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Home My WebLink About11909-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Nd. Z11394 Date December 20 ................. · ................................ ,19 .~.2. THIS CERTIFIES that the building deck addition Location of Property 4075 Pequash Avenue Cutcho~ue h~&~ ~/o: ....................... ~b~i .......................... Hamlet County Tax Map No. 1000 Section . .1,3.7. ....... Block 02 .Lot 018 H±nop ............................... Subdivision Kepbs & LakowJ_tz ..-PfPerl~ra-pNo. 259 .LotNo. 2 conforms substantially to the Application for Building Permit heretofore filed in this office dated September 9 ..................... , 19 8..2. pursuant to which Building Permit No ]! 99.9..Z. ......... dated . .S..e p.t.e.m...b .e.p..1.5. ............ 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 ......... a deck addition to an existing one-family dwelling The certificate is issued to Jon C. Kerbs & William Lakowitz ..................... ?o¥,?6, ¥~&'.&'tA4&¢; ...................... of the aforesaid building. Suffolk County Department of Health Approval n/a UNDERWRITERS CERTIFICATE NO. n/a Building Inspector Rev. 1/81 BUILDING* P:ERMITi ~ (THIS PERMIT MUST~ BE KEPT ON -~H~ PRE/~IS~S UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) Building IDspector. Fee $ .~.,...i....: ........... No. ~' 119 0 9 Z Date Permission is hereby granted to: ~--- . i/: ' .............. ~.~......~ ~~... ...~~~ ..~;~=....~ ,~ ........... ~.~~.~.....~c~.~....~¢'~.z.~.~....~....~ ........ ...~z.~~~~. · .... ~.~ ......................... ~, ............ ~,,,.~,,,,,o~,~Ct~. ...................................... ,...:....,,~ ...... ~ ......... .... ~ ........................................................... .....L....:;.....~~~.., ........ co,~ T~x ~p N~ ~000 S,,o~; Z...~.~ . ~k ;..~..~...., ~ No......~(~ pursuant tO application date ...... ~ ........... ~...~..;...~ ..... ...:~,. nd approwd by the :lnSPect~ FORM NO. $ TOWN OF SOUTHOLD i3uiiding Department Town Hall Southold, N.Y. 11,971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and subr~itted in duplicate to the Building Inspec- tor with the following; for new buJidings or new use: 1. Final survey of property with accurate location of a{i build{rigs, property lines, streets, and unusual natural or topograohic features. 2. Final approval of Health Dept. of water supply and sewerage disposa --(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buHding~ and instatla- 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 ic features. 2.Sworn statement of owner or previous owner as to use, occupancy 'and condition of buildings. 3. Data of any housing code or safety inspection of bui{d{ngs 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 or land use $5.00 3. Copy of certificate of occupancy $1.00 Date ..... , . . New B~dtr'rg..(~..~...~'It~kqr Pre-existing Building(*).._..~i/Vacant Land-. ........... Hou~ No. '~ , S~: ........~ ~'~ ...... : ' ....... ...... , .r,,,,. pplicant .. . ..... ... Hea th Dept Approval ~..~ ' ~.~ ................ Labor Dept. Approval ............. ..,.. Request for Temporary Certificate ...................... Final Certificat~ .... ~.~ ~,~i~,~ s.. ~ ................... Construction on above d;~r,bed, bu~ng ~pe,~J[ meets all apP~abl~odes and reg~ions. ........ ~, R io3o ,,.~o.~o.~a . ~t~O ~ ~ TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 October 31, 1986 TEL. 765-1802 To Whom it May Concern: I concur' with the Southold Town Assessors Office in reference to the Certificate of Occupancy Zl1394 and Zl1395 showing the County Tax Map Number and house number as 137-2-18 & L~075 Pequash Avenue Cutchogue. The new Cou ~y Tax Map number is 137-2-19.5 and the house number is 3985 Pequash Avenue, Cutchogue because of split of the property on 12/22/1982. Yours truly,~ __ Victor Lessard, Executive Administrator Southold Town Building Dept. Telephone 516-765~1937 October 31, 1986 To Whom it May Concern: In reference to the certificate of occupancy %Z11395 showing the County Tax Map Number and house number as 137-2-18 should read, because of split of property 137-2-19.5 and house number as 3985. Frederick E. Gordon Assessors Office FI~EL~ ~NSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C~DE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined.. ~.//..5.~ ...... , 19E.M/ Approved.. ~...~./..fi.. ...... ,1 .9~.. Permit No. '//7 '~ ~..Z Disapproved a/c ........ ~ ................ ,5~ ....... ('Bt ~u' ding nspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS //. Application No ................. 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 applicant agrees to comply with all applicable laws, ordinance~s~uilding code, !5o~sir}l~ codec)and rt~ations, and to admit authorized inspectors on premises and in building for necessa~insp-'e%on,~s. (S ~'/,= ~ )Mx ' ~~licant, or name, ifa cor~o;ation) (Mailing address of applicant)" State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ... ,~'~...°..~7 .... ~..'~x~.~.,.,{...v~..5. .......................................... (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... ~..~..~.. ............ Plumber's License No ......................... Electrician's License No ....................... 1. Location of land on which proposed work will be done .... /. ......X...c~.. ~.~ ...... Q .,t~O,e..~. . .... ........................................................................... House Number Street Hamlet County Tax Map No. 1000 Section ... [~.~ ......... Block ~ Lot. S,kaivisio~ ..... ~ .~:,~ . ~,?. ). . (/). (."~ ~-~ ~ ~ .':(? ..... ~il~a ~a~ ~0 ............... ~ot...,... ......... (Name) 2. State existing use and occupancy of premises and intended use an~ccupancy of proposed construction: a. Existing use and occupancy ...... ~ ·.. ~.:. U~ ...... ~.~ .~.e¢...~: ......................... b. intended use and occupancy .......... 5...~ ....... ': ,~.:'...~. ~:.~ ................... 3. Natur~ of work (check which agplicable): New Building .......... Addition .......... Alteration i .......... Repair .......... ~., Removal ........... .... Demolition .............. Other Work..~..~..C:[..~,,~.. ~ .-~,,,. (Description) 4. LstimatedCost .... :~. ............................... 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 occupancy, specify nature and extent of each~type of use ................ ..... 7. Dimensions of existing structures, if any: Front,../~ ......... Rear .. 2(..,~'. ........ Depth . ~./. ........... Height ....... /~9. r. .... Number of Stories . ./ ..................................................... Dimensions of same structure 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 .... 17~ ............... Rear ..... .~. ~. ............ D.~pth:x..,,~. ..... ; ............ 10. Date of Purchase .... 7./(.~'~.. ................. : Ix/lgme of Former Owner .,~.,..~.' ...................... 11. Zone or use district in wllich premises are situated .... ~..~..~ ............................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ./(k..c>. ..... 13, Will lot be regraded ....... 4,"x/x' ,/¢. ,,./., .~ ......... Will excess fi!l be re~m~ved from premises: Yes ,_ No 14. Name of Owner of premises .'~t~.~..C..~.~. u~. ~ .... Address .~X O..~.~tfl..~ ..... l*~,. Phone No..~.~.?. 7.o1.~/.~ ..... Name of Architect .......... : ................. Address ........ °..~.e.~.~°. ~.. Phone No ................ Name 9f Contractor ......... , ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all. buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block 'number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEWArORK, ~ ~ ~ COUNTY_OF .~~ ?/,.~;.~. ..... ~'~ ........ · ."-~.~-~ff--~.L...% i~'~x ~ ...... being duly sworn, deposes and says that he is the applicant ~,((Name of individual signing contract) above named, i 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 all statements contained in this application are true to the be~t 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 .................. day of... No,,tg, r, gxPublic, ..... ~.. y,~ ..... '~-~..~ ~olk I9,X" ' (Signature of applicant) ~0,