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Home My WebLink About14031-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Plumbers Certification No. Z1~885 Date 'September 17, ., I9.8~. THIS CERTIFIES that the building ....... 9 ,n.c. ?:a..m.i.l,y...DF.e.1' i..i.n.g. .................. Location of Property ...1 3. 7.0. Cases Lane ~, PathwaZ ....... Cutchojgue ~ N. Y;. I4ous; No. ' .................... 'St/eot ............... County Tax Map No. 1000 Section . .1.0.9. ....... Block . 9.5 ............ Lot. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated J.u,n. e...6., ............... 19 .8 .5. pursuant to which Building Permit No .... ]. ~. 9.3.1. Z. ........... dated J u n e 10, 19 .8.5, 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 ......... Family Dwelling The certificate is issued to ..... ~ward .&, M.a..rg.a, ret Krebs ..... io¥,;e'r, ............ of the aforesaid building. Suffolk County Department of Health Approval 8 5 - S O- 04 N766460 UNDERWRITERS CERTIFICATE NO .................................................. ............. Rev. 1/81 FOB~ 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) N_ 14031 Z Permission is hereby granted te,: ........... .....%. ............................... · ¥='=-" ..................................................................... ~ ............. '::x .................... ~";~'"'"~"~:~-' County Tax Map No. 1000 Section ...... ~....O..~ ......... Rlock ...... Q.~ ........ Lot No .....~..7. ........... to application dated ...... --...~...~....~. .................... , 19..~..~., and-- ~' approved by the pursuant Building Inspector. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CEP, TiFICATE OF OCCUPANCY BLDG. TOWN 0~: 80UTHOLD instructions A. This application must be filled in typewriter OR ink, and submitted in trli~t~c'~'e to the Building inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, an6 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 installations, a certificate af Code compliance from the Architect or Engineer responsible for the building, 5. Submit Planning Board approval of compteted site plan requirements where applicable. B, For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-ex'st'ng' land uses: 1. Accurate survey o~ property 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. Dote of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 1, Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5,00 3, Copy of certificate of occupancy $1.00 Date ~.~ ........ 1. .......... / New Building ..... IZ.. ........ Old or Pre-existing Building ............................ Vacant Land ............................ · ocatio. Of Property ........ ....................... Owner Or O .ers of Property ..................................... ........ -~,,~a,~on ......... : ...... /.L°..°.......~.~..~....L.q.t..~otNo..'.~,.g ..... Block No.'..~,,,'~,,,... House No,/.'.,~,.,,~,].' l.R.q3./..~ Permit No. Date Of Permit ,~fm:/..~,G...Applicant ............... ~ ......... Health Dept. Approval .......... ~.~..'.T.~i~....T.~..~........Labor Dept. Approval ................................................ Underwriters Approval /~ ~ (~ (~ ~/' (oO P ann n,~ Board Approval Request For Temporary Certificate ........................................ Final Certificate ...... ..~...i ............................. Fee Submitted $ .~..~..-~.........~.~.~.~]. .... Construction on above described building and permit meets oil applicable codes and regulations. App,,can,. .......... ....... .............................. Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or seal) TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date (please pri~) (please 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 ~ day of ~ ., ,,. Notary Public, ~ County Notary Public THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000287 BUREAU at= ELECTRICITY ..~ ~ ~, ~ ~,,~.,,0.~.0.~,~ ~es~/e~ N 766460 THI~ CERTIF{ES THAT only the electrical ~uipmen~ ~ ~scribed be~m and int~duced by t~ ~ppl~c~nt ~m~ o~ ~he a~ve application number i~ the prem~es ~. Edward ~s, Case~ L~e, coznez of Cedars, Cutcho~e,N.Y ~s examltted on August 2~ ~ 1986 and found to be in compliance tt,ith the requirements ~f this IIoard. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OLY[LET$ SWITCHES FLUORESCEN! Track Lighting 6 heads i-HW~d 4500 watts E R 405 .Bi,'ch L.e. ne GENERAl.' MANAGER This certificate must not be altered in any manner; return to the office of the 5oard if nco(rect. Inspectors may be identified their credentials. COPY F~ BUI'LDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST ROT BE ALTERED IN ANY ~NNER, F1 ~FECTION FOUNDATION (1st) FOUNDATION 2. (2nd) COMMENTS ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C ODE ~I~AL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST FOUNDATION FRAMING REMARKS: ROUGH- PLBG. 2ND [ ;~SULATION [ '3 FINAL DATE / IN$1 El 'l'lON [ ] FOUNDATION IST [ ] ROUGH PLBG. FRAUNDATION 2ND [ ~/INSULATION MING [~] FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ZST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND ~ INSULATION [ ] FRAMING [ ]\FINAL REMARKS: INSPECTOR .... ~// .,, 765.180Z BUILDING DEPT. INSPECTION [ ] FOUNDATION 3LST [ ,] ROUGH. P~G. FOUNDATION ZND El INSULATION FRAMING £] FINAL DATE' ,/'~'~ ~.%' INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved / .~.., 19~.(Permit No.]. q~..~./..~ Disapproved a/c' . .................................... APPLICATION FOR BUILDING PERMIT Application No .................. Date .................. 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 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 agr~s to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspe~ctiog~v/~ ...... -_ ............ °~me, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee,.,..~gent, architect, engineer, general contractor, electrician, plumber or builder. ............................... ................................................ Name of owner of premises E~.~..¢~.. ~ .~.~ 44,/,~. ' (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No... ~' ~7~, Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number ,-~ Street. ~~. Hamlet County Tax Map No. 1000 Section.... mook ..................Lot... .g ........... ~¢ ............... Filed Map No. .~ ..... Lot ............... Subdivision 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy b. Intended use and occupancy ......... ~,~, ~"~,::,~tr ~t~t~' r'~,u~ Heig 9. Size 10. Date I 1. Zorn 12. Doe., 13. Willl 14. Nam Nam Nan' Nature of work (check which applicable): New Building ....... Addition .......... Alteration .......... Repair . ............. Removal .............. Demolition .............. Other Work ............... (to be paid on filing this application) If d~ 'elling, number of dwelling Units .... ./. ......... Number of dwelling units on each floor ................ If ga :age number of cars If b~ siness, commercial or mixed occupancy, specify nature and extent of each type of u~e . ~- Dim ns/on of xistingstruct if ny: Front · .'R ' ...'Depth Heig ~t Number of Stories Dim, ~nsions of same structure with alterations or additions: Front ............... Rear ................ Depl h .................... i. · Height .......... ............ Number of Stories ...................... Dim, ,nsions ofent/re new constrUction Front .~./' ~.' Rear .-~... Depth .J'~J~ ~t../. ~. :..~ ...... Nuraber of Stories ] ] ~/. '. i ] i i ] ] ] ] i ] ..... ¥]].i].i]]]] ...... ] of Purchase ........... ~i .................. rl~ame of Former Owner or use district in which prdmises are situated .... ~.q P.~r~.'~7..~.~. ............................... proposed construc~ipn viol.ate any zoning law, ordinance or regulation: .. ~..o.., ....... . ................ et be regraded . ~..~.~...~i ................... Will excess fill be remov.ed from prermses: Yes oz uwner o~ prermses ...! .,.".~. :,. ........... Address !~..ql. ~ ....... .o.a.e~ Phone No ............ of Architect ........ i ............. Address ................... Phone No. Local property interior ~ PLOT DIAGRAM clearly and distinctly all! buildings, whether existing or proposed, and. indicate all set-back dimenmons from ines. Give street and block number or description according to deed, and show street names and indicate whether cornerlot. STATE OF NEW YORK, S.S COUNTY OF, ,~ ................ ...... ff~...~.~./..~.~: ~:..r.~....-~.: .............. being duly sworn, deposes and says that he is the applicant ~ (Name of irll;Ligid~l signing contract) above named. He is the . (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 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 manne: set forth in the application filed therewith. Sworn to before me this .... 6.~ ............. day oi...~Y-~. ............ 19 bJotary pub,~ic, .~ ............... ~ .... ' ,OTA, ,uBuc. st,t ofN wYo . .r. .... ................... SUFFOLK CO. HEALTH DEPT. APPROVAL H.$- NO. SYSTEMS FO~ ~IS RESIDENCE WILL SERVICES -- FOR APPROVAL OF ~FFoLK CO. TAX MAP DESIGNATION': "' '"' ' DEED: ,L~2~, ' ' '" '" TEST '~LE~ STAMP ~AL YORK SUF FOLK COUNT~' HEALTH "~ '''-~'- DEPARTMENT .- =,. ~. s .o F^M Y DWELu.Oo. ' DATE' '~i~' "'.~ "-- THE S~AGE DIS~L AND WA ~E~ SUPPLY FAOI~IES FOR THiS ~!ON PAVE B~ INS~Ci'~D ~Y ~HIS. DEPA~M~T AND-- ~ TO ~ ~CT~Y~ ~_ ~: " Chef GREENPORT N~¥O~ SUFFOLK CO. HEALTH DEPT. APPROVAL STATEMENT OF iNTENT WATER SUPPLY AND SEWA~ DISPOSAL SYSTEMS FOR THIS RESIDF, NCE W~ILL CONFORM TO~ THE STANDARDS OF THE DEPT. OF (s~ ~EICANT ' SUFFOLK COUNTY~ DEPT, OF HEAL:TH SER¥1CE'S -- FOR APPROVAL OF CONSTRUCT ION ONLY DATE: t APPROVED: SUFFOLK cO. TAX MAP-~ATION: DIST. SEC'~. BLO(:K EL. ~ ...... :"'~: ': 7 :'~ :'~" ': :. :.."-~ ADDR~S: