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Home My WebLink About10774-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..g. 1`.~.0.2~/f. ..... Date ........ J. ua¢..8..... .............. 19.~, THIS CERTIFIES that the building ................................................ Location of Property 15625 County Road 48 h3~s~. ~iE .......................................... ~. ~ t~ h.o. Cu. e. . . . Street Nam/et County Tax Map No. 1000 Section . .1.0.1. ....... Block ...0.I ........... Lot 01 0 Subdivision.. X ........................... Filed Map No. ×..... ...Lot No. X. ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated ·. J u Z,~,.. 16 ........... , 19 [~.0. pursuant to which Building Permit No. 1, .0.7. 7. .~..Z .............. dated .... Ju.~7.. 1 .1 ................ 19 ~)., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which tkis certificate is issued is ......... .~[. U 9.~. church. The certificate is issued to ...49~?.e.P..~gP,s T.o.mP.~°,, .C.h. uv,ch of Ood (owner, ¥&v~'~'~'t~'t.} ...................... of the aforesaid building. Suffolk County Department of Health Approval . .C., ! 7 ,. ,5,/. ~ .4/.8.2. ~. ?.o.b. ~. :. ?. :..9',i.J..1. a. !..P'.. E.. UNDERWRITERS CERTIFICATE NO ..... N 557065 Suffolk County Highway Law~ Permit No. 15397 Rev. 1/81 Bmlding Inspector 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? 1077 Z Permission is hereby granted pursuant to application dated db'L Y /~ 1~..0......, and approved by the Building Inspector. O0 Fee $ ........................ I000- lot ~ /- I 0 Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buddings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topograph m 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 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 $5.00 Date ...... New Building ......./.~ ~ .... Old or Pre-existing Building(X) ........ ~ ~Vacant Land ............ Location of Property ........................ ~'~ .~..?.~ ........... (~ .~.~.(.~'.~.O~. ~.(~. ~ .... House No. -~--~t~f,e~ v Ham/et Owner or Owners of Property .~..~...~. ~ ,ff~..~-..°.~--~..~--~/~.4. ~_~. /~..q~ .?'... 6.~. ~ .......... county Tax Map No. 1000 Section .../O,I ........ B ock .. 1 ............ Lot.../..O. .......... Subdivision: ................................ Filed Map No ........... Lot No .............. Perm it No. Date of Permit .Applicant .. 1~¢.~ ~ ..... .~. ~.~. ,~,~ ..... Health Dept. Approval . ../.~?~ ................ Labor Dept, Approval ......................... Underwriters Approval ., .~.~,,.,c~ ................. Planning Board Approval .................. ~ ,., Request for Temporary Certificate ..................... Final Certificate ....... - ......... ~ 1000343 THE NEW YORK BOARD ,OFFIRE' UNDERWRITERS BUREAU OF ELECTRI~IT~ ~Dr~.l. ~L~t, 19S2 85 JOHN STREET, NEW YORK, NEW ~ORK 1OO3~ y ' q tp ta ~ribedbe~wa~int~ducedb~-t~a~lica~t~a~nt~eab~a~pli~ati~nnum~erint~e~re~ises~f Jeffer~ ~ N~h ~. Rt. ~, ~-~ ~, ~, N.Y. ta~fottowlag toeatlo.; ~ ~.s.m.,~, ~ tst Ft. ~ 2nd Fl. Section Block Lot ~.~¢saai~ao~ ~ril 5, 1982 and found to &e in comptla~ce wi& the r~quire,.ents of tals aoa~d. FIXTURE [ FIXTURES RANGES COC N~-DECKS OUTLETS ~ECEPTACLES SWITCHESiliNCANDESCENT FLUORESCENT ~v%C~v ~,~T K W i A~ ~-~K W 55 40 26 23 22 [ DRYERS i FURNACE MOTORS I FUTURE APPLIANCE FEEDERS SPECIALREC'PT TIME, .OcK$~ { BELL -~oo~T dP "~PEc~i ~;;" ,.~w ,~ ~w ~ ~.o °;E.~:O~ oJ?~ OTHER APPARATUS. ¢ 1 EXHAUST FANS DIMMERS AMT WATTS A W G O~ NEUTRAL 2/O Gcoc~le Elec. R~ I Bo~ 1Sa Ma~n Mattituck, N.Y. 11952 Board THIS COPY MANNER. Church [516] 734-6938 Home [516] 734-6938 REV EUGENE JEFFERSON MR. CHRIS STFWART MR MELVIN MANGHAM MRS RUTH WHEELER Secretary MRS ELIZABETH STEWART IEFFERSON'S TEMPLE CHURCH OF GOD IN CHRIST P.O. Box 438, Cutchogue, L.I., IN.Y, 11935 REV. JOHN JEFFERSON, Pastor p.O. Box 709 Mattituck, L,I., N.Y. 11952 Oooasio~: Place: Date: Time: Ground Breaking Ceremony , Jefferson's Temple Church 0f God In Christ Rt. 27A, Cutchogue L.I., ~.Y. Saturday, October 20, 1979 3:00 P.M. Dear Friends: We, the Pastor and members of the Jefferson's Temple Church Of God In Christ are requesting yoU~ presents at Our Ground Breaking Ceremony. We a~e a medium size congragation but a yery determined one, and with the help of God we would like to see a beautiful church errectea on this site in which God has given to us. The Pastor and members of Jefferson's Temple have been working for many years towards this special occasion. If in the future my dear friends you would like to contribute to this great project, we would be so very grateful. Donations of any source will be most appreciative. Again let us remind you that your presents at our Ground Breaking Ceremony will be greatly appreciated. Thank you. Sincerely yours, Rey. John Jefferson Pastor JJ:es P LD JOHN WlCKHAM, Cha}rman PRANK S COYLE H~NR¥ FREDERICK E, GORDON JAMES WALL Southold, N.Y. 11971 May 17, 1978 TELEPHONE 766-1938 Rev. John Jefferson P. O. Box 709 Mattituck, New York 11952 Dear Rev. Jefferson: The following items must be taken care of in regard to the site plan for your new church. The church must be set back 50 feet from the road. Parking stalls must show ten feet width. Curb cuts must be obtained from the Suf£olk County Department of Transportation. There must be ten feet of buffering on the sideyards. An update from the Suffolk County Dept. of Health is necessary. The Planning Board would also like to determine where the property line is in reference to the existing church. I would suggest that you bring this letter to Mr. Gordon Ahlers and have him take care of the matter for yOU. Yours truly, Copy to George Fisher Building Inspector Muriel Brush, Secretary Southold Town Planning Board HENRY E. RAYNOR. ,Ir.. Chairman FREDERICK E GORDON JAMES WALL BENNETT ORLOWSKI. GEORGE RITGHIE LATHAM, TO D $ Southold, N.Y. 11971 July 11, 1980 TELEPHONE 765- 1938 Rev. John Jefferson Middle Road Cutchogue, New York 11935 Dear Rev. Jefferson: The following action was taken by the Southold Town Planning Board at a regular meeting held June 30, 1980. RESOLVED to approve The site plan for the Rev. J. Jefferson Church prepared by Gordon K. Ahlers, P.E., said plan dated 4/28/79, subject to outdoor lighting being provided as indicated on the plan in ink. I enclose signed copy of The site plan. Yours truly,~ HENRY E. RAYNOR, JR., CHAIRMAN SOUTHOLD TOWN PLANNING BOARD By Muriel Tolman, Secretary Copy to George Fisher, Sr. Building Inspector GOI{DO Consulting Eng~#eer Shelter Analyst N K. AHLERS, P. E. P. A. 8. C. E. August 2, 1979 R. M. Kammerer, P. E. L. S. Commissioner Suffolk County Dept. of Public Works Yaphank, N. Y. 11980 RE: Kev. John J. Jefferson Church County Road 27, Cutchogue, N. Y. 11935 Dear Commissioner Kammerer: In accordance with your letter of July 17, 1979 to Rev. Jefferson, enclosed four (4) copie, s of the Plot Plan are forwarded for your information, use and approval. So as to expedite this project, please address all correspondence to the undersigned at the above address° Thank you. Very truly yours, GORDON Ko AHLERS, P. E. George Fisher, Bldg. Inspector Town of Southold, Southold, N.Y. 1197[ Rev. J. J. Jefferson North Road, Cutchogue, N. Yo 11935 TDWN DF SDUTHDLD E)FFIDE DF BLIILDING INSPEDTDR TE}WN EILERK'!S nFFIOE SE)UTHEILD~ N. Y. Mr.'~U~¥ k'~ 1"~ Y[ ~x Comm~ssloner of Public Works Suffolk County Yaphank Ave., Yaphank, N. Y. Dear Sir. In accordance with Section 239K of the General Municipal Law of the consohdated Laws of the State of New York, this is to notify the Commis- ......... C~ A)4LE~ F-L:- sioner of Public Works of the County ot ~urro~K mar ..................................... ' .......... ...... ....... has applied to the Town of fiouthold for a permit to construct a building .C.,~..Z..~/-L~..~ ~.~; as shown on the attached plot plan, submitted in trlplicate, dated ................ ..................... .~ and titledt ............................................................ We shall withhold fu~her action on this application for ten days or as othe~ise provided in the aforementioned Section 239K. Ve~ truly yours, Building Inspector Town of Southold, N. Y. a7 TOWN OF SOUTHOLD OFFICE OF BUILDIiqG II'qSPEG'I'OR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 `fro )z~ 3 ~ ~ JOHN WICKHAM, Ch~rman FRANK S COYLE HENRY E RAYNOR, Jr FREDERICK E GORDON JAMES WALL Southold, N.¥ 11971 May 17, 1978 TELEPHONE 765 - 1938 Rev. John Jef£erson P. 0. Box 709 Mattituck, Mew York 11952 Dear Rev. Jef£erson: The following items must be taken care of in regard to the site plan for your new church. The church must be set back 50 feet from the road./ Parking stalls must show ten feet width. Curb cuts must be obtained from the Suffolk County Department of Transportation. There must be ten feet of buffering on the sideyards. An update from the Suffolk County Dept. of Health is necessary. The Planning Board would also like' to determine where the property line is in reference to the existing church. I would suggest that you_bring this letter to Mr. Gordon Ahlers and have him take care o£ the matter for yOU. Yours truly, Muriel Brush, Secretary Southold Town Planning Board Copy to George Fisher Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ff~~:;~ :.~2 ' ' .- t~d~,7~/.) //~'ff'/~ ~ (Building Inspector) ~ APPLICATION FOR BUILDING PERMIT Date ... '7 ~ ..... 19~. 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 issuance of Building Pe~R. d. Upon approval of this application, the Building Inspector will issue a Building PennR to the applicant. Such pe~it sh~l 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 pu~ose whatever until a Ce~ificate of Occupancy shill have been granted by the Building Inspector. ~PLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Pe~it pursuant to ~e 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, ~d to admit authorized inspectors on premises and m buildings for necessaw inspections. ........ (Signature of applicant, or name, iffa corporation) .... ..... (~ailing adEress of ap~icant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................... .............................................. Name of owner of premises .~~~ ..................................... (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 ........ ' ................. Electricmn's License No ...... '. ................ Other Trade's License No ..................... ........... lo.,. ...................................... House Number Street .......... Hamlet County Tax Map No. 1000 Section . . .L~?. [ .......... Block ........ ~ ......... Lot...[.~1 ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~.~ ...................................................... b. Intended use and occupancy . '~g-~ ....................................................... 3. Nature of work (check which applicable): New Building .. ,~. ..... Addition .......... Alteration .......... Repair .............. Remoyal .............. 4. Estimated Cost ............................... 5. If dwelling, number of dwelling ~4nits .............. Demolition ...~'. ........ Other Work ............... (Description) (to be paid on filing this application) 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. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height Number of Stories Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ....... ~ ,: ......... ;. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front .... ~-~. ~. ...... Rear ... ~. ~'. t. ....... Depth . .~;O./ ......... Height ...... /.~.t ...... Number of Stories ....... OM..~. ............................. ._..., .......... I0. Date of!Purchase ........... ; ................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .. ~J~ .......................... 13. Will lot be regraded . . A~ ~(>.../j .;..~;~...; .... Will excess fill be rem,,oved from premises: ~,~ No 14. Name of Owner of p_remise~~_.. Address/~X?~. ~/~l~hone No.7.~.~..-.,~,~ .... Name of Contractor ......... ; ................ Address .... .r.....~ ......... 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 humber or description according to deed, and show street names and indicate whether interior or corner lot. . STATE OF NEW YI~RK, , ., COUNTY-OF..~..,-- J ~' ~t[/.~,~-~'~i/-~-~- ...... r~.~., r~ ~.. ,cr-.~..'~-~.~.. ~. ~ .~.,~-.~-. ............ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ......... ~. ~[M. ~ ................................................................. I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulyI authorized to perform or have performed the said work and to make and file this application; that all statements contaihed in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner iset forth in the application filed therewith. Sworn lo before me this .......... /~...~ ..... day of.I. .' ....... .~. ~,,/~..., 19~ Notary Public ...... : . ,~.~ ....... .,~.~.~.~/~. County . ......... , (.~ ~ , ' ~LIZfl~TH ANN NEVILLE_ , ' ........ tS~nature ~f a-,,licant~ \t ~ NOTARY PUBLiC,State of New Y0rN \ 'i No ,52.8125850 Suff/~i~P~.C,.~ty I TeJrn Expires March WHEREAS, a certain highway known as the M!DDLIZ ROAD has been improved and IS on the Suffolk County Road System ann CR No. 27 WHEREAS. REV° JOI~ISl J, JEFFERSON CHURCH, c/o Gordon K, Ahlers, .~4anor Lane, Jamesport, New York requests permission to construct asphalt pavement for 2 accesses and place topsoil ancl seed as per revised site plan and typical section on the n/s/o .~iddle Road, m~mmmz~~~ 1015+~' w/o Alvah's Lane, Itamlet of Cutchogue, Town of Scut hold, NOW, THEREX~ORE, permission is hereby granted to said REV. J0tAX7 J. JEFFfIRSON to do said work upon the following conditions CONDITIONS AND RESTI%IC~I'IONS L When concrete is removed, cut concrete with concrete saw two feet outside the limits of the proposed excavation and for the full panel width. When the cut is made in pavement wttldn 10 feet of the panel Joint, the pavement shall be removed for full panel width from the cut on the far side of the excavation to the panel joint. 2. Sack/iH and thoroughly compact fill using POWER TAMPER, pla~lng soils so that various types of soil are in saxne relative position as before excavating. Grade to original surface. 3. Repl~ pavement, sidewalk or surface same as existing; if concrete, replace using 1:1 ~ .3 ~/z mix stone mix concrete; ff bituminous material, replace using samae type $, If coneret~ curb Is removed, replace with similar curb 1:I~ :BI/~ mix, 5. Edge of Jacking Pits or any other excavation Shah be not less than 5 feet from Edge of Pavement. No undercutting allowed in Pit. ~. Notify the Department ~t Yaphoak 4-1~45! when the work Is to begin so that an inspection can be made of the operatiom This permit shall not be assigned or transferred without the written consent of the Commissioner of Public Works. The work authomzed by thru permit shall be performed under the supervision and to the sahsfaction of the Com- missioner of Public Works or his representative. Particular attention is called to the necessity of thoroughly compactmg the bacg fill, which will be required by the Commissioner of Public Works. The Commissioner of Pubhc Works shall be given one week's notice by said applicant of the date when it in- tends to begin the work authorized by this permit, and prompt notice of ~ts completion. The said applicant hereby agrees to hold the State, County and Town harmless on account of damages of any kind which may arose during the progress of the work authomzed by this permit or by reason thereof. Applicant certifies all persons concerned w{th actual work under thru permit are duly covered by Workmen's Corn- pensation Insurance and the State, County and Town shall be held harmless on account thereof. The Commissioner of Public Works reserves the right to at any time revoke or annul this permit should the said applicant fail to comply with the terms and conditions upon which it is granted. The applicant agrees to pay all necessary expenses incident to supervision and inspection by reason of the granting of such permit as certified by the Commissioner of Public Works, such payment to be made within ten days from the rendering of the certified account. Work under this permit to be commenced within thirty days from the ~ate of permit and continued in an expeditious manner. The applicant shalI su,bmit a detailed plan of structure to be built, with a description ~ proposed method of construction. It is understood that sbeuld future changes in the alignment Qr grade of the highway require changes in the work covered by this applicahon and permit, the applicant shall on reasonable notice from the Commissioner o! Public Works make such necessary changes at b~s own expense within the time so specified in notice. Traffic shall be maintained by the applicant on this section of the highway while {:he work is in progress and until its final eempletlon. A CertifiedBond CheekCash in the sum of $.~.-.*..0.0. ~.*.0..0. payable to the County Treasurer of Suffolk County is on file deposited as security that the highway will be restored to its origmal condition where disturbed at the expense of the applicant, as soon as the work has been completed, and the said Comrmssioner of Public Works is hereby authorized to expend all or as much of such deposit as may be necessary for that purpose, should the said applicant neglect or refuse to perform the work. In consideration of granting this permit the undersigned accepts it subject to conditions described. Date Commissioner of Public Works, Suffolk County · O AVOID S~RIOIIS DAMAGE TO VITAL UNI)ERGROUN-D FACILITIES, PLEASE CALL LONG ISLAND LIGHT- lNG COMPANY AT JUN1P~,'~c 2-9000 OR FOR Tv3LEPHONE FACIIJrrI~S CALL N. ¥. T~JL. CO. FLORA~ PARK 2- OFFICIAL 25 BEFORE STARTING THE WORK AUTHORIZED BY THIS PERMIT. .C) I 2_3 4(3 ,,,,4 POAD i, ",4 r