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HomeMy WebLinkAbout11390-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .................. Date .. October 5 ., 19 THIS CERTIFIES that the building . N.~. DW~..~]ZNG ................................ · 800 Cox T,ane Cutchogue Locahon of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section ...0.?? ...... Block ..... fi. ......... Lot Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....~.~.~.e~.e~r.. ~. .... 19 ~.~[. pursuant to which Building Permit No...fi. fi. ~.c).o.g. ....' ........ dated...... 8~,p..t em]3er . ·..:..............,..2/4 19.8,fl., 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 ......... ... g..qBe. ................................................... The certificate is issued to . ~03T.K~D. D....8¢. 23~. ~...~)A~. ................ , ......... (owner, levee or tenant) of the aforesaid building. Suffolk County Department of Health Approval................, .fl ~-s 0-82 UNDERWRITERS CERTIFICATE NO ~55 .~.5.c).~. ' Rev. 1/81 Building Inspector TOWNO ~ BUILDING DJ~P~I~'~AI~N'~ ~ TOWN HALL :' :; $OUTH0~D; N. Y.: ' BUILDING PEPJ~IT: · (THIS PERmiT ~UST BE KEPT 0N THE ~RE~IS~S UNTILI ULL COMPLETION OF THE WORK AUTHORIZED) t139o z Permission is hereby gronted to: Dote ...' ;; ; "- .... ~,.~ ......... ~ .................................................. '?'~"'"'~'"'~' '~'"~'"' "Z"t'"? .......... "'"~ ........................................ at prem~sos located at ................................................. : ......... q;=.~.-..:,~; .... ~ ......  ~nd '.... p~rs~a~t {o app caton doted ~ ~~ .',~, 1 .... . ,.; .? ~.~. .... ,.. ,pprov~ by the *~ila~ng I~specWr. 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 features. ~ 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. B. 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling ~ land use $/o/e5.00 3. Copy of certificate of occupancy $1,00 Date ,. '~..~.),~,. c~ .'~,../.~.-~.., New Building .. ,.~. ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property , ,~...~,,, , .~. ,~. ~, .~.., .Z..~..~.~..~ ..................~.¢./~.'.~/~,/~..~.~,.--. ........ House No. Street Ham/et Owner or Owners of Property ... ~,. ,~-Q, .Z~..~ .~Z)...~,..X~.z~..~.q. ~-... ~¢~...~..~. ~ ........ County Tax Map No. 1000 Section ....(~..?..~'. ...... Block ..... .0./. ...... Lot... ~.~./'. ....... Subdivision - Filed Map No - Lot No Permit No. //.~..~ .O... Date of Permit .-~.a.-77.~. ~/. t~fApplicant ....~..C,~..,~/../~..~...~.,..~..~/~. ....... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...................... ,~_._ Fee Submitted $...~. ........................ Construction on above described building and perm~brneets all applicabl~eedes end~egu lations. Q'O'-~ (/6~('~ App cant ~"'~ ~ ~]~ ~ ..,0,07 , .... .... ........... 1000378 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITy V 85 JOHN STREET, NEW YORK, NEW YORK 1003B .ate~OVe~er 17, :[982 ~pp,ieation~o. onSile 152833-slN 583597 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by tl~ applicant named on the above application number in the premises of ~. Dar~<, Cox Lane, Rt.25 & Cr.47, Cutchoque, N.Y. in tbe following location; [~ Basement [] 1st FI. ~ 2nd Fl. Attic Section Block Lot was exami.ed .... November 11, 1982 and found to be ir, compliance with the requirements of this Board. FIXTURE OUTLETS 41 DRYERS IECEPTACLES 69 FIXTURES RANGES OVENS EXHAUST SWITCHES 5O FLUORESCENT SYSTEMS OTHER APPARATUS: Elecl;~fl.c Room Heat:e~s;5-1.5 ?anelboards; 1-13cir. 125 amps. Z-~moke Detectors 2-4.$ K.W. P~C Water Beater E R V I C NO Oi~ERCC~.COND. OF A W, G NO OF A W, g. ~/o ?-l.0K~, 3-.65 ~4, 3-.35 N; AWG' NO. OF TRALS OF NEUTRAL 2/0 , ~This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspecto'rs may be identified 'by thei/'~dent a s ~r. r~.~ .v ~u~m~ OePARTMENT. THIS COPY OF':~ERTIFI~ATE ~MUS~ NOT B= ~'"~"~ ' .............. 1000378 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 8S JOHN STREET, NEW YORK, NEW YORK 1OO3~ Oate September ,q~ 1984 Application No. onfile 276927-84 THIS CERTIFIES THAT N 6§8520 only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ~eryl g Daak, Cox i,ane, Ri,. 48 & a~. 25, Cutci~ogue~ in the foltowing location; [] Basement [] ~t rt. ~ 2.d ~. outside Section Block Lot 9 ' · and found to be in compliance with the requirements of this Board. Augus~: ,.3, 198~ FIXTURE FIXTURES RANGES OVENS DISH OUTLETS SWITCHES EXHAUST FANS FURNACE FUTURE APPLIANCE FEEDERS DRYERS TIME CLOCKS UNI~ HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: S E R V I C E 3/o NO, OF HI-LEG OF HI-LEG OF NEUTRAL Motor/s: 1-Sbp Charles Hall. Llec. 760 Long Creek Dr. O$N$EA[ MAN~O~ Southold, N.Y. 11.971 LiC.657-E 11 /<,<._~ '~i)[j? Per This ¢~rfifi¢c~le must nol b~ ~ller~d in ony manner; relurn ~o *he offlco o~ *he Boord i} incorrect. In*p~clors moy be identified by lhei(~edenH~ls. COPY FOR B~ DEP THIS ~ ~ ANY MANNER. FIELD INSPECTION COMMENTS FOUNDATION ( 1 st) FOUNDATION (gnd ) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY G~DE FINAL ADDITIONAL COMMENTS: FORM NO. I ~.~ e. cJ,-t '"O~w~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved~/.'~'.. ~.~.... , Permit No. Disapproveda/c ....... ?'Z'L-. .... :..Z. ...... ,.,/ ...... '. / (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No././.~.<~..d'). ....... INSTRUCTIONS a. This application must be completely filled iu by typewriter or in ink and submitted in triplicate to the Buildi 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 strer or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apl:. 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 pern 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 Occupan 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 t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary.inFgections. · ....... (~g~ure of applicant, or name, if a corporation) P- 9.....B. "~ .... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plmnber or build, ............. tO .tO. t-~ ~__O_ .... Ct~-~-...G .e..tC.e.'-~.~..~.. ,C,.u. ~ .~T.O.~.'r.,- ........................... N,~c of owner of premises ..... L..o .o..e,.~ ~.. ~.,.~ h .o,, ~y_... ~..¢. ~ ¢:...,:t .c... ,.~.,....~. ~. ~ ...... (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 ..... .-~..../.~.~ . ,~ Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on whi0h proposed work will be done. .~ .O .~, ~.~. L I~O ~:... ~ .0..'~.O: .~..O..~..t)..~.. ...~.o. 9. ................' ..... d,..o.~.'$. ~t3~¢7. ................ C~p..,-9.~.o.~ ~.W. ............. House Number Street Hamlet County Tax Map No. 1000 Section ..... ~..~..~. ....... Block ..... I Lot.. 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 ...... .~ l~ e_.~.~..-17~... I~,~..I,~ ........................................ b. Intended use and occupancy .... .~..!'~..~.O...~.'Cc:~....~..~...~[...~.LT.~... ~[:~..~. f~.l.,.q~...[..~).~ ..--. .......... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... Estimated Cost ......................... Fee .,. ¥.v ..................... -~ ........... -' (to be paid on t-fling this application) ;. If dwelling, number of dwelling units ............... Nu]nber of dwelling units on each floor ................ If garage, number of cars ............. ~ ......................................................... i. If business, commercial or mixed occupancy, specify hature and extent of each type of use ..................... I. 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 ...................... /. D~mens~ons of enhre new constructmn: Front ... ~.~..".~. ..... Rear ...~..q'...g. ...... Depth . .,,_,,.q~..'?.o..". .... Height ............... Number of Stories ..... ~ ................................................. 7. Size'of lot: Front ...................... Rear ............. ~ ......... Depth ...................... ). Date 6f Purchase ............................. Name of Former Owner . .~..~. ~.~...~,/P..,~'.A.--.. I. Zone or use district in which premises are situated... ~ ]~1..t~'. ! O.~l~.l.~[e.";...~.~..~.t.C'..~.6..°OJ...~q'.4.. .......... !. Do¢s proposed construction violate any zoning law, ordinance or regulation: ......... ,p'/'.O. ................... 3. Wil/lot be regraded ......... ;. .................. Will excess fill be removed from premises: Yes ~. Name of Owner of premises . ~ .~.~'..~ leA...O.~ .~.~-. Address . ~:0....A'.~.ft..I.~. ~..~~o...'~ .3. ~.':.15 t.~. PC. Name of Arcliitect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether ,terior or corner lot. rATE OF NEW YORK, OUNTY OF. ~.~t.A. r77:..0~..,~. ..... S.S .... .J,.~. ~.O.O..t~../3...J?: .... . .~.'~..Q/..~. ............... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) >ore named. e is the ............. ~ ..... .- .................................................. (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the · ork will be performed in the manner set forth in the application filed therewith. ~vorn to before me this ................... day of ............... otary Public, ....... County NOTAI~Y PUBLIC, State of New Ye~,t ~ Qualified in Suffolk County ~ (Signature of applicant) Commission Expires March 30t 198, ~/~ The sewage dt~pesal and water supp]? facilities for this location have been · nspeeted by this de'~q~me~ and · o b2 ~ati~fa~to~.' ~' ~hief cf General Engineerin~ P.J RODERICK VAN TUYL, P C LICENSED LAND SURV~'YORS GREEN~RT ~W ~ORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. il- SO- ~ STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONF~M TO THE ST~D~DS OF THE SU FOL d . DE,T.9,C. AL ~LICANT -- SUFFOLK COUNTY DEPT. OF HEALT SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY DATE:. H. S. REF. NO., APPROVED:. suFFoLK CO. TAX MAP DESIGNATION: OIST, SECT. BLOCK J~ZL. lOOO O~"-t' ! l OWNERS 'ADDRESS: DEED: sc~d ~' STAMP F~iAL . m'e~, lfle pos$ibili~ exisls ~h~l the~ ~mourllS ol pesfiddes ~ml(or GrI~E:ENPOR T NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STAND~S OF THE Is1 /--r,e~'~--~. t'~'~_ ~..~ I C ANT SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY H. s. REF. AeP. OVED: ( ~FOLK CO. TAX MAP DESIGNATION: DIST, ~CT. BL~K PCL s c c~ ~ recl ~r'~ ve i ~AL 77: /~ ?/ ¥O-TA.'L ~.-K d. H, ~ E G ,~ ~ -------------------~- ~),m"F ~ ~ooo � 1 _ a e OCCUPAHICY OR I U -,lLAVVFUL S E IS V i 11NOT CLIEFICATE , ,��,, OF OCCUPANCY 1 .C.,__L ch zc lc _- fW 4;. 1 `4 V i ; N � r 111A0 ; s ' I •''tom`- , � � .T , ��I — I , i {{ i i , I � I � 3 JJ { , e , t ,y _4• 1 , AP VrD AS NOTED f 1 DATE: B.P. '# z FEE: � BY: m NOTIFY BUILDING DE ARTMENT AT 765-1802 9 AM TO 4 PM FOR THE Unaut€"aor; " FOLLOWING INSPECTIONS: zed alteration or 1. FOUNDATION TWO REQUIRED addition to {tis clow FOR POURED CONCRETE .^ 2. ROUGH - FRAMING & PLUMBING the Sc,� r °2 of 4 n c 4 j } :e Education 3. INSULATION °°• �` < 3 4. FINAL - CONSTRUCTION MUST ,t not c BE Cf FOR C. 0. be` ' :cr s inked seal ore r ALL CONSTRUCTION SHALL MEET ' -5Qal stall n ° €22a11 s� ' IR�MENTS OF THE N. Y. be cosvd r not t THE REQU r a.:d copies. r•, : `y.. STATE CONSTRUCTION & ENERGY ZI CODES. NOT RESPONSIBLE FOR �✓`'_" 9�Z�pr { DESIGN OR CONSTRUCTION ERRORS. , a 1. - r c I l dd x { 1 3 r. ` Af _,_. .. �. � i .' ,�'.,.1 7F w �tR A, .d r /�._. rl e'1 -: .F.. � *' - I s-i .. � ,' ? I / .f.. {`., � rte_ �'�Vit. ;. ,, :7 .,I!. .,., j. '-�-,�/A- •/ 7 t 6 G , -,.� ,. ,E;, .• � � g 1 � C jj 37 A f f l:� f � :l �,+�w/ r '' (:t.� •�a;rt� �„ �_. 3 A,�j �f 3 f+ � /'� / // �d ff i n J d y y.. � / ..i• _ IJ PV �e.,.....,....,-�.«....e,..._,_..,....,�...-._.,e_»....-,.,-,..__.._..,e,.,..,«....,«.:,._..«mow...•....___».„:,..,.>._,,.,, ,..:.« .......:........�,,..,,. _..,:�_,. ,..�,.. ,.e... ! :f � L ,. •,- .._,� t l�Iii/'¢.:,...d-�(.. � ,;.�-'�•�./? 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Now 'D - A So .......... 5�4 -XI "PAN------..... 71.1....'_- �W�­ 7' T 7�1 —7 ------------ 17 ---------- y never, - T7 e7- - Tv- li�ii Ila V01 21", v xu_ 0 IWO o -7 _T gulf- 40 jr oil MIA, PSI lh 77,.L A AW r L L-A 0 K-7 7=_-777' 7 777' 777-_,_- __mv ARM, 'A' W k _17 L_ _j 0 Ow" TO Oil mv 14 Yl I ----------- V-1-4 0 7 CC) An I I ram _7_77-T__— A7-777 lit, 4-- low CIO— sw F E -7 Mr gy Wg G WAN I �W 71 C Q N" RON 42SI AMC my orm" .741 3 At 7;0%W- 1; 77-7- 77777 7777!7 RAN -4". �'�':� WWOF11,11 13 Unauthorized alteration or 4k" 1 M 4'', , 514 0 -1:X_ ,-'' '11�,�'�'��'�"' 1770111"1- 4 17 �s docum-ent is a 77� addition to th* violation of szdr,*on 7209 of Lk the Nevv Education _4 Rm-Owl 30 &t.,S, _jxq ETIG i Q Copies of 145 Ammant not in. ed 7,1 j �in_crs z' I, , 1.11 _0 sc,,al shall not --v seall or c.. 5, be cons',-Lrcd v-n,',*d copies. Q- ,_"" -� W, U", A g-, 7 -4 7 NUNN WN . ............. 'A� w ow vow S.un,;a 0 0- 90, "Al € r f I w. >r r 9 >1 i,11-4-lehi r 4 f-T, r , , , t ry _ t , s n J 'Al 1 v _! , d x , y g I 1" ,�� /C'p•- }}pry ? x. , kit if �: �,�, , -„-..n-,-»...-.._ew.we.. � :i. t� • 1. )� �. : r �,-, .,.._,.,�.-....,--•�-_.-nom—..:-„.. u_. z'E!! .. .. TH M IV y. �. } { r /u,�✓r� .�arm � I _ � r .. r , _ -I : P aif f/�• a i /- ._ .+' r s CII , r i L i . 7 4 ,On .. ' } ,. y � b 1 IL x t aE a x l ,. 1TItfA, �•y E pf, s , Unauthorized alteration or w ! addition to this do umant is x;t� ESS violation of s<-e,r n 7209 of �' the Ma-x -e Education : . o CS co " a � ,_nnont not ' :> v. r �F _.� n y�r r inked hea, nshall off' x ti seal or e a s 9 sial n h 13, ak s� O E 2 11 be eons'dered valid coPielrw o s Al ` ,� x � i t , , of i t4' } 1466 Ae I k E w+ 3, i �, �. ��� ..-: (A..y - �-__� ,:•,. ! Y r 1. 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