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Home My WebLink About12066-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z.i~.2.0.7 .......... Date JANUARY 20 .8~ THIS CERTIFIES that the building ..... AD.DITIO~ ................................. Location of Property ..5~t0h .PEQUASH..AV~I, ............... CtY~/2HOGL!~i ................ Mouse tva. Street Ham/of County Tax Map No. lO00 Section .,. ~L~O ..... Block .... 0~. ........ Lot ....... :~4 ........ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....N..Q .Vt..NJ3...~R...2.9. .... , 19~.2.. pursuant to which Building Permit No .... 1.2.0..6.6.Z. ........... dated ... D~ICEIVlBER. O ............. 19.82, was issued, and conforms to all of the requirements of the applicable provisions of thc law. The occupancy for which this certificate is issued is ......... ....F. OR. AN.-~!DD. IT~[Q.N .TQ. AN...E.X.~.S.T.~.N.G. ONE FAMILY D, .W~.LLING The certificate is issued to .... ~F. RA~IK..Wo - & .I'4AR!.ON. CARR ............................ (owner, lessee or tenant/ of the aforesaid building. Suffolk County Department of Health Approval .. BI/A .................................... UNDERWRITERS CERTIFICATE NO...h159R989 ....................................... Rev. 1/81 TOWN OF BUILDING ,D~pARTMI~NI~ TOWN HALL $OUTHOLD, N. Y. PERMIT: ~ BUILDING (THIS PERJ~IT MUST BE KEPT ON THE PREMISES UNTIL I LJLL COA4PLETION OF THE WORK AUTHOR!ZED) Permission is hereby gronted ~.~ /,_~ , / /~i~ ~. ~ ~ ~ ~n~ TOx ~op No. 1000 S~ction .......... ~ ............. BI~ .~ .................... ~ No. ~ ....................... Building Irispector. Fee ) ........ , ............... FORM NO. 8 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 buiMings or new use: 1. Final survey of property with accurate location of ali buildings, property lines, streets, and unusual natural or tooograohic features. 2, Fina~ approval of HesJth De~t. of water supply and sewerage disposa --(S-9 form or equal). 3. Approval of electrica~ installation from Board of Fire Unde~riters. 4. Commercial buiMinqs, industrial buildings, Multiple Residences and simiiar buiiding~ and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. SubmJ~ P~anning Board approval of completed site plan requirements ~vhere applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildines and "pre-existing" land uses: 1. Accurate ~/ey of peoperty showing aH prooerty Pines, ~reets, buildings ~nd 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 ce~ificate. - C. Fees: 1, Ce~ificate of occupancy $5.00 2. Certificate of occupancy on pr~-existing dwelling ~r land use ~/ 5,00 3. Copy of certificate of occupancy $1 .C0 New Building .,(~[~-~,,,.. OIdorPre-existingBuilding(~),~ .... : ~acant La~d- , ........ H~ No. ' ' ' ' Street Ham/et County Tax Map No 1000Section ./~.o . ,. Block ,//,Q ......... Lot.~ ....... Subdivision., ' ............................... Fil'ed Map'No ........... Lot No, ' ,' ........... Health Dept, Approval . , ~:~,: ........ ' ,L~bor Dept. Approval - . Request for Temporary Certificate... [ ................ FFnal ~ertificat~ ~ - . Fee Submitted S ......... ¢.(~. ~' ~'. .... Cpnstrucdon on above described building and permir meet~ all ~PP¢(Cabl~odes a~ regulations. THE 1000771 April 13, Date THIS CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY BS JOHN STREET, NEW YORK, NEW YORK 10038 1983 201333-83 .,pplica,,o. No.o. Si,e N 598989 only the electrical equipment as described belo~v and introduced by the applicant named on the above application number in the preotises of F~a~k W. Carr~ ¥~/F Peq%%a~h Ave.~ CO~ southern Crc~s~ Rd,, Cutchoq~e~ N.Y. in the /ollowing location; [~ Basement ~ 1st FI. FIXTURE FIXTURES OUTLETS SWITCHES INC^NDE$CEHT FLUORESCENT 9 7 9 [] 2nd FI. Section Block Lo~ and founcl to be in compliance with the rbqulrernents of this Board. OVENS DISH WASHERS EXHAUST FANS DRYERS OTHER APPARATUS: 1-G.F.I E R -V I C E A W G. NO OF HI-LEG OF CC, COND A- W, ~. NO OF NEUTRALS A OF HI-~ OF NEUTRAL Ruland Electric COo~ P.O. BOX ]43, Mattituck~ NoY. 11952 , I 11 / ~ , . IF~ ~, certificote must not be altered in ony ~onner; return to the office of the Boord i, incorrect Inspectors m~y ~ identifi~ by their credentiols. ~1: COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUSS NOT BE ALTERED IN ANY MANNER. ' ~ FIELD FOUNDATION FOUNDATION 2. ROUGH FRAME & INSULATION PER STATE EN qODE FINAL TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......Y.. ............... , proved .............., .......... D~sapproved a/c ............. : ................................. ~ .~/ ................................... (Building Inspector) Application No..4(. ~'~ ~ 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 iot 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 all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and i~ buildings for necessary inspections. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................................................................... ........................................................................................ Name of owner of premises ..... ..~.~.~..-~...z~..../..<E......~...v~.......~,...~..../~../..o.Z~.. ......... .~..~...../~....~. ......................................................... r lc uir¢ If applicant is a corporate, signature ,of du~ authorized officer. ............ ................ (Name and title of corporate/6fficer) Builders License No ........../... ....................................... Plumber's License No .... .~'~...~.~..~¢~..: ........................ Electrician's License No ....... .,¢~.....~.../:.../~..~.~. .................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map, No.L ................ ~ ................ :).... Lot No....4 .................. Street and Number .~.../~......~....~..~.~.....~.....~......~......~..~.~....:~....~...(.?~..~.~¢~ / ~z'~-~.~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy / .~.....~.. b. Intended use and occupancy .......... x~....~..../ff~.......~...~...~../....7~../..~..../~.........~..°......~/~:..,~,/..~..Z~.../../~....~.(....~ ............. 3. Nature of work (check which 'applicable): New Building,. ................. Addition J Alteration Repair .................. Removal ] .................. Demol tion ................... Other Work .................................................... /~ ; ' ,~ O ~..-~ ~_.~-,- (Description) ./Cz 60 ~ ' ., ~ ,- I ~; _,":"~ o 4. Estimated Cost ..................... /-..~.4 .................. w ......... cee ...~ .......... ~ .......................................................................... (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 ............................................................................................................................................. &. If business, commercial or mixed occupancy, 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 same structurel with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number! of Stories ..................................................................................................................... 9. Size of lot: Front .................~..~.~ ............................... Rear ............. .~...D....?. .................. Depth .....~.,2...~... ............. 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. zone or use district in which premises are situated .....,~l ............................................................................................ O 12. Does proposed construction vialate any zoning law, ordinance or regulation: ....... ~.. ............................................ 13. Will lot be regraded ......x~....°..: ............. Will excess fill be removed from premises: ( ) Yes (~No 14. Name of Owner of premises ....~....~....~2...,.....~..'..~l.r~'~.-- ............... Address ..~,?.7[..c./.~.9..6.(W...~,... Phone No ....................... Name of Architect ............... : .............................................. Address. ............................... Phone No ....................... Name of Contractor ...~,.:.~,,~../,../:.4.,,~.,.~...~..0....~...~. ............. Address ......4~,,4~,.Z7.,,7~.; ...... Phone No, PLOT DIAGRAM Locate clearly and distinctly a[.I buildings, whether existing or proposed, and indicate all set-back dimensions from property lidos. Give street and block number or description according tO deed and show street names and indicate whether interior or corner lot. STATE OF NEWd~RK,,/ ~',~ COUNTY OF ~.....;~'J (Nome of individual signing contracf) above named. , He is the ...................... ~.~.~,~ ................................................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this applidation; that all statements contained in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set fo~h in the application filed therewith. Sworn ~o~fo~e me this .......... .......... ................. NOT%RY PUBLIG, State of New YOFk NO. 52.8125850, Suffolk Co~ O0~ . .x gO~0 SURVEY .FOR AT CUTCHOGU~ DATE , DEC. E,1982 TOWN OF S~UTHOLD SCALE= /" = 40' ~UFFOLK COUNTY, NEW YORK NO. E2- 7E2 I 1 VAIIKIP e VAI IKI~~OST~DERAVENUE ~ 'J T~UI~ m l~gl~g RIVERHEAD,NEWYORK NO G 'DEPART AT 765~1802 9 AM TO 4 P~ FOR THE FOELQW NG 'h SPECT~NS ,' ], FOUNDATION - T~O REQUIRED FOR PQURFD CONCRETE 2,ROUGH '- FRA~ING ~ PLUMBING 4, FINAl_ BE CQ~ApLET~ FOR C.O., ALL CONSTRUCTION SNA[~' MEET' THE REO~IREME~S OF THE: N~, STATE ' CON~RU~ION ~ 'ENERGY,' ~DES. NOT ' RESPONSIBLE( -FOR' DESIGN OR rCONSTRUCI-ION ERR. O¢.~: