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Home My WebLink About10250-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.~gf~.~ .......... Date AUgust, 12 8.! THIS CERTIFIES that the building ................................................ 1300 Fleetwood Road, Cutchogue, New Yo~k Location of Property .. .... : ......................................... rtouse lye. Street ........... County Tax Map No. 1000 Section ...1.3.7. ...... Block .95. ............ Lot..0..0.9 ............ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .d.u.n.e.. 1. .......... , 197.9.. pursuant to which Building Permit No. ] 02.5.Q. g ............. dated ..... .J .u.n.e..5. ................ 197,9. ., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which tlfis certificate is issued is ......... ...~..~.~.~.~.~..o.,. ?..~?.~.~. ~ ~.~?.. ~..or.,.~' .??. ?.,:.~y?.~.,.. ?.. L~.,,). ~..L ?.,.~..~ ~5~. ......... The certificate is issued to ........ l,.1.i.l.l:..i .a.m..F.. :..~.a.l.~..h ................................ (ownaK,>t~g~oryt~) of the aforesaid building. Suffolk County Department of Health Approval N/R UNDERWRITERS CERTIFICATE NO ........ .N.~.5 .~.2.1.8. ................................. ? / / /'D /"/ , ,~' - Rev. 1/81 FOR!~ NO, 2 TOWN OF SOUTHOLD BUiLDiNG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~REMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 10250 Z Permission is hereby granted to: ......... ~... .~..Lz.c,~.: /..~.~:~.....~.... ........... ..... b .~.z~.~.~....~..'.~ ....... ~. ........... ~ ..~o.~:Z~6~ Z~.....~.~Y~'...z.~z.Y~.... ~.g:....~.~ ~.<Z~:~. .......... ...~. ..~ ........................................................................ ~. .................................. ~ .............. ~, ~, ~,~ ~, ..z;~.~ ...... ~.~.~.~.....&~.~.~ ....................... '. .............. / ~ ~ .............................................................................................................. ....... __ / pursuant to application dated .......... f,.-~.. ...... ./. .................... , 19. and approved by the Building Inspector. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 ~""October 10. 1~79 ~,,~.,o~o.o~,~ 0~1~ N '¢$~2]L~ THIS CERTIFIES THAT ' only the electrical equ;pment as described be~oiv and introd[wed by the apl~_~mt ~amed on the abo~e appli~ation number in the premises o~ ~illiam Welsh,Fleoct~ood Rd. ,Betaa,Cutcho~ue,~.~. in the follotving location; [] Basement [] Ist FI. [] 2nd Fl. Section Block Lot ~v...,~m;nedo~ October 4, 197~ and found to be ln compllance with the requlrements of this Board. fiXTURE [ EP i i FIXTURES OUTLETS IEC T~C~E$[ E~,.C..S [,,dC,MdD~ESCENT[t=LUO4KSCEhtT[ M~Y DRYERS FURNACE MOTORS ~TURE A~A~E ~EDERSt~ RANGES SPECIAL REC'PT, 1 100 CB R HO. OFEQU[p.X S~=..1 E METER 1~'2W I#$W 3~3W 3,~'4W NO. OF~,~CC~.COND. .,Or,",.',,. V I C E EXHAUST FANS AMT. H.P. DIMMERS OF CC. COND, NO. OF HI-~EG OF NEUTRAL 1-Ol~I M~ttLCuek,g.Y, 11952 This certificate must not ~ alter~ in any manner;, return to the office of the ~ard if incorr~. Ins~ors may be ~ntif~d b~heir cr~ntials. FORM NO, 6 TOWN OF SOUTHOLD 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- tot 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 electrica~ 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 or land use 3, Copy of certificate of occupancy $1,00 $5.00 New Building .... ~ ...... Old or Pre-existing Building ............ Vacant Land ............. House No. Street / Hamlet Owner or Owners of Property ....................................... County Tax Map No. 1000 Section .../. ~.7 ....... Block ....~. 7 ......... Lot...L~?.'~. ........ Subdivision ......... ~ ............. .~/...Filed Map No.. ~ .... Lot No. ~ ......... Health Dept. Approval .... t..//~4, ............ Labor Dept. Approval..~.//,~ ......... ;,(}~..... Under r,ters Approva, X/. ...... P,anmng Board Approva, Construction on above described building ajad-permit meets all applicable codes and regulations. Rev, 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 November 12, 1980 William F. Walsh 8 Michigan Road Bellrose, New York 11426 Dear Sir: This is to notify you that Building Permit No. 102%0Z issued ... June ~, 1979 to construct addition~ will expire on December ~, '19~0 If more time is required to complete the Job and obtain a Ce. tl£1cate of Occupancy, you may apply, ~y letter, for a six (6) month extension. If the work is not completed and the Certificate of Occupanby not iesued after the six (6) month extension period, you are than required to apply for a new building permit. Very truly yours, GEORGE H. FISHER Sr. Building Inspector FORM NO. I ' BUILDING DEPARTMEN~) a- ~ TOWN HALL SOUTHOLD, N.Y. 11971 ~ TEL.: 765-180~ Examined ,~.~:.. 19 7~ ...... Application No./C/¢/.~-~ ~ ....... Approved..~*~..~) .... , l~.Pe~t No.. ~.~ ?~ ~~ ~ ~ .............. ...,7 / / , / ................. --:: ....... ......... 7e- a. This application mus~ be comple~el7 fille~ in b~ typewrRe~ o~ in ~n~n~bmi~d in ~fiplica~ to the Bufld~n~ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee accordin~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 appl5 cation. c. The work covered by this application may not be commenced before issuance of Building Pemrit. d. Upon approvM of this application, the Building Inspector will issue a Building Pe~it to the applicant. Such pe~it shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pa~ for any purpose whatever u~til a Certificate of Occupancy shall have been granted by the Building Inspector. ~PLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Pe~t pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Re~lations, for the construction of bu~dings, additions or alterations, or for removM or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, ~d to admit authorized inspectors on premises and in buildings for necessaw inspections. 4. ..... ................... ~a~ ~ (~ailing address oiappficant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises.. ~-/.Zd~..' .~P~...~7 ~..~/.~. ............................................ (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 ..... :~.J~-~. :' ............ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. x..,? ..... ,,z ........ z:?.': .'./. ........... House Number Street Hamlet County Tax Map No. 1000 Section .../. i.~.-~. ........ Block ..... ,~.'~. .......... Lot....c~.. ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . .~.' .~.~ ./ff./JT-.F~ .... x~. ~.c;. ?. ~. ,~ ............ ............................ b. Intended use and occupancy . ~-~.. ' F' -~ ! · 3. Nature of work (check which applicable): New Building .......... Addition / Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) · 4. Lstwaated* Cost .rd..~?..z .q..c~. .................... Fee ..................................... / (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... 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. D/mensions of existing structures, if any: Front..]. gg.': ./ ........ Rear . g ~. -.~./. ....... Depth..7.~./. ~. ....... Iteight ...~. '.-..~. ....... Number of Stories ... [ .................................................... Dimensions of same structure with alterations or additions: Front .. (.~.. '.~[ ......... Rear .. ;~..~.~ ..~ ........ Depth .. ].~..~../~. ........... Height .... ~.-7 .o .............. Number of Stories.. / ................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... lteight ............... Number of Stories ........................................................ 9. Size of lot: Front 17'0,~'~.~~:. .dr'. jZ~.,.~..9~..~... Rear..J.~;.~.,..~..~ ........... .D~epth ./..g.'~.,. ~'..~': ............ 10. Date of Purchase .//2..~. 7.57.'Z52: ................ Name of Former Owner .~..~.~...~'./~..~.,Y.~. · 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ..... /b(..o .................... Will excess fill be removed from premises: Yes~-~' No 1 4. Nam e of Owner of premises b/Z~.Z.d t.~.~.. J~.- .J~.~fZ,C'~Address ~./V//. ~ ~4&~/V'. ~.~.. Phone No.~'?~... ~.~i. Name of Architect ........................... Address ................... Phone No ................ Name of Contractor J4'~.~.Z4~ ~..~../'~/./~.~,5.~.. 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK~ , COUNTY OF..~...L~.~.kd6~..... S.S ·..~'./.~..~. 4"~..~ .... .~...~ ..~..~.~.../~. ................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ............. .~D. ff~('¢5.. '.O2~.~ .Q~'.. ......................................................... (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 before me this ........................ day of.. · · .'..LJ.Y) ~.~. · ....... , 19 .:.,r3q Notary Public, . ............. ~ ~ ..... County IIIIl~l~lll~l'~ of New York ~~ Me,ch 30~ 19~/ (Signature of applicant) .F