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Home My WebLink About16910-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Cerfi[icate O[ Occupancy THIS CERTIFIES that tile building AD D I T I 0 N Location of Pro~ertv 4570 Stillwater Ave. Cutchogue, New York - - h~,;~'~ ~'o: ....................... 's'tie~i ....................... hi~ie~ County Tax Map No. 1000 Section .... ! .3.7 .....Block 2 ..... Lot 10 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ,,A.p.r..il 6, 1988 pursuant to which Building Permit No. 16910 dated......,........AP r i 1 22', I .......... 988 ... . was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for wtfich this certificate is issued is ......... ADDITIO'N TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to DONALD IRWIN, THEODORE IRWIN & BRUCE IRWIN ..................... ~oh;,,'o'r,'li,~,X~:~ ................... 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 FORM NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Yo NO_ BUILDING PERMIT {THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 9] 0 Z Date .~.~.i~... ........................................ 19...~.'...~ Permission is hereby granted to: .~...~ .~../../~..j.....~:.~:......~..x..~ ~.E..7/.......~,,-~.......~.~ ..................... . , ~ .......... ~ ...... ,....,.~,~ ....................... .... . ................... at premises located at ..... ,ff.. ,~,.Z~,......~~,. ~,'~ ....... ~ ....................................... County Tax Map No. 1000 Section ........ ~....~....~.... Block ........... ~ ..... Lot No ....../..~.~.. ............ pursuant to application dated ................. ~ .............................. 19 .~..,~., and approved by the Building Inspector. Fee $' '~"~'~i ...... ~ing~ Ir~. ector Rev. 6/30/80 JUL - 5 198ii TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted I~ to the Building Inspec- tor with the following; 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. 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. B. 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 pzt~perty showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occopancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion requ ired to prepare a certificate. C. Fees: Addi~an~ $25.00 POOLS $25 . 00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory,S10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vaoant .and c.o. 20.00 5.Updated C.O. / $ 50.00 Date 't ..... · NewCons~uc ~on... Id or Pre-existing Buildi~ ............ Vacant Land ............. ........................... ~ ........ ~ ..... ~.. ;.~ .......... Owner or Owners of Property ~, ~t~..~ ~., ~*~. Coun~ Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Perm~tNo. 16. Date of Permit ~..~ .... Applicant ¥'~..~.~.. ~.,..~..M~.I..~ ........ Health Dept. Approval ........................ Labor Dept. Approval ..................... Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..................... Fee Submitted $. * ...................... Construction on above described building ar~ermit meets a~ applicable codes and regulations. Applicant ....~.~./~...~..T..:. :~~.,~j-t~..'"""¥' \ ................. Rev. 10-10-78 7&S-1802 BUILDING DEPT. INSPECTION []FOUNDATION 1ST [ ] ROUGH PLBG. []FOUNDATION AND [ ] INSULATION []FRAMING [~AL REMARKS:/~./<~, DATE ~f/~/c~c~ ,"SPECTOR~~ ~J~ LA& I0' DUNDATION (2nd) )UGH FRAME & .PLUMBING ~SULATION FERN. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: J FL~O~I ~ ~ Z ,OF_& S ,/ cc,A. THE NEW YORK BOARD OF FIRE UNDERWRITERS 10003~4 BUREAU OF ELECTRICITY Date ~ppllcatlon ~o. on fil~ g~ e~t~ ~u~ment ~ ~ ~w a~ int~c~ by t~ a~ant ~ ~ t~ a~ ~t~ numar in t~ p~m~s of TH~O~E IRWIN, S~ILI., ~TER ~V~,, POhE~5, CUT(.H~U~:. N~Y. OU" examin~ on and found to be in compliance with the requi~ments of this ~rd. ~ 0~ FAN~ RXTUI~ DIMMERS SIRVIC~ DISCONNECT S E R V ~ ~.~.°. I coPY FOR ~L.DmG DEPART ~ ~ o~_culp~-~lE ~J~JST NQT B~ ~r ~E.~] 'N ~NV MANNER. __ TOWN OF SOUTHOLD CIIECK ....... ,- - BUILDING DEPARTMENT SEPTIC FORH ............. : TOWN HALL NOTTFY ~OUTHOLD, N.Y. 11971 CALL ................ TEL.: 765-1802 MAIL TO: Examined '~ ., 19 .~..~ Approved ~.'~.' '. ~., 19~ Pe~it No.~~~~.~. ~ - Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT Date .................. , 19 .. INSTRUCTIONS t~a ~ ~ a. Tl~s appli( filled in by Wpewriter or in ~E a~ ~~spector, with 3 sets of plans, accurate schedule. ~W CO~~ b. Plot on premises, rel~fi~'~~P.r¢~i~!~Pr pubHc streets or areas, of property :must ~ i}g~h off tfi~~~ of this appli- cation. ~' c. The ,ot be commenced be~or~e~ . _P~i't. d. Upon Inspector will issued~fl~ ~q~¢~l~a~t. Such pemit it the work. ~ ' ~'~>"" "~ e. No or in p~t for any purpose ~hatev~ ~t ~ C~fi?~¢ of Occup~cy shall have ~ADE to the Building Dep~tment for the issuance of a ~ldmg Pe~lt pursuant to the Building Zone : Town of Southold, Suffolk County, New York, ~d other applicable L~W~. Ord~ces or Regulations, for the additions or alterations, or for removal or demolition, as herein described. The applicant agrees to appUcable laws, ordinances, ~code, ~de, ~d regulations, and to admit authorized ~spectom on premises and ~ build~g for necessaw inspect~. L ~ ...... ........ (Signature of appf~t, o(name, if a corporatiou) State whether applicant is owner, lessee, agent, ~chitect, engineer, general contractor, electrician, plumber or builder. N~ of o~,~ o~ ~m~, ../~W~,, .~((a ~'~.. ~.~<~...~S& ................................. (as on tho tax roil or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR'S.,MUST BE S~UFFOLK COUNTY Builder's License No. ~....~.. 7. l .~. ............ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... OCCUPANCY OR C"NS 'USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section ........ /-'~...~. .... Block ........... . .'?~..... Lot ....... -~J.~ ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... 2,~f./?..~7.4/.7-./..~.Z.~ ........ > ....... .~,../. ........................ b. lntended use an d occupancy 3. Nature of work (check which applicable): New Building .......... Addition ..; .'~'.. .... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost '~ ~-~Y ~ ~J (Description) ...................................... Fee ...................................... (to be paid on filing this application) 5.If dwelling, number of dwelling units .... .//./~. ...... Number of dwelling units on each floor... ?.//Z~. ........ If garage, number of cars ........ .~./.rSz ................ 6.If business, commercial or mixed occupancy, specify nature an'd';~t'e;i'o'f'e'a;~'t~;;'~f'~ie' i i i i i i 7. Dimensions of existing structures, if any: Front .... q-~'.'.. · Rear q._. ~. z Depth ~. £) Height ............... Number of Stories .. ,,~ .................................................... Dimensions of same structure with alterations or additions: Front ..... z.fi~ .~ ........ Rear ...z7~..~ ........... Depth ...................... Height ...................... Number of Stories .... ,,?. ................ 8. Dimensions of entire new construction: Front .../.&/ .... · ..... Rear ..... /.g: / ....... Depth .... /. ~ ( ....... Height .... ~7.' .qT. '~ ..... t Number of Stories ........... [' ' 'V,' ', ....................... ~ ............... 9. Size of lot: Front . . . ~.0. ................ Rear ..... .'fi"..P,..~.. ...... D__epth /.~. 10. Date of Purchase ....... 5¢,/Z4 ................. Name of Former Ow;;;'..~'-~i i.~. 1 1. Zone or use district in which premises are situated .................. --, . ./. 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ; ............... i ............ 13. Will lot be regraded ....... ~/~ ................... Will excess fill he removed from premises: Yes 14. Name of Owner of premises ~), .~./(~ff, q./z.~d..-4:..f?/~._.q... Address ... ' . · · :~. ..... 3Phone No ................ Name of Architect ........................... Address ............ '~ ...... Phone No ................ Name of Contractor .......................... Address .... : ·. ~. .......... Phone No ................ 15. Is this property located within 300 feet of a tidal wetland? *Yes ..... No .~.. · If yes, Southold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property hnes. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~TATE OF NEW YORK, COU~Y OF ' S.S APPRO¥£D AS lo'rED 7~5. t802 9 AM TO 4 I~1 ~ FOLLOWING INSPE~: I. FOUNDATIOI~ . ,t ;_.z ........ ,__, I ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this apPlication are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this