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Home My WebLink About1459-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No: Z-26247 Date: 01/29/99 THIS CERTIFIES that the building NEW DWELLING Location of Property: 505 TRACK AVE CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 137 Block 1 Lot 20 Subdivision Filed Map No. __ Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 27, 1961 pursuant to which Building Permit No. 1459-Z dated JUNE 29, 1961 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 ONE FAMILY DWELLING WITH ENCLOSED PORCH AS APPLIED FOR.* The certificate is issued to DOUGLAS JENCKS of the aforesaid building. (OWNER) SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A 07/03/62 N/A N/A This Certificate of Occupaucy updates CO# Z-1391, issued 7-6-62. Rev. 1/81 FOFa~l[~O. 4 TOWN OF SOUTHOLD BUILDING DEPART/~ENT TOWN CLERK'S OFFICE SOUTHO~.D, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...... ~.~.8...~t;P.~t,¢k:.....A.V.e ............................ Street Map No.M.~a~d.... Block No ..... ~ .......... Lot No. ~.0~O ......... ~.tl.$OJ~4~.~o.t...~.r?.~., .......... conforms suDCtantially to the Application for Building Permit heretofore filed in this office dated ...................................... ,T.~n.e ........ 2~ ....... 19..61. pursuant to which Building Permit No.~.~¢.0 ..... dated ............................ ~T.12.~¢.....2.~......, 19.~],.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .......... ............. P.'r.i.v.~.t.e, ...o..n~... f.a~d,!?¢... &~elling .................................................................................. This certificate is issued to .,.il'~,l-t.o;Itle...l~,~...~l,~e.~..~....l~.i.~¢ ......... .01¢/~e~'.¢ .................................. (owner, lessee or tenant) of the aforesaid building. H.D.Approval by MaJkowski July 3, 1962 ....... ~:.~ .......... :. '¥'""'"'"'""~'ouilding inspector FOP,~ NO. 4 TOWN OF SOUTHOLD ~UILD~NG DEPARTM~-NT TOWN CLERK'S OFFICE SOUTHOLD~, N. Y. TT~MPORAtl~ CERTIFICATE OF OCCUPANCY No. Zt336 Date }~/_a~. t6 ]9..6..2.... THIS CERTIFIES thet the building located at ..... ~./.~..~.~..~..~.k.....A..v....e. ............................... Street M. ~. Hand Map No ....................... Block No..,~..X. ............. Lot No. 6.~....&...~..O ....... .Q~,t. ah~ne., .................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................................. .~.~...:..2..~. ............... 19..~..,~... pursuant to which Building Permit No..Z.~..~..~..~..... dated Jlh'le 29 19....~...]:., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate b issued is .......... ....P.~.$.v..~.e.....o...q.e-...~.;t .~,~...;L~:~ ,1-.~ L.n.~; ............................................................................................ This certificate is issued to ......J..~.~.~.~.e....~..~...~.fif¥Clf~...~:..~,[J,f.¢. .............. .Q~rzaz'.~ ........................... (owner, lessee or tenant) of the .aforesaid building. Building Inspector TOwN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS I~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1459 Z Date ....................... ~T:L~ ....... P,.O ............. 19.61.. Permission is hereby granted to: ....... Je~. o~e...P.,...~a~e¥.. ~.. :~,,LiZ, e .................. ................. ~ain...Ro.ad .......................................... ......................... C~.teho~.ue ................................... to Build ~e~ .one. family d.~etZing ...... at premises Iocoted at ....Lat..~:..69..&.,.TO.,......~,.~ ~...H~nd. ............................................................ ............................................... T~.~k.....A~.e.~......C~ztcho~ue ............................................................. pursuant to application dated ......................... ~I%l~'l~..,..P,~ ................... 19.6]..., and approved by the Building Inspector Fee $10.00 ............ Building Inspector/ BUI~ING D EP~RI~cr TOW }La~L L 765-1802 APPLICATION FOR CERTIFICATE 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: I. 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 contaims 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 Ypre-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. I. 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 Buildinm - $100.00 3. Copy of Certificate of Occupancy - Updated Certificate of Occupancy - $50.00 Temporary Certificate of Occupancy'-Residential $15.00, Commercial $15.00 ,,,, ..,.1.../.,. ...... ~ o~ ~?. ....................... ,,t~on o~ Property .... '. .~Te.. ~ .... T. . .~. . . . . . .~ ... ~.~*. . .~. .2. ~~. ........................ House No. Street Hamlet ~er or Owners of Property ............................................................. ~nt~ Tex ~p ~o 10o0, Seetiou ...... (.~..~....Block ..... / ...Lot. .a...O.. Filed Map Lot '- ', ~bdivision .................................. :trait No...........~ ..... Date Of Permit .... J ........... Applicant ............................. ,~lth Dept. Approval.......... .............. .. Underwriters Approval ......................... anning Board Approval... ............ .. ...-.. · Certificat Final Certicat · ;guest for: Temporary e ........... e .......... FORi~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. · ...~.~....~ Examined ............ .~/.. ~.. ~.. 19..../... ~f . Approved ............. .yr..~.~......~.~..... 19 ........ Permit No ..................... ~ ........ Disapproved a/c ....... Application No ..................... :'. ...... (Building Inspector) INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 location. 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 issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of 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 and regulations. ........ ....................... (Signature of applicant, or name, if a corporatJon) ................. (Address of applicant~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ... ................................................................................................................................. Name of owner of premises......~....~..;...~....O....~'..?....~.. ......... ~..~..........~......~..'../T'2.../.~/. ,~...~.........~.....~.~.~'...C....~....c~... ........................ If app[icant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ......... ../....c~.....~..)...~.. ................. Lot No: ..~'...?.Z...~...~... Street and Number .i~.'.~...'~...../Z..~..~......~... ...... .../~.....~.....~:..: ........................... C~./..¢/..~.~.....~....~...¢?....~.~....~..~ ................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occu anc' ~ ~' ~ / b. Intended use and occupancy ............... ...~.../'f'.....~,...~....~"~. ............................................................................................ 3. Nature of work (check which applicable): New Building ...... ..~..........Addition .................... Altergtior~ ............. Repair ............... ~...P, emoval .................... Demolition ............ .~.....Other Work (Describe) ....................- 4. Estimated Cost .............. ~ .............................................. Fee ................................................................................... (to be paid on filing this appJi¢~tj~) 5. If dwelling, number of dwelling units..../....~.~.&~....Number of dwelling units on e~ch f~oor If garage, number of cars .............................................................................................................................. . ...... , ...... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .............................. 7. Dimensions of existing structures, if any: Front ............................ Rear ............................ ~pth ............................ Height ............................ Number of Stories ............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8.Dimensions of entire new construction: Front ........ ~ ............ Rear ..... ~ z Depth Height ...~ ...................... Number of Stories ........................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... f2/~ ................................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor ........ ~.~.~ ............................ Address ........ ~. .................... Phone NO...~.~.~. PLOT DIAGRAM Locate clearly ond distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whelher interior or corner lot. ,fl7 , STATE OF NEW~ ¢~ ) COUNTY OF~~.~..) S S. ............ ~Z..~..~(~:C~.= .................... being duly sworn, deposes and says that he is the appliCant / (Nome of individual signing ~pplication) 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 a~ file this application; that all statements contained in this application are true to the best of his know[e~e an~ belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to befor me this , ~ ~ ~ fD~ll~tpte of New York .......... ~.. ~ -~ ~~ ~,. S~ll01k Co[~ty (Signature of a~icant) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN C'ERK'S OmC~ SOUT,OLD, N. ¥. E×om~ned ........... ~..~..~95../... ........... ...... ....... ..... Disapproved a/c ......... .~-~ ~.~.~.~. ~ :.~D:~~ i ....... ............... ~... ,~r?....~...~..~...~...~.. ............ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building inspector. 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 location. 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 issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of 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 MAD[ 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ...... ......................... (Signature of applicant, or name, if a corporation) ................ (Address of applican~g State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ ...~...,,..~... ~....~.. ........................................................................ Name of owner of premises.....~..~.~....'~...~.../.?.?..¢~.. .......... ./.'.~.........~..../..c~..:../~..~.~...~.. ...... ~....~:..~..../.../..Z~...~ ......................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. MaD No: ........ ./....~.....~.....~. ................... Lot No: ~...~..::....~....~. Street and Number ...~.....~..¢~...~.'.~.~......~....~'....~..' ....................... .~....~.....~....~.../.'~...~....C~...CZ....~. .................................. Municipality 2. State existing use and occupancy of pr. emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............ ~/..~,..~......Z~.....c~,..~2. ......... ..,,~....~...'...7~.. .................................................................. b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building Addition Alter~t 911 .............. ~ .... Repair ................. ..~emoval .................... Demolition .................... Other Work (Describe) 4. Estimated Cost ............. ~'~.,~,~..~..#. ................................ Fee ...................................................................... (to be paid on filing this c~ppli¢~ti~n) 5. If dwelling, number of dwelling units....,../.....,'~,:~,~..//.~....Number of dwelling units on each fbor ........................... if garage, number of cars ............................................................................................................................................. 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use .............................. 7. Dimensions of existing structures, Jf any: Front ............................ Rear ............................ Depth ............................ Height ............................ Number of Stories ............................................................................................................ Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front....~."..,~. ................Rear ...... ~..-~...~ ......... Depth .,.,,.C~.....~....,:. .......... · Height ...../.~. .................. Number of Stories ............................ 9, Size of lot: Front ....../...~....~....( .......... Rear ....... ~...~.,...z~..[ ........ Depth ..... ~¢;~.~....~.. 10. Date of Purchase .~.../~.....~../.../........c~......~...~...~..,.',~"...~......Name ,o,f [ormer Owner ........ ..'~.~../.,../~.....~.,.....~,....·f~..,4~ ....... v~l. Zone or use district in which premises are situated ........... ~..........~..A'./.'.~.~.'.~./..TT,~::./.~%~.~.z(.../~..~..~... ................ 12. Does proposed construction violate any zoning law, o-rdinance or regulation? ..... ..~....~., ....................................... 13. Name of Owner of premises.....u~..,~,.~..~...~.....~...:/~..~..~...~. ,,~?dress ../..22~.../MY-rC....6..~.~.~c,J~..~.~4~.-Phone NC) ...... .~.,.,~,~. Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor......"~....~....~f....~ ............................... Address ...~..(~.,~,.~.~T.. ................ Phone NO. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names anti indicate whether interior or corner lot. /f D ~ LOT' : ' '7"' ~A'- r;,, ~ .~ ~'~-. STATE OF NEW~,?OJT~, COUNTY O~ .,:~...~..) ' P,,'/-/1T- "r'w~ ..~ ~ ~.~..';5~: ................... being duly sworn, deposes and says that he i, the applicant ............. ~'~'l~'~'~'"i~diviciual signing ~plicetion) above 'named. He is the .............. ..~,~'~/.~.l-r~ ...................................................................................................................... (Contractor, agent, corlborote officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make anti file this application; that all statements contained in this application are true to the best of his knowlecl~le and belief; and that the work will be performed Jn the m,annej'~l~t~ forthT. ~0K£r~in the application filed therewith. Sworn before me this to...~.~ ' ~ ~%~ [~u~Ii~ S~te of Flew York c ' ~,,4. of ~ ~4~83, Suflolk County ~ ~; '-,