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Home My WebLink About16418-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Z16379 Date November 9, 1987 THIS CERTIFIES that the building . ?°9.1..a.n.d .fe..n.c.e ..................... Locatlon of Property 1210 BRIDLE LANE CUTCHOGUE Ho~,~e No~ ............... 's~'e~i ............... County Tax Map No. 1000 Section .1.0.2. . .Block .08 ......... Lot . .I 4 ............ Subd~vmmn ................. Filed Map No ...... Lot No ......... conforms substanhally to the Apphcahon for Bmld~ng Permit heretofore filed m thts office dated · A.ug .. 3 .I ,. 1.9. .87 pursuant to which Building Permit No .... 1.6.4. .I .SZ. ........ dated ...8. e. p t. 3., t 98. 7 ....... was issued, and conforms to aH of the requirements of the apphcable provisions of the law. The occupancy for which this certificate is ~ssued m ... .. .ln&r. ogn.d..Rgp.1 an¢..fe, nce a..s .a.pglied..fpr.' ................... The certificate ts msued to RICHARD & IRENE MACHNOWSKI, JR. .......... ~o'4.er,~O~ X .......... of the aforesaid bmld[ng Suffolk County Department of Health Approval .... N [.A .......................... UNDERWRITERS CERTIFICATE NO. N 836526 PLUMBERS CERTIFICATION DATED: N/A t~mld~ng Inspector ....... Rev 1/81 IrOR,M NO. It ?OWN OF $OUlr3'IOLD BUILDING DEPARTMI:NT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PEI;~AIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne. ]64,18 z Permission is hereby granted to: .... m~.~.....~..~.. ~..4.. ,,,,,,~ ~ ..~.~.~.....m~...~.....~.: ...... ' ~ · ..~..,..~.:~.,....4;.~.~...~a ..... ~ .. .~.~~...~.~.~.u ......................................................... ~ ................ ~,~ ~,~ M,p No. mOO S,,t,o~ .. J ~ B~k ~ ~ No 1 ~ Building Ink.tar. Building Insi:mctor 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 Th~s application must be filled ~n typewmter OR ink, and submitted m ~ to the Building Inspec- tor w~th the following; for new buildings or new use' 1. Final survey of property with accurate location of alt buildings, property lines, streets, and unusual natural or topographm 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 F~re Underwmters. 4. Commercial buddings, Industmal buddings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responmble for the building. 5.Submit Planning Board approval of completed rote plan requirements where applicable. B. For existing buddings (prior to Aprd 1957), Non-conforming uses, or buddings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2Sworn statement of owner or prewous owner as to use, occupancy and condition of buddings. 3. Date of any housing code or safety inspection of buddings or premises, or other pertinent mforma- tmn required to prepare a certificate. Fees' Additions $25.00 P~oo 1 $~ 1 Cer~ificateofoccuQancy New Dwelling $25.00, Accessory ,$]0.00 Business $50.00 2.'--~rtifmate~6~cupancy on pre-existing dwelhng $ 50.00 3. Copy of certlflcate of occupancy $ 5.00, over 5 years $i0.00 4.Vacant Land C.C. $ 20 00 OC ~0, !~. 5.U2dated CoOo $ 50.00 Date -.--T,....t.~ ......... New C ohs t r u c t. z on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ../.~../..~ . ~/.~./?.I.D..LoLT- .~.~../~...~. ................... .(*. ~. T.~.~.D..(~.o..~-'... House No. Street Ham/er Owner or Owners of Property .................... County Tax Map NO. 1000 Sect,on ../..~.,~ ...... Block . ..~..~. ........ Lot.../.~. ......... Subdiwmon ....................... Fded Map No .......... Lot No .............. Permit No./.~. z~./..~.. Date of Perm~t~ :$ .-.~..~..Applicant . .~? o.O..e~./~...7~..~.~..tJ.O.~. ? o~. ......... Health Dept. Approval ....................... Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ..................... Request for Temporary Cert[hcate ............... Final Certificate ....................... Fee Submitted $ . ~ ~.; O..O. ............... Constructmn on above descmbed budding and permit meets all apphcab[e ~;~des and r~gulatlons. Apphcant ............................. Rev 10 10 78 FOUNDATION (~st) FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. STATE ENERGY CODE ADDITIONAL COMMENTS: X x x X m o 2 m ~°z~ ~z~ mZ -~m 7651802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION FRAMING [~INAL DATE [ooo719 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY s5 Jo.. STREET. EW YO....EW THIS C~RTIFIE~ THAT g~chard Hachn~ak~, ~2~0 BrLd[e Laae, CutiCle, ~.Y ~sexummedon October 1~ L9~7 o.dfoundtobeincolnphatt*eulththerequtre.~ent~oft~sBoard RXTURE OUTLETS ~'ITCHES RXTURES i OVENS [DIS~ WASHERS[EXHAUST FANL NCANDESCENT FLUORESCENT 1 1 DRYERS TIME CLOCKS S E R V I A W G NO OF HE LEG OTHIER APPARATUS t-G. F. CI. .(_SWIMMING _POO__L~ This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to ha~e frequent test and/or repairs ~ade by a .qualified person. R.C. Electric Corp. 112 Keyland Court Bohemia~ N.Y.11716 Lie. 1610E GEN~AL MANAGER Th~$ certdtcate must not be aJtered tn any manner, return to the off~ce of the Board tf incorrect Inspectors may be ~denhfmd by the;r credenhals CO~" FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ,%% ,.% /9O.<70 JA FOR APPRO'v~L TO CONSTEucT SURVEY FOR R/CHARD MACHNOWSKI ~ IRENE LOT NO 17, "HIGHLAND ESTATES" AT CUTCHOGUE TOWN OF $OUTHOLD SUFFOLK COUNTY, NEW YORK NOV 8 ,19~- AP, q/L 2~ 198: SCALE / '~ 5'0 * NO ,~4- $04 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N Y 11971 TEL,, 765-1802 , 191g'/ Permit No I/~ CJI 3 '~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Recemved .......... ,19.. Date . .., 19 INSTRUCTIONS a Tins application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showing location of lot and of bmldmgs on premises, relationship to adjoining premises or pubhc strec or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app cation. c. The work covered by tins application may not be commenced before issuance of Building Permit d Upon approval of this application, the Bmldlng Inspector will issued a Building Permit to the applicant Such peru shall be kept on the premises available for mspechon throughout the work e No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan, shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of bmldmgs, additions or alterations, or for removal or demolition, as hereto descnbc The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and m building for necessary lnsgggtions //lo, c. C .7¢'5(4. (Signature of applicant, or name, I,!~ corporation) (Mailing address of applicant) State whether applicant is owner, lessee,~rchltect, engineer, general contractor, electrician, plumber or bmld. Nmne of owner of pre,rose} f~.///~J~5) b~) ~/(/ ~tC-~ t' If appl}c/al¥ ~orporatlon, signature of duly~uthonzed (Name and title of corporate officer) Builder's License No. (as on the tax roll or latest deed) officer Plumber's License No Electrician's License No Other Trade's License No .......... Locatlon ofland on wtnch proposed work wfll be done /~'~//57 B/[~/~''- /~l-/d~ ..... Itouse Number .............. Street ...... I~a~m'l~ t .................. County Tax Map No 1000 Sect,on /O o~ Block ~ Lot /.~.. Subd~vision .. . Filed Map No Lot (Name) State ex~stmg use and occupancy of premises and intended use and occupancy of proposed construction a Existing use and occupancy b Intended use and occupancy ./~ ~' .rd .~.c~./"O..t~:-~..,.C~.' l~-'~t ,~'/.~:~. 3. Nature of work (check which apphcable) New Building . . Addit~on 6~C.. Alteration .... Repar . Removal ........... Demohtmn ....... . . Other Work ....t~ ..... :T~r~-~/.;~t~, ~ ~ ~ ~ ~ (Description) 4 Est~ated Cost ............... Fee ........................ ~ (to be prod on fil~ng th~s apphcatmn) 5 If dwelhng, number of dwe~lng umts .... Number of dwelhng umts on each floor ......... If garage, number of cars ........................................... 6. If bus~ness, commermal or mixed occupancy, spec~y nature ~d extent of each type of use ............ 7. D~enstons of existmg structures, ff any. Front .......... Rear .............. Dept~ ............. Hmght Number of Stones D~ensmns of same structure w~th alterations or ad&tmns Front ... Rear. Depth ....... Height ...... Number of Stones ....... 8. D~ens~ons of enttre new constmctton. Front .... Rear .............. Depth ........... Height . u bero~Stones Re~' ..~--~-"~-~(~' '~' 'D~t~"'~~ 9 S,z, of lot Front Z~, . .... 10. Date of Purchase ........... Name of Foyer Owner ... -- .................. 11 Zone or use d~stnct m which prennses are s~tuated ......................... 12. Does proposed construction v~olate any zomng law, ordinance or regulation 13. Will lot be regraded .............. WflI excess fill be removed from premises Yes ~N 14. Nme of Owner of premises ~C~ ~q~J~l. Address/~ 8~/~CC~.~Phone No. Nme of Archttect .......... ~ ............ Address ........... ~hone No. Nme of Contractor ~i/~. ¢~..~ q~ Address~ ~f~.~ ~hone No. PLOT DIAG~ Locate cle~ly ~d d~st~nctly fll buildings, whether ex~st~ng or proposed, ~d. mdmate fll set-back d~ensmns fro~ prope~y hnes G~ve street ~d block number or descnptmn according to deed, and show street names and mdmate whe~c interior or comer lot STATE OF NEW YORK, S S COUNTY OF. .. · . (Name of individual s~gmng contract) above named bemg duly sworn, deposes and says that he is the apphcar He is the ............................. (Contrac;o~rporate o'ff]cer, etc.) of said owner or owners, and is duly autt~onzed to perform or have performed the smd work and to make and file th apphcatlon, that all statements contained m this apphcatmn are true to the best of h~s knowledge and belief; and that th work wdl be performed m the manner set forth in the apphcatmn filed therewith Sworn to before me this Notary Pubhc, (Signature of applican SU~Y FOR " R/C~ARO MAC~OWS~/ ~ /~ MAC~OWS~/ F~a ~,~ LOT NO 17, "HIGHLAND ES~A~ES APfflL 2~ 1984 ~WN ~ SOUTNOLO SCALE / '~ ~O' SUFFOLK COUNTY, NEW ~RK N~UTH~IZ[D ALTERATION OR ADDITION ~ ~1$ GUARANTEED T~~ SURVEY ~ A VI~ATION ~ ~ECTION 720~ ~ THE SURVE~R'S INKED SEAL OR EMBOSSED SEAL SHALL HEAL~ DEPARTMENT-DATA F~ APPRO~ TO C~STRUCT ANO~E ~R~ FOR WHOM THE SU~EY IS PREPARED~ HIS BEHALF ~ THE ~TLE C~P~Y, aOV~N- , ~L ~ ~ ~ OS~NOER AVE~E NOTE ALDEN W YOUNG, PROFESSIONAL ENGINEER ~DlVlSION MAP FI~D /N ~E O~C[ OF THE CL~ O~ AND LAND SURVEYOR N Y.S UCENSE NO 12845 HOWARD W YOUNG, LAND SURVEYOR