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Home My WebLink About11579-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z-15826 Date June 9, 1987 ADDITION THIS CERTIFIES that the building ................................................ L ..... 2300 Depot Lane Cutchogue, New York ocatlon oi t'roperry ............................................................... House No. Street Ham/et County Tax Map No. 1000 Section 102 .Block 2 ..... Lot 2.2 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 15, 1982 pursuant to which Building Permit No. 11579z dated .. ~.a.r.c.h...1.7.,.. ! .9.8.7. .......... was issued, and conforms to all of the requirements of tile applicable provisions of the law. The occupancy for which this certificate is issued is ......... ADDITION TO EXISTING STRUCTURE JOSEPH LIZEWSKI The certificate is issued to ..................... ~;o.~n.e;,./~,[~Cr~,~n~r~jx ..................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO.. Iq 785378 N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. I/8'1 NP 11579 Perr~ission is hereby granted to: ~o~ ~o. TOWN OF $OUTHOL~ BUILDING DEPARTMENT TOW $OUTHOLD, . BUILDING P,E~IT ~: (THIS PERMIT MUST BE KEPT ON TH,E PRE~ SES UNTIL LL COMPLETION OF THE WORK AUTHORI~EDY ....... ! ......... r .................... <~>'",~2'~'f at p~emises located at '~"~;'~' ....... ~ ............................................................ County Tek Map No. 1000 Section ...L.,,~,,,,,,~,,,..;...i BIo~ki .... pursuant tO apphcahon dated .r.~. ............... :...,......?..~ ..., -..~- ~Ruilrllnn qspector Rev. i6/30/~80 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 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 instalta- 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-~,xisting" lend uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 ACCESSORY $I0.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00. over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ..Ju~le..g,.J.9.87. .......... NewCOns truc tion ...... Old or Pre-existing Building ... ........ Vacant Land ............. Location of Property ...... D.e. p p.t.. L..a .n.e .............................................. .. .. House No. Street l-lam/et Owner or Owners of Property Joseph L j,zewsk 1 County Tax Map No. 1000 Section 102.00 Block 02.00 Lot .... 002. 002 Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo. ,/J.~.~.~.. Date of Permit .......... Applicant Charles.R..Cuddy . Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ....................... Request for Temporary Certificate ..................... Final Certificate ...X. ................... Fee Submitted $...50...o.q .................... Construction on above described building and permit meets all applicable codes and regulations. nov.~040-zS (Chalres R. Cuddy)~J - '" ' FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 765- 1802 APPLiCATiON FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~,~mma 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of pZOperty 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 $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C O.// $15.00 Date .......................... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ,~ ~.~. O .~ [-m~-~--- . . . .~J~...~..j~,~.~".. .. 'No: ........ Owner or Owners of Property .... .~,~,-- ..... . .~ ,.'-~..,~,~. ~i'. ~ .............................. County Tax Map No. 1000 Section .... ~. ~ .... Block ... ? Lot. '. ' Subdivision ..... ~ J .................. Filed Map No ........... Lot No ....... ~- ...... Permit No. . Date of Permit .......... Applicant ...... ,..'~-..~,~f. ........ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $...~. et~ and regulations. Construction on above describedhui,d ngand erm tt a,, ap . Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRI~CITY ' ~--~ 85 JOHN STREET, NEW YORK, NGW YO~K 1003B "a.. Decel~er 23, 1986 ~.~,i~.H.. Mo...f,e 447632/86 N 7 8 5 3 7 8 THIS CERTIFIES THAT o~y th~ electrical equipment ~ ~scribed be~w and introduc~ by ~he ap~ivant ~med on the a~ve appllc~tion number in the premhes of ~. the foBowlng b,catlon: ~ H.s..nent ~ Ist ~7. ~ 2nd ~. Section Bilk Lot u~s examined on D~Ce~ 15 t 19~6 and found to be in cotnpllance u'ith the requiretnents qf this Board. IqXTURE OUTLETS ~ECEPTACLES SWITCHES ~URNACE MOTORS FUTURE APPLIANCE FEEDERS A~T. H.P. GAS H. P AMT NO A W G RANGES ;PEClALREC'P' JCOOKING DECKS OVENS I DtSH WASHERS ~j AMT' KW A~T K'W~W_ TIME. ·CLOCKS~TRAN' G~[L;L , ~UNIT HEATERS_ · . MULTI-OUTLETNo.SYSTEMSoF FEET EXHAUST FANS DIMMERS SERVICE DISCONNECT I NO. OE j S R V I C l~f IN TH~ P~ISES IND~T~. NO OBVIOUS ~SATISF~RY 2OND~ION W~ FO~D. Joseph J. Lizenski ~~/~J~ DepOt La. GENERAL MANAGER Cu~ohogu~, N.Y 11935 11 Per '~ ~ This certificate must not be altered in any manner; return to the office of the Board if;incOrrect. Inspectors may be identified by their credentials. coP~ ~OR BU Co NO DEPARTMENT. TInS COP~ OF CERT~g~AT~ ~OsT~NoT ~E:AL~R~O ~ ~ FIELD I~SPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING COMMENTS INSULATION PER N. STATE ENERGY q,O E FINAL ADDITIONAL COMMENTS: FOII,M ~0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No, / / ....... 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 plat 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 or areas, and giving a detailed description of layout ofproperty must be d(awn 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 af 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 o 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. .... ........ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premis, es .....~ ....... ~ ........ /.~--'-.~.~.~....~...~..k,..J ................................................................. If applicant is a corporate, slg~ture of duly authorized officer. (Nome and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No. Other Trode's License No ............................................... $ u b d i v ± s i o n Municipality State existing use and accupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ............ ~..][ ........... ~).. ~..[~.~ ..................................................... Intended and County Tax Map No. Dist. 1000 Section_ /0~---- Block ~-- Lot 3. Nature of work (check which applicable): New Building.. ................. Addition ..' Iteration '~1~. k~ . Repair .................. Removal .................. Demolition .................... Other Work ................................................ , .... , (Description) (to be paid on filing this application) 5. If dwelling, number of dweljing units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ...~ ......................................................................................................................................... 6. If business, commercial or,j mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structbres, if any: Front ..... ~ ...............Rear ....... ~.~. ................. Depth ......~.~ ......... Height . .~. . .. Number of Stor es ..... ~ ................................................................................... Dimensions of same structure with alterations or add,t,ons: Front .......... .'~'J-------------,~.~ ........... Rear ......~-.:..1.~.-~ Depth ......... ~....'~... ........... :Height ....... ~ .................. Number of Stories ....L.~ ........... 8. Dimensions of entire new construction: Front ...... ~.~....~.. .............. Rear ........ ~...~.....T.~. ..... Depth ....../.~..; ........ He ght ....... ..~. ......... Number of Stories ............. ~...;. .................................................................................... 11. Zone or use district in which premises are situated ........ ~ ............................................................................................ 12. Does proposed construchon g~olate any zoning law, ordinance or regulation: .... ~..../K~..~ .....~.~ ..... 13. Will lot be regraded ............ i ............... Will excess fill be removed from premises: ( ) Yes ( ~'o PLOT DIAGRAM Locate clearly and distinctly ~ll 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 indic~?e whether interior or corner lot. : STATE OF NEW '~P3~/.~ ,'7/_ ]tc ¢ couNw ........................................................................................... bmn~ duly *worn, deposes end ~oy~ that ho i~ tho (~omo of individu*l ~i~nin~ controcf) ~bove n~med. He ~s tho ............. ~ ............................................................................................. " ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is ~u[y authorized to perform or hove 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 inJthe manner set fo~h in the application filed therewith. Sworn to be~re me this,I~ ' ' ~ ...... ,, ~ ~F~Y ~/ / / H ~gn~pre et appficant)