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Home My WebLink About8949-ZTOWN OF SOUTHOLD B~mnlNG DEPARTlm~IT Town Clerk's O~iee Southold, N. Y. Certificate Of Occul~ncy No.. 19]~5 .... Date .... THIS CERTIFIES that the bui]ding located at ~91~. · Map No ......7.~0 .... Block No ...........Lot No .........1D..-..16 ................. conforms substantially to the ApPlication for Building Permit heretofore ~ed in thi~ office dat,d ... ~o.v..~.~.~. .... ~. .... , m.7§. p~u~t to,him Bu~g ~'e,~t No .... .~..~Z dated ....N..oy.e~..b..eF. .... ~. ..... , 19..7.6., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which ,hi~ certificate is T~e cer'~tcato is issued to .......... . .I~.~... ~o.~.1~. 9.~. ............................... of the afo~said building. Suffolk County Department of Health Approval ......... N/R ....................... UNDEEWEITFA~ ~EETIFICATN No ...... ~70~/~ .............................. HOUSE NUMBEE. ~.9~5 ........ Street ... ~.~l~Sr. AW ...................... ......................................... Cu~clmgus,. ~,w..York ............... ........... Building ~-spoctor Cotmty Tax NU=ber 1000-1~7-01-00~ I~ORM NO, 9 TOWN OF SOUTHOLD BUILDIN~ DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8949 Z Permission is hereby granted to: ~'v/~T K OE Ft L E at premises Iocat~cl at ........................... ~,1.,,~,.1~....~.,..~...~,,~.....~... ....... .~....~....~.~,. ................................... ............................................................................... .~..~..~...C.~....o...;~...u...~':. .................................... ~' I" t~1S HA ~,~ ~',~- 950 ....................... J~.T. ......... L~..,...,,....:....:.~ ........... .! ................................ '. ........ :i ..................................... pursuant to application dated .......................... . .~.....~'~.....,'..~... ...... , I .~.....~..., and approved by the Building Inspector. Building Inspect°r FORM NO. 6 TOWN OF SOUTHOLD , Building Depo~tment Town Cle~s Office 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 Inspector 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 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 installations, 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey.of property showing oil property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and conditiafl of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 t 3. Copy of certificate of occupancy $1.00 New B~t ding Addit on Id or Pre ex,st,ng Budd,ng" ..... ~::::: ~' ':i'.'~.'. [ :[[['' Location Of Property ...... ~.~..~. ...........\ ~ ~ ,1 ~'%,~"~'""~'"'~" ......... '~'~"~'"'"'~' .......... "'~'"'~"~'"'"~"'"~"~"'"'~" Owner Or Owners Of Property~ ............... ...~i~...~..~.........~~........ ....................................... ,,oc ,o ............. ,o ............. PermitNo ~C~).~_c~ Date Of Perm t I I'~(o icant ...~.. ~% ~~ I-lea~th De~t. ApprovaJ ........................................... Labor I~t. Appeal Request For Temporal, Certificate ........................................ Final Certificate .......... ~ Fee Submitted $ .................................... Construction on above described building and p~.~_mL~m._~s a~.acs.~o~b~e~.~ode$ and regulations. Applicant ......................................................................................................... Sworn to before me this ....~.. day of ~~..~..:...~...~ (stamp or seal) THE NEW YORK BOARD OF FIRE UNDERWRITERS I $ BUREAU OF ELECTRICITY ~'- B5 jOHN STREET, NEW YORK, NEW YORK 10038 o.t~. March 15, 1978 .4~.p,*otio..~o.o. fte 894460 THIS CERTIFIES THAT Kurt Koehler 23 H Stillwater Ave., Cutchogue, N.Y, inthefollowl.glocatlon; ~ B~ement ~ IstFI. ~ 2nd Fl. outsi de rasexami~don MarCh 13, 1978 andfoundtobeincompllancew~ththerequlremenlzof~h~B~rd;rT:~ FIXTURE " I I FIXTURES OUTLETS ~ECERTACLES SWITCHES ~NCAN~$CENZ.FtUC~ESCENT RANGES I 12.8 SPECIAL REC'PT ~ 20 I 50 COOKING DECKS OVENS DISH WASHERS TIMECLOCKS BELL IUNITHEATEI~$UNITHEATEI~$ MULTI-OUTlET ,,,,,. SERVICEDISCONN~T lNG. OF] s E ~t ~P ~E EQUIP $~ 1~3w 3~3w 3~w NOO~E~C~D Panelboards: 1-14cir. 12~ am~s Electric room heaters: I-I;5 kw IG.F.C.I. I 4.5 kw hot ~ater heater R I C E EXHAUST FANS DIMMERS Anthony P. Bifulco 50 Miller Ave. Port Jefferson, N.Y. Stati on, ~ .~. This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentio TOWN OF SOUTHOLD BUILDING DEPARTMENT~:: TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Oisapproved o/c ................ j~ ................... ................................................................... .......... (Building ~ns~tor) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or" in ink and submitted in triplicate 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 adjoininn nrem ses or nublic streets areas, and giving a detailed description of layout ofproperty must be drawn on the diagram w~ic"~ s part of ~l~is 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 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 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, housi~ng code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. - ~)' ' *'~¢~r'7 (Signature of applicant, or name, if a corporation) "~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............................................................. ~.~.~....~r~..~ ................ : ...... If applicant isa corporate, signature of duly authorized officer· (Name and title of co~orate officer) Bu der's L c~se No .............................. ~' 8EFo~ START F..'[LING ~ r Plumber's License No .................................................. Electrician s License No ............................................. ~.. ~s ' ufsIc~ o ~ ' Other Trade s License No .................................... I. Locat,on of land on which propoFed work will be done. Map No.: .~.~:.~'~..~.~. Lot No ......... ~.~. Municipali~ 2. State existing use and occupancy of premises and inCended use and occupancy of proposed construction: 3. Nature of work (check which applicable): New Building'. ................. Addition ..... Alteration ....~<: Repair .................. Removal .................. Demolitior ..................... Other Work ................................................... ~'"':'~ /(..~.~.. ~i (Description) 4 Estimated Cost 'D ,.~:,.~?.<.~..; ~ ~:^_ (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... .~....~.J. ...... Number of dwelling units on each floor ....... ~....~'. ........ ~.~.. '~..,~,~ ~._,z~_ ~.~ ,~ '~.r,.~C~'~L~~ If garage, number .................................. ~ .............................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each ~pe of use ............................ 7. Dimensions of existing structures, if any: Front ........~.'~....~ ....... Rear ......... :z ....... ~ .......... Depth ......~:.f~; ...... Height ........ ~.~.i. ......... Nu~er of Stories .............. ~'. ................................................................................................. Dimensions of same structure with alterations or additions: Front ........... A.~./..~r .......... Rear ..... ~:.~.~.~; .......... Depth ......... ~.~ ................. Height .......... ~.~ ............. Number of Stories: ............ ~ ................. 8. Dimensions of entire new construction: Front ............. ~....~ ......... Rear ...... ~:.~.~..~;z ........ Depth .....~..I..'~.~ ...... Height ....... [.~-; ........ Number of Stories ................ ~. ................................................................................................... g. Size of bt: Front ..................... ~:~. .......................... Rear ........... ~.~ ......................... Depth ................................ ]0. Date of Purchase ........................... [.~.;~.~ ............... Name of Former Owner ....... ~m..~.~ ......................... 1 1. Zone or use district in which premises .............................................. ¥ ...................................... ~ ............. ~ ........ 12. Does proposed construction violate any zoning law, ordinance or regulation: ........ ~ ........................................ 13. Will lot be regraded' .....~..~.~....¥ ....... Will ~xcess fill be removed from premises: ( ) Yes ( ~o 14, Name of ~ner of prem.ses ....... ~.~%'.~ ).:~x..~:=... Addre~ .:~..:~ ..... z:.;[.f~:~,~.. Phone .................... Name of Architect .... Addre~ " . ..................... .............................................................................................. Phone No. Name of Contractor " ' ' Addre~ ~ ~ Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from prope~y lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. - ! Iz0-~ I STATE OF N~ YORK, ! c ¢ /~' ~ ~ ~ cou~ o~ ........ A' ...... _~,~_~'"'~'~'"~. ................................ ~.~.~...~.~ ......................... being duly sworn, deposes and says that he is the applicam (Name of individual signing contrac~ above name. He is the O~ ~ ~ ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and file this application; that all 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 fo~h in the application filed therewith. Sworn to before me this ,..,..., ........ ~do~ot~~"~ /¢~.~ ~Z7~ '., ~ , ,~ ~ ~ _':":;:'~ 7Z'"%"'"'r')'/'"D~_ ~ ..... .~ .:,. '... ,N~ P~ ':-.~...;z.~.Z..;.~.;....~-.~-.*';.-."m'F~°unw .................................................................... ; ............................ / ~t (Signature of applicant)