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Home My WebLink About10492-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. Certificate Of Occupancy No..g ~ .42.7. q ......... Date .......... A. p.p.i.~...2.9 .............. 19 .8.6. THIS CERTIFIES that the building ....S.t.o.p.a.g.e..B.u. ~3.d.~.n. g .......................... LnaatinnnfPrnnarfv 2745 VANSTON ROAD CUTCHOGUE House No. Street Hamlet County Tax Map No. 1000 Section . . .1.1.1. ...... Block .. 9.6 ........... Lot ...0.0.8. ........... Subdivision .~ .a.s.s.a.u.. ~.~. :, .C.~.u.b., .P.r.qp e. F.~.7' .Filed Map No ......... Lot No. 3.5. .97.3.6.0. ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated Nov. 13 197..9 10492Z ·, pursuant to which Building Permit No. dated ...~ o. y ....2.3 ................. 197. 9., 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 ......... Build storage building for materials & equipment customary to ~'~i 4'~'½ 'i~i'~ ~ h'g~ ~' '~'~' i' '~6~'e'~& ~'f '~'~'£~ ~Yt'~Y '~'a'~ ~h'. ........ The certificate is issued to ....... ~ D.14/t E D..&. J Og, I~. ~ ~[~I.D.I~ ~ Mg.I~ ~1 ....................... (owner, ~?~eXo~ ]Celge%~,,/X X of the aforesaid building. Suffolk County Department of Health Approval ..... N/A UNDERWRITERS CERTIFICATE NO. N 712071 Building Inspector Rev. 1/81 FOR~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 10492 Z Permission is hereby granted to: ..:~:.'...: ......... t ...... '~....:.:/~.'~ ...... ~..~ .................... ~ ~f~ r~ td ..~.Z~i.?..!.f:..L....~ .......... !~.L'.~Z.~...~.~?f. .... ~.?...r~.u..~.~..¢..~.~..:r. ........ ~.~.~.~..~,~.~c..~ premises located .......................................................................................................... ~'~'a"~; ........................................ r-C '/ '~ 19.2C~:, and approved by the pursuant to application dated .................................... Building Inspector, Building Jnspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m ~ 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 p~operty 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 houmng 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 $15.0 0 3. Copy of certificate of occupancy $1.00 5.updated C.O. $15.00 Date ....~. .......... New Build,ng .... ~ ....... Old or Pre-existin~.g Building.~ ........... Vacant Land ..... .~_ ...... Locat,on of Property jo.~.~. ~,.y .~'~....~.~.~'.~? ./?/...~.z~. ~tr~,~t. ...... ~~~/' 'H~e~ County Tax Map No. 1000 S~ctio~././~ ......... Block ...~ ........ Lot..~ ....... Su, ,v, ,on ................ ¢ Permit No. ~.~.~ate of Permit ~Applicant ~ .~~~. Health Dept. Approval ...... ~ ........... Labor Dept. Approval .... ~/~ ............. Unde~riters Approval ~ Z.~ ....... Planning Board Approval .. ~/~ ............ Request for Temporary Certificate ..................... Final Certificate~ .................... Fee Submitted $...~ ............... _~.. Construction on above described bu ,,ding ~~~i~::::d::r~ations. Applicant ~.~ ..... ~..//~.~.~ ........ ~ ......... THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRI(~IT¥ ~ 88 JOHN STREET NEW ~ORK, NEW ~ORK 1003~ THIS CERTIFIES THAT only the electrical equipment as described belair and introduced by the applicant ~a~ed on the above appllcatiott number itt the premises of in tke following location; [] ~a$ement ~ Ist FI. was examined on ('~,O~Of:~, ~ ),~)~ [] 2nd Ft. Ga~ Section].] ] Block 0~ and found to be ~n comphance w~th the requirements of this Board. rot 008 OUTLETsFIXTURR SWITCHES FIXTURES OVENS DISH WASHERS EXHAUST FANS FLUORESCENT OTHER APPARATUS: E R V I C NO OF CC COND PER ~ NO OFNEUTRA($ AWG OF NEUTRAL Ed~','a:~ F. tLb~clera~mn GENERAL MANAGER ~ Th~s certihcate must not be altered n any manner; return to the office of the Board if nco re~t ns ecto~s m ........ ; . ~ . ~l~ i ..... "~ ' ~F~AN.Y~ANNER' ~ ~L ~/,~ I~ f ~ C'~ 5 F'i f,..;/ax I / / %~.,/ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved ~4~f ?-~ 19~¢ Permit No ........... Disapproved a/c ...... ~----.-..~------ ........................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No. /.~. ~(-.?. · .~-~ .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 fssuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue 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 de~6~,ition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing//5ode, and regulations, and to admit authorized inspectors on premises and in buildings for necessar~nsPections, c~ ,~ ,' y . .... (Signature of ap~lildant, or name, if a corporat'o ) .,. .... ....... (Mailing addres~f applidant)~/ ls~ssee, agent, architect, engineer, general contractor, electrician, plumber or builder. State whether applicant (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 ..... ./:/..~..4~..~7~ ............ Electrician's License No....~...~..~.L~.~ ............ Other Trade's License No .................... 1. Location of land on which proposed work will be done ............................................... House Number Street Hamlet ~ounty Tax Map No'. 1000 Section ..... .g'~./. ......... Block O ~ Lot O~30~ s.. )P o .............. uouivision ~-.~rv ...... ~ .....' ......... ~..- ...... Filed Map No ............... (Name) 2. State existing use and occupancy of premises and ifltended use and occupancy of proposed construction: a. Existing use and occupancy O~V.~..~.~.~Z~!./-.~....~..~.~./../d.zO~'~ ........................................... b. Intended use and occupancy ~4:7../~..~....~./~. v~x(.'~..~(-dF~4P~/~A~.~, g'7.~e47..?.~4/(ffiA4rz5 .~..~. ..... New Building~O 3. Nature of work (check which applicable): ... ~.~.~¢.'. Addition .......... Alteration .......... Repair .............. RemQval .............. Demolition .............. Other Work ............... ! ~ /. ~- (Description) 4. Estimated Cost ........................... Fee ..................................... (to be paid on filing this application) 5 If dwelling, number of dwelling enits ............... ~-' Number of dwelling units on each floor . .-w-.. . . Ifg b arage, num er of cars ..... I ................................................................... 6. If business, commercial or mixed occupancy, specify na:tu~e and extent of each. type of use ......... ,,,.../ ........ , ~ -.O. .,..d...C, '- O. pth ..~..O. ' ?. Dimensions elf existing structures, if any: Front...: ...... Rear .......... De ........... ' /.~.~..4..o'~..- N ntb fSt Height. . u er o ories ................................................... Dimensions of same structure w~th alterations or additions: Front ........ .-"; ....... Rear ....~-'. ............. Depth ~ Height Number of Stories 8. Dimensions of entire new construction: Front .... ~..(9.' ...... Rear ...,~ .(~. ' . Depth .,,~...O. t Height .l?.I. .4-...o?:. .....Number of Stories .... O. ~..~. ............................................. . · ' ~_o ' Sc>c> h ~.Q~- 9. S,ze of int. Front .... ~. · · ~ ,1. .......... Rear ...................... Dept ................... 10. Date of Purchase ..... [ .~.9..~....' .............. Name of Former Owner ....t,r~..2~.~.u.c~. .... ~ .......... 1 1. Zone or use district in which pr~mises are situated ..... Z~a. ~..~.&.~..~..~,~../~-.../..(~.~/tg~. 7./~ .~. ..... 12: Does p~oposed construction violate any zoning law, ordinance or regulation: ..... ,~, ,'¢ ....................... 13. Will lot be regraded ......... i./Yr. ~ ............... Will excess fill be removed from premises: Yes · F ~t~' *' ,¢ ff., ~- 14. Name of Owner of premlseSz?~ 2. . ... f.-..: .~/~-J~42J.). Address ~.,e. ~-4/¢.~., ..... ~.... Phone No. 7~..~. 7~.?.~.. .... Name of Architect ............................ Address ................... Phone No ................ Name of Contractor ..... ~,~..a -:./-. ~.~. ............ Address ................... Phone No... ............. Locate ~learly and distinctly all property li~es. Give street and block interior or corner lot. PLOT DIAGRAM buildings, whether existing or proposed, and, indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether 0 STAT'E OF NEW YJ~RK' SS' COUN ...... . 7;d .d.C..h .'2¢..¢. being duly sworn, deposes says that he is the applicant (Name of individual signing contract) above .named. i Helis 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 fie this application; that all statements cont0ined 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 before me this Notary Public, . . . . ~ ....... County N~us°?, ~ ~.°'~-~, rS,gna, fpp,cant) NOTAR ~v Yor ' trite o a ' ] Nc. o2-4522026 - Suffolk ~ounty Commission l~xplre~ March