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Home My WebLink About13415-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y, Certificate Of Occupancy No. Z13311 Date ~p .r.i,1. 2 ..... 1985 THIS CERTIFIES that the building .... hJ. 9,w' .D.w. ,e.3..3_.%n. g .............................. Location of Property 620 Wunneweta Rd. Cutchogue h~t~s'e ~ ............... Street Ham/et County Tax Map No. 1000 Section ....19.4 ...... Block ... 1..1 .......... Lot ....0 .:!..4 ........... Subdivision..~.a.t?..A..N.a..s.s.a.u.. ?.o.~.n..L ........ Filed Map No. 156 .Lot No. 298 conforms substantially to the Application for Building Permit heretofore filed in this office dated ....A.u. cl.' .... 2.9. ........ 19 .8.4. pursuant to which Building hermit No...~.3.4.1.5..g ............. dated .... .S,e,p,t:,: ..... .1.5 ........... 19 .8.4., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which tiffs certificate is issued is ......... ...... c. 9.n.s.t.r..u.c.~. ?..r.iy.a.'¢.e..o. qe., F.a.m.z.' .Zy..D.v.e.Z.Z.~..rig .............................. The certificate is issued to PATTERSON, ROBERT (owner, I~s~ crr~t*mrrt) of the aforesaid building. Suffolk County Department of Health Approval 14-SO- 179 UNDERWRITERS CERTIFICATE NO ................ P.e..n.d.i.n, cj .......................... Building Inspector Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST B£ KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13t15 Z Permission is hereby granted to: ..... ...... ...c~...~..~.,.V.,.....u..~..z/. ....... County Tox Map No. 1000 Section ...... .J...(~...~. ........ Block ......... I.) .......... Lot No ....... I.~ ............ .................C~ ...'~....~ ...... .......... 19.~..~.., and approved by the pursuant to application dated ~W,d~.~. Building Inspector. Building Insl:~ctor Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions ~1...~ BLDG DEPT TOWN OF ~OUI~IOLD A. This application must be filled in typewriter OR ink, and submitted in duplicate 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. Approva~ 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 p2~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 requ ired to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $1 5.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date ... · .. Vacant Land New Building .~. ....... Old or Pr, e-~isting Building ......................... Location of Property ..... ~.... ,~'.~..~..~....~..~'. ~ .... ~ ~ ......... O~f.~,/...Z/,~... Owner or Owners of Property . ,/~...; ~,/,'~41: . .~.. ,~'..-~l ........................... County Tax Map No. 1000 Section / ~jf' Block .... /../. Lot . ./~.~.... · Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.../.3.~./.~. DateofPermit... ~./.¢.~·Applicant...~.~.~..~.~/.'~.. · .~ Health Dept. Approval I ,~ ~..~...O, r ~ O.qJ Labor Dept. Approval Underwriters Approval .~.~.~..L~ ............ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .~ ........................ Construction on above described building a~~~ ~o~ ~ App ~can~ ......................................... Rev. 10-10-78 FIELD INSPECTION FOUNDATION (1st) FOUNDATION {2nd) 2. ROUGH FRAME & PLUMBING INSULATION FERN. Y. STATE ENERGY ~ODE 0~ Wc CO~[MENTS ADDITIONAL COMMENTS: TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit NO. / ~J~'~ Owner~ (please/print) Plumber ~/~-~ ~/L ~. (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, S ~ Fro/~County Notary Public ELLEN M. URBANSKt NOTARY PUBUC. S~a~e of New Yo~ No. 4688534 Qua ifled in Suffolk County Commission Expires March 30, 765.xBoz BUILDING DElft' INSPECTION', FOUNDATION 1ST [ ] ROUGH pI~BG, FOUNDATION ZND IL/I/iNSULATION [ ] FRAMING *REMARKS: FINAL INSpEcToR .. ,.~, ~L ~¢ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved . ~..~'?~m. ~q.. h, 19 ~.q. Permit No..l. ~.~ ! .~. ~ Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .......... ~./~. '.., 19 .~.~. INSTRUCTIONS a. Tins application must be completely filled in by Wpewriter 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 tiffs appli- cation. c. The work covered by tins 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 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 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 inspectors on premises and ?'.~..~ .~/.,d~ ./.~..~:Z./~..~ ;.~ .... admit authorized in building for necessary inspe~tjZones. -- ,r7 , ~ /' ''' i~i~iure';f,'~ljca~, ;; name, if ago porfftior ) .... 3, ...... ................ ? ..... (Mailing address of applicant) t State whether applicant is o~j)er, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................... ./4.r., 7~...-,~.. ............................................................... ame owner o,' .......... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly ~ffhorizgffl~ficer. ~/ (Name and title of corporate officer) Builder's License No .......................... Plumber's Licen}e No..~..~? Electrician's License No.. ~./,.,qt-fg.... ~d/ .. ~.(,~.v · Other Trade's License No ...................... 1. Location of land on which proposed work will be don~e.~...~..tf...gJ.~..~. ~6/~'~.~.' .& ........................ .... ~ ................................ ~(¢z-x.,¢,,.,,,..~,r_-....~.:.. .... ~..'.,-??.."~'. ......... House Number Street Hamlet County Tax Map No. 1000 Section ..... './.O..~. ........ Block . ~../ .............. Lot. ~ff'. ............... ~ ......................... ,f~J~.c~J'~. ~ Map ............... ........... ~. 0"~. Filed No Lot.....~Z Subdivision... / (Name) 2. State existing use and ~ccupancy ~f premises and intended use and ~ccupancy ~f pr~p~sed c~nstructi~n: a. Existing use and occupancy U b. Intended use and occupancy ].~..~ .. 3. Nature of work (check which applicable): New Building ....~..... Addition .......... Alteration .......... Repair .............. RemOval .............. Demolition .............. Other Work ............... '~'/,,~ ¢ (Description) 4. Estimated Cost ......./...o.o .~ Fee ........ i '" (to be paid on filing this application) 5. If dwelling, number of dwelling iunits ..... ~ ..... 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 ... ' ..... ~ ' pth 7. I)imensionsofexistingstructur s, ifany: Front... Rear .............. De .............. Height ............... Number of Stories ..................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ............... Depth : Height Number of Stories 8. Dimensions of entire new construction: Front .... ~. ;L .r~. :... Rear ...c-t/~t ~..'.' ...... Depth .2~.5'. ~. ...... Height ............... Nuniber of Stories .................................................. 7.''" 9. Sizeoflot: Front ... ........... Rear .................... Depth .~,. ~.~. 10. Date of Purchase ......r~ ..... . ........ Name of Former Owner .../'~$"/~. . .~,~.v,g~,/,r4. ~.~... I 1. Zone or use district in which prvmises are situated ..................................................... 12. Does proposed construction viohte any zoning law, ordinance or regulation: ...~x/P ........................ 13, Will lot be regraded ...... ~27) ....... '~ ........ Will excess fill be removed from premises: Yes ~ 14, Name of Owner of premises.. ~ .'.~# .,*,~.../~4,~r~'. Address .,P~t~'.~?~A'~..~]/~..Phone ~o.26f. r.~.g~'.~...... Name of Architect ...... t · · · i ........... ~ ..... Address ...... ,~ ............ Phone No ............ ~... Name of Contractor . .~. ~.,~...~..'~.~r(~.~..~.,... Address~ ............ ~./.tr~..~. J~.~'~, ',~. Phone No.).q .~. (?r7...~. .... PLOT DIAGRAM Locate ¢learl~ and distinctly ail buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blockmumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE O F NEWFY~,./,/ 'SS .......... ~. ~ ./~./~>.~..../-'~-~O~. ~(i. ......... ~e}ng duly sworn, deposes and says that ho is tho applicant (Name of individual sig~ing contract) above named. He ts the ~ .. of said owner or owners, ~d is du~y authorized to perfom or have perfo~ed the said work and to m~e and file this application; that ail statements contused ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~n~r set forth in the application filed therewith. Sworn to before me this i ......... ~ ...... day o~... ~ Notary Public, ............... i . . . .-m~. "4 '1 o Z 0 =o8