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WF* Town of Southold Annex 3/6/2014
P.O. Box 1179
54375 Main Road
Southold, New York 11971
CERTIFICATE OF OCCUPANCY
No: 36792 Date: 3/6/2014
THIS CERTIFIES that the building SINGLE FAMILY DWELLING
Location of Property: 18450 C.R. 48, Cutchogue,
SCTM 473889 Sec/Block/Lot: 96.4-4.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
8/5/1965 pursuant to which Building Permit No. 2846 dated 8/19/1965
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:
move existing dwelling and accessory garage to new location.
Note: This Certificate of Occupancy replaces COZ-3316, issued 11 /4/68 to include the accessory garage only.
The certificate is issued to George & Laurie Helinski
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
Authoriz ignature /
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building 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 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 contains 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.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and 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.
C. Fees
1. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00,
Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25
-~4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date.
New Construction: Old or Pre-existing Building: (check one) ) 1
Location of Property: jQ,X 0 Zl u ~ 1TChnl~ Q r
House No. Street Hamlet J~
Owner or Owners of Property: ~ f O-f a f bltl-f jJh~l
Suffolk County Tax Map No 1000, Section % Block Lot 4,;.
Subdivision Filed Map. Lot:
Permit No._ Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ SQ
y A
Applicant Signature
/ yd' cS)~ • 20 j
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~L VA Ws, LA Oepo7 cq
PERMIT UiRED
UNDER CTION 196
H WAY LAW FOR ACCESS 7`eiki o`)rc 7- -
~O COUNTY ROAD
i P, o as d J,:;, A" la ca /I
SOS ~ ~ ~ocaf%v/1 for
Ga~!F Ma ecY fds~ usf 9~ 1965
Scv /G 5~0 s / V.q /J ~(/Y,C. j~i SON
C u cHO~u~
T
NEW yd R k:. )iL/.r ~ .'i!e+.- ~ r
1 , ~ ! c Cr)_Y C.7) ~Qi7Li~ ~rv~yar.a
Grc~:r~~drt N. 'Y.
s ; Gee s ~cr-e
s n u'3 e_
~Pe e~ 210 4
r
Q~~
y r'.
4 a~
QWN(. STREET G " V}E[fE `pF3T: SUB. LOT
I~4lC~kl K}' a _ ~w~ti i-t:.~.q~:';T{f, a'
• FOWER VINER N , Ile,
rsa s r' era
YEI ~u. SIGs dr a Q S H- W TYPE OF BUILDING
~t;Ir v Y - -t`
RES. / SEAS. VL FARM COMM_ CB. MISC. Mkt. Valve
LAND IMP. TOTAL DATE REMARKS
kwe am
dorc.
a 6 0 0 S_ o a S /8 66 aN?u, 1,,,'a.
40/4 e-11 02/
dogt~ 39 Qo - o 4.56 1 Z4
316 O 0 Bu D t 3~ + Z 1- 3L # n~ -~-a SCR ; .
tVEVJ , a oR1v1AL BELO . ABOV II9 -l3 - Goes d "~'~oR>~eu n
FARM,4 Ie33••~ Vale er fp# Value rl'L
?~Q v 13 -4 Acre V,fe 2' 30 1- ttf•7! ~f
/ZOb X3'7 fx? .06 1'fS / r dam , ~o t't~ir
Tillab
TlMdbte 3 R
-200 :250 0 3700 =~/~;slt7
Woodland -
Swarnpland FRONTAGE ON WATER
Brushkind~ G FRONTAGE ON ROAD
House Plot DEPTH '
BULKHEAD
Total ' DOCK
5
n , s COLOR
#r a¢
7.1
4AAW 777T77'
TRIM
t
;yt
VF -F
Idg, ` +L4 3 i : j - 7 n , 3 3 Foundation Both Dinette "
on _ sG d P" cement u ` Floors o A W K..
rtsion Ext. Walls S Interior Finish LR-
e; ion Fire°Pkrce A! Heat / ELfs OR.' )
Type Roof Rooms Ist Floor "
Recreation Room Roams 2nd Floor FIN. B.
~
Dormer
Driveway -
2.a X Z O yt R u, y O f/Q. a
mom .
I !Y - IT i §'s J
- -
lk
r
s~ /f~ R t s~s.206
/1wAKY La - -
97I'19~ M/ O v L E K o H 0 C. 2 27
i
X4-+4x
PERM REQUIRED
UNDER,jL,CI'ION 1%
HvAY LAW FOR ACCESS I 7`dkin~ "91ca
_10 COUNTY ROAD
Q ~ ,Jo l+n Hcs er r'US/o ealicali-~i/
W \
ar~
Z2=- d Proposes-~1 Bui/~%iv~ /Pe/oc~tYion y
30
~ NlFRY f-{fi FFR/5
HT Mapped AuyuaY' 4 /966
scv/c So=/° V,cri Tiiy/. a$SON
C lfTCNO6UE
NEW YOR.I Y
//Lic rn.+cJ Lond S?rve}rora
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No. 4331.6 Date 1$OT........4.............. 19..68..
THIS CERTIFIES that the building located at .0/N...... W41£..,AGAaACA32..7) Street
Map No.. Block No...: Lot No ......XX7C....... ...ftt,0171CtC.UO..... .w.'.~...........
conforms substantially to the Application for Building Permit heretofore filed in this office dated
A 1 1911. pursuant to which Building Permit No. ,.2846.1
dated A,ug........ 1.9............ 19...65, was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occuponcy'for which this certificate is issued is
P.*iV ate...orm-t-amity:.....dool.-l'ing
0.~110
The certificate is issued to . a:x",V-44i mUk .
(owner, lessee or tenant)
of the aforesaid building. WoAppraval Oct 31, 1968 by R* Villa
(
\ Building Inspector
u:
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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° 2846 Z Date .......................A O....19............ 19.65..
Permission is hereby granted to:
Joseph A...„ Itruj 4 Atty~ AjC t4sr~!„Harris .
.........gout AP AG
to -move an existir ..dwell. ..tR..nAw...4. ati4#
at premises located at & Middle..Awd...W.W.A) .....QiA..W R~OPeE'tiY
CuLgho M&..... X01.9
pursuant to application dated ..AAK .....5..., 19..0., and approved by the
Building Inspector
Fee
r,
..,8 -u..
Building Inspector
S-9
SCHD
SUFFOLK COUNTY DEPARTMENT OF HEALTH
Date October 31, 3.968
Bldg. Permit No. 2846Z
TO WHOM ST MAY CONCERN:
The sewage disposal facilities for a structure located
at S/S Middle Rd. between Denot and
(Give deed location)
Cutchogue, Southold
have been inspected by this department and found to be satisfactory.
Owner Mary Harris District Engineer
Builder John Haurus
District Engineer
~ z
TOWN OF S O UTH O LD
OFFICE OF BUILDING INSPECTOR
>~t TOWN CLERK'S OFFICE
* SOUTHOLD, N. Y. ,J.
Date A??gu.A_5..x..19.6.5
Mr.H.F.Bishop
Commissioner of Public Works
Suffolk County
Yophank Ave., Yophank, N. Y.
Dear Sir:
In accordance with Section 239K of the General Municipal Low of the
consolidated Laws of the State of New York, this is to notify the Commis-
sioner of Public Works of the County of Suffolk that J.Q9.0P11..... X.nzSki7 Attorney
A/C..... Mary...Harris
Move
has applied to the Town of Southold for o permit to aZQ@Qa a building
on ..>~.'/.5:....Muddle.-ROAd.... ...C»:'.27.).....C~1t.C11Q1~'lAP.}...~1..:X..........
as shown on the attached plot plan, submitted in triplicate, datedAug uat..?+y 1965
and titled . px opgsecl„bu locat; on for Mary Harris
We shall withhold further action on this application for ten days or as
otherwise provided in the aforementioned Section 239K.
8/13/65 Approved to the Tovm of Southold Very truly yours,
pursuant to Sec. 239K of.the Gen' ,l 14uni.cipal
Law; before building access drive to Coun y
Road 27A, a permit under Sec. 136 of the hway
Law will be required.
SUFFOLK COUNTY DEPT PUBLIC NOM
H. F. Bisho . Commissioner Building Inspector
Town of Southold, N. Y.
By
William S. Matsunaye_.Y.,~
Chief Engineer
TOWN OF SOUTHOLD
OFFICE ?F BUILDING INSPECTOR
* TOWN CLERK'S OFFICE
S E3 UTHOLD, N. Y.
Date AUVA 4.54..1965
Mr.jRoF,B1zh0p
Commissioner of Public Works
Suffolk County
Yaphank Ave., Yaphank, N. Y.
Dear Sir:
In accordance with Section 239K of the General Municipal Law of the
consolidated Laws of the State of New York, this is to notify the Commis-
sioner of Public Works of the County of Suffolk that ...Abseph.... ,Noupsk,y Attorney
A/C.... Mary • a3`3"•"1•o
Rove
has applied to the Town of Southold fora permit to IDEAM a building
on .ao/9.... Kidd1e..J ...(...0*142ny~r.) ;r t0)309 aY.........
as shown on the attached plot plan, submitted in triplicate, datecAUgUgt.. V 1965
and titled.Pr.4 E3C~..:~tL1'~.ld;L ..~.ID£.a:.11"lll for Mary Harris
, Pea We shall withhold further action on this application for ten days or as
otherwise provided in the aforementioned Section 239K.
Very truly yours,
Building I~ sp~tor
Town of Southold, N. Y.
FORM NO. i
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ......0 19..1 Y. 3 Application No.............................
Approved 19........ Permit No.
Disapproved a/c ...M t;.A.r...... cd-,1114. ti..?t...... 4,'m.¢~. 3. .4 "1 /
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date t...... 1965......
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 applicant. Such permit
shall be keot 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, building code and regulations.
Jose* Krupoki Ala--. -Aay..ill.~,
(Signature o app scant, or name, if a corporation)
{7$ D .XW
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Attorney-..-:..±9d3,t ttt....................,......................................................................................
Name of owner of premises 4qv ,ix.§ y•••••••••••••••••••.••.•..•.•••••••.
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
I . Location of land on which proposed work will be done. Map No.:......... Lot No.:..
Street and Number .$:r 5.•• tRdiJlta•• r,C r lr * outal a..~
Iv~lunicipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy aCi t..,1gad
b. Intended use and occupancy ......V*JQgFtt'$~+B••aB S:9tAMg..44JW67+JJA$
3. Noture of work (check which applicable): New Building Addition Alteration
C?v® inn exitt~ing Ivelling to
Repair Removal Demolition Ot e0 Wor (Descrl e
llE1'TO
4. Estimated Cost ............................................................Fee ......3,0000
(to be paid on filing this application)
5. If dwelling, number of dwelling units ..AM ..................Number of dwelling units on each floor
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 .......3.5 Rear ......3.%..................... Depth ..25/30......
Height Number of Stories ..,.Q1AA..........................
Dimensions of some structure with alterations or additions: Front Rear
Depth Height ............................Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories .
9. Size Iof lot: Front 9..09- '.t,.l/ Rear Depth
10. Dato of Purchase ........................................................Name of Former Owner
11. Zone or use district in which premises are situated *4M.Adlat
12. Does proposed construction violate any zoning law, ordinance or regulation? .........np
13. Name of Owner of premises ,r1X......... Address ....~„'utchogm Phone No....................
No e of Architect ......................................................Address Phone No....................
Name of Contractor .................................Address Phone No....................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr m
property lines. Give street and block number or description according to deed, and show street names and indic to
whether interior or corner lot.
So* Mod plat plane by Q. VanTWI soil
I
i
i
I
STATE OF NE Y~KK, 2 S .S.
COUNTY IOF Q.j~C ..............J
........................W00.0A.... 112" ];oAk ..,.................being duly sworn, deposes and says that he is the applic nt
,(Name of individual signing application)
above neared. He is the AttO1"2111y. m-agent
1 (Contractor, agent, corporate officer, etc.)
of said oy~ner or owners, and is duly authorized to perform or have performed the said work and to make and ile
this application; that all statements contained in this application are true to the best of, his knowledge and belief; nd
that the work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
ay of UgUtr.............. 190...
Notary Public, ..........~P1 fD ~a2 acs... Count cc P"/~- ignat of applicant)
NOTARY PUBLIC, Sts No Plew Yol~(
No 520618100 Si lolk County
Commission Expires March 30, 19
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PERMIT UNDER Q
ACTION 136 i
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