The URL can be used to link to this page

Home My WebLink About9958-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. Z9534 Date May 22 19 79 THIS CERTIFIES that the building ............ 7.6.5...B.a.y.b.e..r.r~.. ?..o.a.d. ....... &. ....... Location ofPro~ert, 545 Bridge Lane Cutchogg. e, New York House No. Street Ham/et County Tax Map No. 1000 Section ... ? .'1.1 ...... Block ..... .'l ~. ....... Lot ..... .'l.,.6. ........ Subdivision..~.a. 8..8.a.u...P.~.,..~.l..ll.b..P..~.Op.o. .... Filed Map No..'1.5..6 .... Lot No ..... 1.3 ....... conforms substantially to the Application for Building Permit heretofore fried in this office dated .$Op.'l~orilb.~.. 2~. .... ,19.7~ pursuant to which Building Permit No ..... .9.958Z ........... dated ... Se.Btemb. e!e... 2.~ ......... 19..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 ......... The certificate is issued to ..... Tlfl. o. IsgM. ~ .1~0¢.0, .1~1C,f~1, O .............................. towner, ~~ of the aforesaid building. Suffolk County Department of Health Approval 14l.a)r 22~ 197'9 8-SO-11/I. ........ lt61bbi d 'A;' .............. UNDERWRITERS CERTIFICATE NO ..... .N.~..29.6.2.~ .................................... Building Inspector Rev 4/79 FO~M NO.~ TOWN OF SOUTHOLD r BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH*OLD, N. Y. BUILDING PERMIT ~ (THIS PERMIT MUST BE KEPT ON THE p'REMISE~; UNTIL ~ULL cOMPLETION OF THE WORK AUTHORIZED) N? 9958 Z Permission is hereby granted to: · pursuant to application dated ..,.~..;. Building Inspector. Fee $......~..Z..~.. 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 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. B. 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 unusuat 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: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land ~se 3, Copy of certificate of occupancy $1.00 $5.00 Date p/21/79 New Building ...... .x., '., · Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .7~ ,~.5..~.a..~.~.e.~..~...~..~.~.: .~..5.~. ,~d.g.e, .~..a~.e.,.C.~.~.c.~.o.g~.e .............. House No. Street Hamlet Owner or Owners of Property . .~.~.o.m.a. ,s..~..R..o.s.a..~.~.c.~.~.e. .................................. County Tax Map No. 1000 Section .~.0.0..O.S.e.c.~...~.~.];. Block ~.,5 ............. Lot...~.Z .0..1.3. ...... Subdivision ...... .~.a.s.s.a...u..~.o.~.~.1; ............. Map No ............... Lot No ............... Permit No..9.9.5.8.-..Z... Date of Permit . .9/.2.9./. 7.8.Applicant . G.~l~...n.e. .C.q .n.s.t..~7~..c.t.i.q~...Cp.~.p,... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval .... .4/.9.//.7.9 ............. Planning Board Approval ...................... Request for Temporary Cer~ti~icate ..................... Final Certificate ....................... Fee Submitted$... ,..,~, .................... Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPEC~I'OR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFI¢t~ , _ ~OUTHOLD, N. Y. ................... 19 ......... ~Application No ~:~"~'~ . Approved ................ lJ~"d..~ l'.Z~mit No ..... ~ ........... :, ...... ' ............................... ....... ......... APPLICATION FOR BUILDING PERMIT Date ....... :.~.~.~. ,. ................ .?.)..~.?... ~..., 19..?.~. ...... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sere of plans, accurate plot plan to scale. Fee according to schedule,: b. Plot plan showing location?of lot ahd of buildings on premises, relationship to adioining premises or public streets or areas, ~nd giving a detailed description of lo,your of property must be drawn on the diagram which is part of this application. c.. The work covered by this ,applicati6n 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, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. co s _ycTzy. ........ ........... ..................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Builder Name of owner of premises ..~,o....!~...8...~...~..o..8.~..~.~...~.~..e. ................................................................................................. If applicant is a corporate, signature of duly authorized officer. ...Ev.e~egt..j....~.~cl~s,...li/$ce..l~e&£dent ....... (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. Electrician's License No. 7..~.0..T..~. ................................. Other Trade's License No ............................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: 3. Nature of work (check which a'~l~cable): New Building' .......~.. ......... Ada~ll~n .................. Alteration ................. Repair .................. Removal .................. Demolitior ..................... Other Work ................................................ . .... (Description) 4. Estimated Cost ......~........~..~'.~.%..~...~. .............................. Fee L~ V (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 ...... ozze..caz'...g~'nge .............. ,Deck...~,.~.....~..c..~..~...ff..~. ......................... 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 ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Fr~o~ .......... ./f.~. ..................... Rear ..~.~ ...................... Depth ...... ~,~ .............. Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ..... ~J...~.'~ ........................................... Rear ...... .J,J..~'. ............................ Depth ..... .~...~...'/. ................. 10.', Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ...... .~...~.~. ...................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....no ................................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes ( ) No 1 4. Name of Owner of premises .'~tol~ts...&.Ro.sa...['uc£].e... Address .~OE~,.8~S~,H.,¥.... Phone No..,2~J.?.6 .... Nome of Architect .~,...[~.i¢,k. SO~ .................................. Address~,...~O~.~'~,['l.e~ ......Phone No. Nome of ContractorC'.~...9.,O..~...s..t..'..,..C...O.~P,.~. ............... Address .~...~..~..d..'..t..~...~.~l~ No.....7.,2..8...-..9...2..2...[ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil 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 STATE OF NEW Y4DP, K-,_,~_ [SS COUNTY OF ...... .~..~..[. · ,z'. 9, ,~ .~. · ......... ~.' ............... ~.~.~.~.~.~,...~.,.,..~'.~ll.g~ ........................................... :.being duly sworn, deposes and says that he is the applicanl (Name of individual signing contract) ', ', above named, Vice President Me is the ............................................................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform ~r ~ave~ perfSfmed the said work and to make and file th~s application; that all statements contained ~i9'this ,applic~tilq~ are t,r~e to the best of his knowledge and belief; and thor the work will be performed irC'he manner s~t'fbrth ih th~'&p'p'lication filed therewith. Sworn to before me this ....... ,,:.;c.. Notary Public, . ....................... County ~~~'" (S,gndfure of appl,cant) KA~LE~ ,, '~W' ~, ,. .~%~YNNE CONST. CORP. ~e water and sewage disposal systems fo~ ~tS ~stde~¢e Will confo~ to ~e standards '' of SUffolk County H~lth pepar~ment s~ices . ..... ~ :. f~, ~:,~,~, Everett J. ~'uchs //"' ,¢ / 0 SUFFOLK COUNTY OEPAP~TME~IT OF HE;ALTH SERVICES ' p/o7-- ' rile EXISTENCE OF RIGHT OF ~NO OR/EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE LOTB BLOCK STENCE O~ R~GHT; Of W~'~'~: A,~ID OR/EASEMENTS' ,OF JtECOND,' I~, ANY~ NOT SHOWN ,~l~E GUARANTEED, ,t t FE6 TfON OR START FRAMING ' 2. FRAMING INSPECTION 3. BEFORE COVERING PIPES OF ANY KIND 4. FINAL WHEN JOB COMPLETED NOT RESPONSIBLE ~R DESIGN OR CONSTRUCTION ERRORS 5. ALL CONSTRUCTION MUST ME~ REQUIREMENTS OF N.Y, STATE CODE ~ AND TOWN HOUSING CODE & ZONIN~ // b~ -7 0 .I ,1 :0 J !'~ ~ ?~f¢:~_~-> ~,-;~ ~ ~, -~:~ 0