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Home My WebLink About12703-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Ho., ,z),2. ~..o.9 ......... Date ....... q.??..S. ................... i9S. 4., THIS CERTIFIES that the building rrlle.~.. ~.w.q[..l~.n. cj ............................... Location of Property ..5.87~.Pe.quash Ave. a 95 Eas~: Road Cutchogue ho~ No. ' .....................~/~; .......................h~A, io~ County Tax Map No. 1000 Section . .1..19 ....... Block ...0..6 .......... Lot 011.1 Subdivision ..... }[ ......................... Filed Map No .... .X .... Lot No...X. .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... A..nq.u.s.t...2.3 ..... ,19.8.3. pursuant to which Building Permit No .... .1,2.7. .0 .3..Z. ......... dated ...... Qc..tp.b.e.r...2.8. .......... 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 ......... ...... ~. p.r.~,w.~.e..o. ,n.e.-.g .a.m.~.~.~..~.w.e. % .~.~.n.c~: ...................................... The certificate is issued to wIL..L.I..Aki. &..S.U. SAN T. RAWICK ........... h,¥.'~r, '~;,~-eY dr~b~) ...................... of the aforesaid building. Suffolk County Department of Health Approval .. ~ 3 :'~q.Q'7.1 3.4. ,...3/.2.8./..8.4.,...Rg?.~' :. ~....V.J: .1.k.a, UNDERWRITERS CERTIFICATE NO .......... kq..6.3.8 ~. ~.4 ............................... Building Inspector Rev. 1/81 lrOF,~ NO. ~ TOWN 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) 12703 Z Permission is hereby granted to: ............ ~).o.~.~:~. .~ .,... ~..~:l .~ ...... U .~. :~.. ~ .... ~ ........................... ~.2~ ........................................................................................................ at premises I~ated at ................................................................... ~ ............. ~ ...................... .~. County Tax Map No. 1000 Section ....... L.!....°.. ....... Block ......... .~.~. ........ Lot No.../..!.:.../. ............ pursuant to application dated .~.S~..L..~..:.~.~..~......'.~...i.~.. ............ , 19~.~., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,"jouthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in Wpewriter 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling / land use --?re-Ex ±s t,±ng C.O. $15 · 00 3. Copy of certificate of occupancy $1.00 Vacanf, land C.0. ~ 5.00 ,~ Date , ~ .............. New Building .... 'X ........ Old or Pre-exi~ing Building ........ ~.~cant Land ............. ........ Location of Property ..... /.¢. Subdivision.. *. . ~ . .%...L,~'. ;m.'~..Filed Map No ........... Lot No .............. ... Date of ~ermit ¢~¢.-?~Applicant ~;~.d?~¢..I.~ [~{~:.,~,.~/[;.;'. ~t-.I ('. Unde~riters Approval ~' c, / ~ Plann ng Board roy, ............. ..... ~equest for Temporaw Cortificato ................... 'Final Cort[ficato .................. Fee Submitted $ ............................. Construction on above described building and p,ermit meets all applicable codes and regulations. ~ __ f_~\ Applicant ...kf,E ...... ...~..~/~.'(.~..C~b.~.....~..l~.'~..'' ..... 85 M~II Road · Box 966 · Westhampton Beach · New York 11978 · (516) 288-6840 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000143 BUREAU OF ELECTRICITY 8S JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment as described below and i~troduced by the applicant ~med on the abo~e application number in the premises of in tbefollowlng location; ~ Basement ~ 1st FI. ~ 2nd FI. Section Block Lot was exa~ined on ~'~ ~ ~ l~ and found to be in cot~pliance with the requiren~ents of thls Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FAN~ OUTLETS FLUORESCENT DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E E V I : C OTHER APPARATUS. ~o~or~: 1-4. Skw., hot water heater. 2-G. F .C. I · 2-~nake detector NO OF CC. COND. PER 4/O NO. OF NEUTRALS 4/0 Lic#102~ This certificate must not be altered in any manner; return to the office of the Board i~f i[tcor,[ect. NT. THIS COPY~ OF CERTIFICATE MUST GF~4E~AL 11 / may be identified by their FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION FER N. STATE ENERGY ~ODE FINAL DATE COMMENTS £ / ADDITIONAL ~OMMEN FOUNDATION FOUNDATION AND [ ] INSUi~TI~ ~k~FINAL · ,INSPKTOR ~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH 'PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL DATEr '' INSP£~i 76S-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND £ ] INSULATION FRAMING .~ FINAL REMARKS: 765-t802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND[] INSULATION ~[~/%],~FRAMING //~li~.~ .,, , ....... REMARKS: of je~~e fio,O01 HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT N NEAREST WATER MA N~MI. - HSOURCE OF WATER= P~RIVATE *./pUBLIC N ~UFF CO, TAXMAP D~ST tDoo SECTION 119 ~.OCK.-~ LOT te/o It K. THEI~ ARE NO D~EI. LIN~$ WITHIN I00 FEET OF TH~S FROPERTY OTHER THAN THOSE SHOWN HEREON. ADDRESS SURVEY FOR WIL/_/AM TRAWICK ~ SUSAN TF~AWICK AT CUI'CHOGUE TOWN OF $OUTHOLD SUFFOLK COUNTY. NEW YORK .u~uT.omzEo ^LTERAnOH ON AOOIT,O. m mis SURVEY eA V~OCAnON OF .CT,O. ?ZOS Or NEW YORK STATE E~CATION LAW ffCOPIES ~ ~lS ~VEY HOT KAR~G THE LAND HO[B~ CONSIOEREOTO B[AVALIO T~UE COPY ~GUARAN~ES INDICTED H~REON ~ALL RUN ~LY ~ ~R~ FOR WHOM THE SU~EY IS PREPAREO ANO ~ HIS BEHALF ~ ~HE TITLE ~P~Y, GOV~N- MENTA'AL A~ENGY ANO LENDING INSTITUTION ~ISTED H~E~ANO TO ~E ASSIGNEES OF THE LENDING INSTITUTI~. GUARANTEES ARE ~T T~SFERABLE TO A~ITIONAL INSTITUT~S OR SUBSEQUENT OWNERS ~OISTANCES S~WN H~R~ON FROM PR~ERTY LINES TOEXISTIN6 $TRUC~RE$ ARE FOR A SPECIFIC PURPOSE ANO ARE NOT TO BE USED TO P~P~TY LINES OR FOR THE ERECTION ~ FENCES DATE: SCALE: NO. NOV, 30.19~$ · 3 - I BRANDIS & SONS, INC. 1618 I ..L. YOUNGe, I YOUNG YO.K I II~ ~ I ~[" w.~ou.~,..o~[ss~o.G~ [.Gm[[. I I II~1 '"~ ~"~ ,v,o, ,.,.~c~,, ,o.,,~, I I ~ L~T~ ~ ~L(W),~IC TANK(ITIaCE~OLS(~) ~N ~E~ I[ ~ ~ J N.~S. LICENSE N0,45893 SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. THE WATER S~LY AND ~WAGE D'IS~SAL SUFFOLK COUNSY ~P~, OF / H~LTH CONSTRUCTION ONLY ~ ~: ..... I /~ ~ ~ [0 ~ A VALID ~UE COPY, NI2062 · , f~eet I STORy ~acilitie~ f~ ;" ~ io~ation have tnsp~Cted by this deCar%ment ~d fo~d , Chief ~f G~iral E~ineerl~ ~rvic~ ~ALTH D~PARTMENT-DATA F~ APPRO~ TO C~STRUC T NOT. Et · = MONUMENT ~ = STAKE' BRANDIS & SONS, INC. 1618 SURVEY FOR WILL~AM T/?AWlC/~ E~ AT CUTCHOGUE' TOWN OF $OUTHOL. D '~UFFOLK COUNTy, NEW YORK SUSAN Tt?AWICt YOUNG a YOUNG ALDI~N W. YOUNG, PROF'ESSlONAL ENGINEER AND I~AND SURVEYOR N Y.S. UCENSE NO. 1:~84§ HOWARD W. YOUNG, LAND SURVEYOR N.~ S~ LICENSE N0.45893 DATE: SCALE: / NO. ~3" 1059 GUARANTEED TO, WIIII,4M 8 SUSAN TR,4WICK ~ 400 OS'lEaNDER AVENUE RIVERHEAD, NEW YORK