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Home My WebLink About12656-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14313 ~ Data April 11 1986 THIS CERTIFIES that the buildingqN. E.. F.A.M.I..L.Y..D..W.E.L.L.I..N.G .......................... Location of Proparty 60 Emory Rd. & 2305 Little Neck Rd. Cutchogue - ~/~S~- ~0: ....................... ~r*e,~ t' ....................... //~/'e ~ County Tax Map No. 1000 Section .... 1.0. 3. ..... Block ....6 ........... L3o~ ................. Subdivision .. Sp~r~y. ~y~Qv..e~ ............... Filed Map No..3.2.3.1 .... Lot No....6 .......... conforms substantially to thc Application for Building Permit heretofore filed in this office dated · £.ep~....26 ........... 1983. pnrsuant to which Building Permit No.. fi.2..65.6.Z. ............ dated ...~. q .L .o .b ?. v. . .3 ............... 19~. 3.., was issued, and conforms to all of the requirements of tha applicable provisions of the law. Thc occupancy for which this certificate is issued is ......... · .O.v.~, ~.aroi~y..4~t~J-.],%vg ......................................................... The certificate is issued to ALBERTA & WILLZAM JACOBS (owner, ~X ~)~SrO0 of tha aforesaid building. Suffolk County Department of Health Approval ..... 1.3. .- .S.O.n ~..6.5 ........................... UNDERWRITERS CERTIFICATE NO. N 6 4 1 9/4 0 Rev. 1/81 Building Inspector FOII~[ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12656 Z Permission is hereby granted to: ..... ~.~~....~..~.~' - _ .~ ................. · .......~.~.~....~-~~.~__~...._ ,,~,~; ........ ..~,,,~.. "' '~.~...~..:~.;.....u...~.~.~ .......... , ~ ,o ................ ~.?.,~ ....... ..L~:.~l..%~.~...~.d.: ............. ' .................................... ........... ..,,...~....~., ....... ...,..,,.~...~ ........... , ........... ..................................................................... Count*/ Tax Map No. 1000 Section .... ~...0...~. ........ Block ...... "..~ ............. Lot No .....~.....c~...J ~. /_ Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD 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 I ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate ~ocation of al~ buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supplv 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. Plannh~g 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 p~:operty showing all property lines, streets, buildings and unusual natural or topograph ic 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 inform+ tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 4oVacant Land C.O. $5.00 5.Updated C.O/ $15.00 Date ........ New 8u[Jding ............. O;d or Pre-ex[stisg 8uildiog ............. Vacaut Land ............. Location of ~rop y ...................... ,,/,..t~.~ ...: ............. '.'.~...---/ HouseNo. ~ ~/// i;~ ~ Stre~ ' H~mNt ~ Owner or Owners of Property . ~. ~.~.~.~~.~. ~ ................... 000 S .t o. .... ..... ,,oc ........... ..... .eaR. Dopt. Approval . ~[. ~.~. :t¢0 ......... labor Dept. ~pproval ........................ Bequest for Temp~ary Certificate ..................... Final Certificate ........... Fee Submitted $.. ~.. ~ ...................... Construction on above described building an,~.~it .me:ts all applicable/~odes and regulations. Applicant....~..~..~..%.~..~ ................. 113502t THE NEW YORK BOARD OF FIRE UNDERWRITERS ]aS BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date April 26, 1984 ,'pp,ic,tio,,No. onSile 2 5 .35--1S4 N 641940 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant ~amed on the abo~e application number in the premises of William Jacobs~ Emo~y Rd, Cutchogue~ N.Y. it, tbe yollowing location; [] Basement [] 1st FI. [] 2nd FI. Att i C ' Section Block Lot was examined on A ~}Z'~ 1 ~ ~ ~ ~ ~84 and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST OUTLETS 9 24 ~L0 9 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIMEC/OCKS UNIT HEATERS MULTI-OUTLE1 SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: Motors; 1--F. 1-Snoke Detector 1-4o5 KW. Hot Water Heater S E R V I C E AW.O, OF CC COND 4 OF NEUTRAL Three "C" Elect., Inc, RT. 1 Box 45M Sound Ave. Riverhead, N.Y., 11901 LIC.#3327 This certificate must not be altered in any manner; return to the office of the Board if incor,rect, Inspecto~ 30PY OF, GENERAL MANAGER / Per may be identified by their MANNER. FIELD I~S?E~TION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY FINAL ADDITIONAL COMMENTS: FOB~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT 'TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined..Q)...~...~..%. J.., 19 ~.~. Approved ...¢T~. !.., 19'~.~. Permit No..J..~..G. ~ .~ Received .......... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by Wpewrit~er 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 {>f 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, a~nd regu~ati0n?, and to admit authorized inspectors on premises and in building for necessary ins~,~cd~ion~ ~ /" I.~ f_/ ..... ,,, ........ (Signature of appli,ca~;; ~ }~.' corporation) · ? " ~' (Mailing address of applictlnt) (/~,~5'~ 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 duty 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 ...................... ~.~ /~/5 ~ I. Location of land on which proposed~ork will be done .................... House Number Street Hamlet County Tax Map No. 1000 Section ../.~.~ .......... Block ..... ¢ .......... Lot.~ ~/ Subdivision .... .~.~. ~&~ .. .............. Filed Map No. ~ g.~/ ......... Lot. ~.. / (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Exist ng use and occupancy ........................................................... b. Intended use and occupancy ....... ~. ~~..~.~~ ................................. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Rem6val .............. Demolition .............. Other Work ............... 4. Estimated Cost ........ /,' ....· ........................ Fee ~ ''~ 57 0 (Description) I (to be paid on filing this application) 5. If dwelling, number of dwelling !units ..... ..........f 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 ...................... a. Dimensions of en~ir~ new constm, ction: Front .. ,?~..~.. ........ Rear . i~.6; ........... Depth 'i ~.' ~.' ........ Height ....... e.. 7 .....Nurober of Stories ..... /. ~.'~ .;Y~.. ......................................... 91 Sizeo~lot Front ..,.//..o.....~. ........ Rear.~,(.~.: ................ Depth ,/.$~.,5..ff.. 10. Date of Purchase ........... i .................. Na~e o f F~orn~.O_wner ............................. 1 1. Zone or use district in which premises are situated ...... /~-*-r~ .................................. 12. Do~s proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ...... ,./PFP. :..: .............. Will excess fill be removed from premises: Yes 14. Name of Owner of premises ~r.d..~... 14~iz').-f;.... Address ................... Phone No .............. - . .~.. Name Of Architect . .......................... Address ................... Phone No ............... Name of Contractor ..t~. y)~.. ........... Address../~..~,/<~.....~:.:.:.:.:.:.:.:~%...' ..... Phone No..7. ~.~/.'x.~5.-~././..c~. PLOT DIAGRAM Locate c/eariy and distinctly a/1i buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE~,V ~'~, ./.d, .'/~;~ '~ ~ ..... ... ~ .~.~..¥'7~. · .~. ?.; ....... being duly sworn, deposes and says that he is the applicant (Name of individual s~niflg contract) above named. (Contractor, agent, corpo?ate officer, etc.) of said owaer or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and file this applichtion ;l that all statements contiined N this application are true to the best of his ~owledge and belief; and that the work will be peffo~ed in the m~ne'r set forth in the application filed therewith. Sworn to b~fore me this .... ..... I ] N~RY PU*LIC~t~. ~ ~ew Yor~ W ~ (Signature of apphcant) ~ ~o. 52,8125550, $uffol~ CO~ ; r~;m [xnirga March ~. Z // 'it SUFFOLK CO. HE^ T. DEPT. H. $. ,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. (st APPLICANT SUFFOLK COUNTY DEPT OF HEALTH SERVICES -- FOR APPROVAL OFi CONSTRUCTION ONLY DATE: H. S. REF. NO. '~":%P '~]!'~; APPROVED- t i- SUFFOLK CO TAX MAP DESIGNATION: DIST. SECT BLOCK t,-.~.. OWNERS ADDRESS: DEED: L. ?,;//,E~ p. TEST HOLE STAMP SEAL .z t i b RC ~;- ' · LICENSED l~IND'~. ,~: :':/.::;. , GR EENpORT sTATEME THE sySTEMs~ FOR THIS CONFORM TO~ THE SUFFOLK SUFE'C)IZK :. COUNTY i S-ERVICE~ -- FOR ' APPRO~VA~ CONSTRUCTION ON ; ' ~ H. S. R~F. NO.: