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Home My WebLink About12031-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Occupnncy No. Z. 1. 1 7.4.1. Date June 27 ........................................ ,19 THIS CERTIFIES that the building . o~.e., f oln.~]~y..d.w.e. ~, .~.~g ........................ Location of Property .~735 ......... BeeD.e, ,Dr,., ,& . ~ln.o.~Lr. ~q.d. ........... .E.g~ .t. Cutchogue House No. Street .... 12t~l'et County Tax Map No. 1000 Section . .1.Q3 ....... Block . .4 ............. Lot ...3.7.: .2 .......... Subdivision .... Sunn.y..$h~;e. es ............. Filed Map No...3.~ .1..Lot No.. 1. .3 .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated · .0¢.LaDer..£9 ....... , 19 8.2. pursuant to which Building Permit No..~?..0.3.q.Z. ............. dated .[qo~re~her. 2.2 .............. 19 ~32., 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 .n. 9 .w ..... ·. dw~.l 1±n43 .................................................................... The certificate is issued to ...... S.~an l~.y. R u~.an ~ ~.e.i.~ ................................. of the aforesaid building· Suffolk County Department of Health Approval .... t:) .- 5 $3.-. q. 2 2 ............................ UNDERWRITERS CERTIFICATE NO ............ ~tfi 0 2.4.9.~ .............................. Bnilding Inspector Rev. 1/81 TOWN o~ sour, O:~D i BUILDING DEPARTM~N~ TOWN HALL SOUTHOLD, N. Y. N? permission is BUILDING PEIU~IT (THIS PERMIT MUST BE KEPT ON THE PREMISS UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) 12031 Z Date... hereby granted to:~.~ ...... Ot ptemis,~ located at .~/~..'~.~. .... ',,~ .'-~.'.. '.', ""/' ......... '...~.~' ....................................................... ?'", ........ , ....... r ...................................... Cour~ty To~< Map No. 1000 Section .......... . Block .~..~........ ~Lot No. !.~....~-~.. -.~.-'.....~... purSUant ~0 application dat~ ~~..~.~.~:...~...., 19~;~nd :appmv~ by the 8~il~lng I~spector. ~ ' Rev. 6/3o/~0 : ~ FORM NO. 6 '1 ,1 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 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. 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 unusual natural or topograph lc 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 ~r land 3. Copy of certificate of occupancy $1.00 Date . New Building .... ~ .... Old or Pre-existing Building(X) ......... =/Vacant Land i ........... Locat on of Property , .,-~. Owner or Owners of Property .~/ ~,5.~ ,.~ ........... ' ............ County Tax Map No. 1000 Section .. ~,~ ~ ) ..... Block ...... Lot. ~,~ ....... Subdivision ................................. Filed Map No ....... ,...Lot No ..... ...~ ....... Permit No./~¥~.J .~ Date'of Permit ZJT.~..Applicant. ~,~//~ ~/~.~ . . . Health Dept. Approval . J.~. '~ ¢~.:/.~, ~ .... Labor Dept. Approval ...................... ,.. Unde~riters Approval .. T y C lC Request for emporar ertificate ..................... Fina ertificate ~ea Submitted $..~ Construcdon on above described buildin~ and p B~cabl~do~ and regulations. F 1000520 THE NEW YORK BOARD OF FIRE UNDERWRITERS [18 BUREAU OF ELECTRICITY ~- 8G JOHN STREET,'NEW YORK, NEW YORK 1003~ .a,e ~'~y 12, 1983 A..lle,.tio. No. on3'ile 207238-83 P#1350122 N 602496 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number itt the premises of N~ockhall Bldrs. Lnco, S/E/C Beebe Dr. Emo~] Rd., C~chogue, N.Y. in the followlng Iocatiott; ~ Basemeut ~] 1st FI. [] 2nd FI. Section Block Lot w,s ex.,nl.ed on ~,~y 9, 1983 ,nd /o,,td to be in compliance witk tke requirements of tkis Board. FIXTURE OUTLETS DRYERS OTHER APPARATUS: Motors ~ 1-F. i'G.F~Io FURNACE MOTORS HP, FIXTURES FUTURE APPLIANCE FEEDERS 1F2 S RANGES SPECIAL EEC'PT. R COOKING DECKS OVENS DISH WASHERS AMT K W. ,~T K W. MT K W TIMEAMT. CLOCKSAMpS, TRANBELLs; ~UNIT HEATERSH, P. MULTI-OUTLETNo.SYSTEMSoF FEET i ' V I C E EXHAUST DIMMERS AW, C- OF CC, COND NO OF HI-LEG A,W. G- NO OF NEUTRALS A,W.G OF HI-t~G OF NEUTRAL 1 4 1-Ek~ol~e Der:eot:or I~t Elect. 56 ]~m~ Ct~ Sayville, N.Y., 11782 LIC. #423 /GJ~NRRAI/MANAGER ,~ 11 : , '~'~['r"~n~u!Lu~UU~'~'AHrMENT'THiSCOP~YOFCER~IFICATEMUS~NOTBEALTERED NANYMANNER '~! FIm~D I~SFECTION 1. FOUNDATION (Ist) COMMENTS FOUNDATION (2nd) ROUGH FRAME & INSULATION PER N. STATE ENERGY GODE FINAL ADDITIONAL COMMENTS: FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ Date..~. ~.k'..~..'~'.?.../~...~..../. ?..., 19 . Zc>~ PLEASE TAKE NOTICE that your application dated. ~GT~&~..~ .... , 19~. for pemit to construct..~..~: ¢. ~~ ...................... at Location of Property ~ .~. ~.~. ~d~ ........ ~~'~ Z house tvo. { Street ~ _ Ha~let County Tax Map No. 1000 Section ...[0.~ ..... Block ...0 ~ ....... Lo~.. ~. ~d,~,~,on.~,,~~,,~d ~ No .... ~.~ ~Z. ..... ~o, ~o... Z7 ........... ...~e..~~ .... z>~U.;...~ .................................. Building Inspector RV 1/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1802 Approved ~...7~..~'. ....,1~..2". Permit No./,ZC)...~../. ! Application NO../.~..~..'~. 5 ........ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ../A..-.,~.~ ......... 19 ff..2--~ a. This application must be completely filled in by typewriter or in ink and submitted 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 of property must be drawn on the diagram which is part of this appli- cation. 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 issued 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 appUcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspactors on premises and in building for neces .sa.r.y. ~,g,,~./..~ ~ '(Signature of applicant, or name, if a corporation) (Mailing ,pplicant) State whether applicant is owner, lessee, age-fit, architect, engineer, general contractor, electrician, plumber or builder. ~/ (as on the tax roll or latest deed) Builder's License No ......... .'TZ. ............... Plumber's License No.. Electrician's License No .....~,'~ ~. 7gr'~. .......... Other Trade's License No ....... .---. ............. 1. Location of land on which proposed work will be done .................................................. .///. ........ . ........... House N~r [ Hamlet County Tax Map No. 10~ Section /~...Z .~.'.q.:/~ck .................. Lot.../. 3 ............ Subdivision.. ~Z-~ ............... Filed Map No..~. ~.~ ...... Lot.../. ~ ........ / (N~e) 2. State exist~g u~ ~d occup~cy of premises and ~tended use ~d ~cup~cy of propo~d construction: a. Exis~ u~ ~d occup~cy ...... ~~..~ ........................................... b. ~tended u~ ~d Occup~cy .../. ~¢ ~..~. ,~ ............................ 7... / 3. Nature of work (check which applicable): New Building .... Addition .... ~ ...... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... : ../_Z .~-- ~o~-.~/' '.- o~, (Desci iption) 4. Estimated Cost ..... ~.7./. ~'.:gg. ....................... Fee/~. · · .*~...~..,/ff~. · ,~. ....................... ; (to be p~d on filing this application) 5. If dwelling, number of dwe~ing ~nits... Z'. ......... Number of dwelling units on each floor.. Z ............ If garage, number of cars ..... i. ~ ............................................................. 6. If business, commercial or mixed occup~cy, 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 sine structure with alterations or additions: Front ................. Rear .................. Depth .................... ... HeiSt ...................... Number of Sto~es ...................... 8. Dimensions of entire new construction: Front ...~O. ........ Rear ... ~ ........ Depth .g~.~ ...... Height ............... Number of Sto~es ..... Z .................................................. 9. Size of lot: Front .. ~J.~ .... ~ ........... Rear .... /Z.~ ............. D~pth . .~O ....... , ...... 10. Date of Purchase ...... ].r.. :.. ~ 81 ............ Name of Fomer Owner ~.~ ~.. 2~ ~ ~.*.*. ( ...... ~ Zone or use district in which pre~mises are situated ..................................................... . Does proposed construction violate any zoning law, ordinance or regulation: ...~. o ....................... 13. Will lot be regraded ......... ; ................... Will excess fill be removed~romrprem~es: ~ No 14. Nme of Owner of premises ff~ ........ Address .&~~ .~~No. Name of Architect .... ~~t.~ ...... Address/.~~~one No.. N~e 0f Contractor ~~~ ..... Address/~q~ .... PLOT DIAG~ ~~ Locate clealy ~d distinctly ~1, build~s, whether existin~ or propped, ~d~ indicate ~1 set-back d~ensions from properly lines. Give street ~d block number or desc~ption accordin~ to deed, and show street n~es and indicate whether interior or corner lot. STATE OF NEW YORK, ,S.S COUNTY OF ................. ......,J.~'.O..$. ~..//_~. ....... .~..~..~...g..~. ................ being duly sworn, deposes and says that he is the applicant (l~ame of individual signing contract) above named. He is the ........ .~-~..~..~.5. ~.~,.~-...~p.. ............................................................... (Contractor, agent, corporate officer, etc.) of saki owner 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 are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to ~ ' before me this ..........''. .... ........ Notary Public, ......... .. ~ .... County NO. 52.-32S1965 ' 1 t ~ ~ualified in Suffolk Countb~'j~ ~rm Expi,res Ma~¢h 30, 19[ ~/ SUFFOLK CO. HEALTH DEPT. APPROVAL ,'~ . - tG' / STATEMENT OF INTENT ~?: ~, [ THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL SERVICES -- FOR APPROVAL OF ~ ~ CONSTRUCTION ONLY t.- '~r ':' , SUFFOLK CO. TAX MAP DESIGNATION: .......... < DIST. S~CT. ~-OCK ~C. i . OWNERS ADDRESS: property is agricultural area, the ¥ exists that water supply, may contain trace amounts of pesticides ar~/or nitrates· ROO£R~CK YAN TUYL, ~.C. LICENSED LAND SUI:~k~'"ORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. '/~- "~0- ~2~ THE WATER SU~LY AND SEWAGE DIS~AL SYSTEMS FOR THIS RESIDENCE CONFORM TO THE STANDARDS OF THE SUFFOLK CO, DEPT, OF HEALTH SERVICES. SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY ' ....... . ,.,... ~~ ,. ,. ,,,:. -., , ,,, ,,~ .. .~ ' I P-. G"f.. OWES; I, 5 .... Or3 T,Doo~.' -oT rF ,i¸ / NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLO\^tIN~ ~H?ECTIONS' l. FOUNmATImN - TWO REQUIRED ~0 t I J O PL:~ N