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Home My WebLink About11318-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate O[ Occupancy No..Z.].~.5..3.6 .......... Date Flarch 9 19.~.~ THIS CERTIFIES that the budding ...~..~.~.~?.~..~.~?. .................................. Location of Property ,..2.~.~.0.. ?.~5:~..w.~?. Drive Cu~hhogue House No Street Ham/et County Tax Map No. 1000 Section .. ? .0.9. ...... Block ...O.~ ........... Lot q 2 Subdivision. ?..~.57.w.~,7. ?.~.~..m? ............. Filed Map No. G..O.G.G....Lot No. ~ 2 conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... A..u~.~.~.~...~ ....... ,19~.q. . pursuant to which Building Permit No. ~ ~134 8Z dated . .~.u. gu.~. t. ~. ................ 19 .~.?, 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 ......... ...... .t79.~' .@.n. 5.n.~.~pu.n..d' p. qo..~..&. ,g. 9.ng.e...e.n. q3:.o..s.e.~. ............................. The certificate is issued to . . . .Gp..b~....B... ,&...lVI.~.~. $9.~..FI.:..~.~.~...o.~ .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~./.~. .................................... UNDERWRITERS CERTIFICATE NO...~3.~.0.~.~. ........................................ Building Inspector Rev. 1/81 FOF,,~ NO, 2~ TOWN OF SOUTH0,~ BUILDING D~PARTMEN~ TOWN HALL SOUTHOLD, N~ Y. BUILDING P, EP-J~I~ ~ (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLC~I'ION OF THE WORK AUTHORIZED) ~ , 11318 Z ~ T (b 19.Z/ Date ...... ~.. ....~... ,: ........................ , /~,.....A..~..%~~..~. .......~ /_~..~...~ ....... -~-,~...,,.,..u.Z~ :: ,. ...... ~~'. ...... .~..~~....,~,~....,~...~~' ~ .. ~ ~ .......... ...~ ...... ~~/~~..L ....................................... ................ ......................~~' ~~..... ~...~.... ........... ~..~...~''~'~ .... : ........................................ ........................................ co,,w T~ ~p No. 1000 S~t,o, ..,..t~....-? ~t~k .'~...~ ~.~ ...... Lo~ No. Ot..~,.L~~ ....., 19~.., and approved by the Building Inspector. Rev. 6~30/80 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 buddings 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 buddings, 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 buddings (prior to Aprd 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peopert¥ showing ali 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- t~on 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 Budding ., ~...~. .... Old or Preexisting Building(~) ..... ~ fVacant Land -. ........... Locat.on of Property . ..~, .-7~.-L~.... ,,../~, .~./~:/.~../}.: ~...~ ~ ~ _ ~ ~ ~/~ ~-~ Hou~ No. Street Ham/et Owner or Owners of Property d~ ~ ~ ~,~ ~ /~d ~: ~ ~O ~ .... ~.~ ..... Lot ................ County Tax Map No. 1000 Section ............. Block /~ S~d~s~o~ ~~ )Z. ~.~. ....... ~,~d M~ ,~ ~.;'...~o~ ,o...(.r~ ....... Permit No./( .~/~ ~.. Date of Permit ....... 4..Applicant . .~D~,Z. ,. ~'. .......... 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 permit'meets all app~cable_,codas and regulations Rev, 10 10 78 iouo~o7 THE NEW YORK BOARD OF FIRE UNDERWRITERS in the following Iocatlo~; ~ Basement wttsexa,~inedoa ,~4C :~]~ ~98~ aadfou,tdtobelncompllancewttktkerequlrementsgthlsBoard. FIXTURE OUTLETS SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT R NO OF NEUTRALSl AWG OF NEUTRAL GENEI~AL MANAGER t:L Per- This cerhflcate must not be altered in any manner; return to the office of the Board if incorrect, inspectors may be identified by the~r"credentials COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERit'IflCA~E BE ALTERED IN ANY MANNER. FIELD ~INSP~CTION FOUHDAT!ON COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: FOB~ NO. ! TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, Examined .... Approved .............. 1~*~.'*... Permit No./../."~:,~...(~.. ................... Disapproved ....................... ;; ....................... ................................. ...... APPLICATION FOR BUILDING PERMIT Date August 3 19 81 INSTRUCTIONS a. This application must be completely filled in by typewriter ot~ 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 buddmgs on premises, relationship to adjoming premises or public streets o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 msue 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 Buildmg 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. applicable ordi nances,)a~ ~t,~ons, and The applicant agrees to comply with all laws, ilding code, housing code, and regule to ~dmit authorized inspectors on premises and in, buildings for np~~ ; '~'~ii~r~/-~f-a~-~/iure of ~'~'~icant~ name, if a ~'~l~i!!ii~i'"~ .... tbuuz~ z~vumue,Bayshore,N.Yo 1 7 7 (Address of opplicent) State whether opphcant is owner, lessee, agent, architect, engmeer, general contractor, electrician, plumber or budder. ............................................ ..C..o.~ .t. ~.a..c. ~9~.'..~. ~..t..~.¢~ ................................................................................................................ Name of owner of premises ....J. 9.bP.,..~:.~2.¢.8 ............................................................................................................................. If applicant is a corporate, signature of duty authorized officer, (Name and title of corporate office~) Builder's License No...~ .................. Plumber's License No.' .............. : ...................... Electrician's License No ............................................. Other Trade's License No ............................................... 6066 Location of land on which proposed work will be done. Map No.' .. p..a.~.~?!.a.y...~.a.~.~..s. .......... Lot No....]:..2. .................. Street and Number Fairway. Drive~Cutcho~..qe,N.Y. "'~{'Z.~ d-~) Municipality State existing use and occupancy of premises and mtended use and occupancy of proposed construction: a Exisiting use and occupancy ........ .o.~.e....f.e..~.~.~.~.~...¥..e.s..~.d..e...~..~..e. ................................................................................ b Intended use and occupancy ....... 9/'i.¢...~.~t~.Y...~.$.e ............................................................................................. SESAME CONSTRUCNoN SERVICES INC. 3. Nature of work (check which applicable): New Building,, ................. Addition .................. Alteration ................ Repair .................. Removal ................... Demolition .................... Other Work ....8..~,.[.,~.~.G...~..0~..~ ....... (Description) 4. Estimated Cost ..... .:~t~.,..9,~,0.,0,~,,0,,O, ........................... Fee ...................................................................................... :... (to be paid on filing this application) 5. If dwelling, number of dwelling, units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature end extent of each type of use ............................ 7. Dimensions of existing structuces, if any: Front ....... ~.2..~ ........... Rear ........ 1..]:.2..:} .............. Depth Height ....~.~ ................ Numbbr of Stories ....... 2...7. .................................................................................................... Dimensions of same structurejwith alterations or additions: Front ....................................Rear ............................ Depth ................................ H,eight ..................... i ...... Number of Stories 8. Dimensions of entire new construct on Front ..... ~.0, .......................... Rear .......... ~..0. ............. Depth ..... .2...0. .............. Height ..[~¢~u~d,. Number:of Stories ....... /~/¢c~p.d .............................................................................................. 9. Size of lot: Front ......... ,1..8,.0,,,,.0, ..................................... Rear ,.,~,0.,,.,0. ............................. Depth 10, Date of Purchase ........................................................ Name of Former Owner ....................................................... 1 1. Zone or use district in which premises are situated ..................................................................................................... 12, Does proposed construction violate any zoning /aw, ordinance or regulation: ........... ~ .......................................... 13, Will lot be regraded ...... .~,.9 ................. Will excess fill be removed fr~rr~premis~sL(~ Yes ( ) No 14, Name of Owner of premises ....a.?.~....l~..~?..? ............................. Address ..C.~.c..~..o.~..~.~.,..~....... Phone No.'.%~.Z:"..'..~.'. ...... Name of Architect P,o~e . Address ................................ ,Phone No ...................... ............................................................ '1250 St:, ~.ou~.~ ,~*~_Ue ' Nome of Contractor ..A.~,C....g..~.~..~..~.p~....~.?.?.,]..e. ..................... Address .~ftY, Ohg~..qa]~.~.~.~ ..... ~ne No....6..6..6.,-..9..0,.0.,0. .... PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and indicate oil set-back dimensions from property lines. Give street and blo;k number or description according to deed, and show street names and indicate whether interior or corner Int. C ~l'A1 E OF NEW ¥ORI< ~ COUNTY OF ..... ~L..~. · ~./'~.~.~ .~. · ........ (Name of individual sig~ing contract) above named. He ,s the ................ ' (Contractor, ~, corporat~fficer, etc.) ' of said owner or owners and ~s du~y authorized to perform or nave performed the sa~d war and to make and file this application; that ail statements contained in this application are true to the best of his knowledge and be ief; and thor the work will be performed in the manner set fo~h in the applicat~ filed therewith. Sworn to before me this l '~ (Sig~m of~li~nt) -I ,,il mm' ~