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Home My WebLink About11732-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Dat~ .............. lvia~r..'18 ........... 19~..~. THIS CERTIFIES that the building . Additio~ ..................................... Location of Property '1230 Cases Lane Cutchogue House No. Street Hem/et County Tax Map ~To. 1000 Section . .109 ....... Block ...~ ........... Lot .... .'1 .~ ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... ~...u.~..~..'l ......... , 19 .~?. pursuant to which Building Permit No..'1 q ?~:~ ............. dated . .~ .u~..e..~. ? .................. I~.~.., 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 ......... .... .~... ~..~.~.~.~. ~.o.~..~..o..~..~:.~.~.~..~.~., .~.~.~.z.z..~.n.~ ................................ The certificate is issued to .. ~9.k. .~. '...~.~.~.o..!.i.n.e...B.e.q~.e..~ ............................. (owner, le~ae or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...Iq'/.~.. .................................... UNDERWRITERS CERTIFICATE NO....5T5.8.8. 8..od3.. ...................................... Building lnspecfor Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTH'OLD, N~ Y. BUILDING PERMIT (THIS PEPu~AIT MUST BE KEPT ON THE PI~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ..... ~.~.~-~../,,~.... .................................................................................................................... at premises located a~'~.,~'~,.) ............. ~...)'~...~.¢~',~......~:l~',a"~e ......................................... ..................................................................................................... C~n~ Tax Map No. 1000 Section ..~..~ ........ Bilk ....~.~... ~ No....~.~. ........ pumuant to application dat~ ..~...~Z ....................... , 19.~and appr~e by the Building Inspector. 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 disposel-(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 instella- 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 building[ 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 or land use $5.00 3. Copy of certificate of occupancy $1.00 Date ........................ New Building .. O~--~OId or Pre-existing Building ~' Vacant Land Location of Property ../.3,..~.o. ................... ~..~.5'..=-.5.....~ .R... ......... ~.~..'~..E.H..~. ~..~.~.. House No. Street Hamlet Owner or Owners of Property ...~.~..~..~', .~., .'~..E?..~..o.L. ~..~.&'.....~..~.C...K..~; .~. ................... County Tax Map No. 1000 Section .../..~..4/. ....... Block .... .-~'.. ........ Lot.../..~. .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. I/.~..~.2.. Z... Date of Permit~//.//~.~..2,..Applicant . :~..R~...~.../..~; , .~.~.~.~..~.~. ~ ........... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval...~.~.. ~ .(~.~.d~.(~. ..... Planning Board Approval . .... ~/~ .............. Request for Temporary Certificate ..................... Final Certificate .... ~. ................. Fee Submitted $,. ,'~J, ,J~..~-'~-~, ~...~.. v~ Construction on above described building and permit meets all applicable codes and regulations. FIELD INSFECT179N FOUNDATION (lst) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL )ATE COMMENTS ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~.t. Jm'~.ac'y 5. 19~3 .'~pp,~'atio,.~'Vo.o.,;il, 1~5-~ P~117~ N588848 THIS CE~IFIES THAT j~ & ~ ~, ~ ~, ~, N.Y. ~n thefollowlng location; ~ B~ement ~ Ist Fl. ~ Znd Fl. ~c~ion 109Olock 5 Lot 13 u,~ examined on ~ ~, ~ and found to he in compllance u'ith the requlrements of this B~rd. .XTUEE I 7 OUTLETS ECEPTACLE$ SWITCHES l DRYERS FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANE FLUORESCENT SYSTEMS NO. OF FEET E DISCONNECT E R V I C OTHER APPARATUS: NO OF CC. COND A.W*G. INO. OF Hi. LEG I A.W G PER .~ OF CC. COND. OF HI-LEG INO. OF NEUTRALS OF NEUTRAL Jack Bec~ P.O. ~ 528 Ca~e~ ~ CuCebogue, N.Y., 11935 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. f FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 (Building Inlpector) ..... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No./, ,/Z,,~,,~, ........ Date ............... ,19... a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building .nspector, 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 )r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. 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 ;hall 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 ;hall 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 3uilding 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. rhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to tdmit authorized inspectors on premises and in buildings for necessary inspections. · .~(Signature of applicant, or name, if a corporation) (Mailing address of applicant) ~tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. '~mne of owner of premises ......... 8..~. 0.~.eoLItdP-- Bfze~<'~-,~ .,4.*aK ............................................................... (as on the tax roll or latest deed) tf applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No...(.~.. t~. :. Plumber's LicenseNo ......................... Electrician's License No ................ ' .. Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ..... .o. ..................... .............. ?.f. .... ¥:y. . House Number Street Hamlet County Tax Map No. 1000 Section .../..O.~ ........... Block ..... ~. ........... Lot..../.~ .............. Subdivision ..................................... Filed Map No ............... Lot ............... CName) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing usc and occupancy ~_ to,~t_c. *A/~ - R/~. ~' ' DEM T. 1~' .LT. b I tend duseandocc E.I~..~.L..~(M.~ ' ~.E$'~..li~l'l''q't'- '~ n e upancy ................... 3. Nature of work (check whict~ applicable): New Building .......... Addition...~.. ..... Alteration .......... Repair .............. Removal .... ' .......... Demolition .............. Other Work ............... 4t. (Description) ~ ~/~'o ~ - $. Estimated Cost ...... ? .............................. Fee .......................... -~ ...... (to be p~d on Filing t~ application) h If dwefl~g, number of dwe~g units ...... ( ........ Number of dwelling units on each floor... / ............ If~ge, number of cam .. ~ .................................................................... h If business, commercial or m~ed occupancy, spec~y nature and extent o f each type of use ..... ~. ~. :~ ..... h Dimensions of existing structures, if any: Front... Z~ ~ ........ Rear . .?~.'. ........ Depth. ~.~ ........... Height . .~& ~. .......... Nmnber of Stories ... ~ .................................................... Dhnensions of same structure with alterations or additions: Front . .~. ............ Rear . 7.~ .............. Dep~ ..... ~.' ............. HeiSt ...... ~ ............. Number of Stories .... ( ................. ~. Dimensions of entire new construction: Front ............... Rear .. Z~ .......... Depth . ff.~. .......... HeiSt ..... ff~.t ....... ~umber of Stories .... ] .................................... .~ .............. h S~e of lot: Front ...(~.~ .~ ............. Rear .... ff ~ ~ ............. ~p~ .~'.'~ ~ .............. ). DateofPurchase . ?. ~.~..~ ............. Nameof;c merOwner ~ ~o~..~ff~ t.~' h Zone or use district in w~ch premiss are situated...~.~~ .................................. L Does proposed construction violate any zoning law, ordinance or regulation: . ~ ............................ L W~ lot be rended .. ~ ...................... Will e~cess fill be removed fm~remi~s: Yes ~ ~. Nme of Owner of premisesd~ff.0t ~. ~f~Address~6~ ~A~..(~.~ ~hone No~A'~g~... rc c ~ ~,~ ~,~' ' it N~e of A hire t ........................... Address .............. ~ ,Phone ~.,... ............ N~e of Centractor .......................... Addre~ ................... Phoae ~ .' .......... ~ .. PLOT DIAGRAM' Locate cleoxly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from :operty 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 NEW YORK. COUNTY OF .... ,~,.~..~?.~. ~.g.... S.S ......... ,./~¢~ I~, ~c*(~'~ being duly swom, de~s~ys~t~theapplicant (Name of individual si~ing contract) ~ove named. · is thc ....................................................................................... (Co~actor, ~t, corpse o~ccr, etc.) If ~d owner or owne~, ~d ~ duly auto. ed to pe~om or have ~o~ed ~e mid work ~d to m~c ~ ~e ~is OppUcation; ~at all statcm~ts cont~ed ~ this application ~ true to thc best of h~ ~owledge ~d ~lief; ~d that ~e ~ork wUi be p~mcd in the m~ner set f~th ~ the a~li~tion filed th~with. Sworn to ~fom me this 19~ .............. · ........ , Tn'L~ OCCUPANCY OR USC IS UNLAWFUL WITHOUT CERTIFICATE .jiLL r,,,?....__~_~ . = ~ . .~ . ~ .. '~ ~ : ~ , .- .'~C, :e~;.,'.. ,, ~ ~ , - '-"- --<' '-" /.-¢'~' D£NCE WILL