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Home My WebLink About16997-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Zt7812 Date MARCH 3, 1989 THIS CERTIFIES that the building Location of Propertz 550 House No. 1000 Section County Tax Map No. Subdivision ACCESSORY CUTCHOGUE WEST CREEK AVENUE Street 103 Block 13 Lot 5.2 Hamlet Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 20, 1988 ~ursuant to which Building Permit No. 16997Z dated MAY 16, 1988 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 AN ACCESSORY SHED. The certificate is issued to LINDA FAULKNER (owner, XXXXXXX~) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Building Inspector Rev. 1/81 ~O~l~ NO. B TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWH HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 16997 z Permission is hereby grant d to: . __ __ ¢/'~ .~ ~, ................ COU.~ Tax Map No. 1000 Section .../~. ......... Bilk .......~.~. ..... Lot No .....~...~ pursuant to application dated ........... ~ .............................., 19..~ and approv~ by the Building Inspector. Fee *......~~ Rev, 6/30/80 TOWN OF SOUTHOLD BUILDINC DEPARTHENT TOWN HALL SOUTROLD, NE~ YORK 765 - 1802 1197 APPLICATION FOR CERTIFICATE OF OCCUPANCY DATE ~ ~ ~... NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ Location of Fropert~..JT~$.O. ........... .~.C~.~.~.~,.. ~¢ .o~E .o. ~,~, '~'~ .... ~/~.~ ~ ..................... ~o, .~Z. . ,Owner or ,county Tax ~ap No. 10oo Section Z~.. Bloek /.3 .... Health Dept. Approval .................. Uuderwrlters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Fee Submitted: $./.~.,.~.~ ..... Final Certificate ................ rev. 10/14/88 'OUNDATION ( 2nd ) ~OUGH FRAME & .FLUMBING 7NSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ J FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~FINAL REMARKS: DATE ~-/; ~ INSPECTOR _ Health Dept. Ref. ~ 14-S0-119 SUFFOLK COUNTY HEALTH DEPARTMENT SfNGLE FAMILY DWELLING ONLY H.D.R~F. No. f,/ ~o 11% DATE ~' ~ ~ ' I I I _ THE SEWAGE DISPOSAL AND WATER SUPPLY FACILITIES FOR THIS LOCATION HAVE BEEN INSPECTED BY THIS DEPARTMENT AND FOUND TO BE SATISFACTORY. · ~ 'Chief ol Wasta~'aier Management Seatioa ": ~-,,,,, ..... AP. PROVED AS NOTEI 3, INSU~?~ON 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL s-~T~ $OUTHOLD, N.Y. 11971 , ' TEL.: 765-1802 Examined ......... 1 ....... .... ... .. Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... gEPTIC FORM ............. : NOTIFY MAIL TO: a. Tins 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. 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 York, and other applicable Laws, Ordinances or Regulations, for the,0onstruction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordina~fl_~d'm.g code, housing code, and regulations, and to admit authorized insl~e~rs on premise~ and in building for neck: '~¢q~ , ~-~rr~oratio~L ~ i'~.. ' ....... ih'ailing address of appli~i) State whether applicant is ow~y, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... .... ............................... , ................ .................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co~orate officer) · ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... 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 / 0 ~ Block / ~ Lot 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 ...... ~.)0/I/~_- . b. Intended use and occupancy ......................... ........... · · ........... 3.: Nature of work (check which applicable): New Building .. Addition .......... Alteration .......... Repair .............. RemoVal .............. Demolition .............. Other Work ............... -- 4. Estimated Cost ........... , ~.* ..................... Fee .................. · (to be paid on filing this application) · . ,. 5. If dwelhng number of dwelhng Umts ........... Number of dwelling unitsF~ e. ach floor ....... If garage, number of cars ..... i .................................... g/ ............................ 6. If. business, commercial or mixedioccupancy, specify nature and extent of each.type of use ......... .A/. ¢r¢... ~ .... 7. D~mensions of existing structures~, if any' Front 2". '7 p~ .O~ [3~,,,h Height .... ~ ........ Number of Stories ...... : ..... ~ ..... .~.V4~..~./.,~. ~..~.. ...... D~men ,ons'of same structure wl~h alterations or additions: Fron~'Jl,¢¢~ .~.~ ......... Rear ................ Depth ........... , ......... 4 · Height ................ .'~..~.:. Number of Stories ........................ ' 8. Dimensions of enfirS, new construction: Front ..../(~. .... ~ ..... Rear ..... ./O ....... Depth .. ~( ........... Height ... 7:L (~ ........ ,,Numl)er of Stories ........... ; .... /. ....................................... 9. Si..zeoflot:Front ...4~.'7..~..~,, .......... Rear ..... ?.~.*.~..(¢. ...... Deuth . ...~..t,.'~..' . .... 10. Date of Purchase ~¢."( 7. !~.~ .... Name of Former O~v~;r k,~'~/~ ~/~t,K'~ 11. Zone or use district in which premises are situated ..... .~ .....A~.~.~/ 7~ ........................ 12. Does proposed construction violate any zoning law, ordinance orre uiation':..... '.X?.b.... 'i ................... 13. ~i~.1 lot be regraded ...... ~. ~ . .A~'.O. ..... ......... Will excess fill be removed from premises: Yes 14. Name of Owner of premisesdP..~.. ~.~...~./¢.. ~. .... Address~:...~.....~¢.,~.~ ,dq?.e; .tc~6~n~e No..7~7.6..~.. .... Name of Architect i ~ .... Address ..... ~ ...... Phone No.. ~ .... Name of Contractor ........ i ~.. ~ ...... Address .... :/~-rCwe¢~ ...... Phone No.. ~ ..... 15. Is this property located xftthin 300 feet of a t±dal wetland? *Yes .~... bio ..... · It! 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 properi:y lines. Give street and block number or description according to deed, and show street names and indicate whether ,OCCUPANCy ,us umwm WITHOUT CERTFIOATE OF OCCUPANCy APEROVED AS NOTED DATE:~B.P, # ~.,?,~:~ N OTIFT BOP2'D~NG 766-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION Tla/O REQUIRED FOR POURED CONC/IETE 2. ROUGH -FRAMIN~ & PLUMBING 3. INSULATION 4, FINAL CON~'RUCTION MUST BE COMPLETE FOR C.O, ALL CONSTRUCTION SHALL MEET THE REQUIREM!JNTS OF THE N.Y. STATE CONSTR~FION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CCINSTRUCTION ERRORS STATE OF NEW, YORK , COUNTY OF '~"', ,. ~rr-~Si'S ' ·. "~'~'~.' '¢~''... '~.~.~..~ .~T..~%..'~. · .~. · .~. ·-. ........ being duly sworn, deposes and says that he is the applicant (Name of individ ual signifig contract) above named. ~ He is the . : (Contr~c~M'~r, agent, corp(~t¢~ officer, etc.) of said owner or owners, and is dulyl authorized to perform or have performed the said work and to make and file this application; that ail 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 ~ i ::: , 19 .~. ~Z/ .. . day of.i ~ Not, a~y Public, ....... ' ... . NDA &COOPER i / Notary Publlo, State of New York/~./ .,,._?0:.48.225_63. Su.ffolk_C. ou.n_tv/(7 mrm expires Oeeem~er u 1, 1 ......... Count~~_ (Signature of, applicant)