ applicant ~d on the above application nu mb~r in the premises of ~l~r~ scillwater Aven~e, Cutchogue, ~ Garage in the following b,ca~io.: ~ Basement ~ lst rt. ~ 2nd FI. Section Bt~k Lot ~sexatninedon ~'~ch 30, X9~7 andfoundtobeincootpllancewhhthereqttiretnentsqfthisBoard. FIXTURES RANGES ~KINGD$CgS OVENS DISH WASHERS EXHAUST ~ FIXTURE OUTLETS 'e*'~JTC~ES INCANDESCENT FLUORESCENT DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E~ R V I C E OTHER APPARATUS: Mo ~ors ~ 1-1bp. ~ Eluc~r~c room heater~ ~ 1-2.5kw., 2-2.0kw ·, 1-1,2~kw., 2-1 oOkw. ~ 2-G.F.C.£o 1-Smoke du~ecgor Track ll~h~ia~ 20 feet 5 lice~ 7355 Main Road Mattituck~ NY 11951 Lit#7§3E This certificate must notbe altered in any manner; return 1o the office of the 8oard if incorrect, inspectors may be id air credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY, OF CERTIFICATE: M~ST:NOT,, :i! . BE ALTERED, N ANY MANNER. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit NO. /~'/6~ Owner ~ (pleage print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature) Notary Public FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Ha~l Southo~d, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ 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: 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: Additions $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory,SI0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certiflcate of occupancy $ 5.00, over 5 years $~0.00 4.Vacant Land C.C. $ 20.00 5.Updated C.C. $ 50.00 Date ................. New Cons truction ...... Cid or Pre-existin9 Building ............ Vacant Land ............. Location of Property .......... .~..~-./.S:. ...................... .~..~/~..~.. House No.~ Street Ham/et Owner or Owners of Property . .. :~..~...~..~..~....'~...~.(..~-~./~./ ............... County Tax Map No. 1000 Section .. I .~, .~. ........ Block ....... ,~ ...... Lot.. ~ ............ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No..I,L[.~.~.~. Date of Permit .~]~P.Applicant..~.~.L:J..C~..."~...-~...~...~...¢~. ........... 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 pe~it meets all applicable codes and regulatio~ns. COMMENTS FOUNDA FOUNDATION 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ;ZND [ ] ~ISULATION / FRAMING [~ FINAL 765-1802 BUILDING DEPT. NSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE ~/~ ~ ~ INSPECTION ~ ~/~ [ '] FOUNDATION 'IST I' ] ROUGH PLBG. ~,~ · [ ] FOUNDATION ZND [ ] INSULATION FRAMING [ ] FINAL DA'rE / ~////~/~ INSPECTOR 76S-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION FRAMING [ L DATE "~'~ INSPECTOR ~-~z~2~' 76S-1802 BUILDING DEPT. INSPECTION' FOUNDATION, 1ST [ ] RouGH PLBG. FOUNDATION 2ND[ ] INSULATION FRAMING [ ] FINAL BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR 765-1802 BUILDING DF. PTi INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FINAL DATE / ~//~/(~ ,NSPECTOR.,~~~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined...~..o~...~...~.o.., 19g..~,. Approved....~..o&..~...,),. p.., 19~./o. Permit No.. ~. ~../P.~..~...'~ Disapproved a/c ..................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 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 necessary inspections. (Mailing address of applicant) II State whether applicant is owner, lessee, agent, architect, en~neer, general cop_t~ctnr~-electrician, plumber or builder. Name of owner of premises .... ~ .o~-... ~..J~ · ~..~.~ ........................... 4] (as on the tax roll 6~ latest de~d) 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 ...................... I. Location of land on which proposed work will be done. ?..~. (.~. ..... :.~".//..L,9. ql~. e~... :. ~Z...~.,. ........... ............................................................. oc5. House Number Street Hamlet County Tax Map No. 1000 Section /3 ~ 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 occupancyd~. ~. ~ .,drx...~c~. ~~.~;11.~/ ................... b. Intended use and occupancy ~.~.~.~..~.~.t.~..$..~..O.~.~....:~*~/~.~.~../ 3. Nature of work~(check which h~lSJicable): New Building .......... Addition .......... Alteration ..... r.... Repair ........... al~l~Ren3ox;al .......... Demolition ........... Other Work ............... ~ ~ ~~ ' (Description) 4. Estimated Cost .... ~..~.~ .O...O.*.~. ........................ Fee ................................... ' ; ~' (to be paid on filing this application) 5. If dwelling, numbar of dwellin~ units ............... Number of dwelling units on each floor ................ If garage, number of cars .... i.~.. (, .~. ~r~., ........................ 6. If business, commarcial or mix0d occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing strnctur~s, if any: Front .... / %/(t .t...~.... Rear ... ,J.~. !..~... Depth..9..~..~ ....... Height ..... [. ~ ........ Number of Sto. ries ...... ] ..................................... , ............ Dimensions o_f same structure With alterations or additions: Front -~ .~. ...... Rear ~..~. . Depth .... .'~.~/i ........... i... Height .... ./.~ ~ ............. Number o~f Stories .... ~.,...; ............ 8. Dimensions of entire new construction: Front .... -~..~ ....... Rear... 3..~ ....... Depth ...:.~_.~t ......... Height ...... !.~. ...... ~NUgaber of Stories .............. t ......................................... 9. Sizeoflot: Front .(~.~,.'~.~; .......... Rear.. ,/.~..~ .............. Depth .~.-2. ................ I0. Date 6f Purchase ........ ~. !.~.'~.~ff ............. Saj~ne of Former Owner .... .6r..o.~..F'q ~ ............... 11. Zone or use district in which p~*emises are situated ...... I.{.~.r .............. 12. Does proposed construction vinlate any zoning law, ordinance or regulation: .... /~J..~? ...................... 13. Will lot be .regraded ...... ~.i ............. :. ....... Will excess fill ]>_e, iremCved from premises: Yes No Name of Owner of premises .R. 0[o~.°~. ~.~.]]~.t t'i.. Address t{.~../¢ .~ ./]..o~.'~¢ Phone No . . Name of Contractor ~..U~.q~ .~.~.~. W.t{~ .~m~. ....... Address ~../.~. ~cJ'.~..~r~... Phone No.~.. ~.: .~'?. ! .~ .... Locate clearly and distinctly all property lines. Give street and bloc} interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. S.S PLOT DIAGRAM buildings, whether existing or proposed, and, indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether (Name of individual sigr ~ng contract) above named. ' being duly sworn, deposes and says that he is the applicant 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 contlained 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 ~? APPROVED AT FOR THE pLU~DING / NOTIFY [IUILDING 765-1802 g AM TO 4, '1