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Home My WebLink About13156-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. J.% $Q.7.7. Date December 21 1984 THIS CERTIFIES that the building New Dwelling Location of Property ...6.5...W.e..s.t..C.o.y.e..R.d.....&.. 6. House rye. Street Hamlet County Tax Map No. 1000 Section . I 12[ .Block 03 ..... Lot 0 01 Subdivision ...A..19,n.z.o...J.e.r.s..ey. ............ Filed Map No.. 7.6.3 .... Lot No...1.3. ......... conforms substantially to the Application for Building Permit heretofore fried in this office dated ..... M..ay..3. .......... , 19 .8. 4. pursuant to which Building Permit No....1.3.1..5.6.Z ............ dated ........ .M.ax ..... 2.5. ......... 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 Dw, elling The certificate is issued to JOHN R. DEMPSEY ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval 13- SO- 2 2 9 UNDERWR1TERS CERTIFICATE NO. N669201 & N669717 Building Inspector Rev. 1/81 FORBg NO. ~ 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? 13156 Z Permission is. hereby granted to: ~ ......... ...... ...~..~..~.. .......... ~7~..× .......... ~.:.. ................. ........... ~.~.~.~_.~ ......... ~..~,....~,.~ ,o .......... ~.~.~.....~.....:~.~.....~:Z~z~ ......................... County Tox Map No. 1000 Section ...../../. ,/. ............ Block ....l~,~. ........Lot No.--...~..~. ........ pursuant to application doted ..... .~....~...~.....~..... ..................... , 1~.....~., and approved by the Building Inspector. Fee $...Z..~....~....~ Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall ,~outhold, N,Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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 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. For existing buildings (prior to April 1957), Non-conforming uses. or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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, Co Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling/ land use --?z'e-E×±sting C. 0. $15.00 3. Copy of certificate of occupancy $1.00 Vacant la~d C.O. $ 5.00 D~cember 21, 1984 Date .......................... New Building ...... ~. ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property 65 West Cove Road~ Cutchogue House No. Street Ham/et Owner or Owners of Property ..... .J.o.}~n....R.....D¢.~.p.s..ey. .................................... County Tax Map No. 1000 Section ...1.1.1. ......... Block ...3 ............ Lot....1 ............ Subdivision..A.I. 9.n.z.°...J.e.r..s.e~. ............... Filed Map No.. 7.6.3. ..... Lot No..1 ~ ........... PermitNo. 131563- Date of Permit 5/25/84Applicant John. R. Dempse.~y Health Dept. Approval .~D - ~O... _ .-~-~.,r~ ............ Labor Dept. Approval ..................... . Underwriters Approval ,~.k~.q. rJ.~,rI .............. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted ..... t.d ........ Construction on above described building and permit meets ~al~-a~plic~codes and regulations. l oqq . ...... ~ ~,, THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 01 85 JOHN STREET, NEW YORK, NEW YORK 1OO;38 ~a,~L~:~,~:~,' :~.~ ~.~s4 ~.~.~,,,~o.o~/.~39~/s~ N 669717 THI~ C~ffTI~I~S THAT o~y the electrical eq~ipr~e~t as described bel~ and i~troduced by the applicant named on the ab~ application nu.~ber in t~ premises of ~. t~/ouo~,,~ ~o~io,. ~ ~.~,.~nt ~ ~t ~'t. :~ Z=d r~. S~ct~on mo~ rot w~s examlned on Z40~3 ~ ~ ~ ~ ~Y~ and found to be i~ co.~pliance with the requirements of this Board. FIXTURE SWITCHES OUTLETS DRYERS Ia FIXTURES INCANDESCENT FLUORESCENT RANGES OVENS DISH WASHERS EXHAUST FANS OTHER APPARATUS: S E R V I NO, O E COND' OF CC, COND NO, OF NEUTRALS This certificate must not be altered in any manner; return to the office of the Bourd if incorrect, inspectors may be identified by their credenfiaJs. co~,~ Fo, BU!LO,.O ~?a~?:T.~?CoP~, 0~ ¢ ?_*' ~!~[[?~5~?Z~ ~ a~5~-~?' ...... FIEL~ INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ~,ODE FINAL ADDITIONAL COMMENTS: ~.~' 76S-1802 .,, ~UILDING DEPT. :'~ INsPECTIO~N [ !] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] INSULATION FRAMING/~//.~"~[ ]FINAL 'FORM NO. i TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 l Permit (Build~ng Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date ....M.ay..5. .......... 19 .~.4. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~ts 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 r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ztion. 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 zall 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 mil have been granted by the Building Inspector. APPLICATION IS HERE~Y MADE to the Building Department for the issuance of a Building Permit pursuant to the uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or _egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to flmit authorized inspectom on premises and in building for necessary inspections. Jo,h.n R. Dempsey (Signature of applicant, or name, if a corporation) ?0 Box 5, OutchoF, ue, NY 11935 (Mailing address of applicant) ;tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. owner qame of owner of premises .. J. oh~..ti.. D.e.n]ps~.y.. ..................................................... (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No... G. eorg. e. IYla.r..t: in.ek... Electrician's License No. O.0. Electric Corp. Other Trade's License No ...................... ~. Location of land on which proposed work will be done .............. · ......... ........................... e tCove O cho ue .... '. '/ ~;;~d ~;~/ ....................... ~;r;~; Hamlet ...................... County Tax Map No. 1000 Section ...~.1.1 ............. Block o .5 ............... Lot 2. ................. Subdivision .... ~lo.nzo. ~.ora~y ................. Filed Map No. ...~.~.3. ....... Lot . ~ .~ ............ (Name) State existing use and occupancy of pre~nises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... VaC. a~g. 3.a~td .............................................. family dwe]] ing~. b Intended use and occupancy one · 3. Nattu~d~~plii~ licable): New Building ... X. ..... Addition .......... Alteration .......... ,, [-' '.?f~'~' o)l.k-t,~lo~ n~mtqltion .... Other Work 4. Est~a,tpd Cost ... gl.50,.q qh ....................... "e5 .... , ..................... , .... , 5:-~-~ ~; , *' tto be paid on filing this application), number of cars ; I .~ ,, If garage, · .................................................................. 6. If business, commercial or mixedl occupancy, specify nature and extent °f each type °f use .................... · ' ' ifa y Fro Rear 7. Dimensions of ex,sting structures, n : nt ............................. e .............. Height.......,,....,.NumberofStohes ........................................... : ........... Dimensions of same structure wi~h alterations or additions: Front ................. Rear .... ,., ........... i HeiSt Number of Stories Depth .............................................................. 8. Dimensions of entire new construchon Front .... }2.' ........ Rear , ~2 ~ .......... Depth . 4~.[ ......... ,. 9. 8ize of lot: Front ~5~ ' ....... Rear ,1072.. Depth ~00 ' 0. Date of Purchase . , .2~6~ .... [ .................. Name of Fomer Owner ., .~rgh~. ............... 1. Zoneorusedistfictinwhichpre~isesaresituated,',.'gY'~e~de~l~'" · ......,. ....................... .... gl , no, 2. Does proposed construction wolate any zonm aw, ordinance or regulation: .............................. 4. Name of Owner of premises .qgiP~.q'.'........ Address ................... Nme of Architect .......... ! ................. Address ................... Phone No ................ N~e of Contractor ~ Address Phone No PLOT DIAGRAM Locate clearly and distinctly all lbuildings, whether existing or proposed, and, indicate all set-back dimensions from ,roperty lines. Give street and block humber, or description according to deed, and show street names and indicate whether ~terior or corner lot. i See at~achcd survey ;TATE OF NEW YORK, S.S 7OUNTY OF ................. ......... J oi~'1. I~.... I:)e rn.p.~ ey. ! ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) .bore named. te is the ................................................................................... (Contractor, agent, corporate officer, etc.) ,1' said owner or owners, and is d~ly authorized to perform or have performed the said work and to make and file this pplication that all sta~e~nents contained h~ this application are true to the best of his knowledge and belief; and that the york will be performed in the manner set forth in the application filed therewith. :worn to before me this I , MiC~t~Et,.~. "~r-t:,, ~~LLT~gnat~;e of applicant) NotmY Public, State of NewYoI~ No. 30.4722108 Commission Expirei March 30, 19~I'U' W Hi.T¢'JH JO }.N',JN].~iY8~O