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HomeMy WebLinkAbout20935-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20992 Date SEPTEMBER 4, 4992 THIS CERTIFIES that the buildin~ Location of Property I945 House No. County Tax Map No. 1000 Section SHED ADDITION BROADWATERS ROAD~ CUTCHOGUE{ NY Street Hamlet 104 Block i1 Lot 1.8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 1~ 1992 pursuant to which Building Permit No. 20935-Z dated SEPTEMBER 3~ 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 SHED ADDITION AS BUILT TO AN EXISTING OMB-FAMILY DWELLING The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 JOSEPH D. CAVANAGH & WIFE Building Inspector I~OB~ NO. ~ TOWN OF $0UTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, FI. Yo BUILDING PERMIT (THIS PEI:~/VtIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ' N~°. 20935 Z Dote ............... ~ ................................ , ~.....~.. Permission is hereby granted to: ....... l?~..~....z:.,~.~.~ ~~ .... ~ ..... ~ ~...~ ....... : ...... ~.~.....e,~.~..~ ............... ~,..~.~.~ ...... ~.>Z~:...~: ............ ..................... >:: .......... : ..... .......... :~Z:;:Z:...: ................................................................................................................. ................................................ ~ ............ ~.::::,~.~ ........ ~.: ..... :/z:~.: ............ ~ · ~ ~-' ~ ............ ............................................. :.~.:::::....& .O~.:~.:...~.:....:..:...: ............................ co..~ ~ ~ ~,. ~o~ s~.o. ...... :~ ...... ~ ....... : ......... ~o~ ~ .......... ::.~ ...... Building inspector. Fee $,.., .~.,, .~.;,....~.. ..... 6130180 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 J~PPLICATION 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 Underwriters. 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. C. Fees 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 - $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 - Resident~a~ $15.0~, Commercial $15.00 /id Or Pre exlstln D~g~ Ji~n.t..t.l.~.~..~../..~ ..................... New Construct lo~ I .~.~.~ 1 '~ -f^ - · . g ' . g ................. Location of Property.~.~.~.. ~..~.~.~.~..~.7'.~.~ .!~ ..~2~ ..... .~y..~f~. ¢.~v..~..~.. ....... House No. Street Hamlet Onwer or Owners of Proper~ .... ~ ...................... Count Tax 'a No 1000 Section /~j~_,-, z/ , // ~ / ~ . Y ~ P , ,~ ~ ~;.=~ .......... Bloc~..~./ ............ Subdivision. ~!~'..~,~...~.~~.Filed ,ap.l~.~. .... Lot..~..~....~.../~ ~.~.~?.~.'~'- Permit No. . Date Of Permit . Applicant .... Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval . Request for: Temporary Certificate.. ....~-F~ Fee Submitted: ~ ..................... ''..~ .~, © o / / / FORM NO. 1 ',~ ~t ' ,~, ', TOWN OF SOUTHOLD ~ ~ BUILDING DEPARTMENT I, SED ' I I~~'}~- TOWN HALL · SOUTHOLD, N.Y. 11971 ~'V' TEL.: 765-1802 .... ermit ............ Disapproved a/c ..................................... 50ARD OF HEALTtl ......... SETS OF PLANS .......... /SURVEY ................... //CIIECK y¥-zz¢ 7 .. / HAfL TO: ,~l~Ildin g Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date a. This application must be completely filled in by typewriter or in ink and subznitted to the Building Inspector, with 3 ;ts'of plans, accurate plot plan to scale. Fee according to sche~lule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ztion. c. The work covered by this application may not be c'~)mmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit tall 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 zall 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 Ccunty, New York, and other applicable Laws, Ordinances or egulations, for the construction of buildings, additions or alt, cml end, or for removal or demolit/on, as herein described. he applicant agrees to comply with all applicable laws, oral, bane building code,th-qusi,u~code/~d regulations, and to lmit authorized inspectors on premises and in building for nt~essa] inspectiot¢~r ( t /t ~ { ] __ .. ~u~['-e_':Z::plicant, or nam e, if a 'c~r pora fion ) THE CAVANAGHS R.R #1.1.9.45, .El. ROAD. WAIF. RS ltd ................ rate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... ............................ .. · applicant is a corporation, signature of duly authorized officer " 'DATE~B g # ~ (Name and title of corporate OR 765-1802 9 AM TO 4 PM FOR THE Builder's License No ........... FOLLOWING INSPECTIONS: 'tS U LAWFUL ND ,,o. - ORE U,R D Plumber's License No ..... FOR POURED CONCRETE · · FINAL - ~ONSTRUCTION MUST Other Trade's License No ...... i3:;i~,';'. :,~3,;>, ALL CONSTRUCTION SHALL THE REQUIREMENTS OF 11~ N.Y, Location ct' land on which ,osed work wil be done. ST,~'I[E (~QNSTRUCTION & ENERGY House Number County Tax X~ap No 1000 Sectio / ~4 Street Hamlet (Name) State existing use and occupancy~ofpremises and intended use and occupancy of proposed construction: ,. , 3. Nature of work (check which ap licable): New Building .......... Addition .......... Alteration .......... Repair .............. Remc val .............. Demolition .............. Other Work .~'~ ...... 4 Esti atedCost /~ (Description) · m ' ' · · ·, ........................ Fee ................. ~ (to be paid on filing this application) 5. If dwelling, number of dwelling nits ............... Number of dwelling units on each floor ...... · If garage, number of cars ..... · ......... dl ................ ht p ify rlzt ...... 6. umn ss, c e ~al or m~xe occupancy, spec ure and extent of eec f tlae ................ 7. eo , nenmons o~ exmt~ng structures! if any Front ~. O .... Rear ~/6>.0 ..~ (2) · Dg ........ He ht . , ..... epth ........... Number of Stones ' ' Dimensions of same structure w _h alterations or additions: Front ..... Rear .................. Depth ..................... ~. Height ...................... Nnmber or.Stories ..................... 8. Dimensions of'entire new construction: Front .... /..d?.,~'... Rear .... e,r.(~). Height ............... Nu(~er of S/or/es ............ 9. Size oflot: Front ..... ~.~..., .......... Rear ..... ]. ""iiiiiiiiiii'~);;[t~'i .... '~'~ ........... 10. DateofPurchase ............ l ..... · ........... Name f'orinerOwner ........ 1 I. Zone or use district in which premises are situated .......... 12. Does proposed construction viDlpte any zoning law, ordinance or reguiation.' ~.' .O~ .. . 13. ~lm~;~;~;gn;;d~/pr.e.m.i~s.i~llt4~i\~ ......... Will excejs fill bfi removed from premises: Yes 7tz~ 14, · 4~'~ ......... Address . ~I~..~ ........... ebone No. 7.. ~.~..~.(~..'~..~ Name of Architect ........... i ...... Address Nam~ ~r,-,_ , . I ................. Phone No ..... 15. Is th~.s property w±th:zn 300 feet of a tidal wet~an~l? -.-- · ........ i ..... · If yes, Southold T wn Trustees Permit ma b re ed ... ! PLOT DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and. indicate all set-bacl dimensions from property lines. Give street and block n~mber or descri ~tj.~_a~q._o_r.d_~to deed, and shoo - . _ t street names nd indicate whether interior or coruer lot, YFT-i TATE OF NE~--~R~ J/// :o uwr v~o~z..~TC3...l/~, s.sI , .,-5.o. ............. ..... ~4~ 0~:..L~. ~ .~.q ('~" .... being duly sworn, deposes and says tim, he is the applicant (Name.o~individual signing~ont~t) ' ' ' ' ;~ '~ ~' :) ~ (Contra or, agent, corporate officer, etc.) 'said c .'~ , ~ i . owner of owners, ~d is duly authorized to perform or have perfo~md the said work and to m~e and Hle this 'plication; that all statements contalne~ in this application are true to the best of his knowledge and belief; and that the ~rk will be perfo~ed in the m~ner se~ forth in the application filed therewith. ~om to before me this [ ........... · ............. ......... o. ~7~S; . (Signature of applicant)