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Home My WebLink About24039-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCuuFANCY No Z-25062 Date JUNE 2~ 1997 THIS CERTIFIES that the building. ADDITION Location of Propert~ 3750 STILLWATER AVE. CUTCHOGUE, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 137 Block I Lot 12 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 31, 1997 pursuant to which Building Permit No. 24039-Z dated APRIL 14, 1997 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 ROOF ADDITION OVER EXISTING PORCH OF ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to of the aforesaid building. AR'ruu~URY (owner) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Yo BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 24039 Z Permission is hereby granted to: ..................................... ~.~.~.. ~...~.Z.... ×z~ ................ County Tax Map No. 1000 Section ........... .,~...~..~.. Block ....... Z ........... Lot No..~'..~ ......... pursuant to application dated ............. ..~.~L~..~'.~.. ........... 19 ..~--Z and approved by the Building Inspector. Fee Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL · 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Nealth Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains .less than 2/10 Of 1% lead. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. For exist.lng buildings (prior to April 9, 1957) non-confo~ming uses, or buildings'and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buiiding and unusual natural or topographic features. 2.. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Buildihg Inspector shall state the reasons therefo~ in writing to the applicant. c. ~Fe~l.eSc~rtificate of Occupancy - New dwelling $25.00, Additions to dwelling *25.00, ~,~' Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, ' Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $i00.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .~. ~.-~7~.~ ............................... . New Construction ........... Old Or Pre-existing Building ........... '-,, . Location of Property ........ ~[('~.~.~ ....... ~' ~;kQ~ .......... House No. Street ~a~et o~ o~ o~,~ o~ ~o~..'~.~...%.~.. ..................................... . ~o=~y ~ ~ No ~000, se~on...,~ ...... ~o~ ...... ~ ......... ~o~ ...................... Subdivision ................ Filed Map ...... Lot ................ Health Dept. Approval .................... Underwriters Approval...~..]~ ............... Planning Board Approvai..~.5.~ ............... [ erticate ........... .. Request for: Temporary Certificate ........ ~ s~t~: $..~ ................... .. . ......~.~.;~.~' '.5 Environment East, Inc 3075 Indian Neck Lane P.O. Box 190 Peconic. New York 11958-0190 516-734-7474 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION 2ND FRAMING [ ] ROUGH PLBG. [ ]~LATION [ L~ FINAL ] FIREPILACE & CHIMNEY REMARKS: DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [~. ~DUNDATION 2ND [ .],~SULATION [~ FRAMING [~] FINAL [ ] FIREpI. ACE& CHIMNEY REMARKS:~, DATE: I NSPEGTOR ~~~/~ )1-~ -" ~on~,~o. 1 ~ S~TS o? ~,~-,~,s ........ TOWN OF SOUTHOLD SUgV£¥ ................. ~,R ,.~ ,l ~ BUILDING DEPARTMENT CIIgC~ ,~ SOUTItOLD, NY 11971 BLDG, D~I) ' ' ~W~4~2~ ~ z~ ~ -~ TEL: 765-1802 ~: OTcALLI PY: HAlL YO; ........... .... · ' ................. Dis~proved ~c .................... ..,~...-- ...... ..........................................~ ~~ ' . ~, INSTRUCTIONS a. Tiffs application ~nust be completely filled in by typewriter or in ink and subrnitt~d to the Building Inspector, with: sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location o£ lot dud of buildiugs on premises, relationship to adjoining premises or public street. or areas, and giving a detailed description of layout of property must be. drawn on tlie diagram which is part of this appli cation. c. The work covered by this application nray not be conmrenccd before issuance of Building Permit. d. Upon approval of this application, tlie Buildiug Iuspector will issued a Building Permit to the applicant. Such permi; shall bc kept on tlie premises available for inspection throughout thc work. e. No building shall be occupied or used iu wliole or in part for any purpose whatever until a Certificate of Occupane:~ qtall have been granted by the Buildiug Inspector. APPLICATION IS ItEREBY MA'DE to the Building Depa.rtment for the issuance of a Building Permit pursuant to the auilding 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. th, applicant agrees to comply with all applicable laws, ordinances, building code, h. ousing code, and regulations, and to ,dmit authorized inspectors on premi.ms and in building for necessary inspections. -- (Signature of applicant, or name, if a corporation) 3,.0.: .¥..~.. ;.~ :;L~.. ~ .e~.. ~.c.... N.~ '.~. ~ (Mailing address of applicant) -;tare wlretlmr applicant is mvner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. C:~_m..~..~. Co.~..WI~A.,~'r~ g-'. · · ~an, e or owne~ or pre,n~ses . .Ae,,~u.~. ~ ......... '.0. e'-..'¥, .......................................... (as on tile tax roll or latest deed) (Name and title of corporate offic-ffl)utl~°rized officer. Builder's License No... B .I .... ~..~.~..f~:. ....... Plumber's License No ......................... Electri,cian's License No ....................... Other Trade's License No ...................... Location of land on which proposed work ~vill be' done .................................................. tlouse Number Street ttamlet Cotm~y Tax Map No. 1000Scction . ' J.~.~. ....... Block ...... L ........... Lot.. 7~' Subdivision ..................................... Filed Map No ............... Lot ............... (Name)~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: .... ............................... 3. Nature of work (check which apt:,licable): New Buildisg .......... Addition .......... Alteration ......... Repair .............. I>,emoval .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost Fee (to be paid on filing this application) · If garage, number of cars ..................................................................... 6. Ifbtsimss, co~ ~erci [or ~ xedoccula, y. slecifynatureandextento£eachtypeofuse .. 7. Dinensionsofcxistingstrtctures, ifany: I~ront.l~l~....C~-,., P,c,-~ ..O. CCOO'. . Dcptlr; .... .... ' .... '''i'i. Ileight ............... Nnmber of Stories ........................................................ Dimensions of same structnra ~vith alterations or additions: Frout . .~..O..~.L.~.~,..~.~.~:.'. Rear .................. Depth ...................... lleight ........ ,~ ............. Nnmber of Stories ltmght .~.'G'. 7.~ ....... Nnmber of Stories 0. Date of Purchase .............................. Ns_me of Former Owner ............................. I. Zone or use district in which premises are situated ...... [~'7.g~..: .................................... 2. Does proposed construction violate any zoning law, ordinance '~ 0 ' or regulation: ................................ 3. Will lot be regraded ..... ~..O. ................... Will excess fill be removed from premisesr Yes No 4. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No. Nmne of Contractor .......................... Address ................... Phone No ................ ~. Is this property within 300 feet of a tidal wetland? *Yes ....... ~ No..~.:. *If yes, Southold Towu Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all bnildh~gs, whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street mid block number or description accordh~g to deed, and show street names and indicate whether ~terior or corner lot. FATE OF NEW YOP. K, S.S 3 uN:r~,yo F ................. ~ (Name of individual signing contraS) " ore named. being duly sworn, deposes and says that he is the applicant :- is the . .') ........................ " · .............................. ;;i;orate off, car, ....... said owner or owners, and is duly aut~d to'perform or have performed the said work and to make and file this plication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the ,rk w~l be performed in tho manner set forth in the application flied therewith. :om to before mc this ...... ........ ........ .¢7 LIND~ J. COOPER NoteW Pubtic, Stat~.o~,N~w~ ~. 4822563 Su~oI~__ ,..~°u'"~n To~ ~res D~~r ~s , · ~ ,-