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Home My WebLink About14658-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ...... .g.1.6.0.2..7 ..... Date August 7, 1987 THIS CERTIFIES that the building ..... w..o.o.d., s..t.o.v.e.: .............................. Location 485 Oak Street Cutchogue of Property f/$~$~ ~/o~ ....................... ~r'e~' ....................... /~$r~/¢~ County Tax Map No. 1000 Section 136 . .Block 1 .Lot 28 Subdivision ..... .E.u.g.e.n..e..H.e.i. 9.h.t.s' ......... Filed Map No...8..5.6...Lot No. 80 & 81 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .M.a.r..c.h. 10, 1986 pursuant to which Building Permit No. 14658 Z dated ....... M.a..r.c.h...17 J.. 1. 9. .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 ......... The certificate is issued to ........ ...... JQSEPIt & MARIE KOZEL of the aforesaid building. Suffolk County Department of Health Approval ................. .N/.A. ..................... UNDERWRITERS CERTIFICATE NO .......................... .N./.A. .................... PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 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) granted to: . ~ ., , I ~ ~ ....... .~...~./.~ ....... ~. ....... .,..~ ...... ,.~.~?.L~C..../~...~.~.~,.....c.~. .............. ot premises located at .... .~.. ....................................... CounW To× Mop ~o. ~000 Sect,o. ...... L.~.~ ....... Block ......... I ............ Lot,o ...... ~.,~ .......... pursuant to cJpplication dated ...... ..~..~...~,,../....~. .................. , 19..~...~.., and approved by the Building Inspector. Fee $ .' ............. Building Insoector Rev. 6/30/80 /~" FORMry~ NO. 6 I TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 TOWN OF SOUTHOLD 765- 1802 : ,,,, ~ ~__.~; APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions ~ This application must be filled in typewriter OR ink, and submitted m ~ to the Building Inspe~-' tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, propertv lines, streets, and unusual natural or topographic featu res. 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. B. 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 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. C. Fees: Additions $25.00 1. Certificate of occupancy New Dwelling $25.0.0, Accessory,.$10.O0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00' 4.Vacant Land C.O. $ 20.00 5.UpdA~ced C.C. $ 50.00 Date .-J'~'~.~ ...... .............. New C ohs truct ± on ...... Old or Pre-existing Buildin§ ............ Vacant Land ............. Location ofProperty L/..,~,,~" 0,/} .~ ST/~/~-~.T./ CuTC ./~.~ .~.O'..~../~.~: ./../f~..4 ..... House No. Street l-lam/et Owner or Owners of Property .~....~/.~. / .~ '/ J-~-~'~'-)/~/ .~.d. 2 ~ County Tax Map No. 1000 Section .. J.-.~.~ ......... Block ..../ ........... Lot...~4J~' .......... Subdivision..~,, ./.),g.C, ,/~. ~,~...~.-,~/.~', ./.7/.~,~. ........ Filed Map No..f~.~ ..... Lot No. ~'~.'~.~,F/ ....... Permit No././T/. (..cz-.~. ~. Date of Permit .~7/~7/~. ~..Applicant .~..~.-[.LT-..~..~..../¥~.2..C...~.~ .... Health Dept. Approval ........................ Labor Dept. Approval ......................., Underwriters Approval ........................ Planning Board Approval .................... Request for Temporary Certificate .................... Fina Certificate .. ~v/ . Fee Su.bmitted $...~. J..~..~ .{~.. /.~, .[.~" Con%truction on above described building ar~ permit meets all applicable codes and regulations. A .cant (2- ............. F1ELD INSUECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDI?] INAL COMMENTS: 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1801] Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... Date ................... 19... INSTRUCTIONS a. 'This application must be comple~ ~lz~ ,l[7~pewrit~ or ~n ink and submitted to the Bufld~g Inspector, with 3 sets of plans, accurate plot plan to. ~" ~%~c~u . b. Plot pl~ show~g loca~ ~? [ ~~ses, relationship to adjoining premises or pubic streets or areas, and gives a det ' ~ 2pt' ~~}~ must be drawn on the diagram which is pas of this appli- c. The work cover~ a ~a~ ~~mmenced before issu~ce of~uaamgPermit. d. Upon approvalof~ i~. ~~ectorwfllissuedaBuild~gPemittotheapp~cant. Suchpemit sh~ be kept on the premi~ [~ ~,~ughout the work. e. 'No bufld~g shall be ~ 0~ t~$~61e, or in p~t for any purpose whatever mtil a Ce~ificate of Occup~cy shall have been grated by th~ ~ ~. ' ' ~PLICATION IS HEREB~ [~to the Building Dep~tment for the issu~ce of a BOlding Pemit pursuant to the Building Zone Ordnance of the~ vn of Southold, Suffolk County, New York, ~d other applicable Laws, Ordnances or Regulations, for the construction of build~gs, additions or alterations, or for remov~ or demolition, 'as herein described. The app~cant agrees to compl~ with ~ appQcable laws, ordinances, b~ild~g code, housing code, and regulations, and to admit authotized ~specto~ on premises and ~ build~g for necessaw i~~ (~e ~%~li~t, or nam~f a corporation) (Mailing address of applicant) State whether applic~t is owner, lessee, agent, ~chitect, engineer, gener~ contractor, electrician, plumber or builder. ........................... 0..~.~ ~.~ ....................................................... N~e of owner of premises..~:& ¢. ~.'rJ...~..~ ~ J.~... ~O.~Lt· -..:.~,&. '~5'~k~;¢ ..... (as on the tax roll or latest de~d) , If applicant is a corporation, signature of duly authorized officer. ' ~' ~ ~/~.k= ~.~ .............................................. >- ...... ~ ..~ I.)~PA~TMENT AT (Name and title of co, orate officer) NOTIFY '~ 76~-t~O? t~, /t~ 'V~) · ~M ~R THE Builder's License No... ~ .............. FOLLO~Va~ml PiumbeFs License No ......................... 2 ROU(~ Electrician's License No ....................... ~. FINAl. CO~I~'r;;[UCT~ON MUST B~ CO~PL~ FOR C.O, Other Tradc's License No ...................... ALL CONSTRUCT¢ON $NALL MEET THE MEflU. ,, t~N,., OF THE N.Y ~ - ~ ~ ~ CODES NO~ R~N~-,~,~,,~ H .. ~.~.b ........ ~. {~ .... ~J~~ ............ .~~~ House ~umber St~¢et Ham]et co~.~ ~ ~ ~o. ]00~ s~o. ..... I. ~.~. ....... .~o~. ....... ! .......... ~ot .... ~& ........... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ~ ~ ~ ~.~...~. [ ~.'.. ~, .~...~ ~Q.~ .................... b. lntended use and occupancy ~I~GL~ '~1) ..~].~ .... '}.~.~.~/~.2 ....... }.. - 3. Nature (~fwork (check which applicable): New Building ..... ' ..... Addition ....... ... Alteration .......... ' Repair .............. Removal .............. Demolition .............. Other Work. ~....~...-.. ~ (Description) 4. Estimated Cost....~/... / / .O...O.. ..................... Fee ........... ~ ............................ '~ (to be paid on filing this application) If dwelling, number of dwelling units .............. Number of dwelhng umts on each floor .............. Ifg " arage, number of cars ............. ¢~> ............................... : ........................... 6. If business, commercial or mixed occupancy, specify nature and extent of each typ6 of use ...'.'~. ~.,¢q ........... 7. Dimensions of existing structures, if any: Front ............... Rear ........ i ...... Depth ....... : ....... Height ............... Number of Stories ............................. : ........................... Dimensions of same structure with alterations or additions: Front ............. j .... Rear .............. .: .. Depth ...................... Height 8. Dimensions of entire new construction: Front Height ............... Number of Stories 9. Size of lot: Front ..: ................... Rear 10. Date of Purchase ............ Number of Stories ................... Rear ! Depth .................... Depth ................... Name of Former Owner ~ 11. Zone or use district in which premises are situated... 12 Does proposed construction violate any zoning law ordinance or regulation: 13. Will lot be regraded ...... ~ ....... ,; ........... Will excess fill be remogzed from premises: Yes No 14. Name of Owner of premisesAJ.o~¢¢/./../ko zest-- Address ¥q¢.~..D.~/( .~ I ph~-^ Name of ArcMtect ........................... Address ~.~.~.(°.¥.*.. (q. Name of Contractor .......................... Address ................ :... Phone No ................ 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 showistreet names and indicate whether interior or corner lot. ' - STATE OF NEW YORK, 3OUNTY OF ................. S.S (Name of individual signing contract) move named. ........ being duly sworn, deposes and says that he is the applicant ~Ie is the ....................................................................................... (Contractor, agent, corporate off,iger, etc.) )f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ipplication; that all statements contained in this application are true to the best of his knowledge and belief; and that tho ~ork will be performed in the manner set forth in the application filed therewith. . ~. ~worn to before me this [d E~ .day of ~¢~tx~- , 19 .~..~. ~ ................. ,' . ' .' ' qotary Public, .................... Countyf~ ~ ?q~ (~ \ Il V ! '~..0.(Sigmature~-f~. appneant