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Home My WebLink About12506-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z12714 Date ...... August 20 19 84 THIS!'CERTIFIES that tile building ......... .p.o.o..1 .................................. Location qf Property ..... 2.9.7.4..5 Main Rd. Cutchogue i ¢¢ouso/ye. Street Hamlet County Tax Map No. 1000 Section 102 .Block 2 .Lot 13 Subdivision...... ..... .x ............... ....FiledMapNo. .......x .Lot No .... .x......... conforms substantially to the Application for Building Permit heretofore filed in this office dated 12506Z Ju.ne 22 19 8.3pursuant to which Building Permit No ................ dated ..... .J.u.l.y..2.3. .............. 19..83,. 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 ......... .......... Rq9~ ................................................................ The certificate is issued to JAMES & CAROL HOUSE (owner, of the aforesaid building. Suffolk County Department of Health Approval ....................... N. [.A. ............... N623..10S UNDERWRITERS CERTIFICATE NO ................................................ Building Inspector R~. 1/61 FORM NO. 2 TOWN OF $OUTHOLD BIJILDIHG DEPARTMEHT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 1250~ Z Permission is hereby gronted to: .......... , ................. at premises located at ...~....~...?... ~ .~ .... ~ ...... County Tax Map No. 1000 Section .... .]....~..~ ....... Block C:~ Lot No.. ) ..~. ......... pursuant tO application dated [ ,~.~o~ ..... ..-~......-.~.. ........... 19.~..~., and approved by the Building Inspector. ' ......... ~ ........... Fee $..[..~..:.i ........... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N,Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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 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. 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 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. ;/~ ees: · 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/landuse--?re-E×±st±ng C.O. $15.00 3. Copy of certificate of occupenc¥ $1.00 Vacant land C.O. $ 5.00 Date .... Location of Property ,,, ~P,~, 4frP ..................... !.c.~fA ~ .~ ~Y ................ Owner or OWners of Property ...~.. ~ j. . ~ .............. · ...... counWTax Map ~o. ]O00Secdon~]O~ ............... Block ~ Lo~. ~ ~ F~ied Map ~o ~ Lo~ No ~ Subdivision .......................................................... Permit No. .'~. . Date of Permit . .Applicant .... 5~.~ .......... Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval. ~ ~..~ ~ ~ ...... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... ~' ....... ...... Construction on above doseribod building and~rmit m~Zt ~;cablo codes and regulations. ............................... FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) COMMENTS ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FiRE UNDERWRITERS l(~03~'~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 1003~ THIS CERTIFIEB THAT only the electrical equil, rnent as described below and introduced by the applicant named on the above application number in the premises of Jim l:k~uae~ Main Road~ (DepOt & in the followlng location; [] Basement [] 1st FI. [] 2nd FI. Otl~id~ Section Block Lot was examined on and found to be in compliance with the requirements of this Board. l~bv~nb~r 3~ 1988 FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FtUORESCENT VAPOR t 1 1 1 DRYERS MOTORS TIME CLOCKS UNIT HEATERS DIMMERS SYSTEMS NIO. OF FEET SERVICE DISCONNECT S E R V I C A W.G! NO OF HI-LEG A,W,G, NO. OFNEUTRALS A.W,G, -~ia~_ ~,' i~ooli Tb~ o~rtl£i~te cov~r~ ~1~ at ~ ~t~ ~ i~ti~ only. Cba~'les ~. H~ll Elect. 7~0 Long C~'e~k Drive Southold, NoYo 119?1 This certificate must not be altered in any manner; return to the office of the Board }f COPYOF C£FIIIFII Inspectors may be ,identified MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Examined... ~.~t,t..~,~-.., 19'~.~-. Approved ..0~.~t . .~...~.., 19~. $. Permit No. Disapproved a/c ......... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No.. I..~...~.-7.~. .~ .... Date ........... ~.~ 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 cod,~,, and regulations, and to admit authorized inspectors on premises and in building for necessary in~. ~,//' ' - ''' i~~~t,~~./r6~k~.or name, if: 'c;;~;;a'ti~) .... ...... · ·. .......... State whether applicant is ~ lessee, agent, architect, engineer, ge~ractor, e~c{rician,~T'lblumber or builder. Nameofownerofpremises./t~,~-~ ?.~..~.~.'(--,)~ ................ /'~,~..'T--. ~6/ '~.. 'O't'.''/~''~/.~ /[ (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 ..... .~. ~.b..~ .......~..,~....o5~. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ................................................. ... I. 1t 5' ,~N~" ~: Street :.'~u;',ty ~-a~',M~"~o. 1000 ........ Section ..... ................ Z~. ~,~.'.-~. ~lock ......... ..... .~... .~Tt~:: ~:: ~'~ ~ ~ ~ :~. : 5 'Sub~Nisi°n .... ~"" (k~)~ Filed Map No /~ 27 ;c~ate e~i~i~g U~e :and occupancy of premises and intended use and occupancy of proposed constr~ction: a. Exis}ing'hse and occupancy . . .................. 3. Nat re of work (check winch a~phcable): New Building .......... Addition .......... Alteration ......... Repair .............. Removal .............. Demolition .......... Other Work ~/~ (Description) 4. Estimated Cost /~.,;?'A~ .,,.2f/),~..~r~.//~..ffO ...... Feeff/;5100 (to be paid on filing this application) 5. If dwelling, number of dwellin~ 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 ..................... ~.' Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... /~- Height ............... Number of Stories.. ~ .................................................. ~,/a~t~--Dimensions of same structure With alterations or additions: Front ................. Rear .................. ' Depth ................... !... Height ...................... Number of Stories ..................... 8. Dimensions of entire new consfiruetion: Front ..... ,,'.2:.t ....... Rear ............... Depth .~'./: .......... Height ..... ~( ........ Number of Stories ...... ~. ~.0..c.;. ..... ~ .............................. 9. Size of lot: Front ...... 2' ' '! ............ Rear ...................... Depth ....................... 10. Date of Purchase .... ~..,~. a~'~ ................. Name of Former Owner ...~l~l~..~~.~~ 11. Zone or use district in which premises are situated ..... ,~3 .............................................. i2. Does proposed construction violate any zoning law, ordinance or regulation: .~ ......................... 13. Will lot be regraded ~,,c'Y4~... I ..................... Will excess fill be removed from premises: Yes 14. Name of Owner of premises.. ?~"-'-'-o. OD:-.. ~.Address ................... Phone No. Name of Architect .... ~ >,..,~ :..,. ~, .... .~.. ~. :'~. Address ................... Phone No.. i ' i i ' '... Name of Cortiractor .. (.,g'~../~-p-f(..~ J. Address ................... Phone No. ~ozrp-e,._ PLOT DIAGRAM · Locate clearly and distinctly ali 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 corner lot. STATE OF NEW,YORK, COUNTY/~ ..~. :,/. ,~'~ ' · · ~ :~ '..' ~' ,~.-~2 .~;~'~./: ................. being dulysworn, deposes and says that he is the applicant (Name of indi~i~r~a~ signing contract) above named. He is the .' ~ (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 ~ this application are true to the best of his ~owledge and'belief; and that the work will be perfomed in the m~ne~ set forth in the application filed therewith. ' Swam to before me this ~ ' ....... ..... dayof ..... ~ .... 19~ : N~ ~4~117~, Su~lk ~u~ - ~ (Signature qf applic~t) L~a~d oF K,~4'vi~n~ I&~-is+opowi'c3 [Mi[. .~ ALIC~ j. ROSF. NF~:LD CUT'CHOGU~ LC.,,, & o$ ' 't