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Home My WebLink About13265-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ..... .sg.l.a.r...r.o.o.m...t.o..9.x.i.s.t. J:..n.9..d.w. ?.l.l.J:n..9.. ..... Location of Property ..... ..1'0' .8 9 ............F.a.i.r..w.ay. Drive Cutchogue House ;vo. 'S't/e~[ ....................... fi~iei County Tax Map No. 1000 Section .... .1,0.9. .... Block ...... .5. ....... Lot ....... 1.4.: .6 ...... Subdivision ...F..a.i.r.w.a.y..F.a.r..m,s ............. Filed Map No... 6.9.6.6. .Lot No ..... 1..4 ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated 13265Z ·...J. ql. y . .5. ,. . .19 .8. 4. .... pursuant to which Building Permit No ...................... July 16t 1984 dated ............................. was issued, and conforms to all of the requirements of tile applicable provisions of the law. The occupancy for which this certificate is issued is ......... Solar room addition ~o existing one-family dwelling. The certificate is issued to ............... M....D.Q~.LX .D..I.E.F.F.E..N.B.A.C.H. .................... of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO. N810 8 7 0 N/A PLUMBERS CERTIFICATION DATED: Building Inspector Rev. 1/81 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) N? 13265 Date ..... ./...~.. .......... , N/ Permission is hereby granted to: ..... , ,__ __~ ..£~..~.~....~.:.~:....J..m~::... ,o.~.~. ...... ~...o~.......v...o. ...... ~.~ ...... ~ ....... ........................................................... at premises located at ,.,,J.,/~.,,?,,.O,.,.,,~. ,.~,,~:.,~ ...... ].~.... .......... ~.~~ ....... County Tax Map No. 1000 Section ...... !..?....cJ ........ Block ........ ..~..f. ........ Lot No.../...~.f...~.. ......... pursuant to application dated .... ~...~... ............................ , 19.~...I.., Building Inspector. and approved by the 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 ! ~,--..~-.., 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 electrica{ 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 o~ occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of Occupancy on pre-existing dwelling $ 50.00 3. Copy of certiflcate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O/ $ 50.00 Date .......................... New C OhS t r uc t i on ...... V/ Old or Pre-existing 8uildingJ~ ............ Vacant Land ............. Location of Property ./.~...~..., ~7.~..'~..~¢;.~.~z' ............................ . .7:~-../.¢:O..., .~..c~. ~'7. , . House No, ~/ Street Ham/et Owner or Owners of Property ..................................................... County Tax Map No. 1000 Section , ./~, ~: ........ Block ...~.~. .......... Lot.. - . .. Subdivision ........... ~...~'~-?'~,~.~7~.~. .... Filed Map No ........... Lot No .............. Permit No.'~.~..3~..~.... Date of Permit ..?/ Health Dept. Approval ........................ Labor Dept. Approval ........................ Request for Temporary Certificate ..................... Final Certificate .................. '~' Fee Submitted $ ......................... Construction on above described building and perD~ all ~licable codes and r~ulations. ~ -- PP .... ? ~' ~ .-~.V.: .... ~'~ ' / ...... Rev. 10-10-78 ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY THIS CERTIFIES THAT ' o~y the e~ctrical equipment ~ ~scribed be~w and introduced by t~ applicant ~med on the a~ve appl~ation number in the premises of P,~ Die~enb~ch~ 6 ~'ai~way Dr~v~ Cutchogu~, ~sexa,nlnedon ~y ~, ~957' andfoundtobelnco,npllan,'eu'iththereq~dremen~s~fthi~Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES RUORE$CENT FURNACE FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R NO OFpERCC~COND A W O OF CC, COND OTHER APPARATUS: l-G, ~' .C.i. I C E NO, OF HbLEG OF NO OF NEUTRALS AWG, OF NEUTRA[ Pat Lane 11952 This certificate must not be altered in any manner; return to the office of the Board if incorrect Jnspectbrs may be credentials. FOR: BUILDING DEPARTMENT. THIS COPY OF CI ~,LTERED, N ANY MANNER. TOWN OF SOUTHOLD OI:FICIZ OF BUILDING INSPECTOR P.O. BOX 725 TOWN IIALL $OUTHOLD, N.Y. i 1971 TEL. 765-1802 This iu to adv{ae you that the lob und~e~r b. ui~dlng per,nit no. 13265Z ~anued to M Dolly Die~xenoacn on .~.7_/!~/~__ fo~ ~ddition ~s completed and a f[rlal inspection has ( ) has not (x) been done. fn order to complete thie 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 ~$25.00payable to the Town of Southold. Please {ndlcate to Whom the Certificate of Occupancy is tO be mailed, and arrange with this office for an inspection date Occupancy or use i,~ unlawful without a Certificate of Oecupnncy. Plenl~e help us to clear t,p th,~s matter so that legal act{oa doe~ not hnve to be taken. Thank you for yollr prompt attention. Very truly Victor Lessard Execu~ lye Administrator VL:gnr FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ~ODE FINAL COMMENTS ADDITIONAL COMMENTS: Approved i. ~..., 1 Permit No. !.'~..~..~..~". ~ Disapproved a/c .......................... ' ........... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 (Building Inspector) APPLICATION FOR BUI LDING PERM IT Application No .................. Date ...~ .....19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 Occupai~cy 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 buildings for necessary insp~flio~ ~ -,~ (Sb(nature ofappdca , , }~ (Mailing address of applicant) State whether applicant is owner, lessee~ architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...~....,/~?.g..Z)(....~)../.~.~ff'../y'~-A/.~..,~..~..~ ................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of~co~orate of~r~ Builder's License No. T~..~. .c/...r~....~..~.-7~.,~..~...X~.~? ' Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. · ............. ........................... House Number Street Hanflet C~hnty Tax Map No. 1000 Section ..../..~).~. ......... Block .. ~ Lot... /6~' Subdivision. ~..~)./.~.../~.J.~.~.../'~ .'~..~.4'. .......... Filed Map No...~fl..~.~ ....... Lot / t,~ · (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~.xS~. /. .Z? .Z~. dr(...~-..~-'. ............................................. b. Intended use and occupancy 3. Nature of work (check which applicable): New Building .......... Addition ...... Alteration .......... R~pair .............. Remoyal .............. Demolition .............. Other Work ............... "- (Description) Estimated Cost ~ Fee (to be paid on filing this application) 5 If d elling umbe of dwelling Units Nub of dwelling units on each floor . · · · w ,n r ............... m er ............ If garage, number of cars ' 6. If business, commercial or mixed occupancy, speg~.Y nat~ure, and\extent of each type of use .................... 7. Dimensions of existing structure~, if any: Front [~.~.~. · .~..~.-z.o.~..).. Rear .............. Depth ............. Height'...............Num'ber of Stories'. ..................................................... ~ " ' additi Fr Rea Dimensions of same structure with alterations or ons: ont ................. r ............... Depth .................... i.. Height .... v- ................ Number of Stories ................... 8. Dimensions of entire new construction: Front f.--~.~. · .ff.~..~.~.,~ Rear ............... Depth ........... Height ............. Number of Sto es .~;~; .... ?..~...,~. ~/ ........ 9. Size of lot: Front .... ./~. ..... i .............. ~" ............ Depth . .~..d~. ~.. 10. Date of Purchase .~../.~..-.~F~.%! .7.7. ............... Name of Former Owner . ~-'.~ ~. · .~.~ ,~..S ......... 11. Zone or use district in which pr6mises are situated... ~..~.. ................ ~ ................... . ...... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...~: .......................... Will lot be regraded . rg/,~..., i ........ .: .......... Will excess fill be removed fro~ premises: . yes .- ~ 14.13' Name of Owner of premises Z)~.t~/. ..~./~'~.~J.~.q~Address ,~0.9(..~/.~...~.7~.~.°~q4 Phone No.7.~. ~...&,q..~..-~. · ·. Name of Architect....~.~47..t~;.~... .................Address ................... Phone No ................ Name of Contractor ....~.~'..~.~.~. ............... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and blockl 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 of individual mgnmg contract) : (Name .... ' ' above named. He is the ' .......... : (Contractor, agent, corporate officer, etc.) of' said owner or owners and is d~ly authorized to perform or have performed the said work and to make and file this application; that all statements contained m this application are t. ue to' the best of his knowledge and belief; and that the work will ,be performed in the man~er set forth in the application filed therewith· Sworn to before me this i NOTARY PUBtlG, State of New Yor~ o · · ] . No, 4707878, Suffolk Couot~ Term [xplres March ~-~ -- S aa~59'aO"E, ZOO 9~' ~' , ~ , ,'~ . { '.~ "~ . :, ~IOV ~ ;5 1977 OF THE CLERK OF ~FFO&K COUNTY ON