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Home My WebLink About8187-z~ORNI ~[0. & TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Ot~ice Southold, N. Y. Certificate Of Occupancy No..Z7~.6. t ..... Date .............. M..~r.' J.O. ...... , THIS CERTIFIES that the building located at . .Bric, ge. Lane ............. Street Map No~ ~gtar. ,kc.... Block No ........... Lot No, .~ ..... Cutcl~ogue...I/. Y., ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ Se.pi;.. 9.., 19.7~. pursuant to which Building Permit No. dated ............. .~.~p..t.. ~., 19.7.~.., 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 ...P;r:~va];.e .one..£ata;L3.y.d.~.e].ling ...................................... The certificate is issued to . .~qa;c.v. elq..~ia3.ct.v~ge]. ..... 0~tne~.-,bu[lder ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · .I~a*. · · 9-..].977. · .bY. 1~,. Vi.~a .... UNDERWRITERS CERTIFICATE No..N262.~2 ...... Dee. .2.~ ....]97-~ ............. HOUSE NUMBER .... .2~.Q ..... Street .~ .B?.~d. ,g?, .L.?.~,e ..... .C.~.~.e..h.o.g.u.e. ........... ..... :i ........... Building Inspe~ffor l~Olt~ NO. ~ TOWN OF SOUTHOLD BUILDIHG DEPARTMEHT TOWH CLERK'S OFFIC~ SOUTHOLD, H~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8187 Z Date ........................ ~-p.t.....9 ............... , 19...~.~. Permission is hereby granted to: ...~:~c.~...,~.u.~z ~e:L ...................................... ......... ~c~.~.~ ......... ~t ~&~.~ek. ..................... to ..~,:~L L~:-..~.~w...o~e...£ma ~.~.y.. ~.we _~ .3.4:~ ................................................................................... at premises located at ....~Q.~..~.....~.S~.~'...Az~.....(.~.~.~7~ .............................................................. ................................................................... ~.~,.~g~..~, ............ ~.uJ~gu~ ...................................... pursuont to oppllcotion dotod ..........................~e~l~......c). ............ , 19...~/..~., ond approved by the Bulldin~ In--or. Building Inspector ( · 'l' I;' !I THEii'i'NEW YORK BOARD Of FIRE UNDERWRITERS ~ I ~[~: ~' I ; I: BUREAU Of ELECTR C TY I r ' i [':; ' ~1 ~ ;~ ~ ~ ( ~ 85JOH~I STREET, NEW YORK, NEW YoRK 10038 '' '' :~ - o~y ~h~ .~ctrical ~quip~ent,~ ~e~bed be~w ~ i~tr~u;ed by the .ppllc.nt named on the above'aPPlication numbe~ in the premises of ~arre~? w~z~0gel;~ e/s/~r~ge ~Lane 2059 '. n/o ~a~n Roa~, ~utehogue, L. ~ ~ OTHER'APPARATUS: DonaldI ;~ , :' ' ~:i: GENERAL MANAGER This certificate must not be altered in any manner; return to ihe office;of the~'Boord il~ inrcorrect. Inspectors may be id~ntlfied by t~eir'?~edentio~s FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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 disposel-(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. 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Data of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 X $5.00 April 2~ 1979 Date .......................... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. 2140 Bridge Lane Cutchogue Location of Property ................................................................... House No, Street Ham/et Warren Waldvogel Owner or Ow.ers of Property ............................................................ County Tax Map No. 1000 Section ..... 85 ........ Block ...... ~ ........ Lot ....... ~.~ ....... Subdivision ..... .~.s.~.8;.~..A.o.~.e..8.- .............. Map No... ,5.~,7..2. ....... Lot No ...... 5 ........ Permit No...8.1.8.7.~..' Date of Permit. c~/.~../7~, .Applicant...~...~1~, . .~...~~ .... Health Dept. Approval ........................ Labor D~ )roval ........................ U nderwriters Approval ........................ Planr Request for Temporarv Certificate ¢ Fee Submitted $. '1. O0 oroval ....................... ~ertificate ...... :~..( .C.Q~y .) ........ Construction on above described building and ~ regulations. Apl Gary S~I~FOLK COUNTY DEPARTMENT OF HEALTH SERVICES Health Servtces Reference Number '-ftC'So -/~P ,~ 10. Sewage Disposal System: A.~gal 1 on s. eptic tank: Pr~S/t~r~_Equ 1 va 1 en t Block APPLICATION FOR APPROVAL TO CONSTRUCT A PRIVATE SEWAGE DISPOSAL SYSTEM AND A WATER SUPPLY 1. Applicant ~Y/)/[c/~ ~/;~,)~<-~-~-.Phone ~?~/~ 5. Subdtv._~~_ Address ~c ~- ~£~ /)//z;; ,7o~' ~' //Ir/,. 6. Sectton~.~J~.J~;e 2. Pro,Pry Location ~/F /Y~DGK ~ :~;, ~t~ ~,~7. Lot ~r Vlllage /qZ///~( T~nshtp Ja~7//~ ~3 g. Publtc Water 3. Public Water.~mpany Na~ Distance to 4. Lot size: W~dth /fi feet Length ~ feet (For Heal~ Se~tces ~pt. Use) ~ Le~ing pools: ~.~.~[' NL~r of pool s / · _ ~cas~t]41~ Block Special. ll.~pr~e we!l, fill in the fol- _i~inq~ anks. C. Total well depth D. Depth to ground water E. Amount of water in well The undersigned CERTIFIES: "Construction of authorized installations will be in accordance with the Suffolk County Department of Health Services' current standards thereto." This application will be valid fQr one year from the date of approval indicated below and may be renewed if a current local Building Department Permit is in effect. Date /l~t(., //, /~ /// Signed~ ;;R ;H;'DEP:;M~;; OF HE~L;H SERV;CES: USE ;NZ;i 'Bal;;'~n'~he information~present~d here- wtth, tt ts the opinion of the ~par~nt of Health Servtces that an ade~ate and sat~s- facto~ S~age Dtsposal S?~em and ~ater Suppl~ can be Installed on thts plot. I~/ APPROVAL DATE ,~//~7~ SIGNED ~ -- __ S-15 Rev. 4/1/73 18.157N I a. Tht~ ~ion must be completely fllled in by t~emtter ~ in inkond mbmitted IntflplleMemlbe~uildlng ~ b. ~ ~ M~.~ .~r~_ .~, of ~t o.~. of bul~ on p~,/.~ od~.~ng W or_ areas, ana ~vinl m all,Oiled dmcrlptian of Ioyout oflm~m~ mu~t ~e arawn an the dmgmm which-la llart,oe c. The wo~ covered by this application may not. be commen~d before imum'~e of Building PMmit. d. Upon q~pr0~l of this (q~licotlan, th~ Bultcl~n~ Implcto~ will Imue a Building Permit to the q~licom. Such permit ~ei Nobuilc~llbe .occu~i.~.or umd inwh(~eor inpart for any puq)o6e whotever until o Cmti~x~te of Oceupano/ B .A.P.?LICATION I.~ HEREBY MADE to th~ Building I:)qx~rmnt for ~ i~manm of a BoIM.~ Pemlt Ragulotiom, for the construction of buildin~, oddtflonl or olmmtl0m~, or for removol'~ dmnoMIon, i ne applicont ogree~ to comply with oil oppl~:oble Iow~, orchnancm, b~ildi~g code, hou~nO code, oM m~MoHonl, omi to ocimlt authorized imi~'to~ on prernl~e~ ond in Iwildlngl for necemory Inq~ctiom. ............. ....... ............. (Signature of applicant, or name, if a cmlx)rotlon) State whether applicant is owner, levee, agent, architect, engineer, general cantmctor, electrician, plumber or builder. '~,i ......... '; .................. '~'~'~z:"x, ........................... ~,"~"'"'-:"'~'"':' ........... ; ................................................ If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) Builder's License No ................................... ~ ...~..~ ~Z~/~'~/' _ .... Plumber's License No ............. ~)~.~..~.M~. ......... ~.~' Electrician's License No .... ..~...~... ......... Other Trade's License No. ................................................ ~:at,an of [~ ~ ,,~,c~ ~,~_.. ~ wi[[ be ,~,. ~op No.: .....Z'~..2.~.. ................... L~ ~...~..., .............. Street and Number ........... /~.~.l:~../?.]C. ...... .~.~ ......... ~'~-~!~l~.~..~w ........................................ , ...................... State existing use and occupancy of premises and intended use and occupancy of p~ comtmction: a. ~.,(i$iting u~ and ocCUl~n~ ....... .~.....x ................................................................................................................. ~,. ,nte~use~occu~ ............................. ../.. ........ ..~:~. ......... ~'.'~...,....... ............................. 3. Nature of Work (check which applicable): New Building........./e'~.......... Addition .................. Alteration ............... Repair .................. Removal .................. Demolitior. .................... Other Work .................................................. (Description) 4. Estimated Cost ........... ~.~.~.~. .............................. Fee ......... ..'~..../........~ .......................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ 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 ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. DimensJons,~,of safe structure with alterations._ -ar additions: Front .................................... .~, Rear ............................ Depth ...... ~.. ............... Height ...... .~. ....... "'....'...'.Number of Stories ......... ~. ................. 8. Dimensions of entire new construction: Front .............. ~.~.. .............. Rear ......... ~../.. .......... Depth ........................ Height .................... Number of Stories ........................ -/. ........................................................................................... 9. Size of lot: Front ............... ~..~...~. .............................. Rear ....................................... ~. Depth ......~..,e~..~. .............. 10. Date of Purcha~ .~....~. ........... ~/.~..?.~.. ........................... Name of Former Owner ..... ~if~.;~.~..~ ........................... 11. Zone or use district in which premises are situated ..........................-~'.~..~..~ ..~....~.~..~- ......................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............ .~..~ .................................... 13. Will lot be regraded ........ ~..~. ............ Will excess fill be removed from premises: ( ) Yes (fi) No 14. Name of Owner of premises ....~..~.x~.~.~....O...~....~.....I-... ....... Address ~..,~;:~...~Phane No.~.~'~..~....~.~,/C7 Name of Architect .............................................................. Address ................................ Phone Nb ...................... Name of Contractor /! Adaress .................... .//. ........ 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEVV.,~Iii~x. ,. J ~ ¢ COUNTY OF~ ........ ~'~ ................................................................................................. being duly swam, depos~s and says that he is the applicam (Name of individual signing cOntracf) above named. He is the .................................................................................................................. ~ .............................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, anc~ 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 tha~ the work will be performed in the manner set forth in the application filed therewith. Swam to ~fore me this · g ...... . ...... ......................... JU~IT~I 9~ ~" .... '"'i~,:~'r~'ature of app'ti~t) ' Notal[y Publie, ~tete. of New Yo~ No, 52.0344963 SulfoJk County :- ~i,,ion Jixpires March 30, !~he sewage disposal e,~d '~e, ter supply .facilitie~ For th1~ looatlo~ h~w~ b~en :inspecte4~s ~pa~tmsnt and found ~lef of ~eneral Englneerln~ OF HEALTH APPLICANT: ADDRESS__ ___ TEL ~ ' MON~/ME*Nr SUOO/V.I~O# M,~P P/LEO IN F#~ OFF/CE OF THE C~£RK O~ SUFfOlK COUNFYON YOUNG & YOUNG 400 OSTRANDER AVENUF, RIVE~H£AD, NEW YORK SURVEY FOR: WARR~/V W~q£DtlOGEI l. OrNo. 5 . ISMAR ACRES" AT GUARANTEED TO: CUT'ClYOGU~ ! r~l£ r/rl~ ~U,a~,~IW'EE CO. SOU THO& D ' sc~[~: /,, 50' ] APPROVED AS NOTED FEE: ~'f~8 BYj~.Z NOTIFY BUILDING DEPARTMENT / ~a D 2¢*'0 ' '"