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Home My WebLink About16815-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy N_ ZI6730 March 22, 1988 u .................. Date ................................ THIS CERTIFIES that the building Add i t ion Location of Property 510 MATHEWS LANE CUTEHOGUE House No. Street Hamlet County Tax Map No. 1000 Section 84 .Block I ..... Lot 20 Subdivision ...... -- . ................ Filed Map No .... ~7...Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 7, 1988 pursuant to which Bui[d[ng Permit No. 16815Z dated ....M.a.E c, h...1.5.:..1 .9.8.8. ......... 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 ......... .p.e.c.k. addition to existing one family dwelling. The certificate is issued to SCOTT AND LINDA KAYEL ..................... ..................... 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 TOWN OF $OUTHOLD 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-°16815 2: Permission i~ hereby granted to: ~t prJmises located at ....... ~,../',~,'........~.,~~.....~ ......................................................... County Tax Map No. 1000 Section ......... .~.....~... .... Block ........... Z ........ Lot No ............ ~. ...... pursuant to application dated .......... ~.~...~.. ................................. , 10..~..~., and approved by the Building Inspector. Fee $...~~ Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town HaL~ 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 followlng; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approva~ el electrical insta{lation 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-existir~g" land uses: 1, Accurate survey of property 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 1. Certificate of occupancy New Dwelling $25,00, Accessory ,$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5,00, over 5 years $10.00 c.c. o.oo ..-,:_. 5.Updated C.O. $ 50.00 Date ......... .... NewConst~-ucti on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of PropertyH o u ,e' ' ' f ] 'O'' 'N o, ' '~' ' ' '~' ' ' A' 'et'"' ' f~ ' ' 4. ~.~ Y. ~, ....... .~. . . .~. . .'-,~ ~j c~ ~ . . Owner or Owners of Property ...... T~., .~:~. ~ ................... County Tax Map ~o. 1000 Section ............... Block ............... Lot ............... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.t ~O ~..( ~'.. Date of Permit .3f.[,~-f~'~ .Applicant.. f,~,,~ 0~-~ ..... . .~,z~ .~ ~ .... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ....................... /..."~ .... .............. ,FOUNDATION { 1st) FOUNDATION 2. 12nd) ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: · . / OCCUPANCY OR USE IS UNLAWF1JL W~l bOUT CERTEICATE FEE:~~y~ NOTIFY BUILDING ~65-1802 9 A~ TO ~ PM ~R THE FOLLOWING INSPECTIONS: FOUNDATION '[WO REQUIRED FO~ POURED CONCRETE R()~GH FRA~NL~ ~ PLUMBING 2i, INSUt,,A FION 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] ~NSULATION / FRAMING ,ru/] FINAL REMARKS: Lj~Ng YOUNG & YOUt,~G 400 OS'I'RAND,ER AYENL,rE, ~IYERH£AD. N'£W V:ORK Examined '~¢~.. ......... , 19.~.~. Approved. 3///. Disapproved a/c ..................................... ................................. APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH . 3 SETS OF PLA S 'FORM NO. I SURVEY ........ Q ,~' TOWN OF SOUTHOLD CHECK -'%Y-~I.~ ..... BUILDING DEPARTMENT SEPTIC FORM .~. ........... TOWN HALL NOTIFY $OUTHOLD, N.Y. 11971 7.3q. ' TEL.: 765-1802 CALL .............. MAIL TO: INSTRUCTIONS a. This application must be completely filled in by typewriter 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. o. 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 York, 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 inspects. , , , ~ '" iJik;~it;re of a~l~lila'n~ j or naif(e, if a corporation) 0y,¢_,... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. O. ¢ ,OF-_-_-_-_-_-_-_-.X~£, .~., ....................................................................... Name of owner of premises .......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No ......... i ...... ~.'c.~.~' .c~ tv. ~te... ~ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ..... .77. .............. 1. Location of land on which proposed work will be done .................................................. ..5';.o. ........... ............ ...... ............. House Number Street County Tax Map No. i000 Section ........ ~..Zff. ...... Block ..... /. ........... Lot....~..0 ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended nse and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy ~ c ...... 3. Nature of work (check which apphcable): New Building . Addition .......... Alteration .......... Repair .............. Removal i ............. Demolition .............. Other Work.../~ ~-r2./C~ ...... d Cost ~ ~O(~O O'-0 i (Descriplion) 4. Estimate .... · - .......... ~ ..................... Fee ...................................... i ' (to be paid on filing this application) If dw b it{ ' f d .-'--. 5. elling, hum er of dwelling un ............... Number o welling units on each floor .............. If garage, number of cars ' ~: 6. If business, commercial or mixed occlupancy, specify nature and extent of each type of use . ---7 ............. 7. Dimensions of existing structures, if~ny: Front ............... Rear .............. Depth .............. Height ............... Number of Stories ....................................................... Dime i . nsions'of same structure w~th alterations or additions: Front ................. Rear ................. Depth ...................... Height ...................... Number of Stories ..................... 8. Dimensions of entire new construction: Front .......... . ..... Rear ............... Depth ............... Height ............... Number (?f Stories ........................................................ 9 Size of lot: Front ' Rear Depth l0 Date of Purchase ' Name of Former Owner 1 1. Zone or use district in which premise~ are situated.. 12. Does proposed construction violate any zoning law, ordinance or regulationi ................................ t3. Will lot be regraded ............. 1 ............... Will excess fill be removed from premises: Yes No [4 Name of Owner of premises ' Address Phone No Name of Architect ..... ~ Add ......... 1 ............. ress ................... Phone No ................ Name of Contractor ' Address : Phone No 15. Is this property located witkin 300 feet of a tidal wetland? *Yes ..... No ~-.. · If yes, Southold Town Trusteels Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buih lings, whether existing or proposed, and. indicate all set-back dimensions from )roperty lines. Give street and block numt er or description according to deed, and show street names and indicate whether nterior or corner lot. ;TATE OF NEW YORK, 'OUNTY OF S.S ............................................., ... being duly sworn, deposes and says that he is the applicant (Name of individual signing co.htract) hove named, i ~e is the .......................... i ...................................................... i (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ')plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the 'ork will be performed in the manner set forth in the application filed therewith. worn to before me this ............... · ~.......day of ........ .~....~'~. ..... 19 ~?. :otary Public, ....'~[ ' fl~459~<... ~ .~,/~ ,~.~.. ....... County .~..~ - . ....... . N0. a?078't8. Sufl0,~ C0un~t~,'a (Sigffature of applicant) ~'m Expires M~ch :~0,1~