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Home My WebLink About12740-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z12733 Date Aug. 28 19.8.4 THIS CERTIFIES that the building ................................................ 1435 Vanston Rd. Cutchog'ue Location of Property f~s'e ~o~ ....................... 'S't/e~i ...................... h~/nl'ok County Tax Map No. 1000 Section .1.1.1. ........ Block ...0.4. .......... Lot ...0.1. .3 ........... Subdivision. ~l.a,s. 8O.u..P.I;,..C.t.u..]p..P.~gP.. ..... Filed Map No..8.0.6. .... Lot No...3.3.4 ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated · .9~.t ........3.1, ........ 19 .8.3. pursuant to which Building Pem~it No..1.2.7. .4.0.~. ............. dated .... No.v. ...... 7 ............. 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 ......... One Famil~ .D.w.e. 1..1.i.n.g. The certificate is issued to ...J. 9 .h.n. ?.e..mp.s.e.y..~ .I.n.c... .................................... (owner, ,~s~ee-er- te~e) of the aforesaid building. Suffolk County Department of Health Approval ...1.3. r$9.-.4. 0. .............................. UNDERWRITERS CERTIFICATE NO .......... ~.6. 5. Q.6.0.0. ............................... Rev. 1/81 Building Inspector FO~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12~'40 Z Date ....................... .....~.....~ ................ 19.~..~ Permission is hereby granted ~[o: r~ ~¢---~-~ ~ J ..... ~...~..x...& ................................................... ~o ...~,~...~.~.~.~....~.~.~.......~....~..,~f.~:~~...,...~.... ............... ~..;~......,t~ ........................... ._..., ........... ~......~...~. ......................... ~ .......................... ........ at prem ses ocated at ]..~. ~..~.. ..~...~.....~..c~,: ....... ~..~..~....~..~...4~- .............. County Tax Map No. 1000 Section ...... }.)..~. ............ Block ........ ..~ ........... Lot No...I...~.. ................ pursuant to application dated .~..o.~.....~.1 ....................... , 19.~.....~,.., and approved by the Building Inspector. ~Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Bo This application must be filled in typewriter 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. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling land use --Pre-E×±s t±ng C.O. $15.00 3. Copy of certificate of occupancy $1.00 / Vacant iand C.O. $ 5.00 Date . .A~F...~.~...2 .~.,..! 9P.4. ...... New Building ...~ ......... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .1 .4,3,5..y~;pz~ .]~9~ ~. ¢.u.%¢~zpggC~..~ ,.~. ..... .1.1.~)~ .............. House No. Street Ham/et John R. Dempsey, I~c. Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section .... .1.~1 ....... Block ...~ ........... Lot .... 1.~ .......... Subdivision. ~assa.u.. PC.... Ol.u,'q. [¢T. qp¢:Jc.t.:J.(~.~Filed Map No...8, .0.6 ..... Lot No..~. ~.4 ......... Permit No...1.27.4P.Z. Date of Permit . .'[ 1 ,/?~.8. ~Applicant .. ~Tp.~.~...~.....D.e.m.~.s..ey.,.. ~.c., ...... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate Final. Certificate Fee Submitted $ ............................. Construction on above described building and permit ~l~'ca~ble codes lnd regulations. ~:) ~,~ i ~z_~} ~:) Applic ........... Rev, 10-10.78 THE NEW YORK BOARD OF FIRE UNDERWRITERS -~000~. BUREAU OF ELECTRICITY ~ 8B JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT ~ly t~ e~tr~al equipment ~ ~sc~ ~ ~d int~uc~ ~ t~ applic~t ~ on t~ ~b~e applicat~n ~um~r in t~ p~mis~ of in theyollowing location; ~ B~ement ~ 1st Fl. ~2nd Fl. Section ll~to¢~ ~ fuel3 ~ ~ ~ ~ and found to be in compliance with ~he requirements of this B~rd. FIXTURE FIXTURES RANGES COOKfNGDECKS OVENS DISH WA~ EXHAUST FANS OUTLETS ~ECEPTACLES SWITCHES DRYERS FURNACE MOTORS FUTURE APPLIANCE ~EE~ERS SPECIAL REC'PT TIMECLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS SERVICE DISCONNECT NO. OF S E R V I C E METER ~ ~ ~ ~ ~ ~/0[ [/0 OTHER APPARATUS: This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credenfio{s. ARTMENT. THIS COPY OF CERTIFICATE MUST NOT SE ALTERED IN ANY MANNER. 6 FieLD INSPECTION FOUNDATION FOUNDATION 2. (1st) ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. Y. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: 76s,1802 · BUILDING DEpT, INSPECTION · [ ] FOUNDATION ZST [ i ROUGH PLBQ. FOUNDATION 2ND [ ] INsuLATibN FINAL ['] FRAMING REMARKS: t t 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND INSULATION FRAMING [ ] FINAL REMARKS: DATE INSPECTOR 76~-180~ BUILDING' DEPT, INSPECTrlON [ ] FOUNDATION 1ST ~ ROUGH pLBG, [ ] FOUNDATION ZND [] INSULATION FRAMING [ ] FINAL REMARKS: . ~' DATE FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 76§-1802 Examined .~ .113/.fi4~....~..~...., 19 ~.~ Approved ]~ ~...~....'? .... 19~. Permit No./..~.'2..~. ~.~.. Disapproved a/c ..................................... ............................... '.:..'c ........ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date .O.C;..~.~k'k-. ~..k.., 19.~ 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 inspections. ............. (Signature of af0plicant, or narfie, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ................................................................................. Name of owner of premises . .~.0..k~..~...k~., .'p..~.tt~x.~ ~. ~..N{,..~..~..C: ..................................... ~' (as on the tax roll or latest deed) If applicant is a co--ion, signature of duly authorized officer. Q,.~--(Nzme ar~ tTd~ ~T"c%~pora~e officer) Builder's License No .......................... Plumber's LicenseNo ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .... ~, ...................................... ~~ ~ ~ ~ ............................................................. Street Hamlet County Tax Map No. 1000 Section .. XX.~ ............. Block .... ~ ............ Lot .... ~ ............ Subd~v~smn~=>~.. ~, ~9~.. ~'~ ~. Filed Map No...~.~. Lot .~. (N~e) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .~¢~. ~....M~. ~D ............................................ b. Intended use and occup~cy . .~*..~.~ .'~¢~X~¢ ............................... Nature of work (check which applicable): New Building ....~.. .... Addition .......... Alteration .......... Repair ........ ; ..... Removal' .............. Demolition .............. Other Work ............... i (Description) · Estnnated Cost ........................ Fee .................. ' .................... (to be paid on filing this application) $. If dwelling, number of dwelling units ............. Number of dwelling units on each floor ............... If garage, number of cars .... i ....... ~ .......................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front.. ~\.~ ......... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... i.. Height ................. Number of Stories ....................... 8. Dimensions of entire new construction: Front ~.'~i( .~ .O~' ...... Rear. (o.~.~. .~.~. ". ...... Depth .~.G.t. ~Q ? ....... 9. Size of lot: Front . .~.Q.~....O .~. J ........... Rear . .~O~. .................. Depth ~..~ ./.o~ ~'.~ ........... 10..D. ate0fPurchase .~.J.g} .... i .................. Name of Former Owner .~.a;\.~.~.~.~..c.~-~.0.~ ............ 1 1. Zone or use district in w~ich pr~mises are situated..[:~.$.~y}e,~.'~-lr~.~ ..... . .............................. ... 12. Does proposed construction violate any zoning law ordimt~ce or regulation, .~ ................. 13. Will lot be regraded .[q.~ ..... i ................... Will excess fill be removed from premises: ~ Yes No No. Name of Architect ........................... Address ................... Phone No ................ Name of Contractor ........ ,. ................. 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 block inumber or description according to deed, and show street names and indicate whether interior or corner lot. , STATE OF NEW, Jv~RK, ,~ ,, "/~i COUNTY OF. ~~,:S'S ...... ,.,.....'~----~.--~..~.,..vx,,, ---o-,,,,,, - _ . . · ...... tt~ame oI ln0.1VlClUal signing toni;fac[ above named· I (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 application; that all statements contained in 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 filed therewith. Sworn to b6fore me this ~ew York Notary Public, . ........ being duly sworn, deposes and says that he is the applicant OLD co, rAy ~,,~. F I'~05,.~HOV,~N P-.EF~kLTO MA~ Og N~E,~-~I~.~' PoIr41 d e s58"44'oo"w. If copper tubing is used for water distributing sys;em; piping shall be of types K or L only ...................................... I