The URL can be used to link to this page

Home My WebLink About12280-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y, Certificate Of Occupancy No. Z16945 Date June 2, 1988 THIS CERTIFIES that the building .... O..n.e.. f..a.m.i.l.y...dy.e. 1. 1..~.n.g... .................... L .. 330 Cases Rd & 225 Meadow Lane Cutchogue oca~lon of Property ............................... House No, Street ' '121~t~let County Tax Map No. 1000 Section I 1 6 . .Block 0 2 .Lot 0 2 2.3 Subdivision ............................... Flied Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 7, 1983 ..................... pursuant to which Building Permit No. 12280 Z dated .... ~. p..r .; .i.1. i .2 .6.,.. [ .9 .8.3 ....... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for wlfich this certificate is issued is ......... One family dwelling, deck and car port. ' The certificate is issued to RICHARD W. BLOCK ..................... ?oV.'o;, ' 4m irk ' i ..................... of the aforesaid building, Suffolk County Department of Health Approval' 13-S0-27 June 1, 1988 UNDERWRITERS CERTIFICATE NO. . N725726 December 10, 1985 PLUMBERS CERTIFICATION DATED: N/A ''~ Bu~Sng Inspector Rev. 1/81 TOWN OF TOWNH~ALL i ' SOUTHOkD, BUILDING PERMIT,! (THIS PERMIT MUST BE KEPT oN tHE PP, Egli COMPLETION OF THE WORK AUTHORIZED)I N.° 12280 Z permissior{ js hereby granted to: UNTIL' ~ULL Fee .. . ot premises located at .'~"~.':~. c~..~. ~.~ ......... ....;.~..';~ ....... ~ .............. y - ~: // . ...... Z~ ........... ~.~.~. .................. ~. ~.~ Cou~ Ta~ Map No 1000 Sect on ~' ~ "~'~ ....... ' .......... . ' .... :,?.. :'"" : ~, pp~ Dy me FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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 natu rat 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 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 p~operty showing all property lines, streets, buildings and unusual 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: Additions $25.00 POOLS $25,00 AI, TERATION~$25.00 1. Certificate of occupancy New Dwelling $25.Q0, Accessory ,$10.00 Business $~0.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 5.Updated C.O. $ 50.00 Date. .~. ~. l New Cons ~ruc t; i on ...... Old or Pre-existing Building ............ Vacant Land ............ .... ........... ..... ........ .?. Owneror pawners of P Fopertv ....................................................... ~'-~¢'~ L (.~C/', I'~/~ C~_ _~ Ham/et County Tax Map No. 1000 Section / ! (~ Block .~. ~.'~.. Lot,. ~).~ ~ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Hea-lth Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and pe/~r~it me, e~ts all applicable.codes a,nd regulations. lOOO343 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRIQIT~ r ~ 0~[ E5 JOHN STREET, NEW YORK, NEW ~ORK IOO3J~ THIS CERTIFIES THAT only the e~ctr~cal equipment ~ ~scribed below and int~duced by t~ applicant ~ed on the able application n~mber in the premises of ~1 ~k~ 330 ~ I~e, Cu~e~ N Y in the following Iocatlon~ ~ Basement ~ 1st FI. ~ 2nd Fl. Section Block Lot mas exam~d o~ ~;~ 2 ~ ~ ~ and Jound to be in compliance with the requirentents of this Board. FIXTURE OUTLETS 57 DRYERS FIXTURES RANGES OVENS EXHAUST FANS E R V NO, O~ECCCOND. J AW. O. OF CC. COND 2/O OTHER APPARATUS: 1 Trao}~ fd,9/ht:.'h'g' 40'-0" - 12 783 E This certificate must not be altered in any manner; return to the office of the Board if ihcorrect. Inspector~ may be identified by their credentials. O"¥FO i O ~DEPARTMENT THISC "C 'OT~I~A ' ~ C RBU L IN QPYOF ERTIFICAT~USTN LT~REO NANYMANNER TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This s to advise you that the job under building permit no. 12280Z issued to R W Block on 4/26/83 for New Dwelling is completed and a final inspection has ( ) has not ( x ) been done. In order to complete this file, it is necessary that n Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $25.00 payabln to tile Town of Soathold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occnpancy or use is unlawful without a Certificate of Occupancy. Please. help ns to clear tip this matter so that legal action does aot have to be taken. Thank you for yo,r prompt attention. Yet! trulY~, Victor Lessard Executlve ~dml. nistrator VL:gar A Final Beard of Health seal is needed FI~ELD ~NSPECTION COMMENTS FOUNDATION FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION STATE qODE PER N. ENERGY FINAL ADDITIONAL COMMENTS: FOUNDATION 2ND [ ] INSULATION I- ] FRAMING £~J~INAL INSPECT~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined f, . Disapproved a/c ........ ~ .~'.... ~ ....... .f~. ....... / ................................ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No..~.~f~.~...~.. ........ 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, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary insp~i~on,~,,~,f~ f~"~ ~ ,,~ (Signature of apl21ic~;tt,~9~3 name, if a corporation) ....... ........ (Mailing address off,,fipplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises. ~.~....~..'. ~ ............................................. (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.~ ...................... Other Trade's License No ...................... 1. Location of land on which p~,posed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section .../~.~. .......... Block .... .~ ............ Lot.. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... .Ifa-t:: '~,~. ..... b. Intended use and occupancy .~ .... ~'7-~... ~c~.' .' i~i .~.'~i i i iiiiiiii iiii 3. Nature of work (check which a plicable): New Building ...P'....... Addition .......... Alteration .......... Repair ............ RemOval .............. Demolition .............. Other Work ............... 4. Estimated Cost. · .r ............................. Fee . . ~- ......................... (to be paid on ~ing this application) 5. If dwelling, number of dwelling Cnits ............... 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../F'~. ~ ........ Rear '. ..... Depth ..... : ......... Height ............... Number of Stories ........................................................ Dimensions of same structure With alterations or additions: Front ................. Rear .................. lDepth .................... :.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ..... Number of Stories ..................................... 9. Size of lot: Front .... ~.~.~..' t~..~.. ........ Rear .... ~..~.[..~"..2~,.. i ..... Depil~' i i~.~..~.~..iii ii i ii iii 10. Date of Purchase ...,~*'A(. ~ ~.~.~¢ . . . Name of Former Owner,~/~.-..d;"2~..~.(*A?.,.~'~F:../~.4,~"r: .... 1 I. Zone or use district in which pr~mises are situated ..................................................... 12~ Does proposed construction violate any zonin, g law ordinance or regulation: . ~ ......................... ~ 13. Will lot be regraded ....... ,,.i .......... ~ ....... Will excess fill be removed from premises: Yes ~ 14. Name of Owner of premises ,~',~,,.~'. ~.,~,/~-/~... Address2/2,/~',~K4t'~'~/'~$,.. Phone No.f'frX Sg~'~. ........ Name of Architect .~A~.~./dz..~. ~. ~/~.~' .z-~ ..... Address ~.-~',~.~,~.~..~,~t. Phone No,.,.gi~,t".~.2,oJ ...... Name of Contractor .../;~,. ............. Address ................... Phone No ................ Locate clearly and distinctly alll buildings, property lines. Give street and block interior or corner lot. PLOT DIAGRAM whether existing or proposed, and, indicate all set-back dimensions from ~umber or description according to deed, and show street names and indicate whether STATE OF NEW_YORK ., S S COUNTY OF. ?.'.~ ?..~.D.~.~.... i ' ....... [~{'~..........~/~.~................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ...................... ! ................................. ~ ................................. : (Contractor, agent, corporate officer, etc.) of s~d owner or owners, ~d is duly authorized to perform or have perfomed the said work and to m~e ~d file this application; that all statements centred ~ this application are true to the best of his knowledge and belief; and that ~e work will be perfomed in the m~ne~ set forth ~ the application filed therewith. Sworn to before me this " ......... ~,: .~..~ .... dasof:. ~/.~/~ .... , ...... ,19 ~ Nora. Public, ~~,~_~..~.....,~~.. C~ ~ ~ ~ ~r ~ualified in Suffolk Count~ -'CASE SUFFOLK CO. HEALTH C,.S. PT. A1I H, S. NO .... '-' I "'" ' ~ z~'s~ : ~' STATEMENT OF INTEN1 .. :'~L~ . . _:_- ~ .:'1 ~ .... :- :, .,~ ~ THE WATER SUPPLY AND SEWAGE . ~ .- _. ,--~; "~'. '.-'~: SYSTEMS FOR THIS RESIDEI .... SUFFOLK COUNTY DEPT. OF. . .- , .. . , ~ . ... -.. -... -~., ~- .':~ [_ ..c..:..~ -' · ' . .~t. -.,...'. ."'.. m ' ,-:. - ~ ~l , ' -- , .' . ~-,.': ~ ~.- ..... ~ ~ ' , , , :~ -'- -.'" ~ - '~ '. , -tm"-,:' ~:'.~'~ SERVICES -- FOR APPRO . , ' , t I , ' ' ,' ' ~ · ' ' ' ' ~ f' ~ · ' ' -"' ': ' ~ :'"<~ [~C]~'~Y~) ' "~'~ :. ',. ,. : ~ .... 1. ~ .. : ' . -' ' ~.76 55'~.~... ':_'. ~ . , ' ',...; ....... :_~-~ [ -'' '~ /.., .~?-.' 4.-~..' ',~j SUFFOLKCO. TAX MAP DESIG~ ..- ~. .,-..~. ~ .... ~. , ~. . · . . . . ,.. ...... .~.~,.~,..~ . , ~.~ ~ [ . , .. j '~,.~'~.:.~. ~. , · ...-.. ~-. · :>-:~. ~ .-- ..- - . ...... · . ......~,. ~,~,, ~ , - -,.... . -t o~. S~CT. I ...... ... . .. .. .... ... ....... . . . .... . ... . J ', · , . ' . .... ~ · ,-..:. · · . . ' .... :~T~ ~.~.. . ~ ~ .... :=' ~' .. ' .-~ ...... .~:,~ ". ,~ , ~' I ,t. ~ ' ':-~'::' .... ' "" ' "" ' ~ ......'' ~ ..... - ':.l ~' . . ~!~P~P~ .... <, .. ~ -..~ .,~ .. --.,..~ E- :.:,~.:. ~ :..:,..,~ ~?::: .%..~.~ :.~ ..... ... ~:~......:,~- .... ~ ~.... ~ ~. . , . , ,.. ~. ~. .~:~?., ~.~}, . ~, ~:~ ,~ ,~--. ~ -~-~.~ ',~ ~-~, ~ { , ' &~FA,~AT:~T .,' ',"' "~ ' ~ :-, ?. ,.,]'~:?~<, ~--,"~::' 't~,~-:~ '-'- .... '.?:-': ~".~-~,:-~;".tD~D: U.~6 ~. ~a~ ' - ' ~,' , , ' - ~ ' ,,,~ <?t'? ,~ ~;~: ~U~t ~ ,'fE~ ~ : .... ' .... ~Y', :>.': --'! TE~T HOLE STAM . . ' ' ~x"' ~. "~ ~ ...... ' ."." '.'.. J I , ~O~ASS~H~ESO~m~ NEW SUFFOLK AVE. /! "-" ",/ACA. NT) SUFFOLK CO. HEALTH DEPT. APPROVAL h. S, NO. ,~ ':>'~' -~: /' STATEMENT OF INTENT THE WATEr SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOr THIS RESIDENCE WILL CONFORM TO THE StANDArDS OF the SUFFOLK CO DEPT. Of HEALTh SERVICES. APPLICANT SUffOLK COUNTY DEPT. OF HEALTH SEt VICES -- FO r APPROVAL Of CONStrUCTION ONLY DATE H. S. REF. NO., APPROVED. SUFFOIK CO. TAX MaP DESIGNATION: DIST. SECT. BLOCK PCL. v.%, .-. :!6 2 OWNERS ADDRESS: P.C. ~0'~- :3;2 DEED: L, STAMP TEST HOLE SEAL L ~lJ ~ L.&-I ~ 4' ~bt.y CObUrg4 ~ F (TYPICAl.) F I ,] I~" D x If~" Ixi FOOTl~_.~ L ..... I&;- 0" ...... .,- FI ~NG DEPARTME~ AT ~-1802 9 AM TO 4 PM FOR THE FOLLOWING iNSPECTIONS: 1. FOUNDATION ' TWO REQUIRED' FOR POURED CQNC~ETE 2. ROUGH - FRAMING ~ pLUMBiNG, 3. iNSULATION 4. FINAL - cONSTRUCTION MUST' BE coMPLETE FOR C.O. . ALL coNSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. sTATE coNSTRUCTION & ENERG~ cooES. NOT RESPONSIBLE FO~ DESIGN OR CON.RUCTION ERROR~ R~EV. DA'~E NATURE O,F REVISION ~'A'~m. ~,,o ~.,~.um, ~ ~ A l T'E:~ E,., ,G U l D I ,CON"SULTING PROFES~$}I,Q,,NA:,I: ,~£NGINE,ERS ~i~C.H. N.Y. ,~,1o34 t o: ? t --. - ~r~4.~/-Z ' / / ~,,.' / // '-,.~.. '-% _ ./ ~: ~ / / '. .... ~ , /~ ~ ~ --- / / It '-. NATURE OF REVISION LTER ,E:, GULDI CONSULTING PROFESSIONAL ENGINEERS WESTHAMPTON ~EACH N.y. ~. LIC.~ 51034 rlAT~E /il ['2. ~EC,'TIONJ ~E.CT oJ'q DATE NATURE OF REVISION ALTER ,E. GULDI CONSU'LTING PR, OI~?SSI~ONAL ENGINEERS,,, PT.ON B'EA~H, ..N.Y. N Y, L, IC.¢~ 5103~ 1-, C-A6E_ ~OA,D 'T~I' !JoL~ ~AUD¥ CLAy ~,AHD LdATE E. DATE NATURE OF REVISION AL~ER E. ~ULDI? CONSULTING PROFESSIONAL ENGINEERS ~