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HomeMy WebLinkAbout13435-zFORM NO. 4 TOWN OF SOUT~OLD BUILDING DEPARTMENT office of 5he Building Inspector Town Hall Southold, N_Y. ~3PDA~.D ~ CERTIFICATE OF 0CCUPAI~CY No: Z-30437 Date: 09/16/04 THIS CERTIFIES that the building NEW DWELLING Location of Property: 350 HIGHLY/rD ROAD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 109 Block 2 Lot 16.5 SL~odivision File~Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in t~is office dated SEPTEMBER 11, 1984 pursuant to which Building Permit No. 13435-Z dated SEPTEMBER 13, 1984 was issued, and conforms to all of the requirements of the applicable provisions of 5he law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH COVERED FRONT PORCH, REAR DECK AND ATTAC}LED GAB_~E AS APPLIED FOR. THIS CERTIFICATE OF OCCUPANCY UPDATED C/O Z-14017 ISSUED 11/21/85. The certificate is issued to ARTHUR NORDSTROM (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF }{EALTH i~PPROVAL 14-S0-176 11/08/85 EL~t-rKI~_AL CERTIFICA~ NO. N 690718 05/08/85 PLUMBERS CERTIFICATION D~£~u 11/19/85 PERFECTION PLUMBING Authorized Signature Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ..... .Zl.4Q17 ...... Date ..... ~.gy.e.m.b.e..r..2.1. .............. ,19~..5. THIS CERTIFIES that the building ...... .°.n.e. v .f.a.m.i. 1. Y..d.w. 9.1.1.i.n. 9: .................. Location of Property .... 3.5.9 .............. ~i. ~.h.~.a.n..~..~.% ............ c..u.~.c.h..o.~.u.e.... House No. Street Hamlet County Tax Map No. 1000 Section . .. ~.,0,9, ..... Block ..... .2 ......... Lot ....... ~.6.: ,5 ...... Subdivision, .~. $cjh~a,~.~..~.s.~..~.t.e.s. .......... Flied Map No....6.5.3,7..Lot No ...... .3 ,9 ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..s.ept:¢m.her. 13. .... ,19.84pursuant to which Building Permit No....1.3.4:.3..5.~ ............ dated ....... S. Cp.t;e.mlg.e.r.. $ ~ ....... 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 ......... .... P.r i.v.~te...one. ~ .f~m ~. 1. y..d.~, e..~ .~.~.q g, ........................................... The certificate is issued to MICHAEL ZlJ2-IOSKZ (owner~~) of the aforesaid building· Suffolk County Department of Health Approval ................ k4.:s. 9r.1.7.6. ............... UNDERWRITERS CERTIFICATE NO. N690718 Rev. 1/81 Building Inspector TOWN 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) N? 13~35 Z Permission is hereby granted to: .... ~..~...,..m...,.¥.,. .......................... . to...~ ....... ~......~~ ...... ,.~.~ .... 0~....~.. Counh/ Tax Mop No. lO00 Section ...... ~...~....'~. ...... Block ........ ?.....: ...... Lot No ......l..~..:...~. .... pursuant ,o a~lication dot~ ....... ~~.....~ ............. , 19.~.~.., and appmv~ 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 ml~mmmm~ 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 instalia- tions, a certificate of Code compliance from the Architect or Engineer responsible for the buitding. 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~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 3. Copy of certificate of occupancy $1.00 4.Vacan~ Land C.O. $5.00 New Building ...... ~,;., ..... Old or Pre-existing Building $15.00 Date.//.'./~....'/~.. · .~.~..~. ...... ............ V~cant Land ............. Location of Property ............................................................... House No, . Street Hamlet qwner or Owners of Property . .~.~.~/~C. ...¢~..~ c2~5 ................................ County Tax Map No. 1000 Section .... ~. ~ .~.. ..... Block ..... ~ ....... Lot. '' // ' ,© ... Subdivision ................................. Filed Map No ........... Lot No .............. Perm;t NoJ~..~.~..~..~... Date of Permit'S.; [,~,~.~?.~pplicant ./~, .~(~.~.~fi .,¢~-~.~.'-~. '7~.: ........... Health Dept. Approvat...~ .~.~'~ .'-.~i~. .~. ...... Labor Dept. Approval ....... . ................. Underwriters Approval .~...~.~..~. ,~. !.~ ............ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. ~.~. ........................ Construction on above described building and permit meets all applicable codes and regulations. C,O ,~ ~ I L~ 0 / ~ Applicant .......................... Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITy ~ ~* ~, ~ ~,..~..o,~.o.~,~ ~o~7~ N 6907~8 THIS CERTIFIES THAT only the elec~rlcal equipment os descri~ ~elo~ a~d i~trod~ced by the ~pplican~ named on the able application number in the premises of in the following location; ~ B~e,nent 2~ 1st FI. ~ 2nd FI. Section Block Lot 39 w~ examined on b}~ ~ ~ ~ and found to be in compliande with the requirements of this Board. EIXTURE OUTLETS DRYERS RECEPTACLE-~ I SWITCHES FIXTURES RANGES COOKING DECKS OVENS DI EXHAUST FANS FLUORESCENT SYSTEMS NO. OF FEET OTHER APPARATUS: :L R V I C Lic Z300 g Per_ This certificate m~st not be oDered in any raonneri return to ~he office of ~he 8oard if incorrect moy bm identified credentia COPY;FOR BpILOING DEPARTMENT THIS~COP¥ 0F~?ERTIF!~C6LE~,U:~T ~O~ ~ ~E~LT£REO I;N ANY MANNER. TOWN OF SOUTI~OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. ~i~/~'~ Owner ~,;./~,,~ /~ 2. (please print) Plu~er p~;- ?1~.~ ~,~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plum~Ser' s signature) Sworn to before me this /¢tJ'~ day of ~ , ~9 ~$ . Notary Public, ~~ County ~~o~ary Public NOTARY PUBLIC, State of New No. 52-4636665 Sulfa k County,. Commission Expires Marc ~ 30, 19..b'.~ FIEL~ INSPECTION FOUNDATION (~st) COMMENTS FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: 'Ih' 7GS.'1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION '~ST ['I/ROUGH PLBG. [ '1 FOUNDATION 2ND [~/] INSULATION [ ] FRAMING REMARKS: [ ] FINAL INSPECTOR /~..~- ~ 765-1802 BUILDING DEPT. INSPECTION [~]/FOuNDATiON ZST [] ROUGH PLBG. FOUNDATION 2ND[ ] INSULATION FRAMING REMARKS: [ ] FINAL INSPECTOR ~ '" ~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N,Y. 11971 TEL.: 765-1803 Examined . .~z?.~. ~ Approved ...~...~'-.~..~.~.., 19~ '. Permit No..~.~..~.~.~ .~-.. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT ~eceived ........... , ~: Date ................ ].., 19.~. INSTRUCTIONS a. Tkis 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 this appli- cation. e. 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~ ~/~/insveclions.~'/f / , (Signature- ~ -~--of a~licant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....... ( ........................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. tie' ~f corporate officer) guilder sbic s .................. ff'. · · · Electrician's License No ....................... Other Trade's License No ...................... I. Lo~o~d on which pr, County Tax Map No. 1000 S~ Subdivision . .~{..~.C~. ion ..... ~ .'~)~..~ ...... Block... · .¢~..-. .......... Lot... . ~'.~..: ............. Filed Map No.. {,Q .~.%-~. .... Lot '.~ .... Name) 2. ~ta~e existing use and occupancy of premises and inteqded use and occupancy of proposed construction: 10. 1-1. 12, 14, 3. Nature of work (check !w~ :h applicable): New Building ..... ~..... Addition .......... Alteration ~.~..: :. :.... Repair.. ............ ~em~val .............. Demolition ............ Other Work ............... ""! ",t ' ~ t ' ~"'~ ~' '~'~'''''~ .~)..~. ?. 2..'~. ~ J ~ (Deschption) ['~lq$O .~ ,,~ I ~ ~' (to bo paid on filing this application) 5 If d~l~l~ ~ ......... Number of dwelling units on each floor ................ ~age, nu~ of cars ....................................... ~...~ ........... 6. If business, commercial or mixed occupancy, spec~g nature and extent of each type of use ..................... ' ~ R pth 7 Di if mensions of existing structures, any: Front... ear .............. De ........ Height ....... ~ :. ...... Number of Stories ........................................................ D~ensions of same structure wlth alterations or addi i · t ~ . tons. Fron ....................... , .................. Dep~ ..... ". ................ '.. HeiSt ......... ~ .......... Number o~ Sto~es . .~{; ............ /; .... 8. Dlmensmns~fefitlrenewconstmctmn: Front..~ ..... ~. .... Rehr ...2~...~..... Depth . ~.~...~ ...... Heighf .......... Nu~r~ of Sto~es .... [ .......... ~ ................................ Size of lot Front ~,~'--- ........... Rear..~ ~ s.~ . ' ~pth . A~ ........ Date of Purchase . . ~ ~.~.~ ~.~ ................. Name of FemUr 6~;;' .~?~EV. ~gCO~ ~[ ........... Zone or use district in which premises are situated 7~ ................................... ~ ............... Does proposed construction vioiate any zoning law, ordinance or regulation: . ~O .......................... W~l lot be regraded ~ .... ,...~..., ....... : .... Will excess fill be removed from premises: Yes Nme of Owner of premises ~¢J.~71. ~... Address f~ ~.. Phone No. ~.~. Name of Architect .....';.. ;-~'. ................ Address ................... Phone No.~X--. ~ ........... N~e of Cent actor ~ Addres Pho No PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate ail set-back dimensions from property l~nes. Give street and block or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. ............................ , ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sigping contract) above named. He is the ..................... i .................................................................... i (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 ~e this application; that all 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 .......... /./. ...... ........... Notary Public, ..... .~..~ar~(. ~.'i~.,~ ~19~. County, ' '~' ' 'd~' ' '~ '~' ' ' '0'~".~. . (Signature of ''" NOIARY PUIILIC, State of New York' ' ' applicant), ~lo, 4707878, Suffolk ~ou'ntv ,-- l'eml Expires ~a'rch 30, lb~$