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Home My WebLink About14610-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ~.1.4.6..0.4 .......... Date ....~.u.:l:y..7 .......... · ........ ~ ....19.8.6. THIS CERTIFIES that the building ...... Location of Property .... .3.2.2. 4 9..N.A.I..N..R. QA. ? ............. .C.U..T.C.H.O.G.U. ~ ................. House No. Street Hamle~ County Tax Map No. 1000 Section . .I..0.3 ....... Block . .0.1. ........... Lot .... 1..9...3. ........ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. F. qD,..l.3. .......... 19.8.6 pursuant to which Building Permit No.. 1..~ .6.1.q g. ............. dated ... NAzrCl~..4 ................. 19 .8.6., 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 ......... Alter and renovate farm labor building. The certificate is issued to FRANK CICHANOWICZ III of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... N750550 UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION JULY 1, 1986 Building Inspector Rev. 1/81 FORM NO. ~ 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) 1461O Z Permission is hereby, granted to: ..... .~.~.....c~......~....~......!~...~.k....u~... .................. ..... ~.~.~....~.:~..:..!.~.~ ~.~ ..... ,o..~.....~.~......~...- '..a~....~~.....~.,....~~ -- ...... ........................................................................................................................- o~,~o~,~edo~ ................. ~ ....... ~...~ ........... ~~~......~ ............. County Tax Map No. 1000 Section ..... ~..0.....~.. ........ Block ........ .~...~ .......Lot No.....~..~...'.-~. ......... pursuant to application dated ....~... ................. ~~ .~..~ ............... , 19..~...~., and approved by the Building Inspector. Fee $...~....,...~ Building Inspector Rev. 6/30/80 HOUSING CODE INSPECTION August 17, 1972 490 North Sea Drive Southold, New York Tax Roil: C. Green Occupied: Summer tenant Upon request of the Southold Town Building Department I made inspection of this one story framed dwelling and found the following violations of Local Law ~1, 1967 Housing Code of the Town of Southold. I began inspection at approximately 11:15 A.M. and was admitted by Mrs. C. Green and Mr. Sie~ert. Basement: Sump pump installed in floor hooked up to electric outlet with extension cord - Section 528a. Kitchen~ No light switch on entry to control kitchen ~-~-ght - Section 529b. Gas range - ~o shut off valve ahead of outlet at appliance - Section 508b. Front Porch: (enclosed) No light switch at point of entry to control light - Section 529b. No Heating System: Cannot be occupied as dwelling from first day of November to first day of May of following year - Section 513a. Completed this inspection at approximately 11:40 AM. Inspector EH:tle 765-'s802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~INSULATION [ ] FRAMING REMARKs: [ ] FINAL ~_~_~__~ BUILDING DEPT. ~;'~ "~-/' INSPECTION 6~17'' [ *] FOUNDATION 15'r ~ ] ROUGH FOUNDATION ZND ~ ] INSU~TION [ ] F~MING []FINAL SPE~OR 76S.t802 BUILDING DEPT. ., INSPECTION FOUNDATION 1ST [~ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [~F~MING [ ] FINAL ,'iELD ~ECTION COMMENTS FOUNDATION ('~ :OUNDATION (2nd) {OUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL/ ADDITIONAL COMMENTS: FORM NO. 6 ~h(~ ~,,~/, ~ TOWN OF SOUTHOLD ~_ Building Department Town Hall ~,~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANC' Instructions · '. This application must be filled in typewriter OR ink, and submitted tot 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 p~an requirements where applicable. 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 preoare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $1,5.0 0 3. Copy of certificate of occupancy $1.00 Date ................. Old r P isti g Buildi 0 Vacant Land New Building ............. o re-ex n ng ......................... Location of Property House No. Street Ham/et Owner or Owners of Property... .................... · · .~ ....................... County Tax Map No. 1000Section ..,).Of Block f~..l .... Lot. tc~.'~ ...... Subdivision .............. ~ ................. Filed Map No ........... Lot No .............. Permit No ...... Date of Permit ..... Applicant .~.~.~-,~.. L Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Faa Submittad $ ............................. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ,ate ,~pplicatio,,~Vo.o,S, le N 750550 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ~e~k Clcxha'~:c~q~,cz., S/S ~)~d:e 2,5~ 5g0' WfO }I~vlY~r Lane~ Cutck~ ~lC~f~JO~ ;£Uk~ Section Block Lot was examined on and found to be in cornplia~tce with the requiretne~ts of this Board. FIXTURE FIXTURES RANGES OVENS EXHAUST OUTLETS SWITCHEE FLUORESCENT VAPOR DRYERS FURNACE MOTORS FUTURE APPLIANCE TIME CLOCK~ MULTI-OUTLET DIMMERS EYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER ~PPARATUS: - ~G. ~. C~ I. o 1,--~moke D~tectoz' S E R V I C E A, WG AW.G. OF HI-LEG OF NEUTRAL ~lo~nd FJ.ec~rtc Co,. P. O. Fox 143 GENEI~AL MANAGE~/I 11 /' This cerfificote must not be oltered in on), monner; return to the office o~ ~he Board i¢ incorrect, Inspectors mo), be identified b), their COPY FORBUILD NG DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED N 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 ~m~ C~&~3, ~ · '(please print) Plumber ~V~ OVV% (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. JUDITH fl, WURT~ .... "; NOTARY PIJt~LIC, State of New York No. 4787124, Suflolk Coun[~ plumber' s signature) Sworn~ ,t~-~, befoxa, r~D.. this _day · ~ Nota~ Public Notary Public ,~County BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~] I~TI~ON ] FRA. INQ · -' 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 , TEL.: 765-1803 .... Approved...%,. ~.&..~..., 19~,¢. Permit ~o.'~ .%! S ~. Disapproved a/c .................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG. DEPT. TOWN,OF 80UTHOLD Received ........... ,19... INSTRUCTIONS a. This application must be completely filled in by typewriter or 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 Bu/lding 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 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. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on prelnises and in building for necessa i~ctifia~s. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................. .C). ~-~ ca...~. ................................................. Name of owner of premises ...~.~'/% [~. ~:... ~ !..C~..~. ~.C)..L~..L.Cy .~.. ~.... l.?~.. .......................... (as on the tax roll or latest deed) If appl_ic~ ~atio~ign~re o f duly authorized officer. .... :'~ ..... ~. .... ~ .~.~. ........ (Name and title of corporate (al~icer) Builder's License No .......................... Plumber's LicenseNo ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .............. .~.--¢..~......~..~.~.~ .................... ~.?,., .'¢. . Y.~. ........ .~ ~_~ .'~. . . . 7~:. z:x:. ............ .C.~ !~.c5,. .~.?. ~e_. .,. ~.,~ ...... House Number Street Hmnlet C: County Tax Map No. 1000 Section ...t, .t,~ ........... Block ...I, .............. Lot...t.J.,~.) ......... 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 . . . .~.t%...~..DrX. ..... - .... .O.~(, ............................ b. Intended use and occupancy ..... .~.~_.o,.~. 97../~/?...' . .'~.. ~ryx,. ~.~ t~ 3. Nature of work (check which applicable): New Building ..... ' ..... Addition . .~.. .... Alteration .~. .... ~ .... Repair .............. Removal .............. Demolition .......... ;... Other Work ............... i (Description) 4. Estimated Cost ...... .~..~. · .'-~ ................ Fee ~, .~ .~.d~'~ ~...~.. ............. rte bel paid on filing this application) 5. If dwelling, number of dwelling units ...... [. ........ Number of dwelling unlts on each floor ..... If garage, number of cars ........................................... ; ............................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............... ~ ...... 7. Dimensions of existing structures, if any: Front .... 2~. ........ Rear .... /..~'~ .......'Depth .... . .... Height . . .'~ ~ ....... Number of Stories ...... .~... ~ .......................... Dimensions of same strncture with alterations or additions: Front ....... //.t~. !.:... Rear .. J.~ ............. Depth ....... -~. '*7' ......... Height ... ,~.~ ........... Number of Stories .... '~ ............... 8. Dimensions of entire new construction: Front ..... ,/..~. ...... Rear .... 1.5/i ....... Depth .... ~ .~. ....... Height .... ] ~ ........ Nmnber of Stories ........ ~ ................ i ............................ 9. Size of lot: Front ....~,.~. ~-.C~....~ ...... Rear. ,ff~c~ ................ iDepth _..~.~..d~. ........... 10. Date of Purchase .... 1 ."x.. ~-~ ?. c~..~-'Y-. Name of Former Owner i.~-..~Q .~....~.. 91 ~c.~. ..... 1 1. Zone or use district in which premises are situated .~.lT~e 12. Does proposed construction violate any zoning law, ordinance or regulation: ...i ..... ,/~,-2.% ............... ._.~. 13. Will lot be regraded ...... .~ ,(~.~JZ-/~4,/ ......... Will excess fill be removed from premises: Yes 14. Name of Owner of premises' .~:~-A~-,0~.~-. ~,q4,.. Address J2.t~[..~...~7!U. ~-~.~.,~. Phone No Name of Architect ..... ~ wx .............. Address .c3>~,. c. ', ...... :i .... Phone No.'~. ~-..~-O....~fYC~.. Name of Contractor .... ~.q,r~._~. ...... Address . .C~.~c~.. Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. in~dicate 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) a~ove named. He is the (Contractor, agent, corporate officer, etc.)i of said owner or owners, and is duly authorized to perform or have performed the shid 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 ~' ...................... t/'-~ ~.. day~. · · -~.,~-~...~°f ..... /~....-'/~... ........., County' 19 .~ OCCUI~AN~¥ 08 USE, IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY APPROVED AS NOTED NO:~IFY BUILDING DEPARTMENT AT FOR ~OUREg ~ONCRE'rE 2 ROUGH FR~,MING b FEUJ~BING 3, iNSULA [10~ . : , , ', , . .'.;. ,:- .-_