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Home My WebLink About13226-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building reconstruction & repair. Location of Property 335 Lilac Lane .. '~'. Cutchogue House No. Street Ham/et County Tax Map No. 1000 Section .... .'1.0.~ .... Block..............q .Lot .........59 ........ Subdivision ...... X ...Filed Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated .................... ,19. ursuant to which Buildin ermit No ...................... dated ....... J..u¢..e.. ? .~ ............. 19.8.~., 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 ......... ...R.e.c. 9.n.s.t.r..ug.~.i.o..n' .&. repair of portion o£ dwelling destroyed by £ire. The certificate is issued to FREDERICK T. NINESLING ..................... /o¥.;;~ ..................... of the aforesaid building. Suffolk County Department of Health Approval .............. ~.../.A ........................ UNDERWRIZERS CERTIFICAT~ NO .................... ~..59.6.7.~. ..................... Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13226 Z Permission is hereby gronted to: ....... ~..~...~ ...... ........ ~..~L~..~..~.~.~'. ....... ~/~ ......... ......... _~.~.~..~....~....~..¥..~.....zzzY~ ,o ...~.~.~ZL.~..~~ ...... ~.~...~ .................. ~~..~.~...~ ........ ~.~ ........ ~~~..~=~ ot premises I~oted ot ,,,,~m,,,,.,L.~,~ ~.~,...~.~ ......... ~~..~ ~ County Tax Mop No. 1000 Section ..~..(~...~.. ......... Block .0~.. ............. Lot No....~.../...~... ....... pursuont to opplicotion doted ....... ...~.Z~.~. ....... ~....~... ............... , 1~...~., and opproved by the Building Inspector, Rev. 6/30/80 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 i II~ to the Building Inspec- tor with the following; for new buildings or new use: I. 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~"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 New Building ...~.. Id or Pre-exi il ....... Vacant Land ............. Location of Property ~/- ~" ~;~(L ~ ~u.....~........../~o u~ ~ /~ House No.. Street Ham/et Owner or Owners of Property . ~ .................................... County Tax Map No. 1000 Section .~.= ~. .......... Block ...'. ........... Lot .......... Subdivision ................................. Filed Map No ........... Lot No ........ ' ...... Permit No ......... Date of Permit .... Applicant · 'I .... '~' · ....... ...... ~ ....... ;...:Lab r Dept. Approval .. Health Dept. Approval ~ ...................... Unde~Hters Approval ..... : ....... ~..~ .... Pl~nnln~ Board Approval ............. ~equost for lem~orarg Certificate .................... ~~c~ .. .............. F~ Submkt~d $ ............. ~(~ ...... ~ .... l'~ Construction on above described building a,.n/~l,~ermitmeets all appl,~ic~ble codes aqd regulations. .:': .... ........................... C_ ............. ,~. ~o-~o-~s ' ) 3 g~5 3 ~ 7 Fre~e~i~ T. Nbeslmg RR $1- 335 Lilac ~ne Cut~ogue, N.Y. 1~3~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 1003~B ..to A~-~t~ Z~ .~ppllcatio, No.o,,/i,e ~8~ZS'VS'~N656676 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the aboue application number in the premises of l~ed' ~%I~nesling, Lilac Lane, N/S St~rling ~iane~ Cutchogue~ N.Y. in the following location; [] Basement [] 1st FI. [] 2nd Fl. Section Block Lot was exatnlned on ~[Uo~%IE~, ~ ~ l~z~ and found to be in cotnpliance with the requiretnents of this Board. FIXTURE OUTLETS DRYERS FURNACE MOTORS OTHER APPARATUS: 1-SO0~ T~aasfex. b~vitch. FIXTURES FLUOR~¢ENT FUTURE APPLIANCE FEEDERS RANGES K.W. ~PEClAL REC'P S NO, OF C~,COND A, W. O. OF CC, COND 2/0 COOKING DECKS OVENS DISH WASHER! TIME CLOCKS BELL UNIT HEATERS NIULTI-OUTLE1 V I C E EXHAUST FANS DIMMERS NO, OF NFIITRALSA,W. O. OF NEUTRAL 2/O Dif£ Electric Eox 2~ Swe~ytown Road ~ ~ti~Jle Is.l~d, ~. 119&3 ~C. 339 ~ ~ ~ .... Per ~ hm cerhflcote mvs~ not be ol~ered in any moaner; retvm ~o ~he off ce o~ ~he Board [~ incorrect In ...... L ~ ......... ~ FIELD INSPECTFON COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ?DE FINAL ADDITIONAL COMMENTS: R D & R CONSTRUCTION CO. Selden, N.Y. 11784 Roger C. Hansen (516) 698-0880 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 Examined..'/..6t.F.~....e..~...,19..~. ~ Received...:/~.~...,19 . Approved~'...t. ?...., 1~. [~. Permit No.../J.~.' .-' .~..~' Disapproved a/c ......... :~ ................. ~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date....~/../..~. ........ 1~. 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 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 admitA~uthorized~nspectors on premis.es and in ,building for necessary in~ections. /V / :' /, ..... .. ................. ~ -~ ) ,~ (Signature of applica:, or name, if a c~poration) :. ri'lb,Z,: ............ ..-9 .~. ,,/(Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .. . .:4 ........ .......... / ........................................................... l~ame oI owner olpremlse8 /../~ ............................................................. ,/ ..... (as on thee tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer). , Builder's License No ........... Plumber's License No ......................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. t~ou~e N~:b;r~ ~ ............ ~;r;;; ............... C>z ......i~t;:l~i .... /' ................. County Tax Map-- ~/No~.1000 Section .... ff.0..~. ........ Block ..... ~../ .......... Lot... (~/. 7 .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of prexnises and intended use and occupancy; of proposed construction: a. Existing use and occupancy... ~..tt4.~...t~z~.~g-~./..c.: ~....~,~/~'~.~././?..~-- ............................. b. Intended use and occupancy . ~..,~.ff~.. ~../.7-.~... z..~,y+-.~./'.4<~. {5~..]~.'...z*~..~.~:,.~.~.7 .--: .~ ./0...~/, .~..e~.~::. ..... 10. 11. 12. 13. Nature of work, ~which aplplicable): New Building ..... ' ..... Addition .......... Alteration .......... Repair ..... ~ ....... Rem6val ......... Demolition .......... Other Work ............... Estimated Cost ..... ~. ................ Fee...~/..6~.. ........ (Description) (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 ..... ~ ................................................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... i · · Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height Number of Stories Size of lot: Front ..................... Rear ...................... Depth ...................... Date of Purchase ............................ Name of Former Owner ............................. Zone or use district in which ~remises are situated ..................................................... Does proposed construction vie ate any zoning law, ordinance or regulation: ................................ Will lot be regraded ........ . ................... Will excess fill be removed from premises: Yes No Name of Owner of premises .................. Address ................... Phone No bfA Name rchitect ......... ' ................. Address ................... Phone No ................ Name of Contractor ......... ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly ail 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 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 sig~ing contract) above named, i He is the ..................... 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 file this application; that all statements con(ained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mann{r set forth in the application filed therewith. Sworu to before me this ........................ day of .... ~ ........... 19 ..~? !NOTARY PUBLIC, State el New York ; ..... : No, 470'7878, S(/If0lk C0imt¥ I (Signature o.f applicant) 3019 ~IgHHA':aU 3H1 aY:aU ggvg"Jd 'LZ*O6&fL~ ,~6°G6£· 69°90~