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HomeMy WebLinkAbout14175-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14856 D September 5 ~ ................. ate .............. a .................. 19. THIS CERTIFIES that the building One family dwelling ..... ; Location of Property 2735 Perlu. ash Ave.nue..~. Cutcho ue, N Y..~.~9.3.5 ~louse tVo. Street Ham/et County Tax Map No. 1000 Section .. 1..0..3. ... . Block 12 Lot 013 ' Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .July 18 19 8.5. pursuant to which Building Permit No 16. ] 7~ Z. dated ............................3uly 30, 19 .8.5. , was issued, and conforms to all of tho requirements ,. of the applicable provisions of the law. The occupancy for which this certificate is issued i~ ......... One family dwelling The certificate is issued to Theodore 0. Beebe, Jr. (owner, Iz~ee~o~ of the aforesaid building. Suffolk County Department of Health Approval - 85 - $ 0- 92 Pending (7/3~/86) UNDERWRITERS CERTIFICATE NO .......................................... .. . . ... . Plumbers Certification Dated: Sep~e.m~er. 2, 1986 Building Inspector Rev. 1181 l~O~v NO. B TOWN OF $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) NM 14175 Z Permission is hereby granted to: ........ ~-./.~o..,~..~,...~.~ J...,c. ......... ~..~.......z.~.~. .......... .~....~2.~ ........... ~.~..~.~.~...~...~..:..z..:..--- -- ................ , ,o ....... ..~.~.~..~.~..~.T......o.z~...~,~_~..(.~.~ ........ ~.~....//., .......................... Cou,ty Tax Map No,, 1000 Section ..... ./~...'~. ........ Block ...../..~. ........ Lot No.....(~..,~.,,..~ ........... pursuant to application dated ....... ~.~..~.. ....... /'..~.. ................... , 19~...~...~and approved by the Building Inspector. Fee ~* ~___..7'* $...~.~ ............ Building Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 SEP 5 Ig86 ~ f~i .DG. DEPT. APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate 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 peoperty 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 occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5,00 Date .~/l~'~.~. ................... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~.~.~.~.~. ............ &(~.~.~,//,, .,/~.V.~. ' .CUT.CJI 0~.~¥. House No. Street Hamlet Owner or Owners of Property ...~_~./.~.~.~.~.~.~...~. ~....~2~.g.g..C-....~ ........................... County Tax Map No. 1000 Section ../.~.-~. ........ Block ....~./~, ........ Lot.. L'~/3 ......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. LL/~, .7.~...Z. Date of Permit .7./~. ~..~g...~..Applicant...~.~?..~¢.~.~...~.,. ~.~f~?.~...~..~ ...... Health Dept. Approval .~.~..~. ,~-~...-:...~.,¢~...Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Certificate ..... ~ .......... Request for Temporary Certificate ..................... Final ,cz/- Fee Submitted $~.~..~. ' ................... Construct,on on above described building a~l~:rn~it meets~plicable codes and regulations. Applicant . ,~'.~_~?-¢ .0: ..... ~ .............................. Rev. 10~10-78 TOWN~ OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. Owner ~00~ f~ 3~ (please print) Plumber~F~/~c~'~ P/O~ ~/ ~ ' (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (p/mber's signature) Sworn to before me this 19 ~'~:' · / J N~tary Public Notary Pub 1 ic ,)~~c°unty NOTARY PUBLIC, State of New Yore No. 52-4636665, Suffolk Cou6~ Commlss[on Expires~ F]EI,D iNSPECTION COMMENTS __.._.~_. ,.~ FOUNDA'rlON (2nd) ROUGH FRAME & PLUMBING 1NSUL^TION PER N. STATE ENERGY C, ODE Yo FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 ~,xamined....qf' .9'./~.,..~-.~.' .... 197 ,pproved....<~.~.~.~...~.0...., 197..~Permit Nol. (..~./. Z.~.~-.~ )isapproved a/c ........... i" i'. ............. ~ ...... ----.--.-.--~ · · ./>¢f? · ... · C/'~tB'uilding In sp e ct or ) TOWN OF SOUTHOLD Received ........... ,19.. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be ~ompletely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~ets 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 ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. 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 hall 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 roll 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 uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or [egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ?he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~dmitauth~rizedi~spect~rs~npremisesan~inbui~ingf~rnecessaryinspec/~`~2~2--}tr~/~- trJ ~-& t0 (Mailing address of applicant) ~tate whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Il. (Name and title of corporate officer) Builder's License No....~.~. ................ Plumber's License No ............ Electrician's License No.~.k~. ~.(~h ...... Other Trade's L}cense No~~...~.~.q..~. Location of land on which proposed work will be done., p.E. (.q.u..PO. fO...g y..E ..... &.T .~.H..0.6.~. (.~ ............ House Number Street Hamlet County Tax Map No. 1000 Section . J.0. ~ ........ Block .................. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use an~t occupancy of proposed construction: a. Existing use and occupancy ...... .~..~.?x3d~.:. }.~..~J..'..~.~ ......................................... b. Intended use and occuoancy . ~]. IDf.Z'~t:..C-./.P~.~. . . ..~ ............ : ....... . ................. ............ 4. Estimated Cost ............ i ...................... Fee 5. If dwellii~g, number of dwelling units . t'. .......... Number of dY Natfirgbf w6~l~ (c-~h~ck which a~plicable): New Bctilding~...'. .... A. Idition .......... Alteration .......... Repair ..... ....... ;.. Removal ............ Demolition ............... Other Work ............... (Description) ...................... (to be paid on filing this application) ,elling units on each floor ................ If garage, number of cars .... ! ................................ . .................................... 6.. If business commercial or mixed occupancy specify nature and extent )f each type of use 7. Dimensions of existing structures, if any: Front ............... Rea) .............. Depth ............... Height ............... Number of Stones ......................................................... Dimensions of same structure with alterations or additions: Front .................. Rear .................. Depth ........... h. Height ............... umber of Stories ............. , ......... 8. Dimensions of entire new conslructmn Front ...q. ........... Rear . ~.~.~ ......... Depth . ~.*. .......... Height .............. Number of Stories .... Oq~ .................................................. 9. Size of lot: Front .... 40 ..... i ............ Rear..&g0 .................. Depth .~0[.~ ................ 10. Date of Purchase ~../.~../g3 - Name of Forme Owner . ~.c.o..t?,~.. ~...,~.e~- ..... 11. Zone or use district in which piemises are situated ...................................................... 12. Does proposed construction violate any zoning law, ordinance or regulal [on: ..~.0 ......................... 13. regraded ....... .................... Will excess fill )e removed from premises: Yes Name of Architect ......... i" .... Address ................... Phone No ................ ...... Address ........ Phone No..7,~ .t/.-. gsa'./ ..... property lines. Give street and bloc] interior or corner lot. f PLOT DIAGRAM 'i Locat~ clearly and distinctly all buildings, whether existing or : number or descri[ ~0O/ and. indicate all set-back dimensions from , street names and indicate whether STATE O; NE¢O,R,K, ~ ~ · ................... (Name of individual~signing contract) above named. ' being duly vorn, deposes and says that he is the applicant He is the ............................ (Contractor, agent, corporate o 'ricer, etc.) of said owner or owners, and is d¢ly auth'orized to perform or have perfo: med the said work and to make and rile this application; that all statements cohtained in this application are true to thq best of his knowledge and belief; and that the work will be performed in the mum er set forth in the application filed therewith. - S~$~'n to be~o[e~m? this , ~ 1 Notaw Public, .~ .... ~2. f ~ ......... County / ~, ' .~ ~ ~ ( ature ofapphcant) D£~ARTH£NT DF HEALTFt 'B5 MI~Y 22 A~ 8 '~5G ' . . o~ . ~LY DWELLING ~'. '~ ~ T SURLY FOR THEODORE O. BEEBE, JR. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICE~, AT CUTCHOGUE D~TE: MAY 3,1985 FOE APPROVAL OF CONSTRUCTION ONLY ~N ~ SOUTHOLD SClLE= 1%30' DATE F. (] ~ER AVE~E ~ ~-:~, "~' ~-*~ I YOUNG a YOUNG NOTE: · = MONUMENT 0 = PIPE ~ = STAKE ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND LAND SURVEYOR N.Y.S. UCENSE NO. 12845 HOWARD W. YOUNG~ LAND SURVEYOR ~~~ ~ac~s(~l ~, ~[~ N.Y.S. LICENSE N0.45895 ~ ~~.~ o~r~o ~ OT.~. SUFFOLK COUNTY HEALTH S!NGLE FAMILY DWELLING H.D. REF. NO. DATE. L AND ~.¥ATER SUPPLY LOCATt¢ HAVE ~EEN INSPECTED BY THIS (~)'~ Chic; stewater Section :.NT ANI HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRU.CT # NEAREST WATER IAI#IMI. 4. #SOURCE OF WATER~ I~I'a~TE__P~IC i ~OORIr SS STAKE NOTE: ·:MONUMENT O:PIPE JUNE 25,1986 SEPT. ~), 19~5 DATE: ,MAY 3~1985 SCALE: I": 30' NO. 85- 393 GUARANTEED TOI ORTH CO. AVENUE NEW YORK w. You.o, ff 'lllE LOCAI'CIi OF WI~L{W), I/~PTI¢ TAItK|Sll ! ¢[SII'OOLI(Ct) I1~# I ~ T -~ 0 I>L:_ ,.7 ,?