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Home My WebLink About13620-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..z1471.Q ......... Date ...... q~$~.~5., .................. 19~§. THIS CERTIFIES that the building ........ qr~q~. ;fAro. $.1Z .d..w.e.l.l.% .rig .................. Location of Property 2010 Eaywaters Road, Cutchogue, New York House No. Street Ham/et County Tax Map No. 1000 Section 111 .Block 6 .Lot P / 0 16 Subdivision ............................... Map No. 806 .Lot No. 370 Sec. D.Nassau Point Club ProP.Filed .................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ? 8.4. p gp 13620z Dec mber 1 t, 19 ursuant to which Buildin ermit No. dated ...D.e.c.e..m.b.e.r...1.1., ............ 19.8. 4., 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 ......... One family dwelling The certificate is issued to Harry Miller ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval 14-50-237 N725522 UNDERWRITERS CERTIFICATE NO .................................................. Plumbers Certification Dated: May 14, 1986 Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13620 Z Dote · I~ ..~.~ ..................................... . ,,..~...~ Permission is hereby gra~cl to: -- , ......................... ....-~..~.~....)..~.~...~o ...................................... County Tax Map No. 1000 Section ....... )..1..! ........... Block ........ ..~., .......... Lot No...J....~..:..~ ..... pursuant to application dated ..~.~.q~...,..~.. .................. , 19..~.~...., and approved by the Building Inspector. Building Inspector 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 Bo This application must be filled in typewriter OR ink, and submitted ~ ~ 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 unu~Jal 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property 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 $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ~,/ /~ 5.Updated C.O. $15.00 Date ...... ~.~ ..... (. ............ New Building v~ Old or Pre-existing Building Vacant Land Location of Property .................. .~..~-: ."'~'~. · ........... .c. t~...<'.? .~ ..... House No, Street Ham/et Owner or Owners of Property .... .~'~.. · ~ ~ · ~ ........ '../~ ......~.~. .................... County Tax Map No. 1000 Section ............... Block ............. Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. I..~.~. ,~...~. Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ..... ¢~ '7' o. Construction on above described building and permit meets all/ap~lc~ble codes and regUlations. Rev. lO-lO-7a THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~[~J 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date J2~C~lOG~ 0~ ~ ~ Application No.o. file 3364~[/85 the followi~g location; ~ Basement ~ 1st Fl. ~ 2nd Fl. Section Block Lot examined on and found to be in compliance with the requiren~ents of this Board. FIXTURE OUTLETS 54 DRYERS IECEPTACLES 54 SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FLUORESCENT SYSTEMS OTHER APPARATUS: S E R V NO O COND. O~ CC. COND. ~/o C NO, OF HI-(EG A. WG OF HI-LEG This certificate must not be altered in any manner; return to the office of the Board if incor~rect Inspecto~ COPY .DING DE GENEI~AL MANAGER .Il ~' may be identified by their credentials. ) IN ANY MANNER. TOWN OF SOUTttOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. ! 1971 TEL. 765-1802 CERTIFICATION Date Building Permit No. I "~ Owner h/~.rr~ //~9; [I¢' (p~ease print) Plu~er ~~ ~ f~ ~ ~ ~ ~p p' I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this of Notary Public, County (plumber' s s~ Notary Public FIELD INSFECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING COMMENTS INSULATION PER N. STATE ENERGY ~ODE FINAL Memorandum from.. · · BUILDING INSPECTOR'S OFFICE TOWN OF SOUTHOLD TOWN HALL, ~OUTHOLD, N. Y. 11971 765-1802 June 19, 1986 ,/ Dear Mike: I am writning you regarding the Miller application for C.O. We do not have an underwriters for him in the office. If you have one bring in and we will make a copy until we receive ours. it 7GS..~.802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTM£NT TOWN HALL SOUTHOLD, N.Y. 11971 Examiner'S. ,~'J .... 19~q... TEL.: 765-1803 Approve; J'~....erq...-~.... i.)..., 19~q.. Permit No./..t~..~A.0. ~ Disapproved a/c ....... : ........................... ~ . ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No .............. J uL~ ............ BLDG. DEPT TOWN OF SOUT)OkD INSTRUCTIONS a. This application' must be completely filled in by typewriter or i'n inl~ 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 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 apprc':al 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 buildiug shall be occupied or used ~n whole or in part for any purpose whatever until a Certificate of Occupan st,.all 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 tbe Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of bnildings, 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 inspections. (Signature qf applicant, or name, if a corporation) k..u.. .,,.'r ...... :.. (MMB-ng address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build~ Nmne of owner orpremises ........ ~ .~.~ ................................................ ~ I .~. ~'.~'.~.I"M' (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authori2ed officer. (Name and title of corporate officer) Builder's License No ........ ~. ~..~ .............. Plumber's License No ..... .~...O.9. ? ........... Electrician's License No. 1. ~'"t, ~ Other Trade's License No ......... ~ ............ ' ~,C> ~ ~, 1. Location of land on which proposed work will.be done..~..~...~ ~ &'l'&"'r'tt4 ~ ~ ~"~ '"~ .,:... ~ . .................. e~"l~,~ House Number Street Hamlet ..... ........... County Tax Man No. I000 Section ......... ,,. ............. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............... 07..~..~ J i ~: ' 'i"'~: :i}' ~'t'~'~(' ...................................... ' b. Intended use and occupancy ......... 3. Nature of work (check wbicb applicable): New ). I. 2. Repair ....... Estimaied Cost. If d~velling, number of dwelling t~nits ...... .~.. If garage number of cars ' If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... Dimensions of existing structures if any Front ."7. Rear Depth I'Ieil~k.~ e -' O~l Nuniber of Stories Dimensions of same structure xvith alterations or additions: Front ~ Rear Depth. ................... [.. lteight ...................... Num_.ber of Stories ........ ~. ...... .. ...... DimensionLof entire new construction: Front . . . ."11 .~ .-~..~ .... Rear . . .~. ?..'~..~ ..... Depth .~....'~..'?9.~ ...... I-teight . l.~..~a. ~ ....... Nun{bet of Stories ........ [ .......... . .................................... Size o£1ot: Front ..... ~, .~..,.O..~. ........ Rear ..... ~[ .~..~.'~....~' ........Depth ., .~..~.."~..~* ............ Date of Purchase ........... ~ .................. Name of Former Owner .......... ,t .................. district in which pr~mises are situated :' Zone or use ...................................................... Does proposed construction violate any zoning law, ordinance or regulation: ...&¢..~ .......................... ,~ Wil.~ lot be rcgraded ...... ~..~.! ................... Will excess fill be removed from premises: Yes No Name of Owner of premises I~1~1..~.~[ ~ ~.... Address~l. I!~..~. ~le..~t'i~.~.~.~'-... Phone No ~' ~ .~.~.~..~'..'~.'$..... ~ ~l~a,~ ....... Name of Architect ......... ~ ............... Address ......... · ........ Phone No ................ Name of Contractor .. ~ .... ~.~,..~ ~.~..~. ....... Address'-i .~.~.. t. I.l.I...~.¥?~.~.. Phone No.'lh .... ~ Addition Alteration Building .............................. ·. RemOval .............. Demolition .............. Other Work ............... (Description). / Fee ' (to be paid on filing this application) ..... Nmnber of dwelling units on each floor..~ ............. PLOT DIAGRAM Locate c early and distinctly ,qll buildings, whether existing or proposed, and, indicate all set-back dimensions from roperty ifl~es. Give street and block innm her or description according to deed, and show street names anti indicate whether tcrior or corner lot. ~ rATe OF NF./W YJ~RK., . ........ '~.;~.../'.\.. ~>~ ..... being duly sworn, deposes and sayg that he is the applicant (N~ndMdual signing'co~ract) )ave nmned. , ' f said owner or owners, and is duly auth~ ~rm or have performed the said work and to m~e and file )plication.; that all statements con~ained in this application are true to the best of bis knowledge and belief; and that the 'ark will be performed in the manner set forth ~ the application filed therewith., worn to before me this , ....... : .~7':~ ':..day of ~, 19g~/' "~ ~" oral,Public, . .... ~... ~....~... ~o. unty , .' ~-H- ' - ~ ~/ ~, ~1~ ~.~& ............................... ~ [ l~~a~ (Signature of applicant) 0 z 8 o~ > h ,tn II / . / / J k.. *0;: ' k.) o