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Home My WebLink About11583-zFORM NO. 4 TOWN OF SOUTHOLD, BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Z.1.1.16.4 ......... Date ........ August. 3.1., ............ 19 .Et2 THIS CERTIFIES that the building ................................................ Location of Property 1050 Dean Drive Cutchogue House No. Street Hamlet County Tax Map No. 1000 Section . .1.~.6. ....... Block . . .QS. .......... Lot .... Q~ 2 .......... Subdivision ..... X. ......................... Filed Map No...X. ..... Lot No...X ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated · ?.9.r.c.h...~ ............ 19 .8.2. pursuant to which Building Permit No... 1. 1. ~.8.3...Z ........... dated ..... ~.a. lq q .h..1.9. .............19.8.2., 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 ......... e,ncloaure of existing porqh on one-family d~;ellin, g. .. The certificate is issued to .... P.~..e.s.t. qn,..K.... ~.e.a?.s.. ~..E. 1..i .z.a.b.q .t.h..H. eM.....C.~..u.s.e ......... (owner, lea~ee.e~ ~ of the aforesaid building. Suffolk County Department of Health Approval .... t~/.l? ................................... UNDERWRITERS CERTIFICATE NO ............ I4. ~ ~i~6 ? ............................. Building lnspecfor Rev. 1/81 BUILDING ToWN HALL sOuTHOLD, BUILDING PERMITi CTHIS PERMIT MUST BE KEPT ON, THE,PP, EMIS~S UNTIL COMPLETION OF THE V~/ORK ^UTHORI~ED~ ~? 11583 Z Perr~ission~ is hereby granted to: .......... pgrs~ant tp applicahon dated . ..~. ~.~.~ ...~....~-19 and 9pprov~ by the BU ding nspector ': ~ ~' : FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N;Y. 11971 APPLICATION FOR CERTIFICATE OF Q_CCUP,~NCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to tile, Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate Ioc~tion 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, Induszrial 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" iand uses: 1. Accurate survey of peoperty showing all property line,s, 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 ~ny 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 use 3. Copy of certificate of occupancy $1.00 $5.OO Date ....... ~'~.~;;. ~::~ ~"~ ....... New Building ............. Old or Pre*existing Building z'~. ......... Vacant Land ............. Location of Property ... /..~?,~..q ............. ~.. · .'~. · .~.: · · .............. ~-~ House No, ~ ~ Street,~ ~.~am/e, Owner or Owners of Property ..... ~ ~.~., .~~. . ~ffZ~~..~.~ County Tax Map No. 1000 Section //~ g~ock ~ Lot...~.~. Subdivision .... /~~ ............. Filed Map No ........... Lot No .............. Permit No~/~.~. Date of Permit .Applicant ............................. , .... Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval / .Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ,. Fee Submitted $ ......... ~ ~.q ............ C~nstructi~n~nab~vedes~ribedbui~dingandpAp~ican~e~mee~s~~~a~i~c~desandregu~ati~ns~ .......... 1000024 THE NEW YORK BOARD OF FiRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 .ace July 8, 1982 /ippllcationNo. onfile 173555 - 82 TH,S CERT,.,ES TH^T N 5 6 9 3 8 7 only the electrical equipment as ~scribed below and ~ntroduced by the applicant named on the able appl~atlon number in the premises of ~es~ ~s & EI~ ~se, s/s ~ ~., L~ & ~t Ave's. ~ho~. N.Y. ~., ~,,~,~d o. July 1, 1982 s~t~o. .~o~ rot and found to be in compliance with the requirements of this Board. FIXTURE OUTLETS 2 DRYERS IECEPTACLES 10 SWITCHES FIXTURES RANGES OVENS EXHAUST NCANDESCENT FLUORESCENT OTHER APPARATUS: 1-~.F.I. E R V I C NO O~ERCC~COND. NO. OF HI-LEG OF HI-lEG NO. OF NEUTRALS Dettnar Elec. Co. P.O. Box 482 Riv~rl~ad, N.Y. 11901 lte.643-E COPY FOR THIS NOT BE !~ ANY (DEAN DR.) FIELD IN~?~C~ION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL bATE COMMENT~ ) ADDITIONhL COMMENTS FOI~I NO. ! TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned ...... ~,~ ~ ..................................... ~ ............ ..../ {Buddm~ Inspector) Application No..~..~...~..'~.:: .......... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ 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 adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn 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 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 oil applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspectJ~)n,s. /~. (Signature of applicant, or name, jfa corporation) ........ ..................... ~ __ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engl er, general contractor, electrician, plurrJber or builder. c~ .7...>.> ~o~-- . .... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .............. .~..~. ............................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... S u b d i v i s i o n Location of land on which proposed work ~11 be done.,Map~No.: ........................................ Lot No ......................... Municipality State existing use and occupancy of premises and intended u~ and occupancy of proposed construction: b. Intended use and occupancy County Tax Map No. Dist. 1000 Section property lines. Give street and block whether interior or corner lot. 3. Nature of work (check which applicable): New Building'. ................. Addition .................. Alteration ............ Repair .................. Remg.v, gj · ................. Demolition ........... v ....... Other Work .................................. ; ............. . .... ~//' . ~ ' (Descr pt~on) Esbmated Cost .............$....., .................... /.u~ .......... Fee .......................................................................................... (to be paid on filing this application) 5. If dwellin~ number o{ dwo~inO units ......................... ~umber of dwollino unlt~ on o~ch floor ............................ If garage, number of cars ...} ......................................................................................................................................... 6. If business, commercial or; mixed occupancy, specify nature and extent of each Wpe of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... J Height ........................ Number of Stories ................................................................................................................. Dimensioas of same structu(e with alterations or additions: Front ....................................Rear ............................ Depth ................................ ::Height ............................ Number of Stories ................................ 8. Dimensions of entire new cOnstructmn: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stor~es ...................................................................................................................... 9. Size o¢ lot. Front ....................................................... Rear .......... ~,,~ ......................... Depth ............ ~ .................. 10. Date o~ Purchase ............... ; ........................................ Nome of Pormer Owner ........................................................ 1 1. Zone or use district in which premises are situated ......................................................... %.% ................................... 12. Does proposed constructioq violate any zoning I~w, ordinance or regulation: ........................................................ 13. Will lot be regraded' . ....... Z.~ .............. Will excess fill be removed from premises: ( ) Yes ( ) No Nome o~ Architect ............................................................ Addro~ ................................ ~ho~o Mo ....................... Name of Contractor ~~. ~O6 ~ ~ ~.~ PLOT DIAGRAM Locate clearly and distinctly 611 buildings, whether existing or proposed, and indicate all set~ck dimensions from number or description according ta de~d, and show street names and indicate STATE OF NEW YORK. [~ ~ c ........ ~../.'..//.(.'~...~/.. ......... ..~..¢_..~...~.. ...................................... being duly sworn, deposes and says that he is the opplJcenl (Name of individual si:gning contract0 above named. ; (Contractor, agent, corporate officer, etc.) of sold dwner or owners, and 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 ore true to the best of his knowledge and belief; and thor the work will be performed in!the manner set forth in the application filed therewith. Sworn to before me this ; NOTARY PUdLIO, State of Now 1/o. 52-452q77! Qualified in Suffolk County · DATE: B. ~ ~,- FEE: BY: ~ _ : . :} t - '' ~ ~ -' ' ALL CGNS:]i-RLJCI!ON SHALL . : ...... ] t~-~ ' Porch ;Dean Drive Cut chogue ~ New York One inch equals ' ~ ~ I Screened : '~.,t , ¢ Preston K. Meats ~ ". ~: . February 26, 1982 ~ :D:~ Front'Porch ' [