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Home My WebLink About13421-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..............---.Z13217 Date ........... .F.e.b... .... 1..5 ........... 19.8.5. THIS CERTIFIES that the building . New Dwelling 2500 Little Neck Rd. Location of Property 65 Emery Rd. Cutchogue House No. Street Hamlet County Tax Map No. 1000 Section 103 .Block 04 . .Lot 040 ........ Lot No ............ Subdivision Sunny Shores .Filed Map No. 3231 .17 . conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ~ .u.l.7. ........ .2 .... 19 . .8 .~pursuant to which Building Permit No ..... .1.3.~. 2. .t .g ........ dated· · ..... · .....-.. · ..-....-..'Sept' 6 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 ......... New Private One Family Dwelling ............................... METZNERt JOSEPH The certificate is issued to ..................... [o~n'or,~'--~,t~) ...................... of the aforesaid building. Suffolk County Department of Health Approval .... .1A=$9.-.1.4 ~ ........................... UNDERWRITERS CERTIFICATE NO. N 673681 Building Inspector Rev, 1/81 I~OR.M NO. B TO%VH OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13421 Z Date ...~ .......................................... , Permission is hereby granted to: a.~..~.~..a.~.~....~.~..~...... ~.....~ ,-,..,-. ................. ~ ....... ~ ....... :.., ......... ~ .......... -~.;; . ....... ........ .................. at premises located at ......~....~.....~...~..,....~....~....g~.., ....... ...~..~.~...~.-~. ...... County Tax Map No. 1000 Section .... ).;o.0.....~. ........ Block .......... .~. ......... Lot No ........ .~....0.. ......... to application dated ..... ,~.....~.. ........................., 19..~,.,~., and approved by the pursuant 11 Building Inspector. Building Inspector Rev, 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY · EPT. Instructions A. This application must be filled in typewriter OR ink, and submitted ±n dupttothe 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. F n{~ aporoval of Health Deot. of water supply and sewerage disposal--(S-9 form or equal). 3. ~,ppr0val of electrical installation from Board of Fire Underwriters. 4. Commemial 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 pzoperty 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. F~es: -- 1 P. ertificate of occuoancv $5.00 -2. Certificate ot occupancy on pre-e~ing dwelling $15.0 0 3, Copy of certificate of occupancy $1,00 4.Vacant Land C.O. $5.00 Date .J/9%A) 22- .'/~ ~ New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ..... ~ ~ o,~ ~ House No. Street Ham/et Owner or Owners of Property /~ ~ ~% ~?t+ .~.~ ~u"~c'~'~ oC-~ ~ County Tax Map No. 1000 Section . ! .O..~. ......... Block .... .~. ......... Lot...T.t.~ .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. I .'~..~..~. [ .~.. Date of Permit c~ .I.~.1.~.~...Applicant .............................. }~. ~0 - [~(0 L pt App Health Dept. Approval . .~ ................... abor De . roval ........................ ~ k0r') ~{~\ Planning Board Approval Underwriters Approval ..................................... ,,,,. Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $....~: .o..~ ..................... Construction on above described building and permit meets all applicable codes aod regulations. i q '/ ........................... Rev. 10-10-78 FIELD INSPECTION ItDATE tl COMMENTS FOUNDATION (~st) FOUNDATION 2. (2nd) ROUGH FRAME & ?LUMBING INSULATION PER N. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS iool . THE NEW YORK BOARD OF FIRE UNDERWRITERS ol BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment as described below and int~duced by the applicant natned on the above application number in the premises of go~ph ~ J~ ~t~, 65 ~ I~. ~ Cut(~ogl~ N Y in tbe follow~ng Iocation~ ~ B,se,ne,t ~ 1st Fl. ~ 2nd Fl. Section Block Lot was exa~nined on ])~, ~0 ~ ~ and found to be in con~pliance with the requirements of this Board. OUTLETSFIXTURE SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANE FLUORESCENT DRYERS OTHER APPARATUS: E R V I C NO O~E~C~COND, A.W,G NO, OF HI-LEO A W.G, INO OF NEUTRALS A,W G, OF CC, COND OF HI-LEG OF NEUTRAL · 2/0 1 2/0 Qutn],mi El~;trlc 169 }~ay Ave. ~mpto~l 11~J46 Lie.. 2839 COPY. FOR INER. O1 J B V':,/;L O. 4,0 ~ w,r,r,~ zo 9 4.'`::/~ X > n~ .,f,. C.R !) :L :L (>'.'F. 0 76S-180A BUILDING DEPT. INSPECTION [~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION AND [ ] INSULATION [ ] FRAMING REMARKS: [ ] FINAL DATE, 7GS-XSOZ BUILDING DEPT. INSPECTION FOUNDATION XST [ ] ROUGHL PLBG, [~]/FOUNDATION 2ND [ ]INSULATION [ ] FRAMING [ ] FINAL REMARKS: ~/~ ,, DATE INSPECTOR i ~/~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION :)ND [~INSULATION ( ] FRAMING FINAL REMARKS: ,NS.CTOR /~ "FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 76fi-1803 Examined..-~.~-. ............. Approved Disapproved a/c ..................................... ................................... (Building Iaspector) APPklCATION FOR BUILDING PERMIT INSTRUCTIONS Received ...... ,1 Date .2... ~.].,v. .......... , 19 ?.~.' a. Tins 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 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 admit authorized inspectors on premises and in building for necessary inspections. ~/.'t('g.4 Y.. ¢0.~! 5. ~:A: V.~. T/. q .~. . f.~.' /.~. IAi./.e?...f./tl.c.. (Signature of applicant, or name, if a corporation) , . ¢.7.8-...W'p.O.I)/-.~..w......~.g.E... $7:..~.~..~..rY....~.y.. (Mailing address of applicant) //q~O;, State whether applicant is owner, lessee, agent, architect, engineer, general' contractor, electrician, plumber or builder. k.':. ......................................................... Name of owner of premises /~2 ./-. ~tJTY..r. 5....d-g$.*~. ~....~.~.~./Iff..~. ...................................... (as on the tax roll or latest deed) If appl[caJ3t is a corpmAati, gn, signature of duly authorized officer. , · (.;: ?,-es,d,,,, t) (Name and title of corporate officer) Builder's License No. ~.'a.~. I./t. f?. q ./),../].~..~..~. ~.~.8 ~'l;t,/~/oc'$) ~ Plumber's License No ......................... [44C, mi**tJ'ck Electrician's License No...6'(/.'7.~ .~.r.. Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .as-wz) ~.qa&~.d (,,g' gmO,ey ~0/q¢9.. .CO.TC.HO~.O~. /v, V, House Number Street Hamlet County Tax Map No. 1000 Section . .O. ).Q.~ ........... Block ...O.Q.~k ........... Lot..0. ~.~ ............ o~n/~'5'0,¥ .,,~.x[. $/;10 ~5' Filed Map No. ~ ~S Lot . l .~.. 5~C. Subdivisi ................................................. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ~.fl.~..~..'~.~.~.../. ~/]~. [~ ............................................. b Intended use and occupancy ~]~.~] ~ ff'f~../~f. ,~...~f.../.,O.~/t/d''~f'' ........... 't 3. Nature of work (check which a plicable): New Building ....... Addition .......... Alteration .......... Repair' . ............. RemOval .............. Demolition .............. Other Work ............... ~.~.Qj ~)~'0 }"~ .~,. a e3 (Description) 4. Estimated Cost ......................... Fee ...... ' ............. " ~' (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 mixe~ occupancy, specify nature and extent of each type of use . .~]2t ................ 7 Dimensions of existing structurqs if any: Front ~.lfl Rear : Depth Height . ~..'77. ..... Number of Stories ...~. .... ~ ............................................ Dimensions of sam__e structure with alterations or additions: Front ~-- Rear ...-7 .............. Depth ................... i.. Height ....... ~ ............. Number of Stories...ng~. ~' ........... 8. Dimensions of entire new construction: Front ...6~ .~.r.. Rear ... ~r ~ " ........ ~.? ........ Depth $.R..t~ .......... Height I$ ~ Number of Stories d.~t~a. .............. Size of lot: Front . ] 5'0.. , .. Rear ...... ] 519. ............ Dept,h, ... I~. ................ Zone or use d~stnct m which prem~ses are s~tuated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ...A{.Q ........................... Will lot be regraded ...... ¥~:.5 ................... Will excess fill be removed from premises: Yes Name of Owner of premises ~. ~{ .~q$... ~.~.[~lf~. Address .z~7 .S'0P/~.g...~n. j,q~.~g Phone No. ~lt: ~.. Name of Contractor $c. qr.~0'.ot~.. 5~r/t.E~. ......... Address ~.q.&Wq¢d/q~.~.//,.~ $~. ~qt~. Phone No.~7tx ~~?.?/.~ ..... ~ PLOT DIAGRAM r) ~/t~ [o ~f ~b Locate clearly and distinctly al! buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block?umber or description according to deed, and show street names and indicate whether interior or corner lot. ~ ~ 11. 12. STATE OF NEW YOuR_K, COUNTY OF ,~d-/../.cT./'~-??..A ./< ......S.S . ~. g~.~.O.g.Y.....lq.... ,S..' .~. [~/~. i .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ] He is the ~Q,/b:'.[/~. ?~C..~.~. [ ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that ali statements contained in this application are true to the best of his 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 ........ ~,~...6( ........... day o~...,2..~.~... ~o. 4720~1 i ~ali~d i~ Suffolk ~oun~ ............ 19 ...... coun~y.~. (Signature of applicant) ~Z 1~3.0 NOT m~Q'D.-S~EE t:'tL~ hdAt~-