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Home My WebLink About13855-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13882 Date September 26 85 THIS CERTIFIES that the building porch enclosure & deck addition. 5765 Stillwater Ave. Cutchogue Location of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section ..... 137 .Block 4 .Lot 5.1 Fleetwood Cove .Filed Map No. ---- ~ ~,1263.'ot~*o. 14 & 15 Subdivision conforms substantially to the Application for Building Permit heretofore filed in this office dated .A.p r i i 1 198..5 ilding P 13855Z ................... , . pursuant to which Bu ermit No ...................... dated A p r i 1. 11 1985 was issued, and collforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Enclose porch and construct deck addition. The certificate is issued to ..... MATILDA BURROWS ................ ..................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N/A UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/8'1 ~0~ NO. lB 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) · ~ '. ....... !~ ............ N-° 13855 Z Oote ...... ~ ............ ~9.~.~." Permission is hereby granted to: , ............ . . of premises Iocoted ot ............................................................................................................................ County Tax Map No. 1000 Section .... ~.....~.....~. ........ Block ....... ..~ ............ Lot No .....,,~.:...! ........... pursuant to application dated ....... ~....J. ........................ , 19..~...L..~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Ao This application must be filled in typewriter OR ink, and submitted i ~ 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 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. 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 buildings or premises, or other pertinent informa- tion requ ired 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 4.Vacant Land C.O. $5.00 Date..~-..~. ?..-. ~,. ,~,. ......... New Building . .~. ......... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~../~...~....~..~..~//./~..~. ,/~,,,¢~,;... ~~ ~ ~'~ Owner or Owners of Property ~1~ ~J~.~ ~. ~ ............................... County Tax Map NO 1000 Section /~ Block ~ ~'/ Health Dept. Approval ........................ Labor Dept. Approval ........................ App ~ ~L~.r.., Planning Board Approval ........... Underwriters royal .- ...... Request for Temporary Certificate ..................... Final Certificate ..../,~.. ................. Fee Submitted $..~.~'.... ~/'~'C C~.~..~. ......... o~nstr,u, ction on above described building and permit, meets all aj~plicable codes and regulations. App ,cant . .,~,., .... ~ .~¢~ ...................... FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION FERN. STATE ENERGY ¢ODE Ye FINAL ; ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved ...C~.. t.I ...... , 19~. ¢. Permit No..J..~..~ .~.~.~..'..~:- Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS AJaR 101985 TOWN OF SOUTHOLD Date.-..~.. ............. 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 Per~it to the applicant. Such permit shall be kept on the premises available for inspection ~hroughout 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 in/sp~ec,~,~s,. __ ~ . ....... (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (a~.o~ 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 .................................................. House Number , Street ~Hamlet County Tax Map No. 1000 Section / ~ .~ ¢' ¢'B'~c~~ ~ Lot ~.~. / Subdivision ~.~/~ f&(¢ .~..C(~ J4~ ......... 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. Inteuded use and occupancy ............. ¥?. ~. ~-. ~/~. ~..~ .¢.~'. ............ 3. Nature of work (check which,applicable): New Building ... ' Addition .......... Alteration .......... Repair ...... ;~ Removal ..... Demolition Other Work (Description) 4. Estimated Cost .................................... Fee ........................ : 4, (to be paid on filing this application) 5. If dweliing, number of dwelling units ...... / ....... Number of dwelling units on each floor ................ If garage, number of cars ............................................................ 6. If business, comm. ercial or mixed occupancy, specif~ nature and extent of each tzpe of use .......... ~ .......... 7. Dimensions ofex~sting structures, if any: Front .... ,,~...~.~ ....... Rear . ~,~.~. ....... Depth ~..~. .......... Height / ./~.( Number of Stories . C') ~ ~ ......................... Dimensions of same structure with alterations or additions: Front ...,,~...~. ......... Rear . .,,~'.~. .......... Depth ,,.~ ~ r .~...//... Height ...... ./f. ~../ .. Number of Stories ..... ./. ......... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ....................................................... 9. Size of lot: Front .../..~? ............ Rear ...... f.~ ....... Depth ,,...?..~.~. ~ .......... 10. Date 'of Purchase ~ .~9,,/~///. ~..~..~. .............. Name of Former 6~vner . ~./~._S..PA ~../-3r. ?: ~ ?..~.~.,~. ~.i 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction vl01ate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ ~. ~.~. .............. ,Will ex.?ss fill be removed fronLpremises: ,Yes ,r:lctcr- 14. Nam e o f Owner o f premises/~/~ ~'.X-.~.~.//.: ./~. P. ~o. ~A'~dress.~ 7.6.~..t .~..~2~ .F~.~.~..?/~one No. 7~.4 ~.. Name of Architect ' · ................ Address . ..0_.: .~..'~.~f.o..~..~..~-w.. Phone No ................ Nam~ of Contractor .......................... 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 block number or description according to deed, and show street names and indicate whether interior or: corner lot. STATE OF NEw YORK, i S.S COUNTY OF .................. ................................................... being duly sworn, deposes and says that he is the applicant (Name ofindMdual si ning contract) above named. He is the - (Contractor, ~/gent, corlSorate officer, et~.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this apphcatmn; 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 mann'er set forth in the application filed therewith. Sworn to b~fore me this i, " ' ............. ' ................. , ...... day 6f. · ~.. ~:. ,~.¢.,..~. · .dT~.... County_ ~/]:]~ j,,~... , ,~ , Notary Public,... NOTARY PIJCLIC, State of N~,,x, York tzv~ (Signature of applicant) No 4707878, 8uft01~ C0~atw T~m £~[ff~es P~!arch 30, ~9~ {. 2, ROUGH . FRAMING ~ PLUMBING 3. IN~ULATiON 4, FIB~AI. - CONST~UCT/ON MUST ALL CCWSTRUCTION SHALL MEET THF R~Oi~'o~MENTs OF TH~ N. STAmE CONSTRUCTION &, ENERGy CO~ES. NOT RESPONSIBLE FOR t2;"r<N OR CONSTRUCTION