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Home My WebLink About20560-zFORM NO. 4 TOWN OF SOUTHOI/) BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20741 Date MAY 19r 1992 THIS CERTIFIES that the building Location of Property 270 NORTH STREET House No. County Tax Map No. 1000 Section 102 ADDITION Street Block 5 CUTCHOGUEr N.Y. Hamlet Lot 18 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 16~ 1992 pursuant to which Building Permit No. 20560-Z dated APRIL 16r 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 EXISTING ONE FAMTIff DW~JJ.INGAS APPL~D FOR The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A · /J Building Inspector Rev. 1/81 I~0u'M NO. B 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) NgN? 20550Z Permission is hereby granted to: ...... . ~.--.'.'.'.'.'.'.~.~....h...s...g ............................. ..'I. ............ ....~,,J]....,~,,,.-~....,~....:.~,.....%:....I..L~..~..~T. .......... , ,o ............ '] ................... '-_'"_-'"'~' ........... ~., ...,,., q",,n~, u~"~"l-~,,'X ...... /9' ......................................................... r~ o, premises Iocot.d o,..~.~..O:.....,~.~...~ ........... .C,~.~~ ................. County Tax Map NO. 1000 Section ..(,~..~; ...... Block ...... .(~.~"~. ....... Lot No....L...~. ............... pursuant to application dated ......... ~ ...... .~...~ ............. , 19.?L..~.., and approved by the Building Inspector. Fee $.~.~....'..~ Rev. 6/30/80 Form No. 6 TOWN OF SOUTIiOLD BUILDING DEPARTMENT TOWN }~LL 765-1802 Bo A~PLICATION 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 ail buildings, property lines, streets, and unusual natural or topographic features. Final Approval from Health 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 contaims less than 2/10 of 1% lead. 5. Commercial building, industrial bu%lding, 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. C. Fees i. 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 acce~;sory 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 Date ..................................... . New Constroction. Old Or Pre-existing Building.. ~ Location of Pr p rty ~.P~ ~-%~ ~T. CL~ T~O~ House No.' Street Hamlet O~wer or Owners of Ptoperty....~-f~.~,.~-.~J.~ ....... ~ ~¢~ ..................... ..... . . . .. County Tax Map No 1000, Section .... ~...Block ...... ~. ....... Lot ..... ~ .............. Subdivision................. .................. . ~iled Map ........... . Lot .................. ... . Permit No..~.O.~.~..~)..-~..Date Of Permit..l:J~..~ ...... Applicant.~j-*.~-C~-'~v-.~--~-~D- Health Dept. Approval ......................... Uuderwriters Approval Planning Board Approval ..................... o . . Requcst for: Fee Submitted: Temporary Certificate ........... Final Certicate.....~. ..... $ ...... . ..,..).. .o.¢. ............. ? " ~OU~DATIO,! (2nd) ~,OUGH FRAME & .FLUMBING i~;SULATIO.~I PER N. Y. STATE E:;ERGY CODE FI:IAL ADDITIONA'L CONME~TS: 7 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. 2ND [ ] INSULATION FOUNDATION FRAMING DATE APR 6 oc9 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TG.. .... TEL.: 765-1802 .... veal a/c ..................................... (BuiFffing Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. ·Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 .areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- tion. ¢. The work covered by this application may not be cSmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit hall be kept on the premises available fgr inspection throughout the work. e. No building shall be occupied .~r used in whole or in part for any purpose whatever until a Certificate of Occupancy hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depm'tment for the issuance of a Building Permit pursuant to the .uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or '.egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. 'he applicant agrees to comply with all applicable laws. ordinances, building code, housing code,~d regulations, and to :trait authorized inspectors on premises and in building for necessaD, jxz~pections. , / ./ (Mailing address of applicant) :tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder2 · [?...vw..'. .... ' ............ :amc of owner of premises .... .(~3.C.I{;:>~W~(..~..~f .... .~ ............. · ..... (as on the t~x roll or latest deed) ~ applicant is a corporation, signature of duly authorized officer. .... '(~,/ame ;nd title of corporate officer) Builder's License No.. ! ....................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. D'TC, ... 2V0. . .¢. . . g. IIouse Nmnber Street Hamlet County Tax Map No. 1000 Section ........ I. ~ .2. ..... Block .................. Lot ................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....................................................... ~(~ ......... ~(~ b Intended use and occupancy / " 3. Nature of work (check which applicable): New BuiJding .......... Addition . .' ....... \Iteration Repa/r .............. Removal .............. Demolition .............. Other Work ........ (DcscnpH~; 4. Estimated Cost ........ .c.. '.. Fee ~/g' c - (to be p~id on filing th~s 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 occnpancy, specify nature and extent of each type of use .................. '7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ........... Height ............... Number of Stories ......... · ........................................... Dimensions of same structure with alterations or additions: Front ................. Rear ............. Depth ...................... Height ...................... Number of Stories .............. ~ .... 8. Dimensions of entire new construction: Front ............... .Rear ............... Depth ............ Height ............... Number of Stories .................................................... 9. Size of lot: Front ...................... Rear ...................... Depd~ ............ ~ ..... 10. Date of Purchase ............................ Name of Former Owner ......................... I I ~Zone o~ use district in which premises are situated ................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................... 13. W~I lot be regraded ............................ Will excess fill be removed from premige~: Yes No 14. N~e of Owner of premises .................... Address ................... Phone No .............. N~e of Architect ........................... Address ................... Phone No ................ N~e of Contractor .......................... Address ................... Phone No ................ [5. Is ~h~s proparty w~ch~n 300 feet: of a c~da~ ~qeC2~nd~ ~Yes ........ No ......... · ~ yes, Southold To~n Truscees Perm~c may he required. PLOT DIAG~i Locate clearly and distinctly MI bulldogs, whether ~x[sdng or proposed, ~d indicate ~1 set-back d~ens~ons from propegy ~nes. Give street ~d block number or description accord~g to deed, and show street n~es and ~dicate whether interior or comer lot. ATE OF NEW,rYO'RK./~'~ /"// ,.. ,. {Name of individual signing contract) ,ye named. being ~tuly sworn, deposes and says that lie is thc applicant Md owner or owners, and is duly a~alhorized to perr'u~,.~'or ba~e performed thc said work and to make and file this ication; that all statements contained iii this application are true to thc best of his knowledge and belief; and that the will be pcrfo~cd in the manner set forth in the application filed therewith. m to before me this ~ ............. ,19 ~ Public, . County / . ~ ~ In S~k ~.~) ~/- .- (Signature of applican t)