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Home My WebLink About15812-zFORM NO. 4 TO~ OF SOUTHOLD BUILDING DEP~RTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z19537 Date NOV. 27~ 1990 . THIS CERTIFIES that the buildin~ Location of Propert~ 1615 MASON DRIVE House No. County Tax Map No. 1000 Section i04 Subdivision ADDITION CUTCHOGUE Street Hamlet Block 06 Lot 18 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 23, 1987 pursuant to which Building Permit No. 15812Z dated M;LRCH 28, 1987 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is ADDITION INCLUDING ATTACHED DECK, issued is PERMIT AMENDED TO MAKE THE DECK LARGER. The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Rev. 1/81 WILLIAM J. & EILEEN M. BREEN N157694 OCTOBER 26~ 1990 WILLIAM J. BREEN APRIL 3~ 1989 ~ /~ B~ildin~ Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N, ¥, BUILDING PEIU~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15812 Z Permission is hereby granted to: ...~...~..~...Z~ ............ ...... ~.~.....~..~~ ............. ~~...~.:..~ ....... !./.>~.~..J .......... County Tax Map No. 1000 Section ..... /...~.....~.. ...... Block ....... .(~...~. ...... Lot No ..... J....~.. ............. pursuant to application dated ..... ..~.~...~J~.~ ................ , 19.~.~., and approved by the Building Inspector. Fee $ ........................ Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTHENT TOWN HALL SOUTHOLD~ NE~ YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY · ........ ~ DATE ~sw CONSTRUCTIOS . ...O~Ln oR P,E-EX,SZr~C ~UILD~ ...... V~CA~ ~S~ ........ O~e~ o~ O~e~s o~ ~ro,,, ......... ~..'...~..~~~ ........ ~,~,~,o~ ....... ~/~ ......... ~.~ ~ ........ ~o~ ..... Permit No. f~(~.~Date of Permit-.'~~Applicant Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: 10/14/88 OUNDATION {1st) OUNDATION ( 2nd ) OUGH FRAME & PLUMBING LUSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-X802 BUILDING DF. PT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [ ~ REMARKS; DATE THE NEW YORK BOARD OF FIRE UNDERWRITERS ] 000~ ] ~] BUREAU OF ELECTRICITY BS JOHN STREET, NEW YORK, NEW YORK 10038 Bate O{X{'OB~ 5,~';, ~'~g~ Appiicat~o~ No. on file /~4 ~ ~ O~ / qO ~ THIS CERTIFIES THAT only the electrical equipment ~ ~scrlbed below and introduced by t~ applicant ~med on the a~ve application number in the premises of in thefollo~'ing locatlon ~ Basement ~ Ist FI. ~ 2nd FI, 0~)~)~ Section Bilk Lot ~'as examined oft ' and found to be in compliance u'ith t he requirements of this Board. FIXTURE OUT'TS DRYERS SWITCHES FIXTURES RANGES OVENS EXHAUST FANS FURNACE MOTORS FEEDERS TIME CLOCKS [,INIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO* OF FEET SERVICE DISCONNECT S E R V I C OTHER APPARATUS: NO. OF CC COND T AWG. _OF CC COHD A, WG OF HI-LEG E GENERAL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect· Inspectors may be identified by their credentials. COPY FOR BUILDING~RTMENT. ~Y OF CERTIFICATE MUST NOTBE ALTERED IN ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit NO.. / Owner_ ~ ~~ ~ {please print) Plumber (pea e print) I certify tha~ the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this ..~ day of ~ ,' Notary Public,~ County Notary Public HELEN g DE ¥OE NOTARY PUI~IJC, ~te of New No. 4707878, Suffolk Coun~, T~m ~pires ~ch 30, 1~ N /Ol F OF SL.,4VIN 0 N/O/F LAND N. 79° 58'50 'S.72o 24'30" W, OF LAIVGEMy R MASON ~50 26'D ' EED 130. 09 L 130 DRIVE N/O/F LAN[) OF L ANoE:MyR 0 0 0 CERTIFIED TO . CHICAGO TITLE INSURANCE SOUTHOLD SAVINGS DANK WILLIAM J. BREEN EILEEN DREEN CO, AREA = 20, 842 SO. FT. PECONIC SURVEYORS (516) 765 5020 P ?. BOX 909 MAIN ROAD SOUTHOLD, N.Y. 11971 N.Y.S. LIC . NO. SURVEY FOR .WILLIAM J. BRE£N EILEEN BREEN AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. lO00 104 - 06 - I 8 SCALE t"= 40' NOV. 3, 198'6 dAN. 16, 1986 Prepared in accordrmco with the minimum ~tond:~cf,, { r ,~ v';'~ as a!¢c~blished by fha L.i,A.[ ..... -l,,I rh;prozed and adopted for such use by The New York State Land 48668 ENGINEERS ~ P.C, LAND OF' SL,4VIN N /O/ F LAND N. 79 o ,5 B '50"E . S.72°24 30 W. MASON OF LANGEMY R DRIVE 130.26'DEED 130. 130.59 N/O/F' LAND OF LANGE~¥R CERTIFIED TO ; CHICAGO TITLE INSURANCE SOUTHOLD SAVINGS BANK WILLIAM J. BREEN EILEEN BREEN CO. AREA = 20,842 SO. FT, PO, BOX I~AIN ROAD SOUTHOLD ~ N.Y. N.Y .S. ~i~VE Y OR S ~ - 5 020 909 SURVEY FOR WILLIAM J0 BREEN EILEEN BREEN AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. ID00 104 06 - I 8 SCALE I''= 40' NOV. 3, 198 6 JAN. 16, 1986 LIC. NO. 48668 11971 ENGINEERS ~ P.C. i'repared in accordonco with the minimun standards for ~ille surveys as established by tho L,I.A, L, S. and approved and adopted for such use by 'fhe New York State Land Title Association. N ?07 F ~1. 79o 58 '50,,E . S.72 24 30 W. MASON CERTIFIED TO ; CHICAGO TITLE INSURANCE SOUTHOLD SAVINGS BANK WILLIAM J. BREEN EILEEN BREEN CO, AREA = 20, 842 SO. FT. LAND OF LANGEMY R 130.26'DEED 130. 130.59 DRIVE N/O/F LAND OF LANGEMY,~ SURVEY FOR WILLIAM d. BREEN EILEEN'BREEN AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. I000 104 ' 06 - I 8 SCALE I"= 40' NOV. 3, 198 6 JAN. 16, 1986 N .Y. S. :~VEYORS 516) 765 - 5020 P. O. BOX 909 MAIN ROAD SOUTHOLD, N.Y. 11971 llC, NO. 48668 ENGINEERS , P. C. ~repared in accordance with the mlnimun standards For ~il'le surveys as established by the L l.A.L.S, and approved and adopted for such use by The New York State Land Title Association. FORM NO. 1 ~ ' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N,Y, 11971 TEL.: 765-1803 Approved · .~. ~...~..~., 191~.~. Permit No./..~7 ,~{ .~..~. Disapproved a/c ..................................... ................................ ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ...... 9. This application must b~ completely fil~d ~ typev~ritegor 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 b~engranted by the Building Inspector. APPLICA2 ION* ¥" 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 inspections. (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or . Name of owner of premises ....~J. .......... ~('xa(>~3 ~.e('e3 m ~£~'~[% (as on the 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 ...................... Electrician's License No. ~.~. ~.~./.~..~'. ......... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ../.(,,) .............................. Or- House Number Street Hamlet County Tax Map No. 1000 Section ...... ./.q..zf( ...... Block....~.. ' Lot .... ]. ~ Subdivision ................ (~I'a~) ................ Filed Map No ............... Lot ............... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~)qf,5oto ~ U{dq'ea~ b. Intended use and occupancy ...e.~J'.S.Q r~t2~- ¢ M /w4.,}~ .~ ........ 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ......... Repair ............ Removal .............. Demolition ......... : ..... Other Work ............ ... 4 Estimated Cost ~Z/(.O./0 O C.~ Fee ' (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling dnits on each floor ................ If garage number of cars 6. If business, commercial or mixed occupancy, specff.'~ iLature apd extent of each {ype of use ............ ~'~ ...... 7. Dimensio.ns,gf ex~ting structures, if any Front .O"q~.¢ (~. Rear Height f.-t ...... Num. ber of Stories (. 5 .rp e. ~,4 ' .. ., Dimensions o.f same structure w~th alterations or additions: Fxoni/'' '~.',,%' ' ' '~ ........ ~21~' ' ~ '~- ......... h · ~ Dept ....~..~/~. ~. ........... Height ...... ~,r ~.,~ ......... Sumber..of S~ones ..... /. ................ 8. Dimensions of entirelaewconstruction Front .~.'~'. .~.. Rear ~ Height .../..~., .c~. ~..~ N_um. ber ~lf/,qtories ........ [ .... i .... . ......... ~?'"'. ...... ii ....... 9. Size of lot: Front ..... ,-.~.,C). ¢..~. ~ ..... Rear.../.~.0~ 0.3.. i. i .... ." '~)~it~' ' / 10. Date of Purchase .. ~7/~ ~."/. ~. ~ .............. Name qf Former O~v~;;'..~-c~.,.. i ~..'~. ~ ~ ~ ~ ....... 11. Zone or use district in which premises are situated ~.C.~'xO.~.,~.% .~.v .~ . . . ' ........... 12. Does proposed construction yiRlate any zoning law, ordinance or regulation: . .'. . ~J.~. 13. Will lot be regraded ........MC],. · .~.,. ·. ~ ............ Will excess fill be rem6ved ~rom ur~moiS~e~: 14. Name of Owner of premises Vd.~..~ ~ Address §of..~..3 ......................... Name of Architect ... ~0.~'..~.p.. ~3~q.~..~.... Address ~.~t/~.qf,~./q i~'~., . Phone Name of Contractor .~t>- ('qo~.~-~/ ~O~..~.~ ~ff. Address ¢~-$, - ~t~.~t~./b~t~.oneNo. ~,.~..~ , (.D:..~i .~..N° ~':~:~.~, .~... ................. ~, ,,e~ ,,~ % ot:aj-g'~ 'as t/~ .... 15. Is this property located ~ithinl,O0 feet of a tid~a~ wetland? :~gs ..... ~'o ~.~] · If yes, Southold Town Trustees Permit ma~ be required. PLOT DIAGRAM Locate clearly and distinctly all 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, COUNTY OF ................. S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ~ He is the ............................................................ . ............................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have perfornmd the said work and to make and file this application; that all statements contained in this application are true to the best ofihis 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 ................. z .... uay of .~. .... .J'~l; ........... , 19 ~.~. Notary Public ..... 7~.. ~7...~. ~ .~.~. County /~/:'//'- ~ ,, /~///~ · · ......... . _ ;//:.= .... : ................ · No. 4767878, Suffolk Ce~nly. '' ...... x-~ (S~gnature of applicant) ~l