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Home My WebLink About10114-zF_ORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector- Town Hall Southold, N.Y. Certificate Of Occupancy No..Z.~ J 5.3.7. ......... Date ....... .lVl.~.Re..h. ?. ................. 198..~. THIS CERTIFIES that the building . ~ .~o..e.e?.s..~.~?. .................................. Location of Property 405 Beachwood Road Cutchogue, N.Y. House No. Street Ham/et County Tax Map No. 1000 Section q~.G .Block OZ~ .Lot . 025 Subdivision...B.??.h.~.o.o.d..0..o¢.o.~.y ......... Filed Map No..?.~7 .... Lot No...2. .......... conforms substantially to the Application for Building Permit heretofore Fried in this office dated 2¢eb:r'ua r7 2& , 19 ?.? pursuant to which Building Permit No. 4 04 ~ gZ dated ~eb~uar7 2~ 19 79 was~ss d ............................... , ' ue , and conforms to all of the requirements of the applicable provisions of the Iaw. The occupancy for which this certificate is issued is ......... ....... ~.97..~n.. ?.qe..e.s?.~. ¥. ~.~..~F.e...~.n...~.h. ?. ?. 9.n.~..7.~.~.d. ...................... The certificate is issued to ...~..5.1~.5.~..m...E~.~.o.~.B. ....................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...~../..A .................................... UNDERWRITERS CERTIFICATE NO .................................................. B/A ~ 2509 Approval as applied for Building Inspector Rev. 1/81 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORI~ AUTHORIZED) Permission is hereby granted to' ~,'~~ /~ ~~ ...... ~.~....~~_.~..~. ........ L~Z..~..~...Tz.z.:.~ ......... ~ at premises located at~...../..~.~~...~...~..~ .................................. pursuant to application dated ~~...~.~ ....... , 1~.., and approved by the Building Inspector. / Building Inspector 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- 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. 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 Date...~...~..'.../.~,.../,~.' .~?~, · · New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property .L ~'i .~..~.~,¢..~. .t~,,~.~.~.. /?.~ C,c"~'~.~ ? ~ ~ ~ ~/ House No. ' ........... ~*r~; t .......07' ......... ~"'7' ..... ~/~/'e ~ Owner or Owners of Property .., .~.~,//It ~ (~ ~ .~ .~.~ "'.'; ', ...... 'L:.' ...................... County Tax Map No. 1000 Section ...... ? ,/..(4~ .... Block . ..7~ ........ Lo[.~i~..'.~. ~ .-~/, Subdivision..k:~ '.:~,'!.t,~-,~ ? ~, t~.[) .... '.q'~_:~'..Filed Map No, ~...Lot No, . ~;- ...... Permit No /~J~ Z~ Date of Permit ...... pplicant .................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .... ,.~ ~ d Construction on above described building and perr]~t meets all apl~fio, able codes and r, egulations. Rev. 10-1a-78 · TOWN OF SOUTItOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 July 11, 1980 Frank R. Zaleski - Applicant 97B Deep Hole Drive Mattituck, N.Y. 11952 Dear Sir: This is to notify you that Building Permit No. 10114Z. ~ssued Feb. 24, 1979 to W~lliam Eng,.l? ,*ll ~×~--i"~'~ o-~., ~,:. ~., 'i ~o ..'..' ."; If more time is required to complete the Job and obtain a CemtiFicate of Occupancy, you may apply, ~y letter, For a six (6) month extension. If the work is not completed and the Certificate of not issued afte~ the six (6) month extension period, than ~equired to apply fo~ a new building permit. GEORGE H. FISHER Sr. Building Inspector Occupancy you are encl. FO~M NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL File No ................................................................. Date ........ ~.~'~....././......, 19.7~, ~o .~.~..~.:-~, .... ~.z.~....~.~w,../~.~..: .............. .~,,~' -~..~.....~...~ ...................... ~..'~..~....~ .~..... :~ ..................... Street '~ ,~., Map .......... .~..::;.:: ................. Block ........ ..~iii~i.ii ...................... [/. Lo~ .............. ~ ................................ is returned h. ew,th a.d disopproved on the fo"ow;no grou.ds ~.,..~..~..~~-*~ ~-~'""'~'~"'c'~~"~~~~ ~..~....~.~..-..~.., <~,,.:~ ........ .... ................................................ ........... :/ ........................... i ..... "~" ....... 2~L;~'~ii;~'i ;~'~;~';~;; ............... FOEM NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGI: $OUTHOLD, N. Y. £xamined ..~.. 9..Z.~ · Approved ........... ~..~ ............. .C....::..., 19.?. .... Permit No. Disapproved a/c ................. :.,,~:- ......................................... ./.~. i ......... FOR BUILDING PERMIT Date .................. ~!~..~....~......~.... ~.~. ............... , 19.....~..9... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 application. 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 issue a Building Permit to~the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, cu~J regulations. ..... ,~ ...~,~¢~;....~. ......... .,,~:..: ............................ ~ .... (Signature of applic~/or name, if a corporation) ............. ~ ~.~.t-~...:~.,., ~..... ~i.~.~,~ ............................... (ASdress of applicant) % State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .................................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. /,~ ....................................................................................... ~.8. ~- '~ .......... (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: .......... ~.~ ....................... Lot No.: ...... ~ ................ Street and Number ......... ~ohwo~d,..~i~a.a~ ....... C~,eb~&~e.r..~.,;Lr,, ............................................................ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: property lines. Give street and block number or whether interior or corner lot. N~ure of-work (check which applicable): New Building/ .................. Addition .................. Alteration .................. Repair .................. Removal ................ ~. Demolition ............... A Other Work (Describe) ......... },~O¥~l ................ 4. Estimated Cost .....................................~'!Uu0,00 ..................... Fee ........................] ........... :.: ...... .~.. ..... 5. If dwelling, number of dwelling uniD~ ......................... Number of dwelling units on each floor ............................ I~number of c~rs 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ...~.~.9 ................ Rear ................................Dept~ .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................Height ............................ Number of Stories ................................ ~. ~i~ fE~n~ir. ,.~ ,o~,~,~,~o,: F,~n~z...~::~ ............................ ~, ....~:.'. ............. '.... ~.,~ ........................ Height .................... Number oE Stories ...................................................................................................................... 9. s~. o~ bt: F~ont ....... .~.?. ............. R~, ............. .~.~. ............... D,pm .......... ~E.t ............. 10. D~te o~ Purchase ........................................................Name oE Former Owner ........ '. ............................................... [ I. Zone or use ~istrict in which premises ~re situete~ ........ ~'.eS~. .................................................................. 12. Does proposed construction violate ~ny zoning law, ordinance or re~uletion~ .......... ~.~. .......................................... 13. N~me oE Owner oE ~remises Vd~..~ ...... Address ............................................ Name oE Architect ...................................................... Address ............................................ Phone No ..................... Name oE Contractor ~.~.~Q~..~..~'~.~.Address ..~4~.~ .................... Phone No. ~.~.~..., PLOT Locate clearly end distinctly ~11 buildings, whether existing or proposed, end indicate ~11 set-b~ck dimensions Erom to deed, end show street homes ~nd indicate STATE OF NEW YORK, ' COUNTY OF ................................ f .... description accordinc ......... ~J~,~8~_~..~...Y-~dl.~d~:~ ................................................. being duly sworn, deposes ond says that he is the applicant (Name of individual signing application) above named. He is the ................... ~.?..~..~.~....~.~..O..~. .............................................................................................................. (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~ the manner set forth in the application filed therewith. Sworntsb:oremethis , --1 9Z ............. .......... Co.n. ......... ~o-r i--~ -lot l""e~ b~r Q'l~d