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Home My WebLink About11706-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.z..1.~179 ......... Date .......... t3ANUAP¢¥ ,,.?- ............ 19 -84 THIS CERTIFIES that the building .. i[xT~W, D.W~Iv~.N.G. ............................... .MQ.O.R.E S LANE CUTCHOGUE Location of Property ... 121.0. .................................................. House No. Street Ham/et County Tax Map No. 1000 Section .... 10-9 .... Block ..... 03 ........ Lot..Q02.D.25...;..-~ Subdivision...C. QU~I~I'~,¥. C/~I/I~..E.S.T.A..T.E.S...; .Filed Map No .... .6 ?.3.6.Lot No ...... 4. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. F~E'. 19 ............ 19.8.2 pursuant to which Building Permit No....1..1.7.0..6.g ............ dated ....... JlINE. '3 .............. 19 02, 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 ......... For a new one family dwelling The certificate is issued to ...I~%....&. HRSo. WALTER..DAY~I'.O.~...ff~..q ..................... (owner,/e,see or tenant) of the aforesaid building. 12-so-46 Suffolk County Department of Health Approval ......................................... .. UNDERWRITERS CERTIFICATE NO. N589513 ..................... Building Inspector Rev. 1/81 FO~M NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHOP, IZED) No. 117~)6 Z Permission is hereby granted to: ...... · ,?".~ .~......,(./.LA...,/,,,_./, c..,, ...................................... ........ ,,..?.~-2.~. .~./7~.,.,..,.......,~...,..~_, .............. ..~ ,o ...... ~.~.~......~,.~.....~'..~,z,~:zz,,,.~.~ ...... .-~.~... ........................... ............................ ............... at premises located at ...(...~.~.~[.) ............. ,/~.~..~..~..~.~.....~.~..~..~J~ ..................................... · ..~.., .................................................... ~ ...................................... ~-~',~,~.~.~...,.z.,.:/. ....................... '.,~ .... ,~.~1...~ .....~ ........................ ~.~.....~ ...... ~ .................... / c~,,.~ ~× M~, ~o. mOO s.~t~.../..~...~.. ......... sl~k ..(~.~ .......... ~t No.~..~...~...~ ,,,~.o.~ ,o op¢~o,o, ao~ed ...Z~..~-x~f.......d..~ ................... , I~.~aZona op,,~ed by the 8~ildln~ Inspetor. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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. 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 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 / /s_/$5.00/ 2. Certificate of occupancy on pre-existing dwelling ~r land use $ 3. Copy of certificate of occupancy $1.00 ! Date ....... New Building v/' Old or Pre-existing Building(X) ~ ~Vacant Land Location of Property I'Z.-Io J--4 J House No. Street Hamlet Owner or Owners of Property ................. - ............................ County Tax Sap Uo. 1000 Section ...),~ ....... Block .... ~.~ ........ Lot. R~.~.'.~. Health Dept. Approval ........................ Labor Dept. Approval ...................... ,.. Underwriters Approval ........................ Planning Board Approval .................. Request for Temporary Certificate Final Certificate Fee Submitted $ ......... ~....l.~..~.l ........ Construction on above described building and pe~.vc meet, s , I~l~l~cable~,code,~ and regulations. Applicant .... ,'~-..,._...~.-:~......k~ L .~.~. ~ ~/~~ ........ 1000817 THE NEW YORK BOARD OF !?!RE UN~DERWRITERS BUREAU OF ELECTRICITY 1 85 JOHN STREET, NEW YORK, NEw ~ORK 10038 Ba,e Ja.ua~7 12,1983 ~.plic..o. No.o,.Si~e 185839'87- N 589513 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ~al~ S..Day~on~ Moores Lane, R~.25s Cu~cho§ue,N.Yo in tbe Sollowlttg location; ~ Baserner~t ~ lst FI. ~ 2nd FI. Section Block Lot ,~a~ ~a,,,~.Jtm. 6 ~ 1983 a,d found to be in cotnpliance witk the require,~ents of this Board. FIXTURE OUTLETS 79 DRYERS RANGES COOKING DECKS OVENS ~THER APPARATUS: Honors: 1-1%hp, Panels: E R V I : C A W, O NO OF HI-LEG OF CC, CONO 4/0 1-4, 1-8, c£~. lOOamps each. 4 GFI, 2 smoke detecto:s--Elec, 11050 room hea=e~s: ?' 1 - 1.5kt~o --- lie, 1799E DISH WASHERS EXHAUST FAI4S Sheridan Elec. 16 Bigh Po~t Washing~on,NY. SYSTEMS NO. OF FEET E NO O~EUTRALS J~ h s cert f cate must not be a feted n any manner return to the office of the Board if incorrect. Inspectors may be identified by their credentials. I~ COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE ~tU~ST NOT ~BE~ALTERED IN ANY MANNER. GENERAL MANAGER FIELD IN$~CTI N COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITI~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 ~ TEL.: 765-1802 Examined d~.../'!~....~. .... , t9 .~..'~'s~ Approved .~..~.~?C..~. 1~..~. Permit No. ! Disapproved a/c , ,---, .... ;~ .............. ~ ..... ', ./ (Building Inspector) Application No .......... APPLICATIO~J FOR BUILDING PERMIT · 'rl: Date ............... , INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi Inspector; with 3 sets of plans, accurate plOt plan to scale. Fee according to ~ch'edule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apt: cation· c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon apprcval of this application, the Building Inspector will issue a Building Permit to the applicant. Such peru 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 1S HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal~olition, as here'.re, describe The applicant agrees to comply with all applicable laws, ordinances, building code, l~usin~6de, and regulatmns, and admit authorized inspectors on premises and in buildings for necessary inspections. ~ /~ .-?....'t. " (Mailing address of ai~plicant) State whether applicant is oxvner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, Namcofownerofpremiscs ~.~.,..~ ~'~O.-~ ~e,,~'~'~,"~"["~.~-~, (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... }.~.q.. .............. PI ber's Li NO .~. ~ g UlTI tense ........................ Electrician's License No .... ',~,, ,~','~,, ~ .......... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ ........................................................... . ................ House Number Street Hamlet County Tax Map No. IO00~Section ;.../.Q.(~ .......... Block ....0...~ ........... Lot..~.~..o~.-.~e~,V-- ........ Sulxlivision. ,~, ,0, ,cc,~,, ,~,,,, ,~/4~,, ,~, ,~,~ ~?,, Filed Map No ............... Lot ....,~, ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a, Existing use and occupancy ..... ~, ,~s~ll~-I ,"[ ..... b Intended and occupancy S '"~"'*?'"~,~.~'~:.~'~'-r ' · 3. Nature of work (check which applicable): New Building I~ Addition Alteration Repair .............. RemoVal .............. Demolition .............. OtherWork.., ........ ,. .. (Description) Estimated Cost ................................... Fee .......................... ~ .....~1 ..... " (to be paid on f'ding this application) ;.If dwelling, number of dwelling units....I ........... Number of dwelling units on each floor... ! ............ If garage, number of cars ............. '~. .......................................................... i. If business, commercial or mixed occupancy, specify ~ture and extent of each type of use ...... --. .............. t Dimensions ofexistingstmctures if any: Front '-' Rear '--' Depth Height ~ Number of Stories Dimensions of same structure with alterations or additions: Front ................. Rear.. ~. .............. Depth ............ ~ ......... Height ...... .--'. .............. Number of St,?ties...-. ................. ..... .... Depth ..... J.Dimensions of entire new construction: Front " Height .... .~..~. ~ ?.;,... Number of Stories ......... '. Size oflot: Front ..... t~t..~.'.* .......... Rear .... .t...)'.'.~.'iiiiiii!i ). Date df Purchase ............................. Name of Former Owner . .ti) ia.~. ~q~ ~'~ T-~L~ 1. Zone or use district in which premises are situated ....... ' ....... ..................... :'. ................. " _>.Does proposed cbfistruction violate any zoning law, ordinance or regulation: ..... .~..~: .................... 1. Will lot be regraded .... ,x~ .................... Will exl~ss fill b.e removed from premises: Yes t. Name of Owner of premisesl~.~.."g..~'~.. ~ .~.ar..~'l'~. Address ~..~...~.0~. ~.4~*.~ Phone No.'~l~."J.".~.~ ..... Name of Architect....__..~.; i i~,,;i~..~., iii ....... Address ...... '...,: ........ Phone No ................ Name of Contractor ......... Address . ."~...s.S .ss...~q. ?...~... l~one No?ll-.~ :..~..'~... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether ~terior or corner lot. I'ATE OF NE~gY~RK, OUNTY OF ~. ~,~S.S ........... i~}.~.,~r~...'. ....................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) >eve named. e is the .......... ........ ...... ~ ....... .... ~. .................................... k ( tL~traclor, age~t, corporate omcer, etc.) ' t' said owner or owners, and is duly a~tl~il~.t~ or have performed the said work and to maki~ and f'de this ~plication; that all statements contained in this application are true to the bcst of his knowledge and belief; and that the 'ork will be performed in the manner set forth in the application filed therewith. ~vorn to before me this (Signature of applicant) lot II COuNT/p? CL ~ot ~ ~0.00 lot .~ inspected by this de~e~t and found ~lef of Oeneral ~8tnee~tnI ~e~tces ff~FCO. T~P ~TI~ SECTION I~ ~CK ~ COT '~ ~E~ ~LIN6 WITHIN IOO FEET OF THIS PROP[flTY OTHER SHOWN HSREON. ~ T~ STAN~OS OF THE SU~K COUNT~ DEPARTMENT OF HEALTH SURVEY FOR L. OT NO. ,~ ~ ' COUNTF~Y C&UB EStaTES ' AT CUTCHO~E ~W" ~ SOUTHO~D 8U~O;K COUNTY, NEW YORK 7209 ~ THE su~p/v/s/ON,~,~P /~/~£0 /u m~ Om/C~ O~ m~ Ct mK O~ ~ffilC TANK(S~ CE~OLS(~),~N HERE~ DATE: NOV. 15,19~1 SCALE: / '~ = 50' NO. 81.- G2'7 YOUNG & YOUNG ALDEN W. YOUN6, PROFESSIONAL ENGINEER ANO~LAND SURVEYOR N.Y.S, UCENSE NO. 12845 HoW~ARO W. YOUNG, LAND SURVEYOR N,Y~) LICENSE N0,45893 AVENUE RIVERHEAD, NEW YORK I I su~Y ~ ' Stir: .... ~'afJ'i~ DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION DATE ~.~Z. ~_~ H5 ' A ' ~ ' ~R WHOM THE SU~Y IS PREPARED N NEAREST WM~ IAIN--MI, ~ -N SOURCE ~ WATer, ~l~TE ~P~IC -- I M~N~AL 'A~NCY ~ND L~NDING INSTITU TlOH LIS~D ~N~ THAN THOSE SHOWN HEHEON NOFK: t : ~UMKNF /l~ AL~EN W ~NG~ PHOFE~ION~L ENGIN~EH NO ~ND ~RVEYOR N II A ~ I HOWARD W. YOUNG, LAND SURVEYOR ~ L~T~W~LiW) ~KiCTANK(STIeC[~OLS(~} WN ~ l( ~ ~ J N.YS. LICENSE NO 45893 OCCUPANCY OR USE IS UNLAWFUL WffHOUT CF..P, TIEICATEL OF OCCUPANCl -t J, L · ZZ~ I I