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Home My WebLink About17548-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z.17444 Date October 21, 1988 THIS CERTIFIES that the building ..... .ADDITION ............................ Location of Property 950 LITTLE PECONIC BAY RD. CUTCHOGUE County Tax Map No. 1000 Section ...1.1. 1. ...... Block ...1.4 ........... Lot 15 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... 0 C3'.,..1 .9 .... [.9 .8.8.. , pursuant to which Building Permit No .... I. 7. 5. .4.8.Z. ........... dated Oct. 20, t988 was issned, and conforms to all of the require~nents of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... WOODEN DE'CK ADDITION TO EXISTING ONE FAMILY DWELLING. The certificate is issued to ...... HENRY ARBEENY ............... io¥,,'~;, ~ ~;g~g.,~ ...................... 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 FOl~f NO. lB TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 017548 Z Permission is hereby ......... ..~....~.4.......~~....~~ ~,~l- . ~...~~ ~ ~-:~,//~' ........................................ ~~.,.~ .................................................................... co~ ~ ~ ~. ~000 s~,,o~ ..... ZZZ .......... ~k .... ~ ......... ~, ~...Z~ .......... Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ,,, ~ to the Building Inspec- tor with the following; for new buildings or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2,Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal}, 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable, B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2,Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3, Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate, C. Fees: ~Additions $25.00 POOLS $25,00 ALTERATION $25.00 1, Certificete of occupancy New Dwelling $25.Q0, Accessory ~]0.00 Business $50,00 2. Certificate of occupancy on pre-existing dwelling $100.00 3, Copy of cert[ficate of occupancy $ 5.00, over 5 years $10.00 5.Upda~:ed C.O. $ 50.00 Date ................... NewCons Lruc Lion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .............................. Owner or Owners of Property ................ ~;., ,-'~.. . County Map No. looo Sect,on /11 d.?. ............... Block ......... Lot .... Subdivision ................................. Filed Map No. .Lot No ......... Permit No ' . ..... Date of Perm , .Applicant ........................... Health Dept. Approval ....................... . Labor Dept. Approval Underwriters Approval ,. ....................... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..................... Fee Submitted $ Construction on above described building and per.m~ meets all.applicable codes and regulations. App cant .......... ,~. ...... ~. ........................... TOWN OF, SO[JTHOLD_.__ TOWN OF IQ. 1 UTHOLD ARTM ENT ALL LY. 11971 BOARD OF HEALTH ............ 3 SETS OF PLANS , ........... SURVEY .... CHECK ............. SEPTIC FORM ................ TEL.: 765-1802 Examined ............... , l ^pproved .......................... Disapproved a/c ................................... ~uildi~nspector) APPLICATION FOB BUILDING PERMIT NOTIFY ~gr p~ 7.~. CALL .... ........ MAlL TO; INSTRUCTIONS "a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- 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 permit 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 any purpose whatever until a Certificate of Occupancy 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 the Building Zone Ordinance of the Town of Southold, Suffolk County, New Yorl% and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building, code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspe/g~tijzins. /~ / ...... O., .-. ........................ (Mailink, address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises JO ~-~.~..~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License NO. l.~.. ~- ?..g~' 7'.t...~ ...... Plumber's License No ......................... Electrician's License No ........................ Other Trade's License No ...................... · Location of land on which proposed work will be done... House Number Street Hamlet County Tax Map No. 1000 Section t I ! Block ]/~ Lot /ff"- Subdivision .................... [ f.l .............. Filed Map No. ].~. ........... Lot., ./'..4 ........... (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 ./ ~. e,, .~. 75 ............ 3. Nature ofwor check which a 2cable: ew Building .... n . ~'.~'~ eration R pair R " Alt e ....... emoval ..... ' ......... . ........ liti Otb k I ............. Demo on ............ I. er Wot ............ Estimate'd Cost ¢ " ' · Fee , tto be paid on filing this application) If dwelling number .... of dwelhng umts Number of dwelling units on each floor ' If garage number of cars .............. 6. If business, commercial or mixed occupancy, specffyal~re and extent of eaf~/pe of use Dimensions of existing structures if any: Front '[ c~ i .............. [ ...... · Rear ./ Depth ,,2..~.. Height Number of Stories ................................... of same structure w~ith alterations or additions: Front Rear Depth i Height ................................. ..................... Number of Stories Dimensions of entire new construction: ............................................ Front Rear ' Depth Height ............... er o f Stones .......... ............. Size of lot: Front ................. Rear. · ............ D pth Date of Purchase ] ~. ~_._4_" Z .. ': ' ' -~'~ .................. rqame olrormer ~wner . ...... one or use restrict ~n which premises are situated... ~ .................... ' ..................... Does proposed construction violate any zoning law, ordinance or regulation: .... '. .' · ,W, ill lot be regraded ...~X] P..,...~. .......... , ....... Will excess fill be remove. 1 from premises: ~ Yes Name of Architect i . ., · '~ .... .;-~ ........... aauress ................. ~. ~'iaone No ~.~s th~s property locaited wxthln 300 feet of a tida~ wetliand* *yEs.'~vf~_ ~'~/'~-~''' · If yes, Southold Tow~ Trustees ~P.e~rmit may be required, i ' /1 ,.. i t'LOT DIAGRAM Locate clearly and distinctly ail lbuildings, whether existing or proposed, and, indic~te all set-back dimensions from deed, and show street names and indicate whether 9. 10. 11. 12. 13. 14. property lines. Give treet and block number or descnptmn according to interior or corner lot. STATE OF NEW YORK, COUNTY OF ........ SiS (N ' ki''';i"i ...... 'ti .......... above named, amc of redly ual s nih contrac being duly sworn, deposes and says that he is the applicant (Signature of applicant) Heis the .(? .~ b.~. i ' (Contractor corporate officer ) ' . , agent, , etc. of said owner or owners, and is duly ?~thorized to perform orihave performed the said work and to make and file this application: that all statements containled in this application are true to the best of his knowledge and belief; and that the Work will be performed in the manner s~t forth in the application filed therewith. Swum to before me this ~ ' ' ............. day of i