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Home My WebLink About10565-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y, Certificate Of Occupancy No...Z.1.0.O. ~../4 ......... Date .... .ff.tl.]..y...'1.52 .................... 19..~.0 THIS CERTIFIES that the building ................................................ Location of Property ...7.?..5..~.'~.~..o.h?.o?l...R.O.8..d, .................. . .~.~. ?.h.O..g?.~ ......... House No. Street Ham/et County Tax Map No. 1000 Section ...1.0..~ ...... Block ...]..O. .......... Lot..J'.J'.°.~. ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Apphcat~on for Building Permit heretofore filed in this office dated ... F~.132?llar~r../~, ..... , 19 80. pursuant to which Building Permit No ..... J...0~.6.5...Z ......... dated .... ~.o.b..r~..a.l~{..~ ........ 198.9. ,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 ......... ... ~rAv..a~.e..qn..e.--E .~..t.zy..r>..~?.~3.~.n¢ ............................................ The certificate is issued to ...K.~.rl..rl.O.~.h...~.87..1~...&..~..8~..O..~.?.~.I~.. ......................... (owner, ~o-~ of the aforesaid building. Suffolk County Department of Health Approval ...... ~..O.-.~.Q-..0~...ff...1~...y..~. ~...1.9.~.0...R.o.~.~.~..~. ?o Villa UNDERWRITERS CERTIFICATE NO... N./4.~.~..6.~ 9. ...................................... Bmld~ng Inspector Rev 4/79 FORM NO. 2 ?OWN 0F SOU?HOLD BUILDllqG DEPARTMENT 'TOWN CLERK'S OFFICE $OUTHOLD, H. Y. BUILDI~qG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10565 Z Permission is hereby granted to: ~.~:..r..~&..~.~.z...d~z.~ . ('a, ; /~,~,~ ....... iZ..~.~.~..Z~ .......... ....... ~./l~...~/~.c~ ,....~.~, .. / ~ 7 ~ to ..~ ~ ~,. ~:~cb.c%.. ~z ~ z~. . ..o. .~, . ..~ ~ ~ ~. ..~ ~-/&.~'~. ............ ..... ~. ~ ............. ~:.r~... ~,~...~.. ~ z~. ~V ............ ~.. .............. at premises located at .~...~.~t~..~7"""~'~O~"'J~'~ ' ~/~,...z~y~,~.~..~.zz.z.=...::... z z/z=[Z~...,.~az~.~¢~ ........ z~. ~. ~z. ~.~z.q.. ~z~, ............................................ ;'4 ................................. pursuant to application dated ~.~~...~ .......... , I~.L, and approved by the Building Inspector. Fee $..£! ....... ;: .......... 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 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. Approve[ 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 Amhitect 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 alt 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date.. l l ..q .............. New Building ............. Old or Pre-existing Building ............ Vacant [.and ............. Location of Property House No. Street 'J Hamlet Owner or Owners of Property . .~..~ .C~...~. ...... ~. .................................. ..--. County Tax Map No. 1000Section ./..1~.~ .......... Block ..'/(~'' .... Lot...l.l.f.~, ........ Subdivision ........... ) .... Filed Map No ........... Lot No ....... Permit No./.~..~.~.... Date of Permit . .~ ,~..~, .~..Applicant ,~ (~k) \~C~ ,.~2 Health Dept. Approval. [ ~..'$.O. Z .(~.C~ ........... Labor Dept. Approval ........................ Underwriters Approval ................... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ... ~ ............... Fee Submitted $...~'~. ........................ Construction on above described building. [,~.~ .~. · .-.'~.and permit meets, all applicable codes and regulations. .................. ,.v.,o.,o_,, iCF ' ,oo THE June Bate THIS CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS SUREAU OF ~LECTRICITY Ks Jo.. ST.gET, ,OO S Appllcatimt No. on file N 482g19 only the electrical equipment as described below and introduced by the applicant named on the abo~e application number in the premises of KennetI~ Sarr)~ Strohson Rd~Baldwin Pl. Cutchogue,N~Y. in the followlng ~ocatlon; [] Baseme~t [] 1st FI, ~ 2nd FI. Section Block Lot was examined on J~.l I't¢ 1~ ~950 andfoundtobeincomplia,~cewithtkerequtrementsofthisBoard. FIXTURE FIXTURES RANGES OUTLETS SWITCHES EXHAUST FANS FtUORESCENT 29 40 DRYERS OTHER APPARATUS Motors: t frac,hp Elco. room heaters: Motors: 1 frac~hp 1 GFCI. 1 smoke detecgor~ E R V I C E NO OF CC COND A W O P~R ~ OF CC COND 1 3/0 AWG OF Hr-tEG 2~4.0, 3-1.5, 5'1.0, 1-10 amp ~ompaetor 5-. 75tOW NO OF N,~EOTRALS AWG OF NEUTRAL 3/0 Kenneth Barry 29 Rustic Rd. M:ttler Plece,N.Y. 11764 GENERAL MANAGER j~J~.~~,~ ,~c~o~rr~.~" This cerhficate must not be altered in any m~annerj return to the office of the Board if ,ficor~ect. Inspectors. ma~'~b'~ COPY ~QR· BUILDING DEPARTMENT. THIS COPY,OF~ I FIELD INDPEC~ION C Olv~l~'±'~ FOUNDATZON (~s~) FOUBmATION (2nd) 2. ROUGH FRAME& PLUMBING INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: TO THOMAS D. REILLY, P.E. Consulting Engineer 4 Bezel Lane SMITHTOWN, N. Y. 11787 (516) 724-7888 GENTLEMEN: WE ARE SENDING YOU~ ~[' Attached [] Under separate cover wa [] Shop drawings ~' Prints [] Plans [] Copy of letter [] Change order [] [] Samples _the following items' Specifications COPIES I DATE NO __ DESCRIPTION THESE ARE TRANSMITTED as checked below, ~ For approval ~ For your use ~. As requested [] For review and comment [3 FOR BIDS DUE [] Approved as submitted [] Approved as noted [] Returned for correcbons [] Resubmit []~ Submit [] Return _cop~es for approval cop~es for distribution corrected prints 19 __ [] PRINTS RETURNED AFTER LOAN TO US REMARKS COPY TO SIGNED: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ...... : . ~.~... , 19 ..... i9 5. Permit D ........ ~ ~ ~sapprovou a/c ..~ ......... - ........ .~/~ ...... ./ n .g2~,~ (Building Inspector) tt 2-7-Z~-- ~ Z/t/: ~f/~t~. INSTRUCTIONS Application No..t(~..~..~.. ......... 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 Permit. d. Upon approval of this application, the Buil&ng 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 demohtion, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. v, ............ (M~iling address of applicant) I I 3~ ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nameofownerofpremises ~<-~*xk~"'-~ ~ ~' -~_-Qs~ ~-~..~....~_~.. ........................ ihe' ta'x' ;o' i i t }t' [ idd) ........ ............... If applicant is a corporation, s~gnature of duly authorized officer. .... ..... .......... (Name and title of corporate officer) Builder's License No ...... : 7T'TTTT. ............ Plumber's License No ..... .~... ~..~...~. ......... Electrician's License No ..... ! .~..~....~. ......... Other Trade's License No ................... 1. Location of land on which proposed work will be done ..... ~../..~ .... . .~..~...~..O...~..5..O...~..'...~....~.... ..... '7 House Number Street Hamlet County Tax Map No. 1000 Section ..... !.o...~. ....... Block ....... 1. ? ........ Lot 1[-* ~ 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 . . .2P~~..~~...- ...................................... b. Intended use and occupancy ...... ~..~..~. ....} ...T;..(.~.~..e~.. '%OZ' f~/?: 5':':7: ~ .......... 3. Nature of work (check which apphcable): New Building ...... Addition .......... Alteration .......... Repair .............. RemoVal .............. Demolition .............. Other Work ............... i ~ (Description) 4. Estimated Cost ...... ~..O.(. .......................... ~c>O Fee ~.. .................................. (to be paid on filing this application) 5. If dwelling, number of dwelling h~nits ............... Number of dwelling units on each floor ................ If garage, number of cars .... .~ .o... :~.¢).~ ~ .qz.~-. ' .................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of e,xisting stmcture~, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... ~.. Height .......... ,. ........... Number of Stories. . S ............. Rear ..... .~'.Q ....... 'I~e'p'tk Dimensions of entire new constr¢ction' Front ~f O Height....~...~..' ........ Number, of Stories ....... ~ ................... '1 ............. 9. Size oflot: Front ...... ~...¢.,., Rear I~ I i ii'~);~it~'il ..~.~ .............. 10. Date of Purchase .... cl..I...~. .).'I ............. Name of Former Owner ............................. I 1. Zone o[ use district in which pre~mses are situated ..................................................... 12. Does proposed construction y, iolate any zoning law, ordinance or regulation: ..... .~..-o ....................... 13. Will lot be regraded ...... ~77~'..~-'. ................ Will excess fill be removed from premises: Yes ($o~'~ 14. Name of Owner of premises .1~...~...~.~4~. Address .c~.~ ~ Name of Architect . .'~'. ?'..a.?'9.~..~.....~.~..x)] ¥...0.. Address .q..~.k.~..~..~).?~hone~}~o.. ?..g..t4. rD *I~ ~ . Name of Contractor .~.~..~..i).~.~ .~.-~.. ~-~ ...... Address .~)..~. ~,.oo'~ Phone No..~ .-I 3 7 .I.~c~.~ .... PLOT DIAGRAM Locate clearly and distinctly all 'bmldmgs, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and block lmmber or description according to deed, and show street names and indicate whether interior or corner lot. STATL OF NEW Y[D,~RK~ . · .. ............................ being duly sworn, deposes and says that he is the applicant (Name of individual 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 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 ...... · .'~.~.....~.. dayofl. ~.'~.,. ,19 No. 4677753~lSuffolk COunty (Signature Of applicant) Commission Exp~rea jMarch 30, 19 ~',~ 'B T _1 1 Iff NOW BROW~tN~ W r~ ~ ,~'~ ~JER UAIN IN DWELLING- EL ~ , ~' ~,GE~ OF 500 FT. ~ ,.~ ~' T~X MAP DISTRICT t000 ~.~.. SECTION 103 ~ stk~(lO~ ~ ~:1~ ;, P/O LOT 11 m ~ f? bid9 , ~ ~ ~ ~ .... ' : (as ~r applicant) ~ ~he sewage disposal and, ~,er , ~t]ppl~ 0 ~ facilities for this location ~ve been sd found __ ~ inspected by this department% 8~-- ~ ~ ~r~ 0 I°am ' ' ~n', :.~ ~_ ~ ~ ~, ~o o ~ O o~ ~ ~,,' z z (99) / ~e~ na '1 nex~ S 05"05 '40'W. ~ ~0 0'7'~ ' J ST R O-H S O N ~ O A 'D ., (~O,O) ~1~ ~ JUW~ ~ I~0 DWELLING WELL PR~OSED D~LLING FEB 4,1980 mu~ er~k SUFFOLK COUNTY DEPT. OF THE WATER sUPPLY a SEWAGE '~AME HEALTH SERVICES FOR DISPOSAL FOR THIS RESI~DE CE ~ ...... % APPROVAL'OF CONST. ONLY WILL CONFORM TO THE ST~ND- ~ ~DDRESS DATE_ ~ ARDS OF THE S~FFOLK H.S. REF. NO, ~ DEPT. OF HEALT~ SERV~E~ ~ , , . ,. APPROVED BY ~ ~/, ~,. ,, ~ ~T~E~E~HONE , GUARANTEED ONLY TO ' I FIL~ ~AP,~NO, DATE KENNETH H ~ GA~E L ~ARRY I "00~ ~' - ~J ~ ~ ,, CHICAGO TITLE INSURANCE COMPANY I . ~ ,.¢'L .. · · · N.Y.. LIC. NO. 0489~2 N~RO~D F. TR~N(NON JR. PENN L C NO 21~t~-E ,:~ (~i;~ 9,E~,~ ~ ALT. 4~3.3~[6 bJ Z NOW BROWN[NG DWELLING -WELL s~t stk STR O COUNTY DEPT. OF flE~L~H $~R¥,IC£S FOR ,APPROVAL'OF CONST. ONLY DATE ~ ApP. RoVED~ DA T'U M APPROXIMATE LOT AREA 29965 S(~.FT WATER MAIN IN EXCESS OF 500 FT TAX MAP DISTRICT 1000 SECTION 103 BLOCK P/O LOT ILl 0 r3 TEST BORING EL 10.0 ( as, p~r applicant ) 2 ~loam ~C -~ .~nd "tna, inext sOs~os'40;W'i I II I ~ i~. ~ ?)Tm'~n'-- ~ ' I~ to l~amng mon ~, .... ~ ............. ' ' ~ '" / .... DWELLI~~L ~ mud ~ ~ crce~ THE WATER SUni ,Y a~ .~E :LE~;HONE ~ ~ SHALL TO THE P~ESON ~O'B File NO. 338 F I,KED SE~L OR EMBOSSEO SEAt. ' W .~ , ~ L~ COUNTY A VACID T~UE CO~Y, ,$ AL~E, . ~ARRY J .2 0 C~ 0 ............... ROXIMATE DATUM APP NOW BROWNING DWELLING -WELL $¢t N stk Id 107) fr bldg In disrepair set na~l next to leamn~] mon STROH SO N (I0,0) mud THE WATER St DISPOSAL FOR.'THIS ,R:[5~'~EI'tC:I~. WILL CONFORM ~ THI~ DEPT, OF LOT AREA 29965 SQ, FT WATER MAIN IN EXCESS OF _500 FT, T~X MAP DISTRICT 1000 SECTION 103 E~LOCK 10 P/O LO T 1 1 TEST BORING EL 10.O (as p~r applicant) Watzr i RO A O ,, '- 105) ~o F/EIER W~AD I NG RIVER 1792 /2t ~" IGc 7c ¢" CE :flFIC&T ' EF OCCU A Y ..................... --~/~.SP,'-IRLT 5t't/l\~c~LE~2 -' NOTIFY BUILDING DEPAff~NT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWff4G INSPECTIONS: ]. FOUNPATION - TWO REQUIRED FOR POURED CONCRETE 2, ROUGH ~ FRAMING & PLUMBING 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C, O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COM~LE. TE a~ YE," O.C. 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