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Home My WebLink About12049-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southo~d, N.Y. Certificate Of Occupancy No. Z-15994 Date July 27, 1987 CERTIFIES th AD D I T I ON THIS at the building ................................................ L ..... 33775 Main Road Cutchogue, New York oca[~on oz rroper[y ........................................................ House No. Street ' 'lfl~r~ie~ County Tax Map No. 1000 Section 097 .Block 0 I ..... Lot 009 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the App]ication for Building Permit heretofore filed in this office dated November l 2, 1982 pursuant to which Building Permit No. 12049z dated . . .D..e .c.e.m.b..e .r.. I.: . .1.9.8. 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 ......... DORMER ADDITION TO EAST SIDE OF EXISTING ONE FAMILY DWELLING The certificate is issued to BARRY VITRIOL & ELIZABETH ANN GLYNN ..................... ?o¥,,'o'r,' fs ¥X f4fi gxx ................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N 5 9 I 7 4 6 N/A PLUMBERS CERTIFICATION BATED: Building Inspector Rev. 1/81 "UI!.DING DEPARTMENI' TOWN HALL SOUTHOLD, N. Y. BUILDING PEIU~t. IT ('FHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) N°. 12049 Z Date i- .............. ~ .......................... , · · Permission is hereby granted tou. .....''; ro ..................... ? ....... ;77 .................................................... "'"' ................. ~ ........................................ ...... 7" .............................. *:.':~:.'"'= .......................... ~'*, ............. ? .............. * ........ ............. et premis.?~ Ioco.~d at ............................................................. ....; ............... .~. .......................... -~ .... -- ¢t. ~... - : , ...................... ~ff/- ................................................................. .. ...................... ! ............. : .......................... ~ ~ / Lot No. County Tax Map No. 1000 Section ~7 ~ ?~ Block . .- ..... '"' ~' ?),>-r-- / ~-. ~.~ .......................... ~ ...... 19.....~,.,' and approved by the pursuant to application dated ....................... , Building Inspector. Building Rev. FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ,~ ~ 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 p~operty 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: Additions $25.00 1. Certificate of occupancy New Dwelling,S25.00, Accessory ,,$10.00 Business $50.00 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 .... :/~..~./.( .............. ,/ NewConstruction .~. .... Old or Pre-existing Buildin§ ............ Vacant Land ............. Location of Property 3'~ 7']_C ./~?~..//~/ Z~4: .......... House No, / Street , Hamlet Owner or Owners of Property ,.~/~?.~.~...?!.//.~!~!2 / (C~/¢//~C~./~ /~,/}/..~/ County Tax Map No. 1~ Section ~,5/'~ Block .... (./.... Subdivision ......... z ........................ Filed Map No ........... Lot No .............. Permit No. /~. ?.'~?.~.... Date of Permit , . .... Applicant ............................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ....................... Planning Board Approval ,,, ~ .... '.'~, .......... Request for Temporary Certificate ............. Final Certificate Fee Submitted $ ....................... Construction on above described building and perm~rneets all applicable godes,,mg8 reg~ulations. Applicant ...... ././.~..~.~;;~,~ ~ ................ Rev, 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS STREET, NEW YORK, NEW Je.a~mry 31, 19~ JOHN ..,e ~pp,i~,tlon~o.o,~ile N 591746 THIS CERTIFIES THAT only the electrical equipment as ~scribed bel~ and int~duced by t]~ applicant named on the able application number in the pre~nises in the following location; [] Basement [] 1st was exa.~i.~d on Jam~ry 27, 1983 FIXTURE OUTLETS DRYERS RECEPTACLES 10 SWITCHES 3 FIXTURES FLUORESCENT ~ 2nd Fl. Section Block Lot and found to be in cotnpliance with the requirernents of this Board. RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS SYSTEMS NO. OF FEET E C NO OF CC COND PER ,~ A W G· NO OF HI LEG~ OF CC. COND AWG. OF HI-LEG J NO, OF N~UTRALS OF NEUTRAL Cce~m~k, N.Y. 1172.5 LiC#28~ GENERAl. MA~AG~? , . Per This certificate must not be altered in any manner; return to the office of the Board if incorrect Ins~ectoYs --,, ~.A~:.~--.:z:~ ~ ~ ..... FIELD INSPECTION FOUNDATION · ~_~OMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERUY qODE FINAL ADDITIONAL COMMENTS: NOTIFY BU 765-1802 9 FOLLOWP,:G FOq PC-Lrq~r) CONCn~z-z 3. INSULATIS~,~ 4. FIN/' L DESfGN OR CnN~'rr~, r,"m~,~,, E-c~,~ ~. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined..d2...-r~-. /. .... , 19 .~..,~ Approved. ~..-~5..d ..... , 19~l~ermit No. ~/. ~'.' .~. '.~'~ Application No. {. ~..~..z~/. ~.~,~ .. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 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 ~all 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 building for necessary inspections. J,,V~ ,~.~..j'~ (Signature of applicant, or a ' p ' j (Marling address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ............................................... .............. Name of owner of premises ../~./~.?.~.{. ~/'I~..[~C '~ATE:~-/-~.P.~ Ic,~Ldq~- ............ :' ......... NOTIFY BUILDING DEPAP, TIx^F'I'~T A If applicant is a corporation, signature of duly authorized officer· 765-1802 9 AM TO 4 PM FOR T .... FOLLOWING INSPECTIONS: .............................................. l. FOUNDATION - TWO REOII1R[r~ (Name and title of corporate officer) FOR POURED CONCRETE '~ Builder's License No..i.~5..o..l~3.12 .i:[.~t.~.'~..~ ........ 2.3. ROUGHiNsULATiON- FRAMING & PLUMBIN~' ~~. 4. FINAL - CONSTRUCTION MUST Plumber's Licanse No.../~. ......... BE COMPLETE FOR C.O. ~1 ~ ALL CONSTRUCTION SHALL MEFT Electrician's License No ....................... THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY Other Trade's License No ...................... '~ C~ODES NOT, RESPONSIBLE , FOR 1. bocarion of lan(] on wnicn proposed work will be done ............ L Y.~ ........... [ ......... [ ( .~..". ......... ............ ............ ............ House Number Street County Tax Map No. 1000 Section .... .~..C~ .N ....... Block ...... .O..[ ......... Lot...O..O...~. .......... Subdivision ......... ~. .......................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............ ,. ..................................................... b. lntended use and occupancy ...~.'.~.~.&..d. ~/ ~'~ ..6.~.J)!.~.¢?.~ ............................... 3. Nature of work (check which applicable): New Building .......... Addition ......... Alteration .......... Repair ......... .~j~.. Removal .............. Demolition .............. Other Work ............... ~/0c/~ C 0 : /..~.. o~ (Description) 4Estimated Cost Fee : / (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 ....... . ................................................................. 6. If business, commercial or mixed ioccupancy, specify nature and extent of each type of use ..................... 7. D~mensions of existing structures; if any: Front... ~2,.~ ........ Rear ...,~ .~. ....... Depth .'3.Q..~ ......... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front . .~f./.J ........... Rear..~.. ............ Depth...~ g~. ( .............. :. Height ...................... Number of Stories..~.. ................... 8. Dimensions of entire new eonstruction: Front..~.(~.' ...... Rear ~ .~/ .. . Depth Height ............... Number of Stories. ....................................................... bi ' 9, Size of lot: Front . .'l ~...~ ............. Rear .... /~ ................ Depth . .,(£..0 ...... ..~ ......... 10. Date of Purchase ..... .~.,ff.~: ................. Name of Former Owner .C'/,f~7U~-.,fl,/~,J//k/.~] ......... 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zonin~/aw ordinance or re~nlation' 13. Will lot be regraded ..... ~..~.0 .............. , .....Will excess fill be removed from premises: Yes No 14. Name of Owner ofpremisesff~.~. ~...[,([ .-~.{~;[..a.z:... AddressP.~.~,.g,/f.jfld~.f~/F_.~7.([~o;f/dPhone No. ~.?f/: .. Name of Architect ........... i ................ Address ................... Phone No ................ Name of Contractor~.fldlf(; ~.~ Addressq.. ~'. fi~ ..... -. 1... Phone No. ~".,~' ..... -..~./.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from prope~y lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW,~O.Rfl~. ~ / ~.S COUNTY OF .3~-. ~ (Name of i6/tividual sign!ng contract). above named. sworn, deposes and says that he is the applicant He is the ...................... ..................................................... . .............. (Contractor, agent, corporate officer, etc,) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;that ail 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. .th/~ ~ ........................ ay of..~. ~'~., 19 ..~.~ N°tary Public' '~~;~¢ '~' 'c~' '~°unty. .~ '~' Notary Public, $~a[e of New York ........................... No. 52-0344963 Suffolk Count~ 15:~.~ (Signature of applicant) Commission Expires March 30~ 1~o~ i-'~--x