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HomeMy WebLinkAbout12279-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13993 Date November 7 ........ 19 .8.5. THIS CERTIFIES that the building .. Addition Location of Property 1450 Broadwaters Rd. Cutchogue /-Iou.;e IVO. Street Ham/et County Tax Map No. ]000 Section ~..1.0.4. ...... Block . 09 .Lot 006 Subdivision ...... ~..~p..".~. '.'..~.a.s..s.a.u. ?..o?.n.~..Filed Map No...1.5.5....Lot No..2..5.7 ......... conforms substantially to the Application for Building Permit heretofore f'ded in this office dated .... .Ap.r.i. 1,..4 ......... ,19 .8.3. pursuant to which Building Permit No...1. 2. .2.7.9, Z. ............ dated ...... .A.p.r..i.1.......,........2 5 19 . .8.3, 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 ......... .... :.Jr.-. ~.~..r.o.?..~.~..t.%o~, .t.o..~.~..~.s~.~..~. ?~..~.~.~.n.~., 7.~7 ................... The certificate is issued to FELLOWS, JOHN B. & ALISON JOAN (owner, of the aforesaid building. Suffolk County Department of Health Approval ....... .N./.A. ............................... N638341 UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 Building Inspector ~O · N. ;12279 Z Pei'missiOn is hereby granted to: TOWN 0 :sauTa 4 BUILDING DEPART/~EST ' TOWN HALL SoumO~.D, ~. ~. ~CT~IS PERk4 3' MUST BE KEP'I~ ON THE UNTIL~fFULL C~PL~ION OF THE WOrK ~U~RORIZED)~ Da~e ... ,...,.~. ........... -- . 19. ot premis-~lbcated at .... Builidlng li~spector. Fe~ $ .............. ' ~ Rev. 6/30~80 Lot No.i...~ .......... ',~and :approved by the FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold. N.Y. 11971 APPLICATION FOR CERTIFICATE OF ocCUPANCY Instructions Bo This application must be filled in typewriter OR ink, and submitted ~ 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-confo, rming uses, or buildings and "pre-existing" land uses: 1, Accurate survey of p~operty 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $ :L 5.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date ,~ov. 6, 198~ New Building . ,.~ ........ ~..~ -. o .... ;~ ' ~ ~u:~:l[~,~ A. (~.~k~J-..OD. Vacant Land . -c~~-,..~ .4~.0...~.~.o.~. ¢¥~.~.e.~..~. ?,4, ,..qq~ p~.qg~ ............................. House No. Street Hamlet Owner or Owners of Property ~P.~.~...~.., .~ .z~[...A.~. ~..~p.~..~. 9.8,.~..~.e.l.l. ql~. ~ ....................... County Tax Map No. 1000 Section .!.0.4 ........... Block ..~. ............ Lot. 6 Subdivision .A.~,e.~.d.e.~..N.~.p..A..o.~...~.a,8.~a.~, ?.~. tFiied Map No..1.~.~. ...... Lot No..2.~,~. ......... Permit No.~.~..'~.?~ .~-.. Date of Permit~).~'i~. ll?~.~.Applicant .Z.O.~..~. ?.....&. ~.],J,.ePD..~9.~.~...~.e~..1.o.w. s Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval og..~.~...~..~..Or..I ......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and parrot meets all applicp]~e codes and regulations. ~O..~,-,,.j~q~ / '// ..4 ' '~Z-~./'~ ,,o - _ ............... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTR,~CITY 85 JOHN STREET, NEW YORK, NEw YORK 1OOS8 ' - March 27, 1~ 2~1/83 ~.~ ~,.,,~.,o,~o.o.~~ N 638341 THI~ CERTIFIES THAT only the electrical equiptnent as described 6e~w ~d introduced by the applicant named on the able application number in the premises of Jo~x C. Fell~s~ B~ters R~, ~c~g~, und fout~d ~ be ~ compliance with ~he requirements of this Board. was examined on ~ch 22~ FIXTURE FIXTURES RANGES OVENS EXHAUST FANS OUTLETS SWITCHES ~tUORESCEt~T DRYERS MOTORS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I / C P -- OF CC COND, )THER APPARATUS: i~G~ F .C. I. NO, OF NEUTRALS OF NEUTRAL i 5 Pat Lane ~ttituck~ 119553 LiO#2S00E This certificate must not be altered in any manneh return to the office of the Board if incorrect. Inspectors may be cradentials. COPY DIN:G DEPARTMENT. THIS COPY OF CERTIFICATE M~ BEALTERE ~ IN ANYrMANNER. FORM NO, 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL · ............ ~E TAKE NOTICE that your application dated ~5.~.... ~ ........ ,19 .~ for pe~it to construct. ~c~.. ~d~ .......................... at County Tax Map No. 1000 Section .... dO.~ .... Block ... O.~ ...... Lot ..... ~ ~... is r~t~rn~a herewith and disapproved on th~ tollow~g grounds.,:~O~.. ~.~. ................................................................... RV 1/8O HEU YORK STATE DEPARTr~E~!T OF E?IRO~IUE~!TAL CQ~!SERVATIO~ Regulatory Affairs Unit Building 40, SUNY Stony Brook, NY l179a Henry G. ~Iilliams ' Commissioner Dear .qO PERi,IT ~.!ECESSARY - TIDAL h~ETLAF!DS ACT i1o , ' ' Houever, 6n~ agdit~onal work or modifications to the p?~ect.may ~qu~?~,~ ,, a permit. It is you~ responsibility to notify this office ]n writing ]t such additional work or. modifications are contemplated,~ ' ~ / ~V~ ~ ~ ~v r ~ I~ lST -OT~ [ . ~ . Assuming you have obtstned any other agDlicable permits, you may grocee~ I ~ vw with you? p?o,iect, Very truly yours, Paniel d. Larkin Reqinal Permit Administrator OJL:RHT:ll F I E Li~ INS'~ECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: i,iI FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803- Appro~e~.'. :./.. ~.~. ·., ,,is~ppro~ed a,c ?~...~... ~./. ..... ..... ~.:~....-.,d.~~: ......... ~:. / (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 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 ~anted 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, additious 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 building for necessary insp~ct[oi!s~ rx __ (Signature of applicant,, or (t~taSne, if a corporation) · ~.. f.?.?. ~ .... ~.-~..~.c..~...":m. ......... (Mailing address qf applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· ............................... ~>.~q.,. /~ ~'--'At- . ...................... Nmne of owner of premises ... ~ O. ~..~....Ce-...-~.~. .~f._r. ................................................. (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 ..... ~...~. ............... Plum~er's'~i0ense No...77~.....,&....?. ¥.~ Electrician's License No. ~' ~ ~ Other Trade's License No ...................... I. Location of land on which proposed work will be done .................................................. · ~.~..~?:7 ............. .tS.~~....~ ....... ¥~:~f~.:..'q..7 ................ House Number~__///,g'~c~ Street Hamlet / Subdivision.· ..~..~.....~.... ~...~....t~/...~.bj.~/.: .... Filed Map No...}., .~., ....... Lot..~..3. ~ (Name) 2. State existjng~use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............... ( ...... '. .............................. b. Intended use and occupancy ........... ((~2~....'t-g'A~...5:. .......................................... 3, Nature of work (check which applicable): New Building .......... Addition ...... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... , .~22~- (Description) 4. Estimated Cost ................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... Z ....... Number of dwelling units on each floor ................ If garage, number of cars ....... J ................................................................. 6. If business, commercial or mixed o6cupancy, specify hat.ute and extent of each ty~pe of use . . 7. Dimension_s,of existing structures if any' Front .2~. ] Rear . .24. ~.. Denth ~. ~'z[ ; ' ' 'ti''' · ................. r '* ............. Height [J ............. Number of Stories .. ~ .................. 6 ................... , ................ Dimensions of same structure with,; alterations or additions: Front . ..~. ............. Rear_ .~.~ ............. Depth...~..~.t. .............. . Height .... f~./..... ........... Number of Stories.../. .... .... ~...~ ....... 8. Dimension. s of entire new construction: Front.. f../..~. ....... Rear ...f.$ ......... Depth . .~...2r~.. ....... Height . .]..~ ......... ~. Number of Stories ...... ff ................................... &. ....... ~ ....... 9. Sizeoflot Front ~.~ . . . ; ........ Rear.../.~.~. .............. Depth .,.~.~.~...~.J~.O. ...... 10. Date of Purchase ............ , ................ Name, of Fenner Owner ............................. 11. Zone or use district in which premises are situated ....... ~.~..~-~4~7~. ....... ,,. .... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... .~.~.: .................. 13. Will lot be regraded . .~L~: .... ~ .x, .......~ ....~,... ~i~l exee~s fill be removed from premises: ~ ~) 14. Name of Owner of premises ~1¢ (~.~o~$.. ~6 ~' e~Ad~'r~ess · ~.oT~. ~..~. ~,,c ..~ Phone No. 7.~ ¥ - ~ ~'~ NameName of Contractor°f Architect ..... ~.~ .......... .' .6~.' ~ ~~ ............. Phone No ................ · ........ 4,~a~ .~ ...... ~ .'?~.../. P. ~.. Phone No. ~.~ .~..~. 1 .~. / .,r~.. 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 coruer lot. ~ STATE OF NEW YO~IC~ ~ /~ c e COUNTY OF ...... ~.~.~l~./..o/A.. ~'~ ............ : · . ..................... berg duly sworn, deposes and says th,~e is the applicant (Name of~dividuai sighing c~ntract) above named. ~He is the ....... ~g~.~ ~ff. ..... ~.~ ................................................ , (Contractor, agent, corporate officer, etc.) of said owner or ownem, ~d is duly authored to perform or have perfomed the said work and to m~e ~d file this application; that all statements contained ~ this application are true to the best of~wledge and belief; ~d that the work will be perfomed in the m~er set forth ~ the application filed therewith. Sworn to befo~ me this I ~0.~ ~2-BI25B50, ~erm Expires ~arcb ,.~ ' ' ~"r . TOWN O~ ,.~:)u"rM©L.O, N.Y. /97' ~', ~ , "" ,~ "'J / ./'