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Home My WebLink About9233-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building .... A.d.c[ 5.; i.o.r~ .................................. Location of Property ...S/fi...M.a.~.n...R.o.a.d. ........... C..u.t.c.h..o.g.u.e. ...................... House No. Street Hamlet County Tax Map No. 1000 Section ...].0.Z ...... Block . 6. ............. Lot ..... Itl. .......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore f'fled in this office dated · M.a.r..c .h..2. 8.,..1.9. 8..7... pursuant to which Building Permit No...9.2.3. .3 .Z .............. dated . .MAY...6 .... 1. 9. .7 .7 .............. 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 ......... · .A.d.d., .t.q n.o.n..q 9.n.f.qr.m..i.n.~ .b..u.i.l.d..i.n.g..., .(.A.n.t.i..q.u.e..s..h.o.p.). ....................... The certificate is issued to WALTER LUCE ..........................(owner, 'L'~ ~g ..................... of the aforesaid building· Suffolk County Department of Health Approval ......... ~I./.A ............................. UNDERWRITERS CERTIFICATE NO ................. N.2~ 9 6 7 9.7.. A I~g ... ~ ~.. 1. 9. .7 .8 ......... CERTIFICATION DATED: Appeals variance #2259 PLUMBERS Board of N/A Rev. 1/81 I~ORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Iq. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P]~EMIS~ES UNTIL FULL COMPLETION OF TH~ WORK ^U'~qORIZED) No. 9233 Z Permission is hereby granted to: ..... ........ ........ ~ ......... ~ ...... ~..~. ............................ / ........................... at premises located at ~~ ...... ~f.~./:~ '~ /' ' f~v ..................................................... :_,,, ,, _'~'-' - "~-2-~..~, to ~.pplicahon dated 19..ZZ, and approved by the ;~' ~ ..... ~'.'"'/L'~'. .......... ' Gouthold Town Planning Board To~n Hall 8uuthold ~ N,Y, Gentle~en ~ · '' .The Board o~ Appeals granted a variance ~2~9 to Waiter &F[ora Lute to build an addition on their "non-Conforming" bullding in f~t ya~ 8/S ~ Road~ Cutcho~ue. Plot ~lan Subm~te4_ to ~a~' attache. Th.~ '~ard a~eed With ~pplicant that there is a%eq~te off street parkin~ ere in the ~l~c packing lot ~ rear of this p~per~, FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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 na~ral or topographic featu res. 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 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. Bo For existing buildings {prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survev of p~operty 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. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 :2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancv $ 5.00, over 5 years $10.00// 5.Updated C.O. $ 50.00 Date ............... NewC°ns%ruc%iOn.%,/ OIdorPIe-existingBuilding ._...f.., ..... Vacant Land ............. · , ! !Street ~~/~ ~;rnlet o~, o~ o~,,o, ~,o~ ...... ~.f.~./-A.. ~. ...... , ............................. ...... ..... ....... .... ......... Subdivision ................................ Filed Map No ........... Lot No .............. Permit No. Date of Permit . . .Applicant ......................... Health Dept, Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ~../ ................... Request for Temporary C~ertificate ..................... F~I~iI Certificate . .~..\ ................... / / Fee Submitted $ Construction on above described building and permit rr~.et~licable/odes and regulations. ~ ?~? ~..,,~t ..... ~/..~~ ................ >]f~'l ° GARY FLANNER OLSEN, ESQ. " , R~.~040.7S P.0, B0X 706 d O' ;Z fS~5( CUTCHOGUE, LI., N,Y, 11935 FO~M' N*O. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ~' ........ ........... ............... ?? Approved ............ ~..._~....~_ ....... , 19..~.?. Permit No .... f..~... ''~'-~ Z Disapproved a/c ...../.. ....... :.....~. ...................................................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ......... Ma~.ch...2~ ................... , 19....7.2.. INSTRUCTIONS a This application must be completely filled in by typewriter o¢ in ink and submitted in triplicate to the Buildir 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 adjoining premises or public streets, areas, and gwing a detailed description of layout ofproperty must be drawn on the diagram which is part of th~s applicatio, c. The work covered by this application may not be commenced before issuance of Budding Permit. d. Upon approval of this application, the Building Inspector wdl issue a Building Permit to the applicant. Such perm 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 Occupan, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Build,rig Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances, Regulabons, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe, The apphcant agrees to comply with all applicable laws, ordinances, building code, hou~i,ng code, and regulations, and admit authorized inspectors on premises and ir~ buildings for n ry ' ectio (Signora ~ure at app icant, or name, ir a corporation) ,5 0,~.. £ka.m k...Le, n e.,....C.u.Lc h o.g u~,...N m.~z ...Y.o :.k...L1.9o. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budde Name of owner of premises ....... .~.a...1..~.~.~'.....F'.......RD..d.....F..],.o..~.~..~..:....k_.u.g..e. .................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Budder's License No .... ~.i...0.::..H.~...~j.g.F..[.:.~.9.:..:.:..:.¢LLL1 Soul. hold Town Plumber's License No ................................................. Electrician's License No ............................................ Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No ...................................... Lot No ...................... Street and Number ....... .s/,s...,.q. La.'c.~...HJ..gb.~..y...P,.czu.f..~...ZS.~...£.uJb.csb.a. gu.~ ............................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Ex,siting use and occupancy .......... ~.[1.~..J.~M~...~Jg.op ....................................................................................... b. Intended use and occupancy ......... ~l~.rA~l.Y~M...flf3.t:.,~.~Ll~...~.h0J;). ....... ~~ ...................... 3. Nature of work (check which opp'~lcable). New Bu,ldmg ....................... .x. ....... Alteration ............. Repair .............. Removal .................. Demohhor .................... Other Work .................................................. /-/ (Description) 4 Estimated Cost ................. $ 5.,.,5.0.1~ ............................ Fee ........................................................................................ (to be paid on fihng th~s application) 5 If dwelhng, number of dwelhng umts .......................... Number of dwelhng un,ts on each floor .......................... If garage, number of cars ................................... 6. if business, commercial or m~xed occupancy, specify nature and extent of each type of use .......................... 7 Dimensions of ex~stmg structures, if any' Front. 2 0 ' Rear .2.~ ............................ Depth .................... He,ght ....,~.~ ............... Number of Stories ...1 ................................. , ................................................................... ..... &2,t,..2.Q ................ Dimensions of same structure with alterations or additions Front ' Rear ..:t~.~;...~.~...,.1.2 Depth ....~.~...3.9..~....6 ?... H.e~ght ...... Ih.! ......... Number of Stories ............& ................ .............................. 12 ............... Depth .. 2.6.~ ........... 8 Dimensions of entire new construction' Front ..... .1.2' Rear. ' Height ...1.6..'. ........... Number of Stories ...... 1. ............................................................................................ 9 Size of lot. Front ..... ,~.,1,0 ........................................... ' Rear ....... ],.1..0.; .......................... Depth ...... ~.4.,5. .................. ' 10 Date of Purchase ................................................ Name of Former Owner ....................................................... 11. Zone or use district m which premmes ore s~tuated ...B.-1 .................................................................................... 12 Does proposed construchon wolate any zoning law, ordinance or regulation' . ....... .n...o. .......................................... 13 Wdl lot be regraded ..... J3.Q .............. Wdl excess fill be removed from premises' (x) Yes ( ) No Name of Architect .................................. Address ................................ Phone No ..................... Name of Contractor ./...£J.d.. Be.abe. ........................... Address ..6.U..f,.6b.o. gt~.e. ......... Phone No. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether ex~stmg or proposed, and in&cate all set-back dimensions fror property hnes G~ve street and block number or desc,pt~on according to deed, and show street names and indicat whether interior or corner lot 44Lc," COUNTY OF ...$uf.f. olk. ....... %4a/,~...~ .... m~d ..~..1.~..,~ ..... L.L~o~ ............. being duly sworn, deposes and says that he is the opphca. (Name of ~nd~vlduol s~gnlng controcf) obove named. He ~s the ......................................................... .o...w.p..e...r..s.. ................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and fi this apphcahon, that all statements contained m th~s application are true to the tha~ the work wdl be performed in the manner set forth in the a~pphcatl~.Q_~filed tkher~z, ltjh. Sworn to before me th,s ". ........ ........................ (/ (Signature of applicant) RUTH M, MYERS ~/ RUT~ sa, II~YERS NOTARY ~LfBLJ~ IB~ of I~w Yor~ NOTARy PU~ Ntat~ of Rew Yom No. 52-:2:84140Q, 6affolk County.., No. 52-2841400, ,~uffolk r--'om~Issloo, ~ ~ 30, 19~.~ Cornrmssioll E~p,res March 30, 1 1 ILO" Z ~EW /"alDDITIOKI I I APPROVED AS NOTED NOT~FY BUILDING DEPARTMENT AT 765,2660 9AM to 4PM FOR REQUI~, I ED ~NSP[CTION5: 1. BEFORE BACKFILLING FOUNDS, · TION OR START FRAMING ~-L~I"T[I~'$ ~ L~-/~'~ ~ ~01~ ~ 2. FRAMING INSPECTION 3. 8~FORE cOVERI.G PIPES OF AN~ KIND RNAL WHEN JOB COMPLETED NOT .[S~ONSt.[[ ~OR _ . . OR CONSTRUCTION ERRORS . ~~. ~l~ ~ ~ 5. ALL CONSTRUCTION MUST MEET REQUIREMENTS O~ N.Y. STAT~ COD' AND TOWN HOUSING CODE ' ZONING F~ -~3 " ., ,, FI -- ~ ....... : ~ r __ -- ' ~ I