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Home My WebLink About13622-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..................Z15429 Date ...D.e.c.~r~l~.e.~..~., ................ ,19 THIS CERTIFIES that the building .. 0zze. f~/aJ, ly..d.w~ 1.1.J.r~g..w.J. %b. ~.g.~ ~.c~e.d.. g.a.p.~ ge Loca:__~o__~ert. q020 Bridle Lane Cutchogue, N.Y. tiu~x ~l riUlJ y ............................................................... House IVo, Street Hamlet County Tax Map No. 1000 Section 1 02 .Block 8 .Lot 15 Subdivision M/o Highland Estates .Filed Map No. 6.53.7. .LotNo. conforms substantially to the Application for Building Permit heretofore filed in this office dated .D..a .c.e.m.b..e F..5. ,. ....... ,1,9 84 pursuant to which Building Permit No. 13622. Z dated ... P 9.c.e.r.a .t?.e?.. ~..2., ............ 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 ~ith attached garage The certificate is issued to ..... AUBREY WANZOR ................ ..................... of the aforesaid building. Suffolk County Department of Health Approval .......... q. 4. r.~.o. ~ .~ .3.3 ...................... UNDERWRITERS CERTIFICATE NO ............ N.. ? J.6.5. ~ .4 .............................. Plumbers Certification dated December 2~ 1986 .... "' iiding lnspecto~ ............. Rev. 1181 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NB :L3622 Z Permission is hereby granted to: ~.~;. ~...~.~ ..... ~.~....~.:~.:......4/...~..~..~ ............... ' ~~O...,.~Jt~., ~.~;l' j ' 0_~ .~..~,' ...................................................... :. ............... .n ..................................................................... at premises located at ...~..o.....~,.?.....~~....~..~ ......... ~~~ ................ County Tax Map No. 1000 Section .....J.,O.,.~.: ......... Block ....... ..~ ........... Lot No ....... ~,...~.. ........... pursuant to application dated~,~......,.,.~.. .............. , 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 A. 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 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 p~perty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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: I. Certificate of occupancv $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.updated C.O. $15.00 $15.00 NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property IO;i.(P 't~AtrDL~ .L~E ~.'-~T'~:-htoC-~.~.~ ..... House No. Street Hamle~ Owner or Owners of Property /.~.L2. ~,~ .~...k~,. J County Tax Map No. 1000 Section ...1.?..'~.. ....... Block ~ Lot .... ! ,~.~... Subdivision .l~! .~7\A.L..~. ~ .C~...'.~.~..V.~..T.~_~,~. ...... Filed Map No. ~...-~.'-~.'[ .... Lot No. ~ f~ Permit No. I.~ ~ '.J-.~ .Z... Date of Permit I'.?'/J~/.¢..zb..Applicant ~.~:e.. b).t.c..~¢.o.,vt.~A. '.E.~ S.%. .......... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . ~ Fee Submitted $ ~' °c) Construction on above described building and permit meets all applicable codes and regulations. Applicant ............................... Rev. 1040-78 Fi'ELD ~NSFECTION FOUNDATION (1st), FOUNDATION (2nd) ROUGH FRAME & ?LUMBING COMMENTS INSULATION FERN. Y. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: ,? THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY' .~,.0011'~9 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~l..,e ~overa~r h...t,,~s .~pp,ic.,io. No. onf. e ~/~ N716594 THIS CERTIFIE~ THAT only the e~ctrical equipment ~ described below and int~duced by t~ applicant ~med on the able application number in the premises of & )~.. ~ 2~ ,. N. s~t~o~ 0 2 mo& rot Jn the follow~ng locatmn; ~ Basement ~ 1st Fl. ~ ~nd FL was examlned °n ~o~ ~' ~ ~ ~ ~ 8 5 and flound to be ln compHance wlth the requ~rements of this Board. FIXTURE FIXTURES ' RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT DIMMERS SYSTEMS NO. OF FEET OTHER APPARATUS: ].~ Smoke Detector Mo~kors-- 1-1 E R V I C A W O. NO OF HI-tEG PER .~ OF CC. COND, ),. ~/o AWG, OF HI-LEG NO OF t4EUTRAtS OF NEUTRAL ~4ega Elect. Co~st~ ~or~. lic. ~17!0-E P. O. Box 292 ./'~gENEI~AL MANAGER Woodbury~ ~Y., 11797 11 P This certificate must not be altered Jn any manner; return to the office of the Board if [nco[recf. Inspectors may be identified by their credentials. COPy FOR ~UILDING DEPARTMENT. THI I ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit Owner AO(~¥ (please print) Plumber ~ ~l~o~ic ~LU~$I~ (please.print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this ~ day of Notary Public, (plumber s signature) TOWN OF BUILDING DEPARTMENT V'~, TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .~ ~./..~r...., 19~t!. Approv;d~-~...c~w. ! .~.' .)...X~..., ) ~2)~2~ ~ 19~...Permit No . · · Disapproved a/c ..................................... ................................ .... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date ..... ~..~..., 19 .~. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted 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 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 issued a Building Permit to t. he 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 °f 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 building for necessary inspections. ·...5..c.~.~.¢. 3.~.q~$..~.~..s.'F. .............. (Signature of applicant, or name, if a corporation) .19,.~,¢>..c?. ~X .~.u~t~[i~ k¢~ ~. 'ko..o.r. ~.o.~. O.,. ¥.,q ..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......... .c7.~..~.~73%~%~...o..o. ~. T'. C% ~X .o.r. ~ t-~; ...................................................... Name of owner of premises . . '.5..c'.~.~. 3 ?..t.-t.?..~.l~-.S....~..~. ~'('. ......................................... (as on the tax roll or latest deed If applicant is a corporation, signature of duly authorized officer. ................ ~.. P. ,t% I.~, 5, ~,, t;> )-~ N~ ~ ..... ~Name and title of corporate officer) Builder's License No .......................... Plumber's License No.. ~-'~.~'. :': .[~. ............ Electrician's License No.. !.~..~.O. 7..~. ........... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ~o'xo ~o.~o~ k ~..~. ~ .c ?. Y..c La .o..o. ~.u.= ............................ House Number Street Hamlet County Tax Map No. 1000 Section .... ! .0..2. ......... Block ...... ~. ........... Lot .... !.~. .......... ... ~_t~ r-4~ ~ ~T/:~-CW~; .............. Lot ............... Subdivision I'~ ~ O 14 .......................... Filed Map No. & ,.5 ~ 7 I ~ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy x/,~ ~./3..~..T/ ............................................... b. Intended use and occupancy . .~.l.~..O/' .~.'.~...~ !~ .t,:33.k.-:(.. 3.% ~ .~. ,I ?..~.-.~..r4 .ff. .......................... 3. Nature of work (check which applicable): New Building .. ~ .' ..... ~Addition..! ....... Alteration ........... Repair .............. Removal .............. Demolition . .-~-./,. .... .. . Other Work ............... , (Description) 4. Estimated Cost .~..~, ~ ~:~ c~?. , ' '~ (to belpaid on filing this application) 5. If dwelling, number of dwelling units. ~ Number of dwelling uniis on each floor.. If garage, number of cars ~ ' 6. If business, commercial or mixed occupancy, specify nature and extent of each tybe 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 ............ i ..... Rear ......... ; ........ Depth ...................... Height ..................... Numbe~r of Stories. 8. Dimensions of entire new construction: Front . ~ °B' 'R,~- ~ c>~ ..................... ............... ~, ...~ .... ' ....... Depth ...~.~/ ........ Helg t .... .~ c,.>.. Number of Stories .......... .i ...... 2..s. ,' .......... 9. S~ze of lot: Front .................. Rear.: ............... jDepth ................. 10. Date of Purchase . .L°. / ! ~.~.~..'5. ............. Name of Former O~vner .Iqto..L4l-/~ .1~.O. [q.O./~9 11. Zone or use district in which premises are situated . ~-~L~.~¥t~k l 12. Does proposed construction violate any zoning law, ordinance or regulation: .... I O ......................... 13. Will lot be regraded ....... b~q~ .................. Will excess fill be removeid from premises: Yes 14. Name of Owner of premi,ses ~ ......... ..... Address ............... ! ....Phone No ................ Name of Architect .¥O. 1FA~, C~.~.~ ~C~-~K~. Address~.B.~.tg.Ctr'~ ~ ' .... ~.~, .,. Phone No ................ Name of Contractor ~'.~.~.'.~3~ h .O.~. g~..~&*.T... Address ~.o..o.y. k4.o.'u.t>' . i ... Phone No.76.,,5-.-.~..°B..o ...... ,o 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 s~o.w street names and indicate whether interior or corner lot. ~ ........ ~-~ F~, / / 22~,26' STATE OF NEW YORK. ~ ~ cog r, v .......... · '{~e of individual signing contract) being duly sworn, deposes and says that he is the applicant above named. He is the ........................... .~..~..7~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this application; that all statements contained in this application are true to the best of hig knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this · · . )~ a o ~) '.(L:~..%~..~... ooq* ......... · ....... yor .......... ..... ,19.,: NOTARY PUBLIC, State o~ New York ,,r z i... 6 -I o