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Home My WebLink About13063-zFORM KIO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy PLUMBERS CERTIFICATION DATED: No..Z.l.6. ! .7.8 .......... Date .~..ep.t..., ,1.6.,., !.9.8.7 ............... THIS CERTIFIES that the building .... I.n.g.r p.u,~.~ .ct..p.q o..1 ............................. Location of Property 2450 Elijahs Lane Mattituck House No. Street Ham/et County Tax Map No. 1000 Section . .l. 0..8 ....... Block . .0.3. ........... Lot . 9.0.6.: .I .......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·...A.p.r.i..~..1.8. ~..1.9.8.~.. pursuant to which Building Permit No. 1.3. Q .6.3.z ............... dated . . . .A p.r.i. 1...2~6. ,.. ! .9.8.7. ........ was issued, and conforms to all o f the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Inground swimming pool and fence to code. The certificate is issued to L 01 S F. WOODHULL ..................... id~;n'6, '~b~,k;f ~/~i~'x'~ i ~ k'f .............. of the aforesaid building. Suffolk County Department of Health Approval ...... ~/.A ................................. UNDERWRITERS CERTIFICATE NO .............. .~ .8.2.5. 7. .9 .7..6./..2.7/.8. 7. .................. Building Inspector Rev. 1/81 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? 13063 Z Dote ~' 2 Permission is hereby grant ~e~cLto~ ...... /~..,..~;.,.~x..~,~....;.~ ...... ...... ~'/Z~.. .~...../.n. .~.~./....~.~. ........ ~o .......... ~/z,~..,r~..~. ....... ~.~.. ....... /. /.~.x~...~..,d~.....~ ~.~,/~.~ ....... ~,~_ ~ ..... ~-' . ~11 . ~__. ' ' .. ..~. ............... ~, .................. ~.~.~....~ ...... ~.~.~ ............ ~. ............. .....,/.... ....... · ~..~....~. -~,' .., ~ ,/_~..~. ...................................... CounW Tox Mop No. 1000 Section ..../.~.~.../. ....... Block ..~....~... ....... Lot No. ~.,~.~..~...,../.'.. the Building Inspector. ~ ~ / /6uildlng 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 -- ~ 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 featu res. 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 certi~cate, C. Fees: 1. Certificate of occupancy ~ -- BUSINESS $50.00 ACCESSORY $]0.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewCons truc~ion ...... Old or Pre-existing Building ............ Vacant Land ............ Location of Property ..................... o ............... House No, Owner or Owners of Property ................................................. County Tax Map No. 1000 Section ..... ./'.~.~ ...... Block ............... d--~ Lot...~ .d.~. ,./. ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No/'-~ ~:~,~ .~.' ..~..~'/O~..~. A p p I ica nt ........... Date of Permit .......................................... Health Dept. Approval ........................ 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, ..~. ~o-~o.~a ~ 3~ ~ ~ 8/07/87 ~ooo~¢ THE NEW YORK BOARD OF FIRE UNDERWRITERS I~UREAU OF ELECTRICITY CORRECTION OF N649722 ~-~,,r~g 85 JOHN STREET. NEW YORK. NEW YORK THIS CERTIFIES THAT only the olectrtcal equipmon$ ~ ~scrlbed below a~ introduced by t~ applicanto~med on t~e a~ve application number in the premises of ~r~. Woo~ull, inthefollo~cing&mcatian; [] Bo~ement ~ Ist FI. ~s examined on 2nd FI. O~A~.~ Section Block Lot and fou,d to be in compliance u. lth the requlre,~ents Qf this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES Ft UOR~SCE~T DRYI~RS SYSTEMS NO. OF FEET E R V I C A, WG OF CC. COND AWG OF Hi-LEO OI~ NEUTRAL GENI~RAL MANAGER PC. J.~e~'~ Sta~io~ ~ 11776 LiO$1101E ~ ~*,~/~ coPY FOR BUILDING DEPARTMENT. TH S COPY OF CE~TIF c~Ej M~$T E~T BE ~LiERED~iN ANY gNNEE. ~ IELD INjPECTION DATE COMMENTS FOUN6ATION ( 1st) __ FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY __ qODE ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 Richard and Lois Woodhull Main Road Cutchogue, New York 11935 Dear Sir: This is to notify you that Building Permit No. 10174Z issued .,. 4~17/77 to same .... ,i will expire on ,,, If more time is required to complete the job and obtain a Certificate of Occupancy, you may apply, kY letter, for a six (6) month extension. Very truly yours, GEORGE H. FISHER Sr. Building Inspector If the work is not completed and the Certificate of Occupancy not issued after the six (6) month extension period, you are than required to apply for a new building permit. Memorandum from .... BUILDING INSPECTOR'S OFFICE TOWN OF SOUTHOLD TOWN HALL, SOUTHOLD, N. Y. 11971 765-1802 Pool ~ar~ 11794~ N/D 765-1~0~ BUILDING DEPT, INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION []FRAMING []FINAL FORM NO, 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 Disapproved a/c ....... ~ ..................... ~ (Buifdifl ., 19~e. : Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No./~d .(-3.<'. ........ Date ........... .~f'..., 19 .~.~' 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 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. Ttte 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 inspections. ......... (Signature of applicant, or name, if a corporation) /~.. Z/. ~r~. ~ .4 ~/~.>/7//d,~...~.x;4 <,¢.. ~ (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 applic~q~t is a c,~orporation, signature of duly authorized officer. ..... .... (NameXadd title of corporate officer) Builder's License No... 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 Hamlet County Tax Map No. 1000 Section ...... .~.(~..~ ...... Block ..... ~.'.':~. ......... Lot .... (~..~.(~.'.]. ....... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... .~./.'~.,*-'7.~.....~.~,~...r..~.~ ....................... b. Intended use and occupancy . .~..~?k~-~. ;~.~ ~y'~-.~(~ ..... , .'"~'~..,~'. ........... 4. Estimated Cost .... ~?, .~.~.: ~ ............... 5. If dwelling, number of dwelling Cnits ............ If garage, number of cars ..... 1 ................ Nature,of work (check which apphcable): New Building .......... Addition .......... Alteration .......... "'~epmr .............. RemoYal .............. Demolition .............. Other Work.,..¥~.. ......... ./..~...a.~9 (Description) ........ Fee ~ ............................ (to be paid on filing this application) ·. Number of dwelling units on each floor ................ 6. If business, commercial or mixe(~ occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structurei, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth i ................... i. · Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ........... ! ........... Rear ...................... Depth ...................... 10. Date of Purchase .............................. Name of Former Owner ............................. 11. Zone or use district in which pr~mises are situated ..................................................... 12. Does proposed construction violhte any zoning law, ordinance or regulation: ./V..~ ........................ 13. Will lot be regraded ...~/.~'~...i ................... Will excess fill be removed from premises: Yes 14. NameofOwnerofpremises ...i ................. Address ................... PhoneNo ................ Name of Architect .......... i ........ .~. ....... Address ................... Phone No ................ Name of Contractor·~e.. ¥~. .b.,~ .~.C0~.~/,O5. Address 1.2-. {t-lOOl'O~../~..~.,... Phone No.7.{~. ~.'7 .TF'/..-~'.... .' PLOT DIAGRAM Locate clearly and distinctly ale buildings, whether existing or proposed, and, indicate all set-back dimensions from prope~y lines. Give street and block interior or corner lot. STATE OF NEW YORK, iS.S COUNTY OF ................. ........ .... ..... (Name of individual signing contract) above named. humber or description according to deed, and show street names and indicate whether ...... being duly sworn, deposes and says that he is the applicant He is the ' ........................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du!y authorized to perform or have performed the said work and to make and file 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 \% i ' , . . GINGER FULl. AM ............... 19~ !Notary Public, State of New York (Signature of applicant)' ~lt D~A~TKI~2 SURVEY FOR AT MA~I'IY(JCK DATE:: N T -DATA FOR APPROVAL TO ~$TR, U,C T TO~JN OF ~OLJ~HOL~ SUFFOLK COUNTY, NEW YORK SCALE: I" :' .'.~OC NO. g,2 - "iD4. Z W Z Z Ld Z 0