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Home My WebLink About18815-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19005 Date MAY 1, 1990 THIS CERTIFIES that the building. Location of Property 24025 MAIN ROAD House No. County Tax Map No. Subdivision ALTERATION CUTCHOGUEr NEW YORK Street Hamlet 1 Lot 12 1000 Section 109 Block Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 30r 1990 pursuant to which Building Permit No. I8815-Z dated FEBRUARY 23~ 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 EXISTING CONCRETE PORCH WITH WOOD AS APPLIED 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 Rev. 1/81 WICKI{AM HOMESTEAD ~ INC. TOWN OF SOUTHOLD SUJLDING D£PARTMENT TOWN HAIL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 18815 Z ~..~......~_~ ............... i ....................... ~t p~,~,ocoted ot ............. ~...~ ....... ~..~......~.~ ........................................ County Tax Mop No. 1000 Section ......... /.~.....~..... Block ............ ./.. ..... Lot No .......... ./..~ pursuant to application doted ........ .././....~....~.. ................................. , 19..?...~.,, and approved by the Building Inspector. Fee $.~.O..~.~. Rev. 6/30/80 Form No. 6 TOWN OP SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIPICATE 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: i. 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 - $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 Construction ........... Old Or Pre-existing Building ............. Location of Property...~..~..~...~. f ........ .~..~..~-~.~ ..... []..x~'~. · .'-~w~..~-~¢f~ .... House No. Street Hamlet Onwer or Owners of Property .................................................. ... . . .... .... . . . County Tax Map No 1000, Section.../. .... Block .............. Lot ................ Subdivision ................................ . . .. Filed Map ........... . Lot .................... . . Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept Approval Underwriters Approval ..... Planning Board Approval ............. .. .. ....... ~/~ Request for: Temporary Certificate ........... Final Certicate ........... Fee Submitted: $. -' -- APPLIC ............................... '. FOU~DATIO.~; FOUNDATIOU 2. (2nd) ROUGH FRAME & -PLUMBING INSULATION PER N. STATE ENERGY CODE FiX:AL ADDITIO~IAL CO?.MENTS . BUILDING DEPT. INSPECTION FOUNDATION /.ST [ ] ROUGH PLBG. FOUNDATION ZND £ ] ~SULATION FRAMING ~r ,~/] FINAL DATE INSPECTOR BLDG, DEPT TOWN OF SOUTHOLD FORM 1~/O. '1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.; 765-1802 BOARD OF HEALTH ........... 3 SETS OF PLANS ........... SURVEY .................... CHECK ..................... SEPTIC PeRM ............... Examined ............. ^p~roved..y:~,3 ........ , l~ .~.R. Permit No./~'g .5~..~ Disapproved a/c ..................................,. . .................... APPLICATION FOR BUILDING PERMIT NOTIFY; CALL .................... MAIL TO: dSE IS -" UN_LAWFUL ?uUT CERTIFICATE '"' OOCUPANoY 1. Location of land on which proposed work will be done; House Sumbcr Street ' ' Hamlet o. ieee /0: ¢ ' f /. County Tax Map N Section .............. BlOck .. . Lot Subdivision FJIcd Map No Lot ' (Name) .. '~ Statee ' ' ' ' -- x~stmg use and occupancy of premxscs and intended use and occupancy of proposed constrnction: Plumber's License No Electrician's License No Other Trade's License No " ~uilder's License ~,. ], .,L~.~. ....... INSTRUCTIONS a. Tlti$ application must b~ completely filled in by typewriter or in ink and submitted to the Building I~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 fids app cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. 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 throu2~tout the work. e. No building shall be occupied or used in whole or in part for a~y purpose whatever until a Certificate of Occupan- shall have been granted by the Building Inspector. APPLICATION IS HEREBY' MADE to the Building Department for the i~uance of a Building Permit pursuant to tl Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinancex Regulations, for the construction of buildings, additions or alterations, or for ~:emoval or demolition, a~ herein describe, The applicant agrees to comply with ali applicab"le laws, ordinances, building code, housing code, and regulations, and t admit authorized inspector~ on premises and in building for neeess.a~ inspections. · .17~.,..~z._~.~...~. 0.~b ~ .~e~o. Crt<). ~3...co..~.~ {I.'{-I'~ ~ ~J'!g*~'~:; ~:~ (Signature oi' ~.ppticant, or name, ifa corporation) ............. vff ....... --¢ : (Mailin= address of applicant) State wh~ther apl~licsn~ iY'0gngi, lefsee, .',~nt~ architect, engineer, general contractor, electrician, plumber or builde, ....... ........ :_' '5/'/7 .......................... ~ '/ (a~on the tax roll or latest deed) 3. Nature of woe(check which applicable}: New Building .......... Additian .......... Alteration .......... Rep,.ir . R~mova[ .... Dcmolition . . S~£. ' )o~ . Tennis Court ......... Accessory Building .......... Fence ....... O~'Wor~;~. .......... 4 Estimated Cost .L~ (~.~.~0... Fee '' (to be paid on filing this application} If dwelling number of dwelling unils . Number o f dwelling units on each t-loot .......... Il'garage number of cars .......................... 6. If business, commercial or mixed occupancy, specify nature and extent o f each type of use ..... 7. Dimensions of existing structures, if any: Front ........... Rear ............... Depth ................ Heieht_ ............ . .. Number of Stories... .................................. ........ . .... ... . .. of same structure with alterations or additions: Front Rear . ; Dimensions .................................. Depth Height ' Number of Stories 8. Dimensions of entire new construction: Front ............ .. . Rear ............ ... Depth . .......... .. Hcicht ............... Number of Stories .............. : ..................................... 9. Sizcoflot: Front ...................... Rear ................ ...... Depth .................... 10. Date of Purcl~ase ...................... : ...... Name of Former Owner ........................... i I. Zone or use district in which premises are situated ................................................... 12. Does proposed construction violate any zoning !aw, ordinance or regulation: .............................. 13'. Will lot be regraded. .... .. .. ................. ..Willcxcess fill be removed from premises: . Yes ..., No. 14 Name of Owner of premises ~ Address Phone No Name of Architect Address Phone No ....... Name of Contractor ........ ' 15.Is this property io'e'~c;d '~ithln I00 Addressfeet Of ................... a £idal wetland-*Ph°neN°*¥ES--.;llO--::'"~ .... ' " *Itc yes~ Southold Town Truat:ees Permit: may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate ali set-back dimensions from property lines. Give street and block number or description accord'.mg to deed, and show street nm'nos and indicate whether- interior or comer lot. A OV ASNOT NOTItrq 8UIL,glNG DEPARTM~ Al' 76F.1802 9 AM TO 4 la~ FOR TilE FOLLO'4VING INSPECHONS: 1. FOUNDATION ~ REOJUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL ME["/ THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR OESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK, S.S COUNTY OF ............... :. ................................................. being duly sxvam, deposes and says that he is the appfiea~ (Name of individual signing contract) above named. (dontraclor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to m~e and file tb application: that all statements contait~ed in this application are true to lite best of his knowledge and belief; and that tl Work will be performed in the manner scl forth in thc application filed therewith. ' Sworn to before mc this " ............ day of ........ .~. ........... 19 Notary Public, .................... County . No. 470787s, Suffo~. _C~. ~m F.~r~ kbmh 30, lU