The URL can be used to link to this page

Home My WebLink About10601-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the BuildinnJnspector Town Hall Southold, N.Y. Certificate Of No ...... Z 10.~.% 0 ..... Date ....... THTS C~,R'[~F~$ t~t the budding ................................................ Loc~fiun of Property ***. 1095. ...... Rl~,~and. ~QSd~t. .... ~ p.~.~bCg~ ~. )1...! · ...... ~ouss No. County Tax Map No. 1000 Section .... 10~ .... Block ..... 8 ......... Lot ...... 3 .......... Subdivision ....Highland. ~nt&~.~a ........ Filed Map No. ~,~'~7...Lot No... ~ .......... conforms substantially to the Application for Building Permit heretofore filed in fids ofnce dated .... ~l~.ch. 2'~ ........ 19.2,~ursunnt to which Building Permit No .... 1D.60~. ~. ......... anted ..... V~nch. 2~ ............. 19.. ~vas issued, and conforms to all ofthe requirements of the applicable provisi~ of the law. The occupancy for which this certificate is issued is ......... ........ Pr£v.a ~e..Qn e.-:F.a~t ~3'..D~,~$~g ....................................... The certificate is issued to .....~ tx=h a rd..1~ o hr.1 ~og .w~~.2 _ ._ ._ ................. of the aforesaid building. Suffolk County Departme~t of Health Approval 10-~0-18 3/2/81 Rob®ft .~: .V.J:.l.l.a. UNDERWRITERS CERTIFICATE NO Rw.l~l Buildln~ InSl~ctor TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S oFFICE SOUTHOLD, N. ¥, BUILDING PERMIT (THIS PFRMIT MUST BE KEPT ON THE PP, EMISE$ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NV 10601 Z Permission is hereby granted ~L--~ ..... ~ z~:~r.<~......h../.o,,.r~z~..~ ...... ~ '~ --~' "~ l,, . . . .G o. . . ./~ z z_ . Jr'~,4 ~. . . . . .,Z. d~ '~. . ..... ......... ,o ..C..~z.,-~z.4.~...c.~ ........ ~.,,.~:.. ~T,¢./-,~/.4~....~.~///,~,,~ .................... .................................................................... ~ .............................. z.:' .................................................. at premises located at ,Z.f-~..7~,'.~,*.-.......¢.Z~'.~..4(z~.~'.x~./-J/~,...~'~2.~ ...... ~'~"~'O~'~G/~'/, ~7~'.'~J". h~9.z/.z~.~.~./-~ ........... .7~....4'~..7......~:.....Z~.z...~ ......................... pursuant to application dated ~/~C~ ....................... 1~.., and approved by the Building InFee ~sP ~ ec to r. ~~~~_~ /.~ ~..-/~[~:...: ............................................. -i~ector 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: I. 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 disposel-(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 New Building ..... × ....... Old or Pre-existing Building ............ Vacant Land ............. Location of Property 1095 Highland Road Cutchogue, N,Y. House No, Street Hamlet Owner or Owners of Property ~,~cb~.c~ .~J~b-~.~,Og ......................................... County Tax Map No. 1000 Section ...... 1 ~ ...... B{ock ...... .8. ....... Lot ......... ,3 ...... Subdivision....~.~.~..~.a.~.d...~.s.~a.. ~.e.~ ........... Fded Map No. 653? .Lot No. 6 Permit No .... ;L.q~Q~ Date of Permit ....3./.2,1, ./.BA~pplicant ....R?..c.~..a.~.~ ?..o.h.~.~.~..g ............. Health Dept. Approval ..... 1L).,,S 0 .-Z.8 . 3/2,/,8 ~. Labor Dept. Approval ........................ Underwriters Approval .... ~.0.8.~ g.4 ............ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... ,~, ................. Fee Submitted $ ........ ~; .0.0. ............. ,-~/~ --~ .~'~ Construct,on on above described building a/nd pp~r~/~'ee~ts/al~p~e,~es and regulations. ~[J~ ~, ,~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~ Feb~ 4, 198.1 ss JOHN ST.EET, NEW YORK, N~W ~ORK ~OO~S in the /ollowing location; ~ B~semen~ ~ lst FI. ~ 2nd Fl. Sec~ionlO2 Block8 Lot6 and found to be in ¢o~npliance with the requtrements o/ thts Board. FIXTURE FIXTURES RANGES OVENS OUTLETS SWITCHES FLUORESCENT VApOE EXHAUST FANS DRYERS FUTURE APPLIANCE TIME ~LOCKS MULTI-OUTLET SYSTEMS NO. OF ee~T DIMMERS SERVICE DISCONNECT OTHER APPARATUS' Motor/s: 2~k~ D~tector8 S E NO OF CC COND / PER C AWG OF CC COND NO OF HI-LEG A W G NO OF NEUTRALS A W G OF HI {EG OF NEUTRAL 2/0 t 2/o 2041 Shelley ID.. East V~a~k~, N.Yo 11554 Th~s cerhflcat not be alt, rn ~y : return to the office Board if i/m.533-B p,.,._ mo), be by COPY THIS COPy OF IN ANY MANNER. FIELD FOUNDATION FOUNDATION 2. ROUGH FRAME PLUMBING {and) INSULATION PER N.Y. STATE ENERGY COD~E 4. FINAL ADDITIONAL COMMENTS: ., / .A":" '~.~x.-"o.. .. _Ob / ~'J '.-"..'~e -,,,, / .;??_....'x,,...oo'% ·: MONOM~N;' n _- STAK~ SURVEY FOR ~'~-~'~ ° AT CU~'CHOGUE DAf[= MdB. 5, 1980 .... ? TOWN OF SOUYHOLD· SCALE: I "- ' 50' ': SUFFOLK COUNTY, NEW YORK NO. 80-/$0 --'--''*O"'"O--O'-- HEALTH DEPARTMENT-DATA FOR APPRO%I~. TO CONSTRUCT T~E I~R~O~ FOg WNO~ THE SURVEY I$ OTHER THAN THOSE SHOWN HEREON. TO ADOITION&L IHSTITUTI(3NS OR SUBSEQUENT __ YOUNG YOUNG mVERHEAD, NEW YORK NO;'~: ALDEN W. YOUNG, PROFESSIONAL ENGINEER SU~III'I$10N hMP FILED IN ~ ~rFICE' OF 7'NE' CI..~I~ OF' AND LAND SURVEYOR N.Y.S. UCENSE NO. 12845 SUFFOLK COUNFY ON APRIL ~,l~FFJ$~ll.~ NO. G53F HOWARD W, YOUNG, LAND SURVEYOR # ?t~ LOC~T1QN Mr WB.L(W), IF. FrlC tAIIqlT)e CESSPOOLS(C~) Wld H[NEON N.Y.S. LICENSE NO, 45893 AIIE PROM FIELD OII[RVATION$ MdQ eR DATA OITAANEO FI~OM OTH[#$ TOY POST E0494 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY DATE.. HS REF. NO.., "dd:'PROVED HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT ADORESS NOTE: SUBDIVISION M,~P F/I ED IN TNE OPF'ICE O,c TN£ CLEt~'K OF SUP~LK COUNTY ON AP~I~ ~6,1~7Y~SFI~ NO. ~537 SURVEY FOR R/CH,~IRD kIOHRI/VG lOT/VO. 6, . HIGHL~IVD £$TATE$ AT CUTCHO~UE TO~N OF SOUI'HOLD SUFFOLK COUNTY, NEW YORK DATE: /~R. 5, /96~0 SCALE: / -" ~0 ~ NO. 80- 130 YOUNG YOUNG ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR NY.S. UCENSE NO. IP845 HOWARD W. YOUNG~ LAND SURVEYOR N.YS. LICENSE N045893 400 OSTRANDER AVENUE RIVERHEAD, NEW YORK SURLY FOR S~ COUN~ D~ARTMENT OF H~ S~C~ RICHARD MOHR/NG tOT NO G , " HIGH. ND DAlE HS ~EF. NO. SUFFOLK COUNTY, NEW YORK ~o. ~0-130 ~COPIES ~ ~lS ~VEY NOT KAR~G THE LANO HEALTH DEPARTMENT-DATA FOR APPRO~L TO C~STRUC T THE ~R~N FOR WHOM THE $U~EY IS PREPARED ~ ~ ~ ~ ~ ~OISTA~C~ SHOWN H~ffiEON FROM ~[RTY ~orE .. SU~/VIS/~ ~ F/~E~ I~ ~O~/C~ O~ ~ ~E~ O~ ALOEN W YOUNG, PROFE SS~ONAL /NGI AND LAND SURVEYOR NY_S UCENSE N0.~845 SUF~K COUNTY ON ~P~I& ~6,1977~SFI~ NO. HOWARD W. YOUNG, LAND SURVEYOR ///~ TEL.: 765-1803 Exam,ned .~../12.~?~.~/..~. 7 i , 19~O~. / Disappro,eda,c .............. ..... .... ././ APPLICATION FOR BUILDING PERMIT FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 ~ Application No. ZO..~. ~../. ...... Date .................. , 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 pier 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 applicatmn, 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 demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buildigg, cod~0, he.using code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary i~n~p~r~..'~/egz~ / (Signature, of applicant, or name, if a corporation) ·..~. ?..~. :/../~...~. ?~..~.~ .~..o,...~/~.,,,/.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ~~/e..~~ ............................................................... Name o~ owner of premises. 47.'.: ~..~/.~ ~..~...../7'.~.~Z*.~. ~ .~. ~/:. ................... (,fits on the tax roll or latest deed) / If applicgl~a c~oratj~.o~jgl~re of duly authorized officer. .... .. ............. (Name and ti~e of c~-porate officer) Builder's L~cense No ............... <.~ ,~ ...... Plumber's License No..~.~('.O...~...~'.~..~'~.~x .~:5) Electrician's License No. 5 ...................... Other Trade's L~cense No .................... 1. Location of land on which proposed work will be done...~.~../?..~....'.~./../.~...~.....Z?../-.~.~. ................. ...... .r.o~... ~~ ~e..~ .................. .0~~o% ........ House Number Street Hamlet County Tax Map No..~Z,~ ,/~/~ 1000 Sectir' '~'~ ......... Block ..~.. ~~ Lot..~ ............ Subdivision. ~ :~ ~ t/~~ .......... Filed Map No ............... Lot ............... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ~' ~'~'~ an~"~ "~ ........ Z ...... ~ ...... ~'. ...................................... b. Intended use and occupancy .................................................................... 3. Nature of work (check whi?h applicable): New Building ...... Addition .......... Alteration .......... Repair .............. Remoyai .............. Demolition .............. Other Work ............... ' ~ __ .,~ (Description) ~4. Estimated Cost .............................. Fee . .t. t ,~'. ~.'"2 .......................... ~ (to be paid on filing this application) 5. If dwelling, numberofdwellingdnits..I ... 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~mensmns of ex~stmg stmcture~, ~f any: Front ..... Rear ......... Depth Height ............... , Number of Stories ........................................................ Dimensions of same stmctfire wi~h alterations or additions: Front Rear Depth ................ . ..... Height .......... ~.. ~ ......... Numbe~of~tofies ...................... 8. Dimensions of e~t~¢ ~ew/onstr~ction: Front . .7~.'.~ Y ...... Rear .. 7~ .¢.T ...... Depth . ~ .......... 9. ~tflot:F~[~Y~:[~f.~t.~s. R~..~..: ............. Depth ~ ................ 10. Date ofiPurchase ....... . ....~ ................. Name of Fomer Owner ............................. 11. Zbne or use district in w~i~h premises are situated ..................................................... 12. Does proposed constructmn viol6te any zoning law, ordinance or re~lation: .~ ............................. 13. Will lot be regraded .. ~ ....................... Will excess fill be removed from premises: Yes 14. Nme of Owner of prem~s . ~~4~ Address /~~. Phone No ~ o Name of Architect ...~/.~i&R~ ......... Address . ~~ ...... Phone No..*.2/2~)~ ..... Nme of Contractor ... ~qff~f.~o~ ....... Address . .qq .~/.~. Phone No. ~.n ~P~ .... PLOT DIAG~M Locate cle~ly ~d distinctly ~1 ~bmld~gs, whether existing or proposed, ~d, indicate all set-back dimensions from prope~y lines. Give street and 1,lock humber or description according to deed, and show street names and indicate whether ~tefior or corner lot. STATE OF NEW YORK, ~ e e~ COUNTY 9F ......... ~ ~.~, · .'..~ ............. ~~~ ........ being uly sworn, aeposes says that is applicant ~ ~ (Name o~ndiv~ual sig~in~contra~ above named. Itc is the ........... ~/~~.~ ............................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is du~y authorized to perform or have perfomed the said work and to m~e and file this application; that ~1 statements contained ~ this application are true to the best of his ~owledge and belief; and that the work will be perfomed in the mann6r set forth ~ the application filed therewith. Sworn to before me this I ~ · ~ ~ ................. , .................... , · ' ~m~ ~lres Merck ~0 _ ___ ' Notaw Public, ... ~<~ .' ..... l L ~OT~ BUILDINB DE~ARTME~ f. ~OUN~A~]? - TWO FO~ p~U,,:D dbN~RET~ ~L~ CONSTRHCTION SHALE ~E R~OU~R~MENTS OF THE N. ~AT~ CONSTRUCTION ~ ~NER~ ~ODES, NOT R~SPON~JBEE FO~ ~ESIGN' O~ CONSTRU~ION i t 1 ~ L 4'l biP