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Home My WebLink About14034-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z15918 Date July 6, 1987 deck addition THIS CERTIFIESthatthebuilding ................................................ Location of Property . J 7.5 .................. .Emory Rd Cutcho~ue House No. ' ...................................... Street Ham/et County Tax Map No. 1000 Section ..... (0.3. .... Block .. 04 .Lot 039 Subdivision .... ~x~.n~y..$.h q .r.e.s ............. Filed Map No. 3..2.3.1 .... Lot No. 16 conforms substantially to the Application for Building Permit heretofore filed in this office dated March 26, 1985 pursuant to which Building Permit No. 140342 dated J u n e 10, 1985 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 . .t.o. ..... .c.o.n.s. truct deck additions, as applied for, to one family dwelling. The certificate is issued to Ronal d R. DiMar t ino (o~vner, lessee or tenant] of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO ..... N / A PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NB 14034 Z County Tax Map No. 1000 Section ..... I...?..~ ........ Block ..... .~..~. ........ Lot No ..... ..~..~. ............ pursuant ,o application dated ..... ..~.~....~.~ ................. , 19...~.~., and approved by the Building Inspector. 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 OCCUP~ Instructions A. This application must be filled in typewriter OR ink, and submitted m~ to the Buildlng 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 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 pz: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,S25,00, Acces,sory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $)0.00 4.Vacant Land C.O. $ 20.00 50.00 Date ...... 5.1. .......... 5. Updated C.O. $ NewC one t~'uction..~.... Old or Pre-existing Building ............ Vacant Land ............ Location of Property / ~/(~- ..~-~..~..~...~ ................ .~.~. House No. Street /-larrY/et Owner or Owners of Property ....... ~. County Tax Map No. 1000 Section ...... .Z'.O.~. ..... Block .... ,~.~. ....... Lot ..... g,~.~. ....... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........ Date of Permit .. J0..Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval Underwriters Approval ~ Planning Board Approval Request for Temporary Certificate ..................... Final Certificate .... ~ ............... Construction on above described building-am:lxpermitlneq,~-al[ apli6JTrbablecodes and regulations. Rev, I0-10-78 ,~ to the Building Ins{aec- ' y lines, streets, and unusual 2, Final approval of Healti~ Dept. ct water supply ano sewerage u~spuaa~-~o-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~coperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 bui{dings or premises, or other pertinent informa- tion required to prepare a certificate, C. Fees: Additions $25.00 I. Certificate of occupancy ~ew Dwe!l~n§ $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.00 3. Copy of certificate of occupancy $ 5.00, ove~ S yea~s $10.00 o.o. o.oo l 5.Updated C.O. $ 50.00 Date ...... [O ........... NewC°nstruction..~.. .. Old or Pre-existing Building ............ Vacant Land ............ L ocat on of PropertY Hou~e No /. .~..~. . ~------J~t,~ . , .~ ...... . ........................ .................. Owner or Owners of Property ................... . .......................... County Tax Map No. 1000 Section ..... /~3 Block ,~.~. Lot. Subdivision ................................. Filed Map No ........... Lot No ............. Perm it N o. Date of Permit Applicant Health Dept. Approval ........................ Labor Dept. Approval ...................... . Underwriters Approval ........................ Planning Board Approval .................. Request for Temporary Certificate ..................... Final Certificate ..... ~ ............... Construction on above described building-and-oermitj~nee¢~ ap~ble (;odes and regulations. App cant ............................. Rev. 10-10-7~ 765-~80~Z BUILDING DEPT. INSPECTION ]FOUNDATION 1ST 2ND FOUNDATION FRAMING REMARKS: ROUGH PLBG. I/NSULATION [~INAL r 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION J. ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] I~ULATION [ ] FRAMING REMARKS: ~ DATE INSPECTOR ¥ ~J~ E~D I~S~ECTIO~ COMME~?S FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~ODE FINA~ ADDITIONAL COMMENTS: - % ~tO,,_4. ~-ISlSNOd$~I iON A~t~N~t '~ NOI-LDf'IidISNOD ~IJ_V.L~ ql~Wrlqd ×,~ z)NIWv~JJ - hUliud ]±~'dDNOD Q-~hvd OkkJ_ - NC.,L,-'v,_,~i uzl '[ ~0~I Wd /z Ol WV 6 gJ3l -LNRV'q±~IVd~u ONIU-h ..... 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . .~..~..1. Approved ...~ . .b"2~... ).0...., 19~.f.. Permit No. I .Cfi..~.q...~.. Disapproved a/c ............... (Building Inspector) APPLICATION FOR BUILDING PERMIT L_ Tow --O b-dfhom _ l:{ec e lye d ........... ~'~9,. · INSTRUCTIONS a. Tkis 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 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 neces~arwinspectiqn'g.~ F'~ ~/ ~ (Signature of applicant, 6r~name, ifa o po ti n) State whether applicant is owner, lessee, agent, architect,' en~neer, general contractor, electrician, plumber or builder. ...... . ............................................................. Name of owner of premises....r~, q>.~).~.l.~'~..~N.....~. ~i~. kg.'-L97.~.~.0. ........................................... (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 ...................... l. Location of land on which proposed work will be done .................................................. House Number Street Hamlet } County Tax Map No. 1000 Section ..... t. 9.°~.. ........ Block ...O.~. ............ Lot..O..~.~ ............. Subdivision....c~...LA?!~..x~..t~..'~..~...~..¢-.~.,~. ........... Filed Map No. ....... Lot.. .......... kO (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...~. ~6.~,k~.~X~,j~o~.>~:~.~,~,~,, ........................ b. Intended use and occupancy ~ ~l ~,~'~ '~'i}.,~ .................... v *t~l~ ~ ~?~,,~ .................... 3. Nature of work (check which applicable): New Building ' Addition ~ ... Alteration .......... Repair .............. Removal ............. Demolition Other Work ............... 4. Estimated Cost .......... t ................ Fee .'.~ .......................... ~ '-' (t o b e paid o n filing this application) 5. If dwelling, number of dwelling Units ............... Number of dwelling 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 existing structure~, if any: Front ............. .~.'.~ .~ ....... Rear .. ~ / .... Depth ~' / ......... ..... Z (.' Number of Stories Height ......................................................................., DimenSions of sa.%e structure wiih alterations or additions: Front ..... S.'Q.q~. ....... Rear .... ~.'..$.~y..e ...... Depth · . .r~.0 . . . ! . Height ... ~?.m!-'. .......... Number of Stories.. fi...~E.,e. .............. Dimensions of entire new constr¢, etlon: Front ..... 2.~.~ ...... Rear ..... 3. ~' ...... Depth ...... '/.~.~. ...... ~ ~ Number of Stories Height Size of lot: Front ......... /~2 ........... Rear.. r ~r)/.. Depth 10. Date of Purchase .............................. Name of Former Owner 11. Zone or use district in which pr~mises are situated ............ ................................ 12. Does proposed construction, violate any zoning law, ordinance or regulation' /~fo. .......... 13. Will lot be regraded .... '~ .-'-' .... ~.,., ~ .. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ~q.~.e,.~...,~;.tY[~.~Tt.~.o.. Address ..['?f~"~f~.~'~b~honeNo Name of Architect ,' .... Address .................. ~. Phone No ................ NmneofContractor.. ...... ...................' Address ............. .. ... .PhoneNo ................ PLOT DIAGRAM Locate clearly and distinctly all[ buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and blocklnumber or descnptmn according to deed, and show street names and indicate whether interior or Cornerlot. :~' ' . STATE OF NEW YOP~, ' S.S COUNTY OF...~--~'~. !~.).~. ..... i' being duly sworn deposes and says that he is the applicant (Name ..... ' of ~nd~wdual agnmg contract) above named. He is the .... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dply 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 ... ..... ....'~.4 .......... daypf.. ~.~'..~.. .......... , 197.r Not aryPu blic .~...~. ~"' ............... ' (Signatuie';i ~liJa'n'ti , i SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONlY DATE:. H. S. REf. NO.. APPROVED: SuFFOLK CO. TAX MAP DESIGNATION: . DIST. SECT. BLOCK PGL, B~ED: L. ~/'~ . TE~ HOLE ~A~