HomeMy WebLinkAbout14025-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Sou/hold, N.Y.
Certificate Of Occupancy
z14761 Date August 5, 1986
No.
addition
THIS CERTIFIES that the building ................................................
705 Old Pasture Rd./155 Honeysuckle La. Cutchogue, N.Y.
Location of Property
House No. Street Ham/et
County Tax Map No. 1000 Section . 1 03 .Block 13 ..... Lot 1 . 2
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
...J..u.n.e..3. ~ .......... ,19~. .5. pursuant to which Building Permit No..~ .4.0.a 5 ~ ..............
dated .J.u.n.e...7., .................... 19~.5. ., 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 .........
addition to existing one family dwelling.
The certificate is issued to ........ .E.v.%q..~..A. t~ .ig.a.i. 1., .B.r.e.s..s ~?.r. ......................
{owner,~,$~6~';r:.¥,~h~
of the aforesaid building.
Suffolk County Department of Health Approval ......... ~.~ ............................
UNDERWRITERS CERTIFICATE NO N 7 4 4 6 7 6
Plumbers Certificationbated Jul,y ~,0,.1986 ...... . ........
Rev. 1/81
FOB,I~ NO. B
TO~N O~ $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N9 14025~ Z
Permission is hereby granted to:
. /q~ ..
.~.~~...~..:.~.,..U..~.~..~. ~ ,
..~...~
et premises located at .,,~, .(~.~.......,~..,, .,~,,.~..~,~-,/~,,~~.~.~'
...~..~. ....... ~..~....~....~ ................................................. , ..............................
County Tox Mop No. 1000 Section ...... - /...(~.....~. ...... Block ....... ~..i~ ....... Lot No....Z.~...~. ..........
pursuant to application dated ....... ....~. ~.....~ ...................... , 19..~.~, and approved by the
Building Inspector.
Building Inspector
Rev. 6/30/80
i~
5 ~fLn ~NS[~ECTION COMMENTS
FOUNDATION (1st)
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
qODE
FINAL
ADDITIONAL COMMENTS:
WILLIAM WICKH^M
ERIC d BRESSLER
WICKHAM, WICKHAM 8~ BRESSLEIR,
MaiN ROAD, P.O. BOX 1424
MATTITUCK LONG ISLAND
NEW YORK H952
February 23, 1987
Building Department
Town of $outhold
Town Hall - Main Road
Southold, New York 11971
Re:
1000-103-013-001, Old Pasture Road, Cutchogue
Owners: Eric J. Bressler & Abigail A. Wickham
Building Permit #s 14025Z - 6/85 & 11435Z - 10/81
Gentlemem:
Please send us the Certificates of Occupancy for the above Building
Permits. Enclosed is our check in the sum of $15.00.
/jas
Encl.
Very truly yours,
Abigail A. Wickham
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted m ~..--..--- to the Building Inspec-
tor 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 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;Coperty 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.
Fees:
1. Certificate of occupancv $5.00
2. Certificate of occupancy on pre-existing dwelling
3. Copy of certificate of occupancv $1.00
4.Vacant Land C.O. $5.00
5. Updated C.O. $15.00
$15.00
Date ......¢?.?0/~/i .................
NewC°ns truction ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property . .9.0. ~ ..0..~.,-. ,~ ..... .~.~.~.'~..%)...(~.,, ~.,~ ....... .C~.'.~.'.[-,~.l~ ,0.(])?.
House No, Street Ham/et
Owner or Owners of Property .~..C} C '.~..~..~..-~----_~...~
County Tax Map No. 1000 Section ............... Block ............... Lot ................
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No! .L'~..
Date of Permit .~.~/~..~..Applicant. J~.(?. ~-,.~"~..~ .k.~.....C~..C~..~)..~.... .......
Health Dept. Approval ... / ............ Labor Dept. Approval ........................
Hnde~riters A~roval ........................ ~lannin~ Board A~proval ......................
Bequest for Temporarg Cerdficate / ...................... Final Certificato .......................
Fee Submitted $... ~9.~ .....
Construction on above described building a ,n~jt meets a~,~pl~l~co, d~ and ragu lations.
Applicant ,~-'/..~
Rev, 10-10-78
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
P.O. BOX ?28
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
Building Permit No. \qD~
Owner ~/~,~L; g~%~._~ {~t-FI9--~ (please print)
· ' (~lease print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1% lead.
Sworn to before me this
~O day of ~ ~ l7 ,
Notary Public,~~ County
(plC~-~-ignature)
Notary Public
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
~g 85 JOHN STREET, NEW YORK, NEW YORK 10038
O.~e .%~pr.%l 15~ Z9~36 362202/85
THIS CERTIFIES THAT
only the electr~al equiprnent ~ described below and introduced by the applicant named on the above apptication number in the premises of
. , ~r~I 7~198f5
w~ exammea on and found to be in compliance with the requirements of this Board.
FIXTURE
OUTLETS
53
RECEPTACLES
51
SWITCHES FIXTURES RANGES OVENS EXHAUST FANS
INCANDESCENT FLUORESCENT VAPOR
64 53L ,
DRYERS
FURNACE MOTORS FUTURE APPLIANCE FEEDERS
TIME CLOCKS UNIT HEATER MULTI-OUTLET DIMMERS
SYSTEMS
NO. OF FEET
SERVICE DISCONNECT'
S E R
NO OF CC COND. I/t A W g
PER ~ OF CC, COND.
OTHER APPARATUS:
~otor~ ~
1-200 a~ Transfer Switoh~ 1-6.0kw ~team
~loctrio ~'~om liuators; 2-1.
V I C ~
A. W G NO, OF NEUTRALS A, W. G.
OF HI-[EG OF NEUTRAL
1 3/0
NO. OF HI LEG
Laurel~ N.~. t3.948 Lio. 1227
GENEI~L MANAGER/
,,
This certificate ~t not be o~tered i~ a~y ~oo~er; return to the off~ce of t~e Board if i.correct. Iospector~ may be ide~tlfled by their
~OPYF 8~: ILOI GD~PA T ENT. THS~OPYOF~EST~FIOATE~ SXNOT~BEALTESEOINANY~ANNES.
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765~1B03
Examined.. · .~*'.~ ·.., 19 8.~.''
Approved ..... ~ .7., 19g.(. Permit No../.~.O..~..~: ..~
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Date .. (O .......... 19 .G~.. ·
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 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 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 premises and in building for necessa .fy(inspections.
...k~¢.qT..o..w.....c~..o. Xr.c,0c~?J.. ~
(Signature of applicant, or name, if a corporation)
! .¢.
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder·
........ ....................................................................
Name of owner of premises . ~.&.\.L-..~..C~[. ~.(,~,...~>..~.~.~ .[-~...~.. .........................................
(as on the tax roll or latest deed)
If appJg~,anl)is a corporakion, signature of duly authorized officer.
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 ..................................................
County Tax Map No. 1000 Section ...1~3 .......... Block .... ~./~ ...... Lot ........ [.: & ......
Subdivision ....... ~ ................. ' ........... Filed Map No. . . ~ ......... Lot
(Name)
2. State existing use and occupancy of premises and intended use and occgpancy of proposed construction:
a. Existing use and occupancy...~...'~. ~ .... ~ ~'~ ............~ [[~*~*~2.~ .................. .
b Intended use and occu anc ~~ ,
· P Y ......................................... ,..v ......................
3. Nature of work (check which applicable): New Building ..... ' .....'Addition .......... Alteration ..........
Repair .............. Removal .............. Demolition ............ Other Work ...............
.~...,~.~2. ~ (Description)
4. Estimated Cost .......................... Fee ..
i ~ (to be paid on filing this application)
5. If dwelling, number of dwellin~ units ............... Number of dwelling units on each floor ................
If garhge, number of cars .... i ....................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .....................
7. DimenSions of existing structures, if any: Front ............... Rear .............. Depth ...............
,Height ............... Number of Stories ........................................................
Dimensions of tructu w'th alterations or add' ' Front Rear
same s re I ltlons: ...................................
Depth ..................... Height ...................... Number of Stories ......................
Dimensions of entire new construction: Front ............... Rear ............... Depth ...............
Height ............... NCraber of Stories ........................................................
Size of lot: Front ....................... Rear ...................... Depth .......
Date of Purchase .......... i .............. Name of Former Owner ;.. ...........................
Zone or use .... ' '
district in which premises are situated .....................................................
Does proposed construction vi01ate any zoning law, ordinance or regulation: .................. i....~......N..!
Will lot be regraded ...... ~.._ .... ~ ............... Will excess fill be removed from premises:
Name of Owner of premises ~ 151~'~.~C:::~-:~ .... Address ................ Phone No ........
Name of Architect . . . . . .... Address.. Phone No
Name of ContractorI~..~'3 ...c~. ~.'~. f .... Address .l~.lT[ .~.%.~.~.. Phone No.o~OJ~.'7. ~h~..'L~...
10.
11.
12.
13.
14.
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 coruer lot.
/
STATE OF NE~YO..R. rK,' ~,i S.S
C 0 U NT,,Y~O F ~Y:~..~ ~c-~-~
iff
(Nam4 of individual signing contract)
above named.
He is the .............
........................' et;') ............................
i (Contractor, agent, corporate officer, .
of said owner or owners, and is dt~ly authorized to perform or have performed the said 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
....... .........
NotalT Public,~~'//~ ' '~'"
~l~,*~ t~,,,~ ~, ~,, '~d~ \3 (S~gnature of applicant)