The URL can be used to link to this page

Home My WebLink About12235-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z~4775 Date August 8, 198.6. THIS CERTIFIES that tile building ". ,[p.g.r. 9 .up.cl.. s..~.i.m.m. $ .n.~..?? ?.l..&.. ??.c.k. ........ 195 Track Avenue Cutchogue, New York Location of Property .. .............................................................. House IVo. Street Hamlet; County Tax Map No. ] 000 Section . l 3.7 ........ Block .q l ............ Lot.. 0. ! .7 ............ Subdivision H/o Sec. 2 ?pry of .Filed Map No. 7280 .LotNo. 7.5 & 76 H.S. Hand conforms substantially to the Application for Building Permit heretofore filed in this office dated March 23, 8..3 12235Z ...................... 19. pursuant to which Building Permit No ...................... April 7, 82 dated ............................ 19..., 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 ......... Inground swimming pool & deck The certificate is issued to William Ellwood of the aforesaid building. Suffolk County Department of Health Approval .......................................... N605983 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 TOWN OF ~OU~'"~(~, ~ BUILDING DEPARTMtNT TOWN ~HALL SOUTHOLD, N. "Il'. ~ BUILDING I~ERMIT~: · CrHIS PERMIT MUST 'BE KEPT ON THE PR£~IS~S UNTIL I iULL COMPLETION OF THE WORK. AUTHORIZED) i N.° 12235 Z Date ...... ~ .................. .. ....... ,~, .......... 19. Permission Is hereby granted to/ ~ ..z .L/ ~ ..... ~ ............. i:...~.~ ............. .... ~.. ................................... :'..'~..,...~?-.~...-.. .......... *o ..,...~.~.......~. ....... .u ........ ~ ........ ~ ............................... ~ ....... ~ ............ ~.~ ....... ~ ~ ~.._.~ .................. '"'"~'"~": ........................................... ~ ................ ?'"~ ::""? ............ ~pr~*~ ~d ~t ............................................ ~.-.~ ................. :. ............. ~..--...~. .......... ~o~ ~ ~ ~o. ,ooo ~,o5~.....~,.~. ~...~ ....... ~...?~o~ ~o. :; ....... ~ .............. euiffJing I~spector. Fee $ ........ ; ............... Building FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in Wpewriter OR ink, and submitted ~m ~ 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 u~usual natural or topographic featu res. ~ 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 P~anning Board approval of completed site p~an requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusuat natural or topographic featu res. 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3, Copy of certificate of occupancy $1.00 5.Updated C.O. $15.00 Date .............. NewConstruc%ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ................................................... House No.Street ~ //' ~Ham/et OwnerorOwnersofProperty . .~.. J.~. .~.t, .~ .~. ~ , ~r~r~l~ ~-~J,'~'TT~g¢£,~t, - i'Y7 I - I-I County Tax Map No. 1000 Section ..... ;'.- ........ Block ............... Lot ................ Subdivision...~, .'..~.'../.47../q..~.....~'?T..(,..?7. .... Filed Map No..I.~..~.O.,..Lot No..7..'a~, .f.?.(q... Permit No. /.qql.~,~. 7Date of Permit ...... ~,/.~..~. Applicant..~..~-../.~.~'.t~...~.. $~)..,~, ~ .......... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate .................... Final Uertificate ...... X ............... Fee Submitted $,...':-~-.: ,0-~...,..~....~ ~).~ ..... Construction on above described building and permit meets all app~.,able~codes an~ regulations. Rev, 10-10-78 lODes3 THE NEW YORK BOARD OF' FiRE UNDERWRITERS BUREAU OF ELECTRICITY : J~o ].z~ l~ 85 JOHN STREET, NEW YORK, NEW THIS CERTIFIES THAT only the electrical equipment as described below and introduced by t~ applicant ~rned on t~ able application number in the premises of ~illi~ Ellw~ ~a~ Aven~ C~tu~o~e, N.Y. in the following location; ~ Basement ~ 1st FI. ~ ~nd Fl. ~tside Section Block Lot was examltwd on J~ ~ ~8~ and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS EXHAUST FAN OUTLETS SWITCHES FLUORESCENT 1 1 2 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS LJNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C NO OF CC. COND A, W, G, NO OF HI.LEG A W G NO. OF NEUTRALS A. W G PER ,6' OF CC COND. OF Hi-LEG OF NEUTRAL OTHER APPARATUS: 1-G.F.I~ (&W~mn~ P~)i) This ~tific~.te covers cemplaince at the date of inspection only. Because o~ m~usuai envir~nents it is advisable 'to have frequent tests and/or repairs made by a q%~lil'ied l~erson. Glezm R. Bradley 169 Horton Avenue Mattituck. N.Y. 1195~ Lic. 1227 This certificate must not be altered in any manner; return to the office of the Board if incgrrect Inspectqrs may be COPY FOR I DPY OF ~ MANNER. FIELD INSPECTION FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. STATE ENERGY CODE k DATE COMMENTS ADDITIONAL COMMENTS: J~ BUILDING DEPT. INSPECTION FOUNDATION '~ST [ ] ROUGH pLBG. FOUNDATION 2ND [] I/~S~l] I LATiON FRAMING I'/~] FINAL REMARKS: INSPECTO FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL,: 765-1803 ^pproved 19 .. e ,it No ........ Disapproved a/c ~Bfiilding Inspector) Application No.//~/a~..~..~./..~. .... APPLICATION FOR BUILDING PERM IT Date ......... ? .~?. INSTRUCTIONS a. This application must be ~completely filled in by typewriter or in ink and submitted,!n 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 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 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 in buildings for necessary inspections. ...... ,...,p.¢ ax..../x,'. ¢.... (Signature of applicfint, or name, if a corporation) ..... ~.o/....eg.¢...~...~..~..~./.?.?./.~....~.../4.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............. ~k~. r,,.,,....c~....,x' .r~.. x,~.. ~ ~ .................................................... Name of owner of premises . .. ~R. ~.../?/.t~ ..... ~..I~.Z..[~.O:~.... ~ ...... .'~.~.r,-6oO.~l:SJ .................. (as on the tax roll or latest deed) dPo~Ax. ~ o /~. ) 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... ~.(~j1/ff... t~.a,/OC~.~/a Other Trade's License No ...................... Location of land on which proposed work will be done. ~./~.. House Number Street Hamlet County Tax Map No. 1000 Section . ./. ~..~. .......... Block ..../ .............. Lot..../.2 ............ Subdivision. ?.).,.~:..~.(~4 icj., .~..~'~.q q~/.: . ~:~· .......... Filed Map No...li'),~ ............ ~:~(~ Lot ...... ~?.~ .'~ q~ .~.~ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... {~! [0. ~., .l~ (~ b. Intended use and occupancy ../~....~..~..D/.~fi.o/2)...,~.. ~;~. ~/Yt .... ..~O..Q.&,..../ .~..~.~'/~ ............ 3. Nature of work (check which applicable): New Building .......... Addition ........... Alteration .......... Repair; .............. Remdval ............ .. Demolition ............ ~.. Other Work~..t..~.q~.~.O-. /)AC~C/( ~c f~71/CP-*(Description) 4. Estimated 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 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 structure with alterations or additions: Front ................. Rear .................. Depth .................... i · · Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ....... Number of Stones ........................................................ 9. Slzeoflot: Front .................. Rear ..... : ........ De ............... 10. Date of Purchase .......... ~ .................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ....... ~.//9~,~.~J. 77.r.O.t~ .............................. 13. Will lot be regraded ........ ~,~-~' ................ Will excess fill be removed from premises: 14. Name of Owner of premises ~..~..o4./.~.¢~.r~7.to~ddress ...~ff, t(J~.. ~ Phone No ............... ' '"'~ Name of Architect .' 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 blocE number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEWt,~-X,,2/~/,~'d'~,,'YO~',, ,,a~ S COUNTY OF .... ~..e ..~...'SU...~ . .'~"_~..~..' .~..?.?../.~.~.~.. ........ being duly sworn, deposes and says that he is the applicant -- (Name of individual signing contract) above named. He is the ........... .~.q..~..~../~...~..~...7-.°.~.' ......................................................... (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 apphcatlon; that all statements contained m 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 f~ed therewith· Sworn to before me this Notary Public,, ........ ,~.. ~ ...... ~o~unty ........... c., ~uz~tm ^uu ~'~tm ] ~' .............. (Signa~'ure of applicant) ~o. 52-8125850, Suffolk /