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Home My WebLink About1655-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-19592 Date DECEMBER 19~ 1990 THIS CERTIFIES that the building. ONE FAMILY DWELLING Location of Property 255 BROADWATERS ROAD CUTCHOGUE~ NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 104 Block 12 Lot 7 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 1, 1962 pursuant to which Building Permit No. 1655-Z dated MARCH 1~ 1962 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 ONE CAR GARAGE UNDER HOUSE. The certificate is issued to ELISABARKER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL AUG. 10~ 1971 UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 PENDING- DEC. 17~ 1990 N/A " //I J ' ' spector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 1655~ Z Dote .................... ~ll~h.... ~ .................. 1962... Permission is hereby granted to: An~r.e.~.. H~.L..A/.(L .....~ 7+..d.r.e...d....~.~ ~ ............. ......... ]~y.. J.v.e ...................................................... ............... ~Le.~.o..g~ ............................................ to. ~i~l.. ne~.. c~..£a~y...d~e:L1 in~ .................................................................................... at Lot at premises located ......... ~,~]. ........ li~$au...l~int..Cl~b...l~ol~f.;~ ............................... ........................................ ]l~oad~at~r~..l~a4 ................................................................................. ........................................................... C'~,t~l~ ............................................................................... pursuant to application dated ............................ .-.~'~h ....... .1. .............. 19.(~.., and approved by the Building Inspector Fee $....~..0..9...0~... ......... Building Inspector FOI~M NO. ~ TOWN OF SOUTItOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. ~MPOHARY Certificate Of Occupancy No. Z~+330 Date THIS CERTIFIES that the building located at Map No. Nass, Pt.~ p~l~ No. ,. Lot No. AUg 11 ,19 71 Broadwaters Road Street · 191 Cmtchogue ~ N,~, conforms substantially to the Application for Building Permit heretofore filed in this office dated i,;areh I , 19 62. pursuant to which Building Permit No. 16; ~Z dated · ' ~ar 1 , 19 62, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . Pr. ira.tm .cne .fa~utly. d~.el~_ing .......................... The certificate is issued to }4ildred }~all ..... f~mer ................ (owner, lessee or tenant) of the aforesaid b-ilding. Suffolk County Department of Health Approval AUg 10~..1~71 by ...... Villa . . . House ~:- 37~ / / , / /. Building Inspector TOWN OF FORM NO. 6 TOWN OF SOUTHOLD . Building Depa~a~mnt Town Hall Southold, N.Y. 11971 763- [8O2 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR Ink, and submitted m am,mmwma to the Building Inspe¢ tot wi&h the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusu; 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 Install; lions, a certificate of Code compliance from the Architect or Engineer responsible for the buildin! 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non,:onforming uses, or buildings end "pre-existing land uses: 1. Accurate survey of p=operty showing all property lines, streets, buildings and unusual natural, 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 inform tion required to prepare a certificate. C. Fees:. 1, Certificate of occupancy $25.00 -- SUSZNESS $50.00 2. Certificate of occupancy on pre-existing dwelling $ 30.00 3, Copy of certificate of occupancy $ 5.'00. 6vet 5 years $10.1~0 .? 5.Updated C.O. $'50.00 Date .......... Houge No. Owner or Owners of Property ..... ~.. . .~.¥~,~'~ .......................... Cou nty Tax Map No. 1000Section ...~..~. ...... Block..~'~ ' .~, Subdivision .............................. '.. ·Filed Map No ........... Lot No ........... Permit No. J ~.~.~.,. Date of Permit .......... Applicant ............................... Health Dept. Approval ........................ Labor Dept. Approval ..................... Underwriters Approval ........................ Planning Board Approval .................. Construction on above describedApplica t .bu lidning and.~/~.. -.~. · .,'f= pe~_J,~fl~_al[ applic,~ c~es.. -- '~' and renu lations. ....... R~v. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS g02] 78'~ BUREAU OF ELECTRICITY : ~- S5 JOHN STREET, NEW YORK, NEW YORK 10036 O. te JAN~)AI~¥ 04~]991 ~pplicatlonNo. onfile 71907090/~0 ~ 0t9906 THIS CE~IFIES THAT o~y t~ e~t~ ~u~ment ~ ~sc~ be~ a~ int~uc~ by t~ ~ant ~m~ on the a~ ~i~t~n nu m~r in t~ p~m~s of Ehl. A R. BARKER, 9.50 in the followlng location; ~ B~nt ~ Ist FI. ~ 2nd FI. GA~ / OUT ,%etlon Bilk ~s examined on DECEMBER ~,~8 , ] 9 Q0 and found to be in compliance u'ith the requirements of this B~rd. Lot RXTUEE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLU(~RESCENT OTHER DRYERS FURNACE MOTORS FUTURE APPUANCE F~EO~RS TIME CLOCKS UNIT HEATERS MULTI'OUTI-~T SYSTEMS NO. OF FEET DIMMERS SERVIC~ DISCONNECT OTHER APPARATUS: ~E~EDENTIAI, SURVEY- I S E R V I C E NO. P.O. BOX 706 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials, COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. · FOF,,~ NO. I TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Examined .........~.~ ./. ......... , 19~..~-~Z Approved ............. ~..! ........... .~... ......... , 19..~?...~ermit No. Z...../...~.....~...Z .... Disapproved a/c ~~.; ............ ,,.:.~. ................. ~ .................. (Building Ir~pector) APPLICATION FOR BUILDING PERMIT Date .............. ....... 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 application. 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 ~pplicant. Such permit shell 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 pa rt 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 regulatians. ............................................ (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ......... ............................................................................................................................................... Name of owner of pr~mises ..................... ( .. ~ ................................................................................................. If applicant is a corporate, signature of duly authoriz~ officer. on ..... ....... 1. Location of land which proposed work will be done. Map Street and Nu~er ..~.~~..~ .............. .~.~~ .........................................................................-- ~ ~ Municipal~ 2. State existing use and ~cupancy of premises and intended use and ~cupancy of propos~ construction: a. Disting use and occupancy ........ ~.....: ....................................................................................... b. Intended use and ~cupancy ~.~... ................................................... 3. Nature of work (check which applicable): New Building ........ ~ Addition .................. Alteration .............. ~... Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ./..~..~.......~Z.. .............................. Fee . O..... ............................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... L..i ........ Number of dwelling units on each floor ..../ ...................... If garage, number of cars ................. / ........................................................ ~ ............................... 6. If business, commercial or mixed occupancy, specify natureand extent of each type of use ................................ 7. Dimensions of existing s~tr;~ctures, if any: I~,i~,t...~ .......... 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 ....... ~...~.t..~. .......... Height ....... .................... Number of Stori~.....L~.~....~..~.~e~, 9. Size of mot: Front ........... ............ Rear I .../.~.~.~... m~ 10. Date of Purchase .-~.~-,..I.Z..~.~ ...................... Name of Former ~ner ..... .~....~..~.~ 11. Zone or use districtU --in which praises are situated ....... 12. Does pr~osed construction violate a:ny zoning law, ordinance~.~or reau at on?~.~O ............. 2~ ~.~.~.~.2~ 13. Nome of ~ner of premises. .t/dce.d.. all Addr~ .~.~1.. ~ Ph e . Name of Architect .................................................. :...Addr~s ............................................ Phone No ..................... Name of Contractor ..~J..(~rZ~6..Address PLOT DIAGRAM Locote cleorly ond distinctly all buildings, whether existing or proposed, and indicote all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street homes ond indicote whether interior or corner lot, STATE OF NEW Y~R~;,~.,~ ) S c COUNTY OF~..~.....) ~>~' · /J '/? /, / ......... ~.,:./..'m.., .~...:~....~...~ ........................ being duly, sworn, deposes and says that he is the applicant (Name of individual~i~ation) , above named. He is the ...... r:~r~:~~--~' ....................... ~ .............................................................................. (~aontrac~ agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform~ performed the said work and to make and file this ~plication; that all stotements contained in this application are true to the best of his knowledge and belief;