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Home My WebLink About20538-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20699 Date MAY 6~.1992 THIS CERTIFIES that the building Location of Property 680 DEERFOOT PATH House No. County Tax Map No. 1000 Section 103 Subdivision ADDITION CUTCHOGUE~ Street Hamlet Block 4 Lot 5 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 2~ 1992 pursuant to which Building Permit No. 20538-Z dated APRIL 10r 1992 .......... 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 DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS AS APPLIED FOR. The certificate is issued to MARY ELLEN FITZPATRICK (owner) of the aforesaid building. 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 SOUTHOLD, N. Y. BUILDING PERMIT O'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL, COMPLETION OF THE WORK AUTHORIZED) N-°N.° 20538Z Date ......................... , 19. Permission is hereby gronted to: ....... ~-,7":~-~" '~7:- / .......................... ~.-~ .............. '; ......... ';?...--;4'....'"7.r .............................. at premises located at ........ ~,.,,,~.,.~,.,.....-/2~,.. ,/.,'~.~ ............................. cou,~ To× Mop No. ~000 Sec,on .... /..~....~ ...... B~o~k ...... ..~. ........... Lot No...~...~ ............ ,u~.,o,t to o,p,,=,o, dot~ ....... ~ ......... A,. ........ , ,9.~..~o,d oppro,~ b, ~e Building Inspector. Building Insoector Rev. 6/30/80 Form No. 6 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 Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Undezwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. 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 existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building 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 Building Inspector shall state the reasons therefor in writing to the applicant. 1. Certificate 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 - $100.00 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 New Construction ........... Old Or Pre-existinJg Building..~ .... Nouse No. Street Onwer or Owners of Property..~..~..~.~...~../.4.~...~/.~..~..~..~../..~-%~.~. ........... County Tax Map No 1000, Sect~on/~..~.~i~i.Bl~ckl'' .i .~%. ii i~ot' ~. iii~.'~iiiiii .................................. Filed Map ............ Lot ...................... Subdivision . . Per~it No.2.~.~...~.. .... Date Of Permit ..... ~. ...... Applican .. Health Dept. Approval .................... .. .. . . Underwriters Approval ..................... . ., . Planning Board Approval ........................ /~ tequest for: Temporary Certificate ...... ..... Final Cert'cntel ~ . ..... ~.... . ~ee Submitted: $..~.~..~ ....................... ............ ?OUMDATIO~.! (2nd) 2. ~OUGH FRAME & ,PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FI;;AL ADDITIONAL COMMENTS /.o'/ // 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] IN~U~ATION FRAMING [,~NAL REMARKS~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 SURVEY ..... SEPTIC FORH CALL . T ........ MAlL TO: (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .' ................. , 19... INSTRUCTIONS a. Tlfis 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. e. The work covered by fids application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will ispued 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 B'iilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and 6thel 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 necessazD~i]~spectio~ ..~.__~ (Mailing address of applicant) ~'/~,~ Sta~hether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ........ r(as on the tax'[o'll ;r lat~t If applicant is a corporation, signature of duly auth,,orized officer. (Name and title of corporate officer) Builder's License No.. 0.,U4T'A-~m~... .............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location oflhnd on which proposed work will be'done .................................................. . e ........ ............. ................ House Number HamlelxJ County Tax Map No. 1000 Section /~.S.~. ....... Block . .~ ............. Lot. ~.. ~ ....... Subdivision~O~S.~ .~D .~ .~ .............. Filed Map No. ~. ...... Lot../. ~ ......... (Name) 2. State existing use and occupancy of premise~and intended use and occupancy of proposed construction: . .............................. // b. Intended use and occupancy .~~ ~~ 3. Nature of work (check which applicable): New Building ...... Addition .......... Alteration .......... Repair ............... Removal .iI ............. Demolition .............. Other Work~ I~.C.~. ...... 4. Estimated Cost ,.#~ ~ .......... . ........ Fee ~ (to be paid on filing this application,) 5. If dwelling, number of dwelling unitsi ............. Number of dwelling units on each floor ................ If garage, number of cars ' 6. If business, commercial or mixed oce, upancy, specify r3ature and extent of each type of use . 7. Dimensio~ 9f ~!sting structures, if ~ny: Front .~.$..' ~. ~f ....... Rear ,.~$..~.z ....... Depth ,~q.~..~.~.2,,' ..... Height .~(~, .~.~C.: ...... NumbergfStories ...,~.ff, Q.., ................................... Dimensions of same structure with alterations or additions: Front ................. Rear .... .. ............. Depth ...................... Height ....................... Numb~ of Stories ..................... 8. Dimensions of entire new constructi6n: Front, ./4/.. ,~.¢~.~7... Rear/.q..~.e..~?~. .... Depth /{~ ..~.~.' ,e~,~? ..... Height Number ,of Stories 9. Size of lot: Front .............. i ........ Rear ...................... Depth ...................... 10 Date of Purchase · Name of Former Owner 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construc~gn violate ~ny zoning law, ordinance or regulation: ................................ 13. Will lot be regraded .. ,//O. ...... i ................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ...... i .............. Address ................... Phone No ................ Name of Architect i Address Phone No Name of Contractor . · .~. · · Address Phone No 15. Is this property within 300i feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold Tow~ Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property tines. Give street and block nut, her or description according to deed, and show street names and indicate whether interior or corner lot, . (Name bf individual signing contract) above named. He is the . .~ .................... i ................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is dul~ authorized to perform or have perfo~ed the said work and to m~e ~d file this application; that ail statements, contained, M this application are true to the best of his knowledge and belief; and that the work w~l be perfo~ed ~n the manney set forth in the application filed therewith, Sworn to before me this ~ ~ ~ . . . ......... .%,