The URL can be used to link to this page

Home My WebLink About18805-zFOP~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19707 Date FEBRUARY 4, 1991 THIS CERTIFIES that the building. Location of Property 4670 PE~UASH AVE. House No. County Tax Map No. 1000 Section 110 ADDITION CUTCHOGUE Street Block 03 Lot 29 Hamlet Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JAN. 30~ 1990 pursuant to which Building Permit No. I8805Z dated FEB. 20, 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 ADDITION TO EXISTING ONE FAMILY DWELLING~ PERMIT AMENDED FOR CELLAR IN PLACE OF CRAWL SPACE. The certificate is issued to EILEEN BtTTEL (owner} of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. N156983 PLUMBERS CERTIFICATION DATED OCTOBER 22~ 1990 Building Inspector Rev. 1/81 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) N~_ 18805 Z Permission is hereby gKante, d)to: ~ /~/ .~ / . ~.. ....... ~.....~A~..~.,....ffz..~/,~ ~'~ ~,,~,.~ .................. : ................................. ,o County Tax Mop No. lO00 Section ..... .Z/Z..~... ........ Block ........ ~ ........ Lot No ...... ~..~... ......... ......... ./..~..~...~. ................................ '19...~..~., and opproved by the pursuant to application dated Building Inspector. Fee $~~. Rev. 6/30/80 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF ~,~ 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. ~. ~ Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swiraming 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 . ...... ............... ew Construction ........... Old'Or Pre-existing ~u az g ................. ,ocation of Property ...... ~.~.?.~ ................ ??.~-.~..~.. ~..~.~ ...... House No. Street Hamlet nwer or Owners of Froperty . . ounty Tax Map No i000, Section...{J.? ..... .. Block....~. ......... . Lot .... . .~..?.. ........ . .. ubdivision ...... Filed blap ........... Lot ................... ermit No...f.~.~.~ ..... Date Of Permit....~./..~.../~.0..Applicant..~.~.~..~.. C~ 7.~.o.~..?... ealth Dept. Approval .......................... Underwriters Approval...N..!~.~.~f.~ .......... fanning Board Approval ........................ equest for: Temporary Certificate ...... Final Certicate. ee Submitted: $ ............................. At~PLICANT FOUNDATIO:;__ -- __ -- ~ FOU!~DATIOH 2. (2nd) ROUGH FRAME & .PLUMBING I~SULATION PER N. Y. STATE ENERGY CODE Fii:AL ADD'ITIOHAL COMMEHTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSU~TI~J~'~'~ INSPECTOR, DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ L DATE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION DATE ~'///~ ~///~t,.'.~. INSPECTOR ~/~-~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS~~./'------' DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] R~~OUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL .REMARKS: ~ DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION ~FOUNDATION 1ST [ ~ ROUGH PLBG. [~UNDATIION 2ND [ ] INSULATION FRAMING [ ] FINAL DATE 765-180Z BUILDING DEPT. INSPECTION [*~FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND £ ] INSULATION FRAMING [ ]FINAL DATE 3/,~/~ INSPECTOR L) ~-~/-~~. FORM NO, 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1B02 Examined ........... 19 Disapproved a/c ..................................... · ti i to 'APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH 3 SETS OF PLANS ........... SURVEY CHECK ..................... SEPTIC ¥ORH MAIL TO: )ate ........ 19.. INSTRUCTIONS a. TI'ds application must be completely filled in by type~vriter or in ink and submitted to the Building l~spector, with 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 stree or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app! cation. c.. The work covered by this application may not he commenced before issuance of Building Permit. t~ Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such perm 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 m3y purpose whatever until a Certificate of Occupanc 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 th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Regulations, for the construction of buildings, additions or alterations, or for ~:emoval or demolition, as herein descr/be, The applicant agrees to comply with all appMca~e laws, ordinances, building code, housing code, and regulations, and t, admit authorized inspector~ on premises and in building for necessary inspections. ... ,' )f . c. . ?. . .. . 4 5. . . . : ...... (~lg" nature of hpplicant, or name, it' a corporation) ...?. ...... ............................ .. ¢ (Mailing address of applicant) / ~ -¢ ~ State wh~ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde~ Name of owner of premises ~/~ (as on the tax roll or latest deed) It' applicant is a corporation, signature of duly authorized officer. Builder's License No ...... t. ~. . ~ ~.~. . .lfl~ ..... Electrician's License No .... Q~¢k .... ~q~.5 ...... Other~Trade's License No 1. Location of land on which proposed work will be done: }louse Number Street. ' Hamlet County Tax Map No :~ F. iled Map No ~. Subdivision ...... Lot ......... (Name) 2. State existing usc and ~ccupancy of premises and intended use and Occupancy of proposed construction: occupancy ....... · .......... [' ...... ........... · . ;,...Z.. 3. Nature of~vork (check which applicable): New Building .......... Addition....~- · · · ·. Alteration .......... Repair ....... ~ ...... Rbmoval .............. Demolition .............. Sw£,mnlng pool. ........... Tenn£s Court .... ~'t/c'"' Accessory Building .......... Fee Fehce ....... Other Work; ........ 4. Estimated Cost ........ . ,. v.~.tPP.~ ..................... ................................... (to be paid on filing this application) 5 If dwelling mber of d lling nits . Number of d oiling units on each floor 6. If business, commercial or mi×cd occupancy, specify natt~re and extent o£ each type of use 7. Dimensions of existingstructurcs, ifany: 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 ...................... Depth ................... . . ,.0. Date of Purchase .......................... . .. Name of Former Owner ............................ i 1. Zone or use district in xvhich premises are situated .................................................... "~ Does proposed construction violate any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded ........................... Wilt excess fill be removed from premises: . Yes .... No. 14. Name of Owner of pmmises .~Jc.C~q.. ~t~ aaa~ ,-t~/~ro ?£~u~,g~+ rb;e~ph~neNo NameName of Contractor°f Architect ....................... ..~4..t4 ( ~..t~M ...... AddressAddress . ~b'~'.jqc TM ............. >c ~3~ PhOnephone NoN° ........ ............... ................... 1~^$, '~:~r -~- -~v, · ? ~ . 15.Is this property located within [00 feet of a tm~a~ wet'~and. YES .... NO.V.. ~If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate eleazly and distinctly MI buildings, whether existing or proposed, and. indicate all set-back dimensions fro'rn property lines. Give street and block number or description according to deed, and show street names and indicat~ whether interior or corner tot. STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the appticm (Name of individual signing contract) above nan~ed. He is tim ........................................... .' ....................... ; ................. ;:: (Contractor, agent, corporate officer, etc,) of said owner or owners, and is duly authorized to pe,rform or have performed the said work and to make and file th application; that ali statements contained in this application am true to the best of his knowledge and belief; and that tl Work will be performed in the manner set forth in the application filed therewith. ' Sworn to before mc this ,." ........................ day of.. · ~ ............. 19... Notary Public ........ ~....~.'....~.4.(/4'e..~.. County ..c;. . No. UBLI~. ~ of ~ ~ . Te'm F--~r~ March 30, i ~_~.~/ ' '~ ........ (Signature o f applic:m