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Home My WebLink About11333-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z- 16233 October I, 1987 Date ................................. THIS CERTIFIES that the building A D D I T I 0 N 540 Cedars Road Cutchogue, New York Location of Property ~t~>{~s~ h/o] ....................... '~'t/e${ ....................... Hamlet County Tax Map No. 1000 Section .. 1.0..9 ....... Block 05 .Lot 0 I 7 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated August 13, 1981 11333 g ...................... pursuant to which Building Permit No ...................... dated August 13, 1981 ............................ was issued, and conforms to all of the requirements of the applicable provisions of the/aw. The occupancy for which this certificate is issued is ......... ADDITION TO EXISTING ONE FAMILY DWELLING EBWARD F. & DIANNA SCHILLER The certificate is issued to ..................... [o~n'e'r,'/~rXt~r,X~x .................... of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO. lq 8 2 9 3 1 2 N/A PLUMBERS CERTIFICATION DATED: / B~/ffding Inspector Rev. 1/81 ~o~ ~o. ~ TOWN '0~ ~UT~O~ BUILDING 1D~PARI'MI NI~ TOWN HALL SOUTHOLD, N. Y. BUILDING P. EPJGI'I (THIS PERMIT MUST BE KEPT ON 'FHE PREMISES UNTIL ~ULL COMPLETION OF THE WORK AUTHOR ZED) ! ./ ~'~ 19..~ ]hl°. 1133.'t Z r>ote ...~... ~...~z:...../. ................... , i ' Permission is hereby granted to: 4;,.o.y.....~.7/. .................................. ............... .... ~..~.~.~o.F~.~.,,....~;..~. ...... ?./.,z..7~. .~. ~o ........ L~r`~x~z~ z~`~2~/~z~ ~/~~`~z4~ ........ ............................................................................................. ~. ;~..-~.~ ................. ~ ........................................ at prem~ses located at ...~.........~.. ........... 4~.~.~Z~· ..... ~ ........... ~'"' · ?.~,.. ........ Lot No....O./,. ,~.. ......... County Tax Map No. 1000 Sect on .............. Block ~.. pursuant to application dated ..~.(~.~:/..,~..,.... ,/,,,?,.......i...~....., 19.~., and approved by the Building Inspector. Fee $.,/..~.,.'~, .......... Rev.~ 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ laammmmm 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 p~operty 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: Additions $25.00 1. Certificate of occupancy New Dwelling $25.Q0, Accessory ~$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of oc,cupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O~. $ 20.00 _/ !_ 5.updated C.O. / $ 50.00 Date ..... ~//./.~7//~..~ ............ Newc°nscrucc~on. ¥ .... Old or Pre-existing Budding . .~?~. ........ Vacant Land ......... _... Location of Property...~.~/~,~ ................. ~../~'./~,~'..~.~¢,. ............ ~.c.-~/'.(3.,~.~...- House No, ~x~ FJ.~ /c~Street ~-~ Ham/et Owner or Owners of Property ..... . ./~. ,,,,..c0.~¢J~.././.. ~., ~,~./. ~,ft~,~.~....~. ./-/'. (¢~ .~/~ ....... County Tax Map No. 1000 Section .. ~.~..~. ........ Block ...4~,~. ........ Lot .... .O./.'~, ....... Subdivision ................................. Fried Map No ........... Lot No .............. //3~., fP it Permit No .......... Date o erin .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ........ ,.~. ........... Fee Submitted $ ............................. Rev, 10-10-78 THE NEW YORK BOARD OF FiRE UNDERWRITERS"i 1001585 BUREAU OF ELECTRICITY ' ~-h9 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT . o~y t~ electrical ~uipment ~ ~scrlb~ below a~ int~uc~ [y the applicant ~med o~ the a~ appti~atlon ~pmber in the prem~ of Edward Schiller, 540 Cedars Road, Cutch~ue, ~ in thefollowlnglocation; ~ B~,ement ~ Isl FL ~ 2~ ~l. Section 109~/~ 05- ~t 017 August 14, 1987 afld foufld to be i. compliance tclth the req.lre,,tent~ ~ff this Board.'*' FIXTURE II~ECEPTACLESI SWilCHES ; FIXTURES ~E.CUe~ i 9 14 12 ~D~RYE? w c~[ FURHNpACE--%TORS" ~ FU:UzR R A PPLI.'oN C E R AE rwE RCS RANGES SERVICE DISCONNECT I NO OF I S M~TER 1 100 CB 1 i~ SPECIAL REC'PT. 1 30i R AWG OF CC COND 2 EXHAUST FANS DIMMERS 2 Daniel A. Fogarty, Jr. Box 1000 Sound Avenue Mattituck, NY 11952 Lic# 771E GENERAL MANAGER 11 certificate raps! nol be oltered m any monner: return to the off ce of the 8oarcl if inc rrect Inspect.o, rs moy be dent f ed by their credent 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [~J//ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [~FRAMING [ ] FINAL REMARKS: DATE INSPECTOR FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1802 Examined ~../..fl ...... , l .~. / / ~ ~ ~ ~ ^p ro¥ d ...... Disapproved a/c ................................. ~ APPLICATION FOR BUILDING PERMIT Application No. ~ ....... INSTRUCTIONS a. This application must be completely filled in 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 stre~ or areas, and giving a detailed description of layout of property must be drawn ou the diagram which is part of this ap~ cation. c. The work covered by this application may uot be commenced before issuance of Building Permit. d. Upon approval of this application, the Bnilding Inspector will issue a Building Permit to the applicant. Such peru 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 buddings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, buildin~ ~ode, housing.~o~ and regulations, mud .... . .... ~ '(' ',: ................ (Signature of apphca'~:~ ~e, if a corporation~ .... 2/., ' (Mailing address of a~licant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil& Nmne of owner o f prelnises .... ~.4q, q~t'4 ...... ~ ~. d~e'~,,g-, . , ,'JT)~4,(./.k4 ~ .............................. (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 ..... ~.C .............. Plumber's License No ..... .~. ~. 7 ../9 ............ Electrician's License No ..... ~,',~(~ .~ ............ Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ ..... .o. ..................... d'. . ............ ................... House Number Street Hamlet County'Tax Map No. 1000 Section .... [.O. ~' .......... Block ................. Lot .... ./~7. .......... Subdivision ..................................... Filed Map No .............. Lot .............. (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~. O/~.~:. :. ........ P.. .................. b Intended use and · occupancy ......................................................... I. Nature of work (check whict, applicable): New Building .......... Addition .... ~. ..... Alteration .......... Repair .............. RemOval .......... Demolition .............. Other Work ............... (Description) Estimated Cost · (to be paid on filing this application) , /. ;. If dwelling, number of dwelling traits .............. Number of dwelling units on each floor ............... If garage, number of cars ....................................................................... L If business commercial or mixed occupancy, specify nature and extent of each type of use ......... : .......... I. Dimensions of existing structure:s, if any: Front .... ~'.~...'~.: ....Rear ...~.~'..~. ..... Depth .~x:5..:~.: ...... Height .. 6?./v.'fi't: ...... Number of Stones ...... a~../. ............................................. Dimensions of sa ne structure with alterations or additions: Front ..... 4.q.~.-. ...... Rear ....~.q.~'. r ........ Depth .-f..~'. 7~.~ .q'.O.~/~: ...... ... Height ...2. g .'~f~.: .............. Number of Stories ~ ..... ~. Dimensions of entire new construction: Front .... d.q.~t2/t~. ...... Rear ....~'.~/'.~... ..... Depth Height ... ~.t~ .'t3f. ...... Number of Stones ...... . .-~.~ ................ ~ ............................. Rear ' Depth ~. Sizeoflot: Front ........... : ........................................ ). Date 6fPurchase ............................. Nam.~ of Former Owner ............................. I. Zone or use d~smct ~n which pmm~ses are s~tuated ....................... ;4~ ........................ 2. Does proposed construction violate any zoning law, ordinance or regulation: .... ~F'~ ................... ~. Will lot be regraded ....... ~t~.O ................. Will excess_fill be removed from premises: ' ~ No L Name of Owner of premises .,ff~¥o,*t,q~...d.~,,/t~:~,~.. Address . .~'*O:~//~ 6'.0~: ...... Phone No. 7~ ~ g. g~... Name of Architect .......... 1 ................. Address ................... Phone No ................ Nmne of Contractor .~ ......................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly ~d distinctly ill: bufld~gs, whether existing or proposed, and. indicate ri set-back d~ensions from roperty ~nes. Give street and block nmnber or description according to deed, and show street names and indicate whether .tailor or corner lot. 'L I'ATE OF NEW YORK.. OUNTY OF .~M..F.~.O.+.~. ...... S.S ,' n4 ...~4 W.~?../3 .... ~ .... · .~gi. '[ I .~ff~ ................ being drily sworn, deposes and says that he is the applicant (Name of individual sigtdng contract) ~ove named. e is the ........................................................................................ (Contractor, agent, corporate officer, etc.) f said owner or owners, m~d is drily authorized to perform or have performed the ~aid work and to make and file this )plication; that all statements con!ained in this application are true to the best of hil~ knowledge and belief; and that the 'ork will be perforlned in the manngr set forth in the application filed therewith. worn to before me this f DATE: ~B P, ~ ~----~ NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING ~NSPECTIONS: 1, FOtJND&TION - TWO REQUIRED FOP POUR~D CONCRETE 2. ROUGH - FRAMING ~ ~LUM~ING 3. lngULAT~ON 4. FINAE - CONSTRUCTION MUST BE C~F~pLETE FOR C 0 ALL CONSTRtJCTiON SHALL ME~t ~ REOUIREMENTS OF THE N. Y- ~TE dONSTRUCTiON & ENE~g~ NOT RESPONSIBLE ru - CODES. DE~'GN OR CONSTRUCTION ERPO,~-~ ,i