HomeMy WebLinkAbout11044-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
THIS CERTIFIES that the building ................................................
1900 Wunneweta Road, ~Cutchogue, New York
Location of Property fi/~t~s~ )V'ol ....................... ~r~i ....................... //~r~/'e~
County Tax Map No. 1000 Section ... 1.1 J ...... Block .... t~.4 ......... Lot ...0..2 ~ ...........
Subdivision..N.a. 8..~.~.u...P.g....C. 1..u.b..P.v..o.p.. ..... Filed Map No. 806 .Lot No. 342
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.... .~.a. ~. g.~..3. ........ , 19...~rsuant to which Building Permit No .... J .1.Q4..4..~. .........
dated ..... .M.a.r..c.h.. 1. .0 ............. 19 .~.1. ,'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 .........
............... Y.v. iva.t~.~. 0n~..F~m.i~ky. p.w.e~ ~ ~..i.qg ................................
The certificate is issued to Claire and Harry Applegate
{°wnerd~ ~rxt~, ~ X x x
of the aforesaid building.
Suffolk County Department of Health Approval ..~. ~. 7 .S.0.-. 0..6 ,~..S.e. ? .~ .... ~..0 .~..~. 9. ,8 .~..~ :..g.... ~. ,t .11 a
UNDERWRITERS CERTIFICATE NO, Iq 539942
/' ,Bui q-'
Rev, 1/81
FOE~ NO, ~ i
'TOWN OF SDUTHOLp i~
BUILDING DEp~RyMEJq~
TOWN H~LC
SOUTHOLD, N~ Y. ~
(THIS PERMIT MUST BE KEPT ON TH.~ PREMISEg
COMPLETION OF THE WORK AUTHORIZED)
uNTIL FiULL
N°. 11044 Z Date ...... ~.~...! ..... ~ ................ , 19..~.~'.
Permission is hereby granted to:
.......~~...~.~.:...~... :...:'. ........
. ...... ~,~~,..~.p~. :....~ ...........
,~ ........ ~x~. ~....x~....~.~.~z~ ....~ ................
.... .... ~.~..~~,. ...~.....~, ....... ~: .........................
............ ~?~..~ ............ : ..............
c~ ,~ ~p ~o. ~o00 s,~t~o~ ..Z~Z ........... ~. ~[ ,;~ .......... : .or Uo..~.z~ ......
pursO~nt fo opplic*tion d~t~d .~~.:..~;..,,-.:..,..,;...~....., i~ t.., ~nd ,pprovod by tho
Building Idspector,
Rev. ,6/30580
Iding ~r~ectoe
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.
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 or land use $5.00
3. Copy of certificate of occupancy $1.00
Date .. !0~30-81 , ..
New Building ...%, ......... Old or Pre-existing Building(X) ......... =/Vacant Land ............
Location of Property 1900 Wunnewe'l;a Road~ ~utchogue, N.Y.
House No. Street Ham/et
Owner or Owners of Property ...C.~..a~?.~ a:~ct Ha~% Ap~%egate
County Tax Map No. 1000 Section 111 Block 0/~ 022
.............................. Lot ................
Subdivision~.~.a~.s.a.~. Point Club Pro];). .Filed Map No. 806
........................ · ......... Lot No, 3~2
Permit No. 1..1.O./+.Z.~Z.,.. Date of Permit .~7.1.0.-.8~1. ,Applicant .Qeorg.e..;.tb_l.e.r. 8. ]3~.~.],d97.,..3~.~ .
Health Dept. Approval ..9-]-0-8]-......,........,......Labor Dept. Approval ........... 'C;l~
Underwriters Approval
· . .Plafming Board Approval .........
Request for Temporary Certificate ..................... Final Certificate . ¢( .......
Fee Submitted $ .?: .0.0. .......................
Construction on above described building and per~r/~s~all app~l~s, a~nd regulations'
Applicant .... ,..,~.~..'%_. ~._ .'~ .... ,.,.'~..'?. , .L,~-,f~¢..~.-~. ......................
Rev. 10-10-78
FIELD Ilq$~ECTION
I.
FOUNDATION (list)
COMMENTS
FOUNDATION
2.
ROUGH FRAME &
PLUMBING
INSULATION PER N.Y.
STATE ENERGY
COpE
FINAL
ADDITIONAL COMMENTS:
iooo~17 THE NEW YORK BOARD OF FIRE UNDERWRITERS
[~ BUREAU OF ELECTRICITY
Jo.. STREET, .E V
THIS CERTIFIES THAT ~ -.~ ~ .... ~ ~
only the electrical equip.tent as described below and int~duced by the applicant ~med on the able application number in the premises of
~p]ega~, 1900 W~:~tra ~1, ~tC~, N~Y,
~.~ ~x.,n~.od o. OctO~ 19, 1981 and found to be in compliance with the requirements of this Board.
FIXTURE
OUTLETS
19
RECEPTACLES
4-2
SWITCHES FIXTURES RANGES OVENS EXHAUST FANS
FLUORESCENT VApOR
22 19
DRYERS
FURNACE MOTORS FUTURE APPLIANCE FEEDERS
TIME CLOCKS MULTI-OUTLE DIMMERS
SYSTEMS
NO. OF FEET
SERVICE DISCONNECT
OTHER APPARATUS:
Elec,l~o~ Hea~r/e; 4.-L5, 4-1.0, 4-~65, 2-.365 K,W.
~..-.o,,..
I ~~oke ~tec~or
S E ~ -R V
No %~C~C~COND ~ w o.
OF CC, COND NO OF HI LEG
i'
2/0
I C E
A W G NO, O=k~EUTRALS A W.G.
OF HILEG '~ OF NEUTRAL
2/0
Jotu% F. Wap~rka Jr.
1680 Wash/akgton Ave.
Bobe~ia, N.Y. 11716 1ic.1261
11
This certificate must not be altered in any manner; return to the office of the Board if incorrect. InspectoFs may be identified
THIS MUST BE ALTERED IN ANY M~NNER.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Examined/.t~E, 6~../. (2...., 19 ~./. Application No. ~/. r./.(?.~..~.. .......
Approved ~/~/~5~/~.../. ~.., 19& Permit No..//. ~...~.C.~..~
Disapproved a/c .....
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ....3.-.3.-.8..1 ........ , 19...
INSTRUCTIONS
a. This application must b~ completely filled in by typewriter or in ink and submitted in triplicate to the Building
Inspector, wi~h 3 sets of plans, abcu?ate ~01ot plan to scale. Fee accor~ling to ~chedule.
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 inspections.
.... G.e. Qrgp..Ahler. s .Blair.,. Inc ..............
(Signature of applicant, or name, if a corporation)
Eugenes Rd, Cutohogue, N.Y.
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
........... g.e.n.e.r. 9.!..qqn..t.r.a.q t. 9.r. ...............................................................
Name of owner of premises .~..1.a.~lT.e...a.n.d...H.a.r.r.y..Ap.p%~g.a~tSe ...........................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
......... .qe. 9.rg.e..b.h3.e.r.s,..P.r.e.s ...............
(Name and title of corporate officer)
Builder's License No...#3l ....................
Plumber's License No..f~79.7.P. .................
Electrician's License No. #13.Q6E ...............
Other Trade's License No ......................
1. Location of land on which proposed work will be done· .. Wulanewe.ta. Road ..............................
.... ./.~..~..~? ................ Wunr~eweta .Road. ................. Cutehogue., ....................
House Number Street Hamlet
County Tax Map No. 1000 Section . 12L1 ............. Block ...... 4 ........... Lot..22 ...............
Subdivision .Nas.aau. P. oint. Club. P.r. ope.r, ties,..lrfil,~ Map No..89.6. .......... Lot . 3.4.2. .......... (Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ...~a¢~rlt. l~nd .....................................................
b. Intended use and occupancy dwe 1.1J, rl..g.
3. Nature of work (check which applicable): New Building . ~c ....... Addition .......... Alteration ..........
~ Repair .............. Removal .............. Demolition .............. Other Work ...............
(Description)
4. Estimated Cost .$65.~.000.E10 .......................... Fee ......................................
(to be paid on filing this application)
5. If dwel:ling, number of dwelling Units . .6 ............ 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 .. 59.' .......... Rear ...... 59.' ...... Depth ... 2~.!' .........
Height ... 2~5.~. ........ Number of Stories ....... 2 ................................................
Size of lot: Front . ~.QQ t R ~.00 ' pth
................. ear ..................... De .................
Date of Purchase 1~80 Name of Former O'~/ner ...........................
Zone or use district in which pr~mises are situated .... .A ......... .......................................
Does propose'd Construction violate any zoning law, ordinance or regulation: ...... no ........................
Will lot be regraded . .no ..... ................... Will excess fill be removed from premises: Yes No
Name of Owner of premises~o.&. C...Apple~ate... Address 156..E79.~h. St..1T/. Phone No.516,-.7.34,-8:L38.
Name of Architect . .Gordon .g~hlers .......... Address . JaJnespo~t,. N,Y, Phone No.7.22.-Z~227
Name of Contractor .~ ~tll.e.l?..~. :B~c~r s..:Crag ,... Address Ollg. c.l?gg!4e. ~. N...Y. ~. Phone No..7.3./4.".5.010 .....
10.
Il.
12.
13.
14.
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 number or description according to deed, and show street names and indicate whether
interior or corner lot.
see attachedlsurveys
STATE OF NEW Y~K, ~ ,o o
couNTy OF .~... o.~
~.O. QlTg~ .~l~..fl ............. ...... being duly sworn, deposes and says that he is the applicant
(Name of individual signling contract)
above named. '
Contractor
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 conthined in this application are true to the best of his knowledge and belief; and that the
work will be performed in the mann6r set forth in the application filed therewith.
Sworn to before me this
Notar~ Pub, hc, . ....... ,,~ ..... .,~. ~ . County
' ff ELIZABE[~ ANN NEYtJZ~ ...............................
~ NOTARY PUBLIC, State ~f~New Yor~
No. 52-8125850, ~uffOIk Cq~_ (Signature of applicant)
I Term Expires March $0, 1 .~....,..~
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
·
REMARKS: '
DATE INSPECTOR
~~'~ INSPECTION
FOUNDATION ZN:D [ ] INSULATION
FRAMING I- ] FINAL
REMARKS: