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Home My WebLink About12481-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 12481 Z Dote ............ ~., ............................. Permission is hereby granted to_gL. ..... ...... ~..z.~.~o.~:~....~..~ ........... ........... .~.~.~...7.......~./..~ ............. ~...:~.....Y...~..~ ....... ~..~z~.. o, premises located at ..~7~.a..."~ ....... ./...~./,<'/gf'~../ ..~.......~....~',.~.......~/~-~.~.~..~:~.~/~Y /.,..~.~../.~ .. ~.~ ............ ~..,~.. .................. .~.~...7.......~.....~ ................... County Tax Mop No. 1000 Section .... /....~...~.. ......... Block ...~...~.'..-~... ....... Lot No..~.../...~...:....~. pursuant to application dated ...... ..~./.~.........../.....~... ................ , 19.Z~., end approved by the Building Inspector. Fee $,.~ ..... Rev. 6/30/80 FORM NO, 6 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 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. 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 buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on'pre-existing dwelling/ land use 3. Copy of certificate of occupancy $1.00 --Fre-Existing C.O. $~5.00 Vacant land C.O. $ 5.00 New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property '.~.~: .~...~..~.../~..~.. ~..../.~..~./..~.&~. ....... .~.~.~...~-...~../~....67. ~ .~.'~ ........ House No. Street Ham/et Owner or Owners of Property . ~/~..,.,d~..~...~[.....~..~?~..L-~', .................................. County Tax Map No. 1000 Section ..../.O..~. ....... Block .. O,Y' Lot...~. / 4' ' -~ Z~ Subdivision.../.7~.~../.~../~/.../)..~/ .... ,"~X ./~...~'/.~. .... Filed Map No. ¢?¢.¢..<~....Lot No.. ~ .~....~. .... Permit No.. of Permit ...~//.o....Applicant... Health Dept. Approval . .[.~. :-.~.0. ~./'./.~. ,.././2..¢ ./.~..Labor Dept. Approval ..... ~.. ................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .. / Fee Submitted $ .... ..-~. ....................... Construction on above described building and~/,~n~,~ll applicable codes and regulations. 1001381 THE NEW YORK BOARD OF FI'RE UNDERWRITERS '[18 BUREAU OF ELECTRICITY ~ January 25 tg~%JOHN STREET, NEW YORK, NEW YORK IOO$~ THIS CERTIFIES THAT only the electrical equipment as described bel~ and introduced by t~ applicant ~med on ~he above application number in the premises of A & G Cole, '/65 Fai'~way Dr., C~tchogue~ N.Y, inthefollowi~glocatio.; ~ Baseme.t ~ ~, ~ ~.d r~. s~tlo,, .Io¢~ rot 32 was examined on 5anuary 16, 195~ and found to be in compliance with the r~quirements of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS NCANDE$CENT, DRYERS FURNACE MOTORS TI,MECLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C OTHER APPARATUS~ 1 ' 1 3/0 Motors:Z-1 i-GFCI l~Smoke Detector Electric Room Heaters:l-l.25 K.W, Jody Pumillo P. 0. Box 182A Mattituck, N.Y., 11952 LIC.#2300 This certificate must not be altered in any manner; return to the office of the Board if'jnco~'rect. OENIERA/ MANAGER ll '~'~ ,' may be identified by their MANNER. M H/ck.¢ S. 6o59'00"E.I $./°~5/0 £ 114 44' ~50 /~ I °00 '~0 FA IF¢ ?lA 7 _~-/1~ OC" Memorandum from.... BUILDING INSPECTORS OFFICE TOWN OF SOUTHOLD TOWN HALL, SOUTHOLD, N. Y. 11971 765-1802 FIELD ~NSPE~CTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY G,ODE FINAL ADDITIONAL COMMENTS: BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION ~/~ FRAMING [ ] FINAL REMARKS: INSPECTOR 7rd-1882 BUILDING DEPT. INSPECTION [ ] FOUNDATION :I, ST [ ] ROUGH PI. BG. [ ] FOUNDATION 2ND ~] INSULATION [ ] FRAMING [ ] FINAL REMARKS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:2 Disapproved a//c ...... '7~ .................. .~/ ..... 7~ / ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No. Z'.c~.~Z .~./ ......... Date ............ ./., ..... 19. INSTRUCTIONS a. Tkis 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. APPLICATIdN 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, bulidigg code, housing c_ode, and regulations3 and to admit authorized inspectors on premises and hi building for necessary insp0c/~i~ . -~ ~' ' ~ - { ;' ~ ~ ~'" ..... / "~ : ' "~' '- .... ~ ..... :' '17 '~' '. ',[ ........ : ...... ,,/- (~ignature of apphcant, or name, ~f a corporatmn) (M ail~l' ~ ;~'s~f 'a'p~li~ 'g~ f"' whether applicant is owner, lesse~architect, engineer, general contractor, electrician, plumber or builder. State Name of owner of premises - .A..q....~...~.:.....~..~..~..~.. ............................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duty authorized officer. (Name and title of corporate officer) Builder's License No ..................... Plumber's License No...~.,, ..... Electrician's License No. d' . ('( "'/ Other Trade's License No ..... ~ · .~ff~. · .~ ...... n /~/ /,~/x.,'A~ .~.~/V'£ /~O - 1. Location of land on which proposed work will be do e...~. ...... f. ..................................... .P.,9. mwd/. ..... ........ .... ' ......... ..... l~I~u~e' ~n her 7~ 6'- Street ~ Hamlet County Tax Map No. 1000 Section ..... /..O.~. ...... Block . . Lot.. Subdivision .... .f2',,~/.~.../~.~.,./ ..... ./~.,~..~.~.,f ........ Filed Map No..~..P.~. ....... Lot...~.~'. ....... .~.. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy .................. . ..... 3. Nature of work (check which applicable): New Building ........ Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... /~.¢ f~)~ .~. / ~/,/F~,~/~ (Description) 4. Estimated Cost ..................... Fee ~'../~,/ ................... ' ............ (to be paid on filing this application) ~'¢i i i i i Number of dwelling units on each floor 5. If dwelling, number of dwelling ~units ...................... 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 structuros, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... i.. Height ........ ; ......... Number of Stories ............ ~ ......... 8. Dimensions of entire new construction: Front . ~..-~..~. ;t' ' ' ~ ~ ,~ , .~ .... Rear .. ff..,ff.'.~, i' ..... Depth ...... ~. ...... Height ............... Number of Stories ...... .~. ................................. ............ 9. Sizeoflot: Front .... ./.~.O... i ........... Rear ....' ./.q~P. ............ Depth . ..~.~..~. ~.:,z..., ............. 10. DateofPurchase .......... ~ ................. .,~me of Former Owner ..~..~..,~..~.K.~'. .................. 11. Zone or use district in which premises are situated... ~"~--~. ........................................... 12. Does proposed construction ~,late any zoning law ordinance or regulation: . ~.~ ........................... 13. Will lo~ be regraded ...... ./~.ff~,.; :,....,~...._ .......Will exc~ess,,fill be rem%ved,f, rp/0 nremise~:, ., Yea _ No' 14. Name of Owner ofpremises .~.,t~ ~,~: ........Cbf,./-~'~ Address ~/ °' '0t~'~'~ '~' ~' · '~' '~°Tne~°'~'~q'~ F/' '~'~"'~'"~--'~ ' '" Name of Architect ..... .~.%. ~ .C.~. (~..~ ........ Address ................... Phone No ................ Name of Contractor ...... P..~..~.~.~ ............ Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly allI buildings, whether existing or proposed, and~ indicate ail 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 coruer lot. STATE OF NEW(~'O~K, COUNTY OF,, ~. ~ (Na~ne of individual signing contract) above named. Heisthe.. .................................... . ...:. .......... . ... . ~ (Contracto~corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the wbrk will be perfo~ed in the m~ner set forth in the application filed therewith. Sworn to before me this .......... ~ ..... ~ .... day off ........ ~.~ .... , 1~ ' ............... .... , £L 24.2 ; an t MEN OF HEALTH .......... SERVICE8 / ~ ~ SURVEY FOR ~ W~RREN E.:aE EKE aMARION M.~[NEKE ~d LoT S2, "MAPOF FAIRWAY FARMS ~...:. ~ AT. CUTCHOGUE DATE: MAY ~8, 1980 ~WN OF SOU~HOLD SCALE= ~' ~ .SUFFOLK county, NEW YORK' ,o, 80-290 ~:~[~:~ ~ N U~U T~ORIZ ~'~ ' A~TION'r OR ADOITfON' m mis GUARANTEED TO: ' ~ ~ ~. SU~[Y~ 4 VlO~ATI~ ~ S~cTIq~ 7~o9 oF TN~ THE TITLE GUARANTEE CO 'HEALTH D~PARTMENT-DATA FOR APPRO~L TO C~STRUCT . ~E~R ~ ~R'WHOM ~HE ~U~EY IS PREPARED ~ ~' ~' 'ff~FGO. Y~XMAP~MIT~ECTION~CK~LOT~ H~I~NDTO mE.~i~l~N~SOF THELENDIN~ ~.. /~ ~ /~/.% ~E~ A~ ~ ~EkCI~I WITHIN IOO FEET OF Tffi9 PROPERTY ~ST ~UYJ ~, ~UARANTi ~ AR~ ~T T~SFERABLE ~ ~,' ~' *,~ ~ I N.~HE~AT~R [dp~ A~ ~EW~SE DI~AL SYSTEM ~ THI[ R~OE~ OWN~S : , ' :'W~L-~FO~M~'~STAN~DS'OF~HESUFF~KCOUNTYOgPARTMENTO~fl~TH I~l~t~ ~ , . T0igJ~.~ '$TRUCTU~ ARE FOR A SPECIFIC L c~ : , ~ , ' ER AVENUE e YOUNG EL,22.5 Lot $$ EL=24.6 pATH 274. ~8' Lot 32 42, 112 so. F~. EL=24.2 284.93' HEALTH OEPARTMENT-OATA FOR APPROVAL TO CONSTRUCT # NEAREST WATEN MAIN 4.~t, ~ N SOURCE~ WATER, ~I~TE ~PUBLIC MONUMENT ' ' SUBDIVISION MAP FILED IN THE OFF CE OFTNE GL£RR OF SUFFOLK (~OUNTY ONFEB, IS, 1974 AS FILE SURVEY FOR A.G. COLE ~ E. COLE LOT $2, "MAP OF'FAIRWAY FARMS" AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNT~, NEW YORK' ~'.~,J~NAD~HORI~ZED ALTERAtiOR OR AO~)tTION TO I~IIS DATE: ,JAN. 17, 1985 SCALE: I "= 40' NO. 85' 1220 SURVEY'~A VIOLATION OI~;$ECTION 7209 OF THE NEW 'fORK S~*ATE ESUCATtSR LAW NCOPIES ~ ~lS $URVE~NOT ~AR~G THE LAND SURVE~R'S INKED SEAL OR EMBOSSED SEAL SHALL 'NOT BE CONSIOERED TO BEaA VAL~O T~UE COPY YOUNG S YOUNG RIVER~AD~ NEW YORK A[OE~ W. YOUNG, P~O~ESSIONAL ENGINEER AND ~AND SURVEYOfi N.Y.S UCENSE NO. : HOW~D ~:~G, LAND SURVEYOR N:Y. S. LI~N~.~. 4589~ OCCUPANCY OR ',::USE ,IS!: NI, AWEUL :i:,' WIT[t(¢ I i C'EltTIEICATE' -OF OCCUPANCY,~ Phone 47 ;-04{)0 ~'~ L~'~ .2' Mare R~a.d If copper tubipg is used for waler distributing system; piping shall[be ' r .S~ ' "" ,:1[ is Used ' Phoi~e 477-0400 Main Road