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Home My WebLink About10611-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy Z 10150 Date S ep~;ember l?, 19 80 THIS CERTIFIES that the building ................................................ Location of Property 525 Tuthill Road, Southold House NO ........ '~'tle~i h~r~/ei County Tax Map No. 1000 Section .... .0.5.~ .... Block .O./q. ............ Lot .0..0~ ............. Subdivision.. ~reno~o.t.t · ~. ~r.k. ............. Filed Map No. 5..1.8.7....Lot No. 26 conforms substantially to the Application for Building Permit heretofore filed in this office dated · .A.~..r.i.1..! ........... , 19. ~.Opursuant to which Building Permit No. 10611 Z dated .... A.p..r.i.1.. 1. ................ 19.8..0, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which tiffs certificate is issued is ......... ...... ?.~: ~. ¥.a.t.~, 9.n~..~.'e._..m~...~.~.e.~. ~. ~.n.g ......................................... The certificate ~s issued to . . . .G~..1..D.~.I..a.l.l.a. ........................................ (owner, of the aforesaid building. 10-S0-28 9/12/80 Robert 2~o Villa Suffolk County Department of Health Approval .......................................... U~WRIT~RS CE~F~C^T~ UO ..... .~..~.9. 9.~7.~. ................................... Building Inspector Rev 4/79 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPART/v~Et~T TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTtJORIZED) N? 106~1 Z Permissloa is hereby granted to: / .... /4z,,.,vp~...~¥... ~Zz~...(.o.,,z~.,.. ...~.o~c~.....~ ~2,....~'.~..:~ .......... .'...... · ..... to ..(/o. zz. srz/~.~.c~....o.x~:. ~:~'~'9"' ~'~' '/'/~"~'~ ........................................ ................. :to.~.....(~.~. ~-.. ~.,..~ ~ ........................ .:- .......................................... at premises located a'~..~.~-.. .......... ..~~Z z.:,~zr_,i ...... ..-~....~:/~..7.. ....................... Z,~.~..~.......~.(~ ............ pursuant to appllcation dated .... ~/.2 ....... .Z' ............... , 1~...., and approved by the Building Inspector. / Fee $.~..~......~..~..% .... / *Building [nrOector 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 ..... .~. ~.-,, ................... ..................................... House No. Street Hamlet Owner or Owners of Froperty ................................................. County Tax Map No. 1000 Section 05,5 Block 0/~ Lot.. ,0.0.,2 Subd v sio, .. . . : ............ P,e No.. .... No... ........ / Permit NO, 1.(~. J. t' .~'.. Date of Permit . ./..~?..Applicant ~..: .~.~?. ........ !~/~: ........ Health Dept. Approval ...... 'i. 9.-.S.g: .2.8..9./? .2/.8. gabor Dept. Approval ........................ !~obez"c A. -Fl:L:La Underwriters Approval . N/+cj0575 ............... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .... ~5...qO, .................... Construction on above described building//"/~// /~ z/~/~/and p e r.r.r.r.r.r.r.r.r. Em~ meets~ll a~plic~lble.~Codes and reg~. ,/, ,~.lati°ns' Applicant .~~~~, ............ ,,,.,o.,o.,, ?OUNDAT~ON (~st) FOUNDATION (2nd) 2. ROUGH FRAME& PLUMBING INSULATION PER N.Y. STATE ENERGY COD. E 4. FINAL ADDITIONAL THE NEW YORK BOARD,( ( BUREAU OF ELECTRICITY ~ , ~ 85 ~JOHN STREET NEW YORK~ Date ~ ~ /lppl~cat~o~n Aumlqt 21, 1980 .' ~ , THIS CERT)~, .~,~ ;~ ' , , ~:f]::,_~ only the electrical equipmenE as described below a~d int~dueed ,. WillinG. ~o ,' ' ~ Rd., 500 n/ S thold, . . "~' ~ - ~.~.,.a,~do~ ~t 18, ,1980 ";- FIXTURE SWITCHES ~, ' , FIXTURES OUTLETS DRYERS FURNACE MOTORS TIME CLQCK~ SERVICE DISCONNECT , OTHER APPAEATUS 1-Smoke Detector NO OF CC :' Rutand Electric o; ',i ~ :' ~"; ' P.O. Box 143 '-", '~' ' : ' , Mattituck, N.Y. 11952 ,,,. ~', , r must not be altered m any manoer, return to the office of the, Bo MULTI-OUTLET SYSTEMS NO. OF FEET~ -EXHAUST FANS FORM NO. 1 TOWN OF $OUTHOED BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Dmpproved a/c ...... :. .......................... , APPLICATION FOR BUILDING PERMIT Date ......... ~.iJ'. .... , ApplicationNo.{l~.~.~..~./. ........ 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 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 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary~nsl~ections. ! ~ ,~ ...:. (Signature~of applicant, or n,&me, if a,corporatioh) /.o. . . .o./. .... (Mailing address of applicant) t State whether~l~pli~ant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... ....................................... Name of owner of premises .. C.J~.,: ....... !.mi ........................................... (as on the tax roll or latest deed) If applica~M~ a corporatio~ slg,~at~x~ of duly auth~rized~ficer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No. ~.~' ~.~..~..o..' .~./~..6~...~ff~. Electrician's L~cense No..~..( .~..~....~..~q~-~...-~ 1. Location of land on which proposed work will be done ................. ~ ......... *. ...... ' ........... County Tax Map No. 1000 Section .. ~:~.. ........ Bloc~.~:-~, ............. Lot .qg. ~ ............. (Name) 2. 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 ...e~ .......... ~":~ ...................................i 3. Natureofwork(checkwhichapplicable):NewBuilding ...~.. Repair..~ ............. Removal .............. Demoli 4. Estimated Cost ....~. ~ ~*-. ..................... 5. If dwelling, number of dwelling units ............... Nun If garage, number of cars ..... ~ ........................ 6. If business, commercial or mixe~ occupancy, specify nature an 7. Dimensions of existing structureS, if any: Front ........... 10. 11. 12. 13. 14. ..... Addition .......... Alteration .......... ;ion .............. Other Work ............... Fee ..... .O...~. ....................... (to be paid on filing this application) er of dwelling units on each floor ....... ~. ........ extent of each type of use .................... ,. Rear .............. Depth .............. Height ............... Number of Stories ....................................................... Dimensions of same structure web alterations or additions: Fr .nt ................. Rear ................. Depth ...................... Height ....... ~ ............. Number of Stories ..................... Dimensions of entire new constmctmn Front... ~.3..~. .... Rear ...~. ~. (-.g.'.' .....Depth ...~..?.'.~..~.... 'gh t 1o .t b ' a . . He~ ............ Num er of Stones ......... .~ .... :, ................................. · J,2oj I -~ ~. '~'"' D?pth Saze of lot: Front ........ ~ .... (.~ ..... Rear ....... /..0s .......... t. gl ............ Date of Purchase ..... l?lOt~-. .... ~.~ .......... Name (,f Former Owner . . O.~O~ ;'3'7 .................. Zone or use district in which premises are situated ......... 4~ ............. , ........................... Does proposed construction wolate any zomng law, ordinance >r regulation: ....//.~. .............. Will lot be regraded ...... ~.~. i. · .~.~.. ............ Will ~ xcess fill be removed from premises: Name of Owner of premises ~{1. l~.~.lot ~ ~, ........ Address, Name of Architect .., ~ ...... } · · · r~ ........... Addres,' Name of Contractor ~ ~..04 ~....~ ~.O?/.,:(.~:~.I ..... Address PLOT DIAGK buildings, whether existing aumber or description accordi Locate Clearly and distinctly all property lines. Give street and block interior or corner lot. STATE OF NEW~RI(~_ ,,_7. , COUNTY OF-'~..~./,~'... ]S.S .......... ....... , .................... (Name of individual sign!ny contract) · '.~ l~o~g .M ~1.~ ...... Phone No. ~f. ff .~ .9 ~ ~.~ .... .... I'B.~"..V?D.¢...d-r~... Phone No ................ 17'~.. Cq/,~,~..~ ..... Phone No. ['>..~.. J.~..4"~... ~M proposed, and, indicate all set-back dimensions from ag to deed, and show street names and indicate whether ag duly sworn, deposes and says that he is the applicant above named. He is the ............ ~ ............................................................. (Contractor, agent, corporate officer, etc.) ' of said owner or owners, and is duly authorized to perform or l~ave performed the said work and to make and file this apphcat~on; that all statements contmned m th~s apphcat~on are :ue to the best ofh~s knowledge and behef; and that the work will be performed in the manner set forth in the application Sworn to before me this Notary Public, ....... ~, ...... _..~.~ .L~.,,~t~..~,F,r.~/~7... Count: ' ~ ( NO~RY PUBLIC, State of N~ Y~ No, 52,8125850, SMf~k Cou~ I : Term E~pi~s Mamh Lied therewith· (Signature of applicant) ~ S? 1~1~04 "' ~' ~' The s~ag di~osat and wa~er sup~17 fmctllties for bhis location 'nave b~ ~' ~hief of General ~ging~rl~ - / RODERII;K VAN TUYL, P.C.~r LICENSED LAND SURVEYORS GREENPORT NEW YORK ~FOLK CO~ HEALTH _STATEMENT OF' INTEN)' ~ THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE -SUFFOLK CO, DE-PT OF' RE~ILTI~ SE~RqI~:~ APPLICANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY DATE' . i i OWNERS ADDRESS: 7./4. *B SEAL h~ ..... --~ / SUFFOLK CO. HEALTH DEPT. APPROVAL ~ H.S. NO. / _~_j~ ' ~ATEMENT OF INTENT : ~ THE WATER SU~Y AND S~AGE DIS~AL / S~E~S FO. TH~S .ES~D~NC~ W~LL / CONFORM ffp,)T~.~ ST~P~D~ ~F THE /~. ~_~ SUFFOLK C~. DEPT..eF-HEA~H ~RVICES. /~' /L f~'./ ~FF~K~ TAX ~ ~~-~*~ DEED L N(~ P J~ SEAL .... LAND ~R~N~RT N~W YORK V~TH~'[ CERTI[:iCA,TE 0[: OCCIJPit,~¥ 'I'" F,R ONT ,, E l.. EVAT" i ON° o R i EAR ELF___ VATION APPROVED tS NOTED NOTIFY BUILDING OEPARCME'NT AT 7654802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 3. FOUNDATION.- TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION ,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. -4 l ' F' OUN DATIOkl o PLAN, t F L_ 0 0 R ~ P.L_ A N~ C R 0 & ~ o S U___: CT I 0 N° o ...q I bE · ~') .... E\/AT"tON,