HomeMy WebLinkAbout15481-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N ¥.
Certificate Of Occupancy
No, z15971 Date J .uly..2. J ~..I. 9. ~7.
THIS CERTIFIES that the bmldmg . .A.d.d.z.t ~9.rt ....................
330 Eastwood Drzve Cutchogue
Location of Property .............................................
House No Street Hamlet
County Tax Map No 1000 Section 10 3 .Block 14 Lot 9
Subdlwsion. E.a.st. wgpd .g..s.t..S..~.c...2. ..FfledMapNo ........ Lot No. 2.0. ........
conforms substantially to the Apphcahon for Building Permit heretofore filed m this office dated
· . .~.o.v...6.,..I 9.8.6 .... pursuant to wbach Braiding Permit No.. 5.4.8. ) ~ ...........
dated .. ~.o¥. 8., . ! 9.8.6. ........ was msued, and conforms to all of the reqmrements
of the apphcabte provlmons of the law. The occupancy for wtuch tlus certfficate ~s issued is ........
.. ~t~.i~9.n. ko ~t~ .e~-.s~g. qr~e. $~i1~/ 4w~.l.l~g... ..................
The certificate is ~ssued to . ROY SCHOENHAAR
of the aforesaid budding
Suffolk County Department of Health Approval
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED:
.May .20~ .t982 ~8.1D. 8~J .......
July 20, 1987
/ ~dd~ng Inspector
Rev 1/81
FO~M NO. lB
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDIHG PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 15~Sl
Z
...~. ~ .q..~ ~...'. .............................
!.,
at premises located at ....~..~,...q.... ~.'~....~....~..~..,......~~ ......
County Tax Map No 1000 Sect,on ~,K)~ Block .... !...~. ........Lot No ..... .~....~. ......
pursuant ,o apphcation dated .. ~,~~ .b .......... 19.~(~., ond approved by the
Budding Inspector
~e, ,..~...L'9 ....
Building Inspector
Rev 6/30,/80
BUILDING DEPT. ~
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING [ ~"i', INAL
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
Date -~/9.o /d~ 7
/
(please print)
(please print)
I certify that the solder use~t in the water supply system
contains less than 2/10 of 1% lead.
Sw. orn to before.me this
day of
Notary Public.
su~oL~
County
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITy
~ 85 JOHN STREET, NEW YORK, NEW Y 10 38
THIS CE~IFIES THAT
~Oy J. Bcbo~aar, 330 [a~C~o~ urzve, Gu[chobue~ ~
~n the~ollow~ng location, [] B~ement
tt~sexam~nedor~ ~}tt~ J.~ ~.9~
~ 2nd FI ~ect~on Block Lot
R~NGES ~'OOKING DECKS OVENS DISH WASHERS EXHAUST FANS
DRYERS
DIMMERS
S E R V I C
AWG
OF NEUT~tAI.
Th~s cerhflcate must not be altered ~n any manner, return to the office of the Board d incorrect Inspectors may be ~denhfmd by their credenhals
COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANN~
'OUNDATION (1st)
'OUNDATION ( 2nd )
~OUGH FRAME &
FLUMBING
INSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIOn;AL COMM,ENTS:
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. Thru apphcat[on must be filled m typewrlter OR ~nk, and submitted m ~ to the Building Inspec-
tor w~th the follow~ng; for new buddings or new use'
1. Final survey of properW w~th accurate location of all buddings, property hnes, 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 electrmal mstallatmn from Board of Fire Underwmters
4. Commercml braidings, Industrial buddings, Multiple Remdences and similar buddings and installa-
tJons, a certffmate of Code comphance from the Architect or Engineer responmble for the budding,
5. Submit Planning Board approval of completed rote plan reqmrements where apphcable.
B
For exmt~ng buildings (prior to Aprd 1957), Non-conforming uses, or buildings and "pre-exmting"
land uses'
1. Accurate survey of property showing all property hnes, streets, buddings and unusual natural or
topograph m features
2 Sworn statement of owner or previous 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-
t~on reqmred to prepare a certificate
Fees
1. Certificate of occupancy $5.00
2 Certffmate of occupancy on pre-exmtmg dwelhng
3 Copy of certificate of occupancy $1 00
4.Vacant Land C.O. $5.00
New Budding ....... Old or Pre-ex~stmg Building
Location of Property .........
House No
or Owners of Property . ./~
Owner
County Tax Map No. 1000 Secuon .
$15.00
Date- '~'/'~ ~' '( "~' '2 ........
~ ...... V/acant Land .............
Street Hamlet
.....................
....... Block ............... Lot ................
Subd~wmon ......... Filed Map No ...... Lot No ....
Permit No.l .~¢~/..~'. Date,, ~,°f Perm,t . ~.~ .... Apphcant ,~.~.~.~./.4y.~..,~/~..-f.. ,/'~..~,
Health Dept Approval ... /I/,/~,,. ............ Labor Dept. Approval ........................
Underwrtters Approval . .~ ~/..2,~. ~ ~' 7. Planning Board Approval ...................
Request for Temporary Certificate ........... Final Certificate ...................
Fee Submitted $ ...............
Construction on above described building and permit meets all apphcable codes and regulations
Appl.cant...~~ .,~~.. ,/,-'J,F-~ ....
Rev 10 10-7a
765-XSOZ
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ *~]/~SUL~TION
[ ] FRAMING
REMARKS:
[ ] FINAL
DATE
7GS-',80-
BUILDING DE:PT,
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING
[ ] FINAL
DATE
INSPECTOR
7GS-~.802
BUILDING DEPT.
INSPECTION
[ ] FOUND~ATIJON.J, ST [ ] ROUGH PLBG.
FRAMING [ ] FINAL
t /
INSP£CTO~
~ BUILDING DEPT.
~~r INSPECTION
'~ / [ ] FOUNDATION lST [ ] ROU~# PLB~.
[ ] FOUNDATION 2ND [ ] INSULATION
['~RAMING [ ] FINAL
REMARKS: ~
DATE ~~.~__INSPECT~
CoT el
L°reo
198'/'
~00°
/
/
SURVEY OF
LOT 20
MAP OF EASTWOOD ESTATES
SECTION 2
FILED NOV 30~1964
FILE NO. 4210
AT FLEET 'S NECK
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
I000 - 103 14 - 09
--' Y S LIC NO 49668 SCALE I" = 40 '
ENGINEERS ~ P C DATE DEC 16, 1986
(516) ? 6 5 - 5C~0 Freparec~ In a¢o~c~o~ce ,~ith the minimum
~tandards for title surveys as estabiisheA by
P 0 BOX 909 the LI.A. LS. and c~pproved and odoptecl
MAIN ROAD for such use by I' '' ~t ~e a,~
SOUTHOLD ~N Y 1197i -~ ""~'
86-756
60
NO TE
~ --MONUMENT
SUBOIW$10N MAP FirED IN
OF THE GL ERK OF SUFFOLK COUNT
NOV~O~ IgG~ FI~ENO
MAY 17, 197,4
· ffu [OC.~O~ OF ~FE~ AND CES$1~O0[S
~D/O~ ~BOM DATA OBTainED F~O~ OTHE~
SURVEY FOR. '
ROY SCHOENHAAR
LOT NO 20, "EASTWOOD ESTATES,SECT
FLEET'S NECK
'row. or SOUTHOLD
SUFFOLK CO, N Y
SCALE I" : 40' IDATE NOV 14,1973
GUARANTEE0 TO.
3-1114
E×ammed. 'ii
Approved 1~~.~
Disapproved a/c ..
FORM NO 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL,, 765-1802
,19g , Permit No.
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Received ........... ,19...
Date //./ ~ .......... 19..67
a. This application must be completely filled m by typewriter or ~n mk and submitted to the Budding Inspector, w~th 3
sets of plans, accurate plot plan to scale Fee according to schedule
b. Plot plan showmg locatmn of lot and of buildings on premises, relationship to adjomlng premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the dmgmm whmh is part of this appli-
cation.
c. The work covered by this apphcation may not be commenced before ~ssuance of Bmldmg Permit
d Upon approval of this apphcatmn, the Building Inspector wlI1 ~ssued a Building Permit to the apphcant. Such permit
shall be kept on the premises available for mspectmn throughout the work.
e. No bulldmg shall be occupied or used m whole or in part for any purpose whatever until a Certfficate of Occupancy
shall have been granted by the Bmld~ng Inspector.
APPLICATION IS HEREBY MADE to the Bufldmg Department for the ~ssuance of a Bmldlng Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or
Regulations, for the constructmn of buildings, addmons or alterations, or for removal or demohtion, as hereto described.
The apphcant agrees to comply w~th all apphcable laws, ordinances, budding code, housmg code, and regulatmns, and to
admit authorized mspectors on premises and in braiding for necessary inspecttons.
.... /U. .
(Madmg address of apphcant)
State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electncmn, plumber or bmlder
............
Name or owner or premises .//~0/ .,., .,fi.c= ./Ti 0 .~ A/. ~../}.~0/~.. .....
(as on the tax roll or latest deed)
If apphcant ~s a corporation, s~gnature of duty authorized officer
(Name and title of corporate oTficer)
Builder's License No 2..~ .g:..
Plumber's hcense No
Electrician's hcense No
Other Trade's License No ..
Location of land on which proposed work will be done
330
House Number Street
County Tax Map No 1000 Section //9 3
Hamlet
.. Block . ./. ~. . Lot Z "
.... Lot ~ O ....
Suba,vlsion..~.,~'~.~'~W,~oO ~5~-,,~/T~', .~'C ZFiied Map No.
(Name)
State ex~stmg use and occupancy of premises and intended use and occupancy of proposed construction
use and occupancy ~-.
3. Nature of work (check which applicable) New Budding .. . Addition. .... t'~ Alteration
Repair ..... Removal .... Demolition . . Other Work
.~.~ ~/~ (Description)
4. Estimated Cost ~ OO , ~¢) Fee
(to be paid on filing this application)
5. If dwelhng, number of dwelling units ......... Number of dwelling units on each floor ........
If garage, number of cars ....................................................
6. If business, commercml or m~xed occupancy, specify nature and extent of each type of use ..........
7. Dnuenslons of existing structures, if any Front ......... Rear ....... Depth .........
Height ........ Number of Stones ..
D~mensmns of same structure with alterations or additions Front ............... Rear ...........
Depth .......... Height ........... Number of Stones .......... , ......
~- 8. Dtrnenmons of entire new construction Front . . ;~ ~z.. . Rear .. 2 ~ ...... Deptk'T~.. .........
Height ............ Number of Stones ..
9. Sizeoflot Front.../~k ..... Rear .1'2.~ .~iiiii'ii
10 Date of Purchase ....... 0-fi- ............. Name of Former Owner ...
1 1. Zone or use district in which premmes are situated ...... ~ .......
1 2 Does proposed construction v~te any zoning law, ordinance or regulation .......................
13. Will lot be regraded .... ,fi/~ ....... Will excess fill be removed from premises Yes
14. Name of Owner of premises ,A~ ,ffC'~p~'. ,t~t,~d~~ Address . ~. ~../-"~,~p~..d?. ~. Phone No .........
Name of Architect ................ Address ................. Phone No ........
Name of Contractor ~ ~./../~. ~.~-~P/~.).' ... Address
15. Is this properey located wit[±n 300 feet o£ a tidal wetland? *Yes ..... ~q'~_~l'~x~ ....
*If yes, Southold Town Trustees Permit maybe required.
PLO~ DIAGRA~
Locate clearly and dlshnctly all buddings, whether exmtlng or proposed, and. mdicate all set-back dnnenslons fro
property hnes Give street and block number or descnphon according to deed, and show street names and indicate wheth
interior or comer lot
STATE OF NEW YORK, S S
COUNTY.9.g ......
.... //./'..~...~ .~,x. (,t, '~~~' '¢:~'7 ...... being duly sworn, deposes and says that he is the apphc~
(Name of individual signing contra'ct)
above named
He ss the ...... .~.~ .~/~. ~_,).~d~., ...................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file t
application; that all statements contained m this application are true to the best of his knowledge and belief, and that
work will be performed in the manner set forth m the application filed therewith.
Sworn to before me this
.......... ~. .... ; day of . . .~ .~.. .... , 19 ~:~.'~.
Notary Pubhc ....... . .~-~...~-...~?-..~'..~.... County,
#011~ ~J~.10. ~1~ ~ ~ ~ (Signature o,r appnca
J
USE. IS UNLAWFUL
Wfl'HOU'f
APPROVED AS NOTED
76~-1802 9 Aiv~ TO ~ Pi[4 ~R THE