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Home My WebLink About19207-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. OERTIFICATE OF OCCUPANCY Nos Z-25974 Date: 08/19/98 THIS CERTIFIES that the building ALTERATION Location of Property: 5200 PEQUASH AVE (~T[~O6~ (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 110 Block 3 Lot 24 Subdivision Filed Map Ho. Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 18, 1990 pursuant to which Building Permit No. 19207-Z dated JULY 18, 1990 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 REPLACE WINDOW IN FRONT OF EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to FRANK W & MARION CARR (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Buil~g Inspect~ Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERARIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPL~'TION OF THE WORK AUTHORIZED) '~920'/, Z Permission is hereby granted to: ~. ...... ~..,~..~.~..~. ~~,....~ _ // .... , · ~~.~...~. __,,,, ........... _.~.~-.~m .......... ~~;;T-5 ....... ~ .... : ..................... ,t ~,,~,~, ~=~t,a ~ ............. ~.~.~...~_~~......~ ..................... .......................................................... co~ ,o~ ~ uo. ~0oo s~,~o~ .... l.~.~ ......... ~k ........ 2 ........... to~ uo ..... ~...~ ...... Building Inspector. Fee $..~..~. Building Inspector Rev, 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPA~ y TOWN 9FSQUTHOLD j 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/i0 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 (prigr 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 df 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 - $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 8/5/98 * BP 19207 (7/18/90) Date ...................................... .. . New Construction.. YDD~ ..... Old Or Pre-existing Building .............. Location of Property...~q9 Pequash Avenue, Cutchou~ House ...................... U~ .......................................... No. Street Hamlet O~r or Owners of Property .... .b~.~./k.~%rjpD..C~ ........................................... County Tax Map No 1000, Section. 110 ...Block ..... ~ ......... Lot..24 Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval .......................... Underwriters Approval ......................... Planning Board Approval ................... .. ... yes Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted co 25.0_0 ..................... APPLICANT ~,OUr4DATIO:i ( 2nd ) ROUGH FRAME ~?LUMBING iNSULATION PER N. STATE ENERGY CODE FILIAL '.' j ADDITIONAL COMME~ITS: BLDG D FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 7654802 Examim:d ................. 19... ,,pprove~./. 5:'.'.., 19/~ Permit No./.. ~.~. ~. ?.-~ Disapproven a/c-. ............. (Bu,lding Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ............ , SETS ?~ P~s.. ....... ::.. SURVEY .... ' .. · CHECK · ~;~ ................. SEPTIC NOTIFY~ CALL INSTRUCTIONS a. Tlds applica{ion must be completely filled in by typewriter or in ink and submitted to the Building Ihspector, with ~ ~ of plans, accurate plot plan t0~cale. Fee according to schedule. b. Hot plan showing location of lot and of buildings on premises, relationship to adjoining premises or publ/c streets r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl/- c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the B~ilding Inspector will issued a Building Permit to the applicant. Such permit !~:I be kept on the premises available for inspection throughout the work. ~. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy '.z:! have been granted by the Building Inspector. ' · 'd'PLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the ......... Zone Ordinance of the Town of Sohthold, Suffolk County, New York, and other applicable Laxvs, Ordinances or ".:'.almns, for the construction of buildings, ad. ditinns or alterations, or for removal or molition as ' ' . ..... ~h.can.t a.gr. ees to comply wlt.h all applicable laws, ordinances, building, code, hous"~ode ~-~' _~_h.e.,r~e._.m_ descnb, e.d ...... umonzeu inspectors on premzses and ~ building for necessary i~ectj~, s. I f-' '~ 1' ~ . .... · ( . (~,gn~t~ure of applicaht, or h'a~me, ifa corporar,o'n) ' '-~ .... y...x_o__q.~ ~.~ ~f. ~ .~ (Mailing address of applicant) · ' '.'~e~her applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......... ..... ................. i (as on the tax roll or latest deed) ..-ant is a corporation, signature of duly authorized officer. (Name and title of corporate ccnse ....... :'::::nber's License No ........ ............... ·: melon s License No Cther Trade's License No ..................... Lo:orion of land on which proposed work will be done; Ooo ~~.... ' ouse Number Street, Hmnlet Cot:n Tax a o. S~ction .............. ............. Lot .......... au ~ v slo~ · · ~' Eiled Map No (Name) ............ Lot .... ~ ........ SI*re e" ' x~stmg use and occupancy of premises and ' · intended use and occupancy of proposed construction: A. Exlsting use and occupancy .......... ; ................................... B. Intended use and occupancy ...... · Nature'ofwork (check which applicable): New Building ......... Additi6n .......... Alteration ...... .; ~, . . R~p~r ... ' ' ......... R~mova: .............. Demolition ............. Swimmin .~ . .',~q . . .. Tgnnis Court ......... Ac essory Building .......... Fep~ce ........ Other Work ...... .C."... I ' o .. \ (to be paid · fidwell n=,number of dwell ng units ............... Number of dwelling units on each floor ..... I ........... If[garage, number of cars ...... ] i ............................................. : .................. ..~Ifibusiness. commercial or mixed ocicupancy, specify natnre and extent of each type of use .... '. D mensions of ex st ng structures, if any' Front .. .. 6.O...... Rear .~. d De-," 'Sbl .......... IS Num bet] o f Siorics' '~ .............. " .............. Heieht ...................................... ~- ' ' ' ................ ~ii ........... D mens~ons of same structure with alterations or addi~ nas' ]~'rnni' ~gl:~-"~'~'q ' ~i ..................... i sole tlr floc F ..... ii .......... Re u er o es .................... D pth ,. mens on n e new constrnc n: Font ......... ar ........... .... e ........ . .... Height Numberl of Stories · i Si~eoflot:''"'''''''""'Front : ................................................ '''' '' ' ' · Dfite of Purchase .......................................... Depth ...................... · , . Rear ) ' Name of Former Owner Z~ i~ ............ · ne or use district in which prem es are situated ................................................. D9 g I .... '., es proposed Construction violate :any zonin aw, ordinance or regulation: ........................... V~II ,, i ..... ,. ct be re~,raded ......... . , ......... ....... Wtl excess fill be removed from premises'. Yes ,.. N~.. N0an f p scs ..... ~ ...... '... ' .. e of Owner o remi Address ................... Phone No ............ Nfisne of Architect ............ ~ .............. Address ................... Phone No ................ Nmne of Contractor ........... i ..... : ........ Address ................... Phone No ................ 5.I~ this property loe~tted within 300 feet of a tidal wetland? ~YE$ .... NO .... · Iff yes, Southold Town T?ustees Permit may be required. i PLOT DIAG ILA. M ! L~ate clearly and d:stmetly.all buildings, whether existing or proposed, and. indicate all set-back dimensions from · operW lines. Give street and block number or description according to deed, and show street names and indicate whether terior or corner lot. FATE OF NEW YORK, OUNTY OF ................. I (Name of individual signio,, ,ore ,~am'ed. S.S being duly sworn, deposes and says that he is the applicant .' is tlie /t i (Contractor, agent, corporate officer, etc.) · .... md[owner or owners, and is duly authorized to pe,rform or 'rove performed t m said work and to make and file this 'plicalion; that all statements containe~t in this applicatioo are true to the best ofh s knowledge and belief; and that the '~rk will be performed in the manner sc( forth in the applicatioo q ed therewith. yom {o before me this ' ' .... ,~ ...... ...../ ....... day or..., ........... l~ .... _ ~s ~h ~ 0 SURVEY FOR AT CUTCHOGU~c DATE , DEC. 8, 1982 TOWN OF $OUTHOLD SCALE, / ' -- 40' SUFFOLK COUNTY, NEW YORK I~o. I ' ~gl I[IP ~ Vgl I[IP ~OSTR~NDERAVENUE ~ l~Ul~ ~ l~Ul~ RIVERHEAD,N~W YORK