The URL can be used to link to this page

Home My WebLink About14286-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14866 Date .. September lO~ ...... 19.8.6. THIS CERTIFIES that the building One family dwe 11..ing Location of Property 600 Private Rd. #2 (Pr. aity Lane) Cutchogue, N.Y. House No. 109 Street Hamlet County Tax Map No. 1000 Section ............ Block ....5 ........... Lot ....0 2 7 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .A.u.g.u.s.~.. 1. .2., ......... ,19..8.Spursuant to which Building Permit No. 1 dated September 16, 85 ............................ 19..., was issued, and conforms to all of the requirements of the applicable provisions of the law. Tile occupancy for which this certificate is issued is ......... ................... 0. n..e. ?.a.m..~.~..d. ¥?.L~.~..n.g' . w~.~h. ~.o...a.~.~.a.c.h..e.~..w.o.o..d..d.e.c..k.s..... The certificate is issued to Donna McLean . (owner, ~e~e~c of the aforesaid building. Suffolk County Department of Health Approval ....... .8 ~.-.S..0 7.1.2. 0. ........................ UNDERWRITERS CERTIFICATE NO. N 760982 Plumbers Certification dated ,September 9~ 1986 Rev. 1181 ~0~ NO. '~ TO~VN 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) NB 14286 Z Permission is hereby granted to.'~_ .......... /_~...~.,~ ....... ~ ....... L~ ........... .... ..~: ...... .,~......~.~.C7. ....................... ....... ....... ~.~.~, .~....~.~..~....~,~.~....~. ~,~/.4.,..-..?~ .................................... to .................................................................~ "~ ,~_ ~'~ ~_~ -~ ............................... ~"'~ .......... U ........................ at premises located at ....~.d~.l:~ ....... ../'.~...~....../.f ~./...~..~...~.........L./..~.C~..~.!../.~.:,~,....~/.~ ..................... ........................................................................................................ ,..~../.. ......... ~ ...... ~..~....'./,. ..... County Tax Mop No. 1000 Section .... ~....~.. ........ Block .g..~.~...'. ....... Lot No. '~'"'~'7 ......... pursuant to application dated ...... ~a~..~..../...?~.. ........................ , 19~.S..'~' and approved by the Building Inspector. ~~uildlng Inspector Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall , SEP I 01986 $outhold, N.Y. 11971 DLDG. DEPi~. APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ~ ~ 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. For existing buildings '(prior to April 1957), Non-conforming uses, or buildings and "pre-existing" ~and uses: 1. Accurate survey of 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. Date of any housing code or safety inspection of buiidlngs or premises, or other pertinent informa- tion required to prepare a certificate. Co Fees: 1. Certificate of occupancy $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 5. Updated C.O. $15.00 $15.00 ............ NewC ohs t,~'hc t,ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ....................... . ......... House No. . . . ? Owner or Owners of Property ............................. . County Tax Map No. 1000 Section .... /,0, ,~ ....... Block .... .~. ....... Lot, ~ .~,'. ,~. ,~. ~. ¢ Subdivision ~, , ~ ........... Filed Map No ..... Lot No ............ Permit No. ,, Date of Permit ,. ~ , .Applicant ...... ~ ....... Health Dept, Approval .~.~, ~. ~.~ ~. ............. Labor Dept. Approval ........................ ........... ,,...,n, ,o.r ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction or) above described building apd per, p~it meets all applflcaj~ble cod%~and regulations. Applicant .................. R~. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS ]_000~4 BUREAU OF ELECTRICITY 1~ B5 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application nu tuber in the premises of Donn~ Mc/~an, Pratiy Lar~, Cutch~u~, N.Y. in tlte foliowlng Iocotlon; ~ ~aseotent ~ Ist FI. ~ 2nd FL Section Block ~s examlned ot~ July' ~]-~ ~L~O;8(~ and fou~td to be in co.tpliunce u'it h the reqt ire.~ent s ~f this Board, OUTLETS 47 54 DRYERS SWITCHES INCANDESCENT FLUORESCENT VAPOR MOTORS FUTURE APPLIANCE pIESDERS SERVICE DISCONNECT S OTHER APPARATUS: RANGES iPECIAL KEC'PT R cOOKING DECKS OVENS DISH !ASHEi.~O,~TiS , NS. SYSTEMS C Lot EXHAUST DIMMERS I~E~LC~' A'W G NO OF HI-LEG A W C~, NO OF NEUTRALS A W G, NO, O CONO OF CC, COND OF HI.LEG OF NEUTRAL 2/0 1 2/0 Motors: 1-1bp 3-G,F.C.I. 2-GnDke Detectors Track LtghtinE 16' ~" 5 lit~ P.D. liarcley Inc. ~/~~'~ 4? Atlantic Avenue West Sa~t]le, N.Y. 117~ ~C. 1~ /~ GENER L MANAGE~ : : CO~Y FOR B~ LO NO DEPART~%~NT. THIS COPY OF CERTIFICATE ~gs~N~T~ ~,A~T~RSD IN ANY ~NHER. ~ TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. [~-g& 7 ... Owner~Om~ot ~, ~q~L~Qr~ (please print) Plumber G~ I~ % Ok'~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. MARILYN R. L/~NG NOTARY PUBLIC, State of New York No. 4751570, Suffolk County.. ~, Term Expires March 31~, l{~.~L/7 Sworn to before me this Notary Public , ~/--~ '// ~ary Pub]'io//~~/ .County .F~ELD INSPECTION 1. FOUNDATION FOUNDATION (2nd) 2. COMMENTS ROUGH FRAME & PLUMBING INSULATION FER N. STATE ENERGY ODE ADDITIONAL COMMENTS: FORM NO. 3 ~NOFSOUTHOLD }lNG DEPARTMENT N CLERK'SOFFICE OUTHOLD, N.Y. 2E OF DISAPPROVAL ... ,~.rc~.o~'o~?../~....~.-.././. PLEASE TAKE NOTICE that your application dat~ ..., ~.. ~.~ ...... ,19 ..... for permit to ~~..f~.... Location of Property ',;ds; County Tax Map No. 1000 Section .............. Block .............. ~t .............. Subdivision ...... [~ ...... Filed Map No .... is returned herewith and disapproved on the following grounds . ~5.. ~..*(*.~ · .~.. ~ ~ ~,¢ r~. ~..dze-.. ~/~,,,5.. a~.~..- -':~ ................. ... a~..~.., e ~.. ~.. ~..~~.. ~... ~ ...... · ~] .............. / ............. [.~..z~5.~...~.~.. ~/~. ~..~/~.~. ~g~. ~... r~.~cz.~ ~ .... /~.c~..~ .... .. ~ t~¢~. :':...--~. ..... ~. ~. ~.~t .... z .......... ¢ ...... ~ ....... Rv 1/80 765-1802 BUILDING DEPT. INSPECTION XFOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION I' ] FRAMING REMARKS: FINAL 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION~ FRAMING [ ] FINAL DATE INSPECTOR ~/~, 7GS-'" 802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH, PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING..~_.. [ ] F~i/N/AL REMARKS:, ~ 0 //)/(~2 DATE INSPECTOR 76S-'1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZND ~ INSULATION FRAMING [ ] FINAL REMARKS: DATE .~ BUILDING DEPT. INSPE " I'ION [ ] FOUNDATION ~.ST ( ] ROUGH PI. BG. ~KOUNDA~ON 2ND f '1 INSULATION FRAMING [ ~] FINAL / 765.'1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST ,, [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [~ ] INSULATION [ ] FINAL DATE INSPECTOR 765-1~02 BUILDING DEPT. INSPECTION ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION REMARKS: ,,, ~ FINAL DATE INSPECTOR / CERTIFy THAT THIS MAP CO~PLETEO 8Y ~E ON ~he water Supply and sew~ SyStem for this residence~ form to the standard of tl County Department of Heal~ UNAUTHORIZEO ALTERATION ~ ADO~T~O~ ~AR;NO A PROVISIONAL LANO VIOLATION O~ S~CTIOH 7~09, YORK STA~E EDUCATION LAW ~UARANT~S OR CERTIFICATIONS INOi~ THAT THIS SURVEY WAS PREPARgO EXISTING CODE OF PRACTICE FO~ ~Y ZHE ~EW Y~K STAT~ ASSOCIATIG LAND SURVEYORS. SAIO GUARANTEEs, SHALL RUN ~LY ~ TH~ ~ERSON IS ~REO, AND ON H;S BEHALF, T~ GOVERMENTAL A~NCY, ANO LENOING HERE~ ANO THE ASSIGNE~S OF THE GUARANTEES OR CERTIFICATI~S ARE TO AODITIONAL' INSTITUTIONS OR COPIES ~ THE ORtGINAL OF THIS MARKEO WITH AN ORIGtHAL OF THE LAN TO 8E A V~O TROE COPy. COUNTy .TAX MAP NO. I000- 10~ O0 - O.-~J CERTIFIED TO. ~o.,~/.4 /~/c ~E.~..~ Tc TOWH OF ~OUT~o ~ SUFFOLK COUNTY Edward A. Bu lock, Jr. L 8 P~OFESSIONAL LAND SLIRVEYOR [~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N,Y. 11971 TEL.: 765-1802 .xam~ned . ~. ......... 19 . ,pproved..~.//~.~' .......... l~ .~.. PermitNo. ~lsapprovcd a/c .... -:-:-. ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS TOWN 9F SO~U. yHOLD Rece±ve6 ........... , 1 9 . · I f/, D. a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 2 ts 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 street areas, and giving a detailed description of layout of.property tnust be drawn on the diagram which is part of this appli tion. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building ~nspector will issued a Buildh~g Permit to the apphcant. Such perm[ all 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 Occupanc3 all have been granted by the Building Inspector. APPLICATION IS ttEREBY MADE to t/{e Building Depa/tment for the issuance of a Building Permit pursuant to tb, filding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o ~gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described ~e applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t~ mit auth°rized inspect°rs °n premises and in building f°r necessary inspecti°n~ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) //~,~o~'' :ate whetber applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) ~ Builder's License No .......................... Plumber's License No ......................... Electncmn s License No ....................... Other Frade s Dccnse N( ...................... /D 9 ,~ Location of laml on which proposed work will be d;ne..; ........ · .~....~L~.. I ./..__ · ........... .c. .................................... [louse Number \', Street ~' Hamlet County Tax Mal~ No. 1000 Scclio,, . /...~. ?.: .0..0 ..... i Block . .~ ~.,..q .0. ....... Lot .0.~..?.,.0..0..;;~. .... Subdivisi(n ~ ........... Filed Map No. ~'.~. ~.~ ...... Lot . .s:~.7 ........ d./ (Name) State existing use and occupancy of premises and intendt;d nsc and occupancy of proposed construction: b. Intended use and occupancy ./~. ~w~~~~rq~ {*~ 3. Nature of work (check which applicable): New.Building ...... Addition ..,........~ Alteration . ...... Repair .............. Removal .............. Demolition ........... '... Other Work ............. ~ ~ .C~.O .~. F . (Description) 4. Estimated Cost ee .., ...... ~ ..... , , , ~ '(to be]paid on filing this application) 5 If dwelling, number of dwelling units ....( ...... ',. .....Number of dwelling units on each floor ............... ~f garage number of cars . .. ~ ................. ...; .......... i, .................. ~ ............. 6. If business bommer~ial or mixed occupancy specify natpr$ and extent of eac~pe of uso ...~.. ~ ...~ .t ...... ~'/~.D'mensi°ns,°f emstmg structures, if any] Front..,.~.~y~~~,~ ...... ~Depth ~ ......... ~ ,leight .... : ...... .... 'Number of Stories,.. ~ ~ .... ~ ...... ~ ............. t Dimensions of same structure with alterations or ~dditions: Front ....... ' ....~ .... Rear; ........ . ......... Depth ......... ' ............. Ite~ght ............. ' ............ Number of Stones .... ' .......~ .......... ~. ~,m~,~,on, of~t~w com~u~t,o,: Front ...~g.:. . ~r ~ .. . ~*pt~ $~: . . Ifelght . ./~ .......... Number of Slones ~ ~ ............. ~ .................. 9. S~ze of lot. Front . .~.~ . .~ .............. .Rear .... ~.~,O. .... . ..... .....De~th ...~ ............ ~0. mt~ o~P~r~h~. ...... ~/~r./~4'. ..... ...,..... N~a~ of'~'o~ Own~ ~~. ~ ........ 11. Zone or use d~stnct m whmh premises are situated. [ ............ ... ..... . ....; ............................ 12. Does propose~ constructiog violate any zoning law ~rdi~ance or. regulation: . ,~. ........ ~ ................. 1~. Will lot be regfaded ...~} ...... ... .............. Will excess fill be removed from premises. Yes No 14. Name of ~ner of~remises ............... ' .... Address.. . ; .. ~hone No . t ~' e ' ' " '*~' '[ ',' ~" ':' ~ '" ' Nme of ~ect .-.~,J(,. ~. ~..,...' ...... Address~/~~... ~o.~.~ 7 ~. ~ ...... ~ N~,~ of Contr~to~ ~C~..~S.&qq~:m..~d~. '. eLOWm~*U ': . . Locate clearly and distinctly all buildings, whether:existing or proposed, and, ifidicate ~1 set-back d~ensions from property lines. Give street and block number or description according t0 deed, ~d ~ w street nines and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................. .I .......... ' ............................... being duly sworn, deposes and says that he is the applicant (Name of individual 'signing contt~act) above named. . , He is the (Contractor, agent, corporate officer, etc~) of said owner or owners, ~nd is duly authorized to.perform or have performed the ~aid work and to m~e ~nd file this application; that all statemm~ts 4ontained in this application are true to the best of his knowledge and belief; and that the work will be performed in the m~nner set forth in the apphqatmn filed therewith:. Sworn to before me this ]~ [~.,~.~. .~.~ ×: FOkkOWING IN?ECT~O~: ....... 2. ROUGH- FRAM,NG 8, PLUMBING ~E COMPEFTE FOR C O ~E ~STRUCT}ON SHALL ~H~ REQUIREMENTS OF THE ~TATE CONSTRUCTION & ENERGY ~ODES. NOT RESPONSIBLE If copper lubing is used for water distributing sys em; piping shall be of types K or L only ON LE,4 D con .., ~' :.- Lf JY SOLDIER USED iN WATER o sYSTEM CA,NNOT sUP:~ LY~n olin tf i% L~EAD. /% * DATE,~B.P. ~ ~ BE CoMpLETE FOR C. O ALL CoNSTRUCTiON SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR ~IGN OR CoNSTRUCTiON ERRORS. 1 · i ×1 7:7 '~'