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Home My WebLink About14135-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .... ~.l.4~.~kO ....... Date ...... D, 9.c.e.m.19. 9~' .1..9 .............. 19.8..5 THIS CERTIFIES that the building .... Q~¢.-.gQ~.. CIW.e.~ ~-~-D.~ ...................... Location of Property .. $ .4.9.5 ............. .H~.~l-l~O ~.~ .R. ~, .............. C..tl ~.c.h..QCj'~.e. .... House No. Street Hamlet County Tax Map No. 1000 Section .... ~.0. P. .... Block ........ 8. ...... Lot ..... .5. .......... Subdivision...~l~lan~..~.sta.tes ......... Filed Map No...65.3.7. .Lot No ...... ~ ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·. g.une. .......... ,19 .~5. pursuant to which Building Permit No .... ~.4.~..3.5.Z. .......... dated ....... .~U~..15 ............. 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 ......... .... P.~ kv~ee, oae~ fara&~y..c~ ¢ ~.~..&nq ............................................ The certificate is issued to EDWARD & FLORENCE McKENNA ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval ................ ~.5.-:S..O:-~_.J,.6. ............... N725965 UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 Building Inspector TOWN OF SOUTHOLD BUILDIHG DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 14135 Z Dote ......... ....'~....,~,~...1..~ .................. I~,.~.--- Permission is hereby granted to: ....'-,~..~.~....t...a....~ ............................................. .~.~.....~:~.:....u..~.~.~.. at ~,,~,,.,,o~oted o,..~..~.~.~......~/~./,~......~.,. ........ ~~....~_ .................... County Tax Map No. 1000 Section ....... J..?....~:T.. ...... Block ....... ..~...~ ....... Lot No ........ ~ ............. pursuant to application dated ..... ~.,.~.~ ................... , 19..~..'~., and approved by the Building Inspector. Rev. 6/30~80 FORM NO. 6 TOWN OF SOUTHOLD 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. Bo 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 prepare a certificate, Fees: 1. Certificate of occupancv $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date.../..~..~..~. ~-.~.2~.~..'~. ....... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ............. ¢7Z- House No, Street Ham/et Owner or Owners of Property ~.~-./-~., .~..~. · .~.~.~..~.'~. · .~-:.~.. ~. ~.~...A~..~ ................... County Tax Map No. 1000Section., /~;~ Block .... ~ Lot ~. Subdivision ................................. Filed Map No .......... lot No .............. /. ~..~..-~. ~ Date of Permit ~ ' ~-/-~'-~'Applicant Permit No. . · ........................................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ..................... _ Request for Temporary Certificate ..................... Final Certificate ....~.. ..... ' .......... Fee Submitted $ ............................. C~onstruction on above described building and per 'rpi~ets all applic~b~i'~s ar~d ~lations. ~,,~,?~(~) \,,~ Applicant..':..~...~/.~/..~.~.../~..~~ ...... Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS ]--~ 0~. BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date I~.~C,~I~ '~1, 19~5 ~ppllcatlo~ No. onfile 351276/85 ~ T only the electrical equipment as described below and introduced by the applicant named on the aboee application number in the premises of in the following location; ~Basement [] 1st fl. [] ~.d ri. s~otio~O00 Bioc~02 and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS OUTLETS SWITCHES EXHAUST · FLUORESCENT 46 3~ 42 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET · ot 8 DIMMERS SERVICE DISCONNECT OTHER APPARATUS: l-~o~ JcLte~ 2-GFC~, 1-~oke Dut~t~r S E R V NO, 0 E COND' OF CC. COND, C NO, OF HI-LEG OF HI-LEG NO. OF NEUTRALS AW.G OF NEUTRAL 2/0 JoCly '~Rillo Pat ~ Rattituck~ L~ Y 11952 2300 This certificate must not ~be altered n any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. GENEI~L MANAGER IN ANY I~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Owner ~-/~?d~~ ~d~j~ ' (please priDt) (please 'print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (Humber' s signature) sworn to before me this 19~ · Notary Public, ~/~/~/~ County / ~ ~otary Public [ON COMMLN Fo I,'OUN DATION (1st) FOUNDATION 2. (2nd} ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY O,ODE FINAL ADDitIONAL COMMENTS: 76S-1802 BUILDING DEPT. ~ INSPECTION FOUNDATION ZST [ ] BOUGH PLBG. FOUNDATION 2ND ~ INSULATION [ ] FRAMING £ ]FINAL //~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . . .'.}. ., 19~..~. Approved Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 ~ 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 othgr 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 necessary inspections~ ~ ~ ¢4X,t-\~Se 7~-cxc,o-~C (Signatfire of appli~, or name, if a corporation) ....'Y.O.. ~.x. \ .~. ~., ~..a&. ...... ~ ~ ....... (Mailing address of applicant) ~,,.~,~tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ... ~ .... ~,~. ~,,~.~ .............................................................. (as on the tax roll or latest dee,d) If applicant is a corporation, signature of duly authorized officer. ~ (Name and title of corporate officer) Builder's License No....~...~.. ,~.....X~..~. '.'~.~(~'(xCk'k , ' ~ Plumber's License No x~ ~ ~ ¢wx~ ~.~ k. - ?~ Electrician s License ~o ................... ' .... Other Trade's License No..~~ ...... 1. Location of land on which proposed work will be done .................................................. .... t~.( ................ ~gd~A.fd ............... ~.. ....................... House Number Street Hamlet County Tax Map No. 1000 Section ..... [ 0.~ ........ Block .... Q ~ .......... Lot ~/~ ~ub~v~o,...¢~.~k~.~G., ................ ~ea~,~o. ~q ~o, ~ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............ ~.~ ................................................ b. Intended use and occupancy .................................................. 10. 11. 12. 13. 14. Nature of work (check which ~pplicable): New Building ... ' ddition .......... Alteration .......... Repair ......... Removal . · , Demolition .[ . Other Work ............... ~ ! ~{ ~' i ........................ (Description) Estimated Cost i~. ~..~.6P F e ~-- I, q 0 .......... 7.: ...................... .................................. (to be paid on riling this application) If dwelling, number of dwelling units ..... f. ......... Number of d, elling units on each floor ................ If garage, number of cars .... i ............................... If business, commercial or mixed occupancy, specify nature and extent if'e'a~il't';p;';f'~e' iiiiiiiiiiiiiiiiiiiii Dimensions of existing structures, if any: Front ............... Rea .............. Depth ............... Height ............... Number of Stories ......................................................... Dimensions of same structure ~vith alterations or additions: Front ... Depth ................... ,... Height ...................... Dimensions of entire new consiruction: Front .TD~./. ~..o ...... Rear Height ... Z'.d/. ' ....... Number of Stories.../. .... ' ........... Size of lot: Front ...~.c?,~ ............ Rear .... ~qO~O. Date Of Purchase .......... ................... Name of Forme Zone or use district in which piemises are situated ................. Does proposed construction viglate any zoning law, ordinance or regula Will lot be regraded ..... ~/a~ ..................... Will excess fill Name of Owner of premises .~. a/W~o/..~f·et~/g/~L...... Address Name of Architect ......... i'. ..... ~ ........... Address ...... Name of Contractor ~'~.k8~',~ . .~..~/~[..C~,.~... Address ...... Locat.e. clearly and distinctly property lines. Give street and blocl interior or corner lot. PLOT DIAGRAM [1 buildings, whether existing or propo: ~ number or description according to dee, STATE OF NEW YORK, [ S.S COUNTY OF ................. .................................................. being duly (Name of individual sigOing contract) above named. , He is thc ..... ~ ................ i ............................... of said owner or owners, and is ddly authorized to perform or have perfm application; that all statements contained in this application are true to the work will be performed in the m. ann~r set forth in the application filed therex Sworn to before me this ............ Rear .................. amber of Stories ...................... · .7~...'iff. ....... Depth .~. f. ......... ..... Depth . .~..~.(~. .............. : Owner ............................. Ion: ................................ be r~_~oved from premises: (~ No · .~. .... Phone No ............ Phone No ................ ............ Phone No..~kct.~..~ .~.~. d, and, indicate all set-back dimensions from and show street names and indicate whether 'om, deposes and says that he is the applicant ricer, etc.) reed the said work and to make and file this best of his knowledge and belief; and that the dth. ign~[i;e of applicant)' ' TITLE N0.8508 ~ 274~9~ SINGLE FAMILY DWELLING ONLY SUFFOLK cOUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY ApPP..OVED~ ~/'~ L_/ v/,~-- - ~. / HEALTH DEPARTMENT 'DATA FOR APPROVAL TO CONSTRUCT M /CEAREST WATE~ IA(H--MI. ~ N SOURCE OF WATER, PRIVATE N SUFp CO, TAX MAP Df]IT JO~O SECTION Io~ BLOCK ~ LOT 5, ~E~ ARE ~ ~LLI~S WITHIN I00 FEET OF THIS ~OPERTY OTHER THAN THO~E ~HO~N HEREON, N THEWATER ~UP~YA~ SEWAGE DISMAL SYSTEM F~ : STAN~ROS OF THE SU~K COUNTY DEPARTMENT WILL EOflFO OF HEALTH ADDRESS SURVEY FOR ED WA RD ~ c KENNA LOT AIO, 8, " HIGHL4NDESTATES " AT CUTCI-IOGUE TOVIN OF SOUTHOLD S UFFOLIf' COUN T"f~ 'NEW YORK ~¢UNAUTHOR~IZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATtON OF SECTION 7209 OF THE NEW YORK STATE EOUCATION LAW reCOPIES OF THIS SURVEY NOT EEARINB THE LAND SURVEYOR'S INKED SEAL OR EMBOSEED SEAL SHALL NOT BE CONSIDERED TO BEA VALID TRUE COPY ~¢GUARANTEES INDICATED HEREON HALL RUN ONLY TO THE P~RSON FOR WHOM THE SURVEY IS PREPARED A/CO ON HIE BEHALF TO THE TITLE COMPANY~ GOVERN- MENTAL AGENCY ANB LENDING INSTITUTION LISTED HEREON~ ANB TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANS;ERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT N DISTANCES SHOWN HENEON FROM' PROPERTY LINES ~F~ COU~ ON APRI~ ~,IgTYASFILE N~ ~53Y FLORENCE IFcKENIVA DATE: SCALE; NO, GUARANTEED TO ' JUN~ 10/985 MAY 9,1985 I'= 50' 85 - ~G AVENUE YOUNG e, YOUNG YO.K ALDEN W, YOUNG~ PROFESSIONAL ENGINEER -:¢:, AND LAND SURVEYOR N,Y.S. U(~ENSE NO 12845'_:~ HOWARD W*YOUNG~ LAND SURVEYOR - ?;~.:.~' ,, N,Y.S, LICENSE N0.4589'~ ,/" T/TIE N0.8508- 274~9~ SURVEY FOR ED WA t~D Mc ff £NNA / OT NO. 8 , "ttlGH/ANDESTATES' AT CUTCHOGUE TOWN OF SOUTHOI D SUFFOLK COUNTY, NEW YORK ~ FlOrENCE McKENNA D£O. 5,, 1985 dUNE. IQ ~1985 DATE: MAY 9,19~B SCALE~ /" u ~ GUR~ANTEED TO ~ N UNAUTHORIZED ALTERATION OR AODITION TO THIS SURVEY IS A VIOLATION OF SECTION 7205 OF THE NEW YORK STATE EOUCATION LAW /NC. AVENUE YOUNG YOUNG RIVERHEAO, NEW YORK ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S, MCENSE NO. 12845. - HOWARD W. YOUNG, LAND SURVEYOR N.Y.S. LICENSE N0.45893 HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT ADDRESS NOTE" · ~ MONUMENT 0 = STYE' SUSM¥/ $1ON M4P F/,~.ED IN TffE'QFFICE' O F TNE' C L E'~tK O F # TH~ LOC~TION OF W~.L(WI~ SEPTIC TANK(ST)D CESSPOOLS~PI SHO~N NEREgN ~E F~O~ ~IEL~ O~6~I~/~TION$ ~D OR DAT~ DETAINED ~NOM OTHERS TD¥ POST E0494