HomeMy WebLinkAbout13629-zFORM NO. 4
TOWN OF BOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-18442
Date OCTOBER 3~ 1989
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property 28200 MAIN RD. & 65 NEW SUFFOLK AVE. CUTCHOGUE,NY
House No. Street Hamlet
County Tax Map No. 1000 Section 102 Block 06 Lot 13.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 10, 1984 pursuant to which
Building Permit No. 13629-Z dated DECEMBER 14, 1984
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 ADDITION & ALTERATION TO EXISTING BANK BUILDING
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
NORTH FORK BANK & TRUST CO.
N-690090 - MAY 3~ 1985
Rev. 1/81
· Buil~ding ~n~e-ctor -
FOU~' NO. ~
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
13629 Z
Permission is hereby granted to:
...... .....................
...~.~..~ ..~ ~.~ ~ ...........
~.~.~..~:...!..~ ~.:~.(.
,o ....~.m......~~...~....~m~....~......~.~..~...
~..;;.~..~ .~,....m~.~,., ~ ~.~ ................
- ....... ['1 .................. "/'~-~ ~"T'.'~-'""~/; ' .....
County Tax Mop No. 1000 Section ./. C~ ..~ , Block .......... .~ ......... Lot No. j '~,~/~ I ~
pursuant to application doted .]..~2~¢-~x~...~...~...../....~. ................. , 19.~...~...., and approved by the
Building Inspector.
Fee $..~..... ~ .........'~-..
Building Insl:~ctor
Rev. 6/30/80
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NEW YORK
765 - 1802
11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
DATE..SJ~ ~
NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING..X~....VACANT LAND ........
28200 Main Road & 65 New Suffolk A~e~e ~t~u~
Location of Property ...........
HOUSE NO. STREET HAMLET
North Fork Bank & Trust Company
Owner or Owners of Property .................................................
County Tax Map No. I000 Section 102 Block 0~ . Lot 013.1
Subdivision ....................... Filed Map ........ Lot ..........
12/~4/84
Permit No..1~ .... Date of Permit 4/2~/~7 .Applicant North Fork Bank
Health Dept. Approval .................. Underwriters Approval..~ ..........
Planning Board Approval ................
Request for Temporary Certificate ....... Final Certificate .. XX
Fee Submitted: $. 5q.00
North Fork Bank & T~st Co.
rev. 10/16L88 j
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 iall~ to the Building Inspec-
tor with the following; for new buildings or new use:
1. Final survey of property with accurate [ocation 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"
[and 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:
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.Oo $5.00
Date ..........................
New Building ............. Old or Pre-existing Building .. '.~... ...... Vacant Land .............
Location of Property ~.~.~.' .4~...~.~./.~/
House No. Street Hamlet
Owner or Owners of Property ............................................................
County Tax Map No. 1000 Section ............... Block ............... Lot ................
Subdivision ................................. Filed Map No ........... Lot No ..............
PermitNo/'.~.~.~.~-.. Date of Permit )~)~./.¢~.Z~/Applicant '/ -
Health Dept. Approval ...... ~ ................ Labor Dept. Approval .~. ......................
.Underwriters Approval..~ ..................... Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ................. ......
Fee Submitted $..~..~..0..~. ....................
Construction on above described building and permit meets all Bpplic~ble codes and regulations.
Rev, 10-10-78
THE NEW YORK BOARD OF FIRE UNDERWRITERS
1000771 BUREAU OF ELECTRICITY
~.,~ ~,~y o~, ~ ~..,,~.,,o.~o.o.~,,~ ~s~/~ N 690090
Tfll~ CERTIFIES THAT
only the electrical equipment as ~scribed below and introduced by t~ applicant ~mm~ on the abce application number in t~ premises of
~o~ Pork Ba~:~ a Trust, ~/S Route 25, Cut~h~e~ NY
in the Jollowlng locatlon; ~] Basement ~ Ist FI.
FIXTURE f ~ FIXTURES
OUTLETS EC TACLES SWITCHES FLUORESCENT
4 6 2 ~
DRYERS FURNACE MOTORS
[~ 2nd Fl. Section Block Lot
and found to be in compliance with the requirements of this Board.
RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS
SYSTEMS
NO, OF FEEl
SERVICE DISCONNECT S E R V I C
OTHER APPARATUS:
~uland Electric
P.O. So~ 143
Mattituck, NY 11952 Lio~242E
This certificate must not be altered ia any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPy[FO~ B~ILDING DEP~RTMENT, THIS COP~ ~ER.
FIELD, INS~ECTION
FOUNDATION (1st)
COMMENTS
FOUNDATION
2.
ROUGH FRAME &
FLUMBING
(2nd)
INSULATION FERN.
STATE ENERGY
~ODE
FINAL
ADDITIONAL
COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
[/._.]--FINAL
DATE
,.INSPECTOR
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
This is to advise you that the job under building
permit no. _~29Z issued to North Fork Bank & Trust Co.
on 1___~4~_4 for Alteration is completed and
a final inspection has ( ) has not ( X ) been done.
In order to complete this file, it is necessary that
a Certificate of Occupancy be issued. Please fill out the
enclosed form, return same to the above office with a check
for $25.00 payable to the Town of Southold. Please indicate
to Whom the Certificate of Occupancy is to be mailed, and
arrange with this office for an inspection date
Occupancy or use is unlawful without a Certificate of
Occupancy. Please help us to clear up this matter so that
legal action does not have to be taken.
Thank you for your prompt attention.
Very t r u ly~,
Victor Lessard
Executive Administrator
VL:gar
encl.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a c ~ , ~...-.,...--~-~.., ~, ~,.<
-- ~ '~=~,.~-.' --_ ~ . .
(Buil~ng Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Application No .................
Date . December 10,. , 19 84
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with:
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 street
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 the applicant. Such penni
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 Occupanc,.
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 th~
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o
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 ti
admit authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant, or name, if a corporation)
Garrett A. Strang
3.2. ,....s.o.u..t.np.l.d. ,...N... Y.,..1. t .9 7 J..
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, I~lumber or builder.
Architect
Nameofownerofpremises The North Fork Bank and Trust Co.
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Build6r's License No... Not Selected
Plumber's License No "
Electrician's License No ~"
Other Trade's License No "
Location of land on which proposed work will be done ..................................................
..~9~.Main ............ Rogd ~ ~} .~.Suffolk Ave. Cutchoque
House Number ,,^ .... Street Hamlet
County Tax Map No. 1000 Section .. 1 02 BI k 06 L 12 & 13
.............. oc , et .......
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 ............ .B.a.n.k..i.n.9..F. 9?.i.i..i.~¥ ......................................
b. Intended use and occupancy ................ .S.a.m.s. ...............................................
3 Nature of work (check which a~plicable): New Building Addition Alteration
Removld Demolition ' ' Other Work
Repair ................... , ......................... ., ..........
; .~ (Description)
$2o,0oo oo
4 Estimated Cost · Fee
(to be paid on filing this application)
$. If dwelling, number of dwelling units. ............... Number, of dwelling units on each· floor ...............
If garage, number of cars ,
6, if business, commercial or mixed occupancy, specify nature and extent of each type of use .B.u.s,i.n..e.s.s.. ] .0.0.% ....
7. Dimensions of existing structures, if ~ny: Front.,. ~ Q,' ......... Rear ,. ~ .3.0. '., .' ..... Depth...7.0 '. ........
Height 3 4' Number of Storia$ Two
..... ~0' Rear ,30.'
Duuensmns of same structure with alterat/ons or addmons: Front ..............................
Depth J7 0: Height ~ .4 ' Number of Stories Two '
8 Dimensions of entire new construction: Front ' Rear Depth
~H, eigh't Number f Stori ·
9. S~zeoflot:Front , 111 , R 120' Depth 19'5'& 362~ '
l 0. Date of Purchase .......... , ................... Name of Former Owner .............................
11 Zone or use district in which premises are situated B- 1
12. Does proposed construction violate any zoning law, ordinance or regulation: . ! ...... N.q .....................
13, Will lot be regraded ..... .biZ'..A ................... Will excess fill bo removed from premises: Yes
14. Nam0 of Owner of premises .....~...~, ?....c..o.. .... Address Love Lane Matt. Phn,~ N~ 298-8366
Name ..e a.chi,.~t Ga.rre~t A. Strang AddresaBx 14 2, Southolt~n,,~4~ 765-5455
Name of Contractor ... ~,o.t; .! $ ¢..1,~'~¢¢, ........ Address ....... , ......... .. Phone NO ................
... i PLOT DIAGRAM
Locate clearly and distinctly all buildin/s, whether existing or proposed, and, indicate all setrback 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. ' ' ' ' ' *-
STATE OF NEW YORK,
See Survey
20UNTY'OF...~¢¢~ .....
S.S
Garrett A. S..t?.a,n,c~ being duly sworn deposes and says that he is the applicant
(Name of individual si~nin$ contract)
'lbove named.
lie is the ' Architect
i (Contractor, agent, corporate officer, otc,)
~f sa~d owner or owners, and is dUlY authorized to perform or have performed the said work and to make and file this
~pplication; that all statements coqtained in this application are true to the best of his knowledl~e an~d belief; and that the
work will be performed in the manner set forth in the application filed therewith,
Sworn to before me this
............ 10 .ao,, e D.e.c,e
Notm'Y Public, ..... -- ~, ...... Coon
NOTARY PUBLIC, obtate Of New York (.~;lt~[llat~lre of apptican0
No, 4707878, ~%[folk
Ten. Expires N]aFct] 30,
. ;. :;::::____:_____
-
. / / ._~' ~ ~-) ~~p_ ~ I /l/M, ,~
V¢lT~g~T CERTIFICATE ___
OF OCCUPANCY
'~:~ "" STRANG
~-~:?, ~
555>~0z5244,. '"'~':.' .~.'~/~ Main Road P.O.516Box.
' GARRETT A. 8TRANG
~r~nl~
~-'~'~ ~'~ Mai, n Road RO. Box 1412 Southold N.Y. 11971
~[~ .~L~-:~ 516 - 765 - 5455
GARRETT A. STRANG
architect
MaNn Road P.O. Box 1412 Southold N.Y. 11971
516- 765 - 5455