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Home My WebLink About13955-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No... Y,].4 3B~l. ....... Date ....... I~.gy' .6.: .................. , 19.8.6. THIS CERTIFIES that the building ....O.n..e..f..a~..i.ly..~..w.e.l.l.i..rig..' .................... Location of P~operty ....... 24 ~ 2..C.r..o.w.n..L.a.nd, Lane, Cutchogue House Ho. ' ....... ~b~i ....................... County Tax Map No. ! 000 Section . ~. 1. 0 .2 ...... Block .... 0..8 ......... Lot ..... .0.1.1. ........ Subdivision../~ighlan~t. ~K~'~.t.e.s. ......... Filed Map No. 8,4.-~ .5.4.1..Lot No: .1.4 ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... May. 1 ........... ,19 B.5 pursuant to which Building Permit No...1.3 .9.5.5. Z. ............. dated ...... May. 20, ............. 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 ......... .... .ane. £.~-~-y..4w.e.l. li..rig... ................................................... The certificate is issued to ...[-I~a.~R.Y.. ~i..LILLIAN BAGLIVI ........ /d~),-~/~'~;d~ ..................... of the aforesaid building. Suffolk County Department of Health Approval ..... .8.5.r 8. 9.".6.9. ........................... UNDERWRITERS CERTIFICATE NO ............. ~.7.1. I~ .49.1. ............................ PLUMBERS CERTIFICATE 4 / 29 / 86 Building Inspector Rev. 1/81 I~OB~ 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) N9 13955' Z Date .............................. , 19 Permission is hereby granted to: .... .............. ..... ~oz.....f~_~..~. ............................... ._ ......d.~..~~.=r...~....~.....//...~ ,o..d~..~.~....,.~.~.....~..~..~..~........~.~.....~..4./~z.z.~.~ .................. ..,~:~r:.:.. ........ ~. .~,~,z~. ~. . ~ :.. ~ z. ./~ z.,~z. .. . ~ ,~ .~. Z. z. ..v,. z .................................... at premises located at ..... ~..~..' ..~........L.~..~.,~'~.....~.....~...~....4~ .~....~....~..~ ............................ ................................ /~/~-~_~m-~/~-/V~ ~' County Tax Mop No. 1000 Section .... ./.(~,....~.. ...... Block ...~..:~.. ......... .~Lot No. ~.Z./. ............. pursuont to application doted .... ~..~..~... ...... /.. ......................... , 19.l~-~-,'~arld 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 t~ 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~3perty 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated,/C'~'~ $15.00 Date .......................... New Building . ...v. ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property. ~.~.. ~...C,~J.. ~ .~..~..~f~...~...X ..~.../~. ~ .~ o 0 ~-~-" .~PG ~) G House No. Street .................Ham/et County Tax Map No. 1000 Section ....A~....~.... B,ook .....~...J. ..... Lot...0./..F. ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant ........... ' Health Dept. Approval ~ ...Labor Dept. Approval '~' Underwriters Approval ...................... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... FeeSubmitted$.....~.~..(~....~. ............... ~ Construction on above describedA~~ .~..buildi and i~ meets all app .... licable g u ations. ~,~ ~~b-c..~¢...'4...'-' ,,..,o_,o., / // ~-/~/z~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~__ ,'..IL BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 40038 Date ~f~' 20, 1985 Application ~o. on fil~ 361642/85 only the e~c trical eqaipment ~ described below and int~duc~ by the applicant natned on the above application number in the premises of 1.~. ~ ~g~.vi, 2465 ~ ~ I~., C~ N Y in the /ollowing location; [] Basement [] 1st Fl. l~ov~b~r 15, 1985 EIXTURE rIXZU.ES 39 49 DRYERS 45 [] 2nd FI. Section Block Lot 14 39 FUTURE APPLIANCE FEEDERS RANGES =OOKINGDECKS OVENS DISH WASHERS EXHAUST FAN TIME CLOCKS JNIT HEATERS DIMMERS SYSTEMS NO. OF FEE1 C E SERVICE DISCONNECT OTHER APPARATUS: S E R V I 1 1/o OF NEUTRAL cu~c~hogue, N Y 11935 Lic 1845 E G~NE~AL ~ANAGEn certificate must not be o~fered in ~n~ monoer; return to the office of the Boord if incorrect, inspectors moy be idenf[fie~b~ ~helr credentials. COP~ FOR ~ THIS COPY OF CE INER, 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. f~ ~ ~-- ~-~ Owner ~s (please print) (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 Notary Publict~County Notary Public FIELD ~IN SP~CTION COMMENTS FOUNDATION (1st) FOUNDATION 2. 12nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 TO Whom This May Concern, We are unab~ to c mpl t your Certificate of Occupancy because ,of the following reasons. /~/ An application for Certificate of Occupancy is not on file. /~/ No Underwriters Certificate on file. ~/~// The check is(outdated~not on~ file.) /~! Nm__Hau~lth4)epc. Appr~va~ o~ L . /'Z/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit # Z Building Dept. ***/--_/No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) Memorandum from.... / BUILDING INSPECTOR'S OFFICE TOWN OF SOUTHOLD TOWN HALL, SOUTNOLO, N. Y, 11971 765-1802 January 3, 1986 Dear Mr. Jacobs: I am returning your ch~ck #1726. The amount is wrong. My letter stated that you owed $64.20. You sent us $64,73, This was just for the amend- ed fee. The amount due for the C.O. IS $5.00. You also need the application filled out which I sent you~ final Health Dept. approval, and a plumber solder, certificate. Once we have all this we can issue the C.O. Yours truly, FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 I, IA¥ 1 31985 BLDG. DEPT, TOWN OF SOU~HOLU Disapproved a/c .................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date IN STRUCTION~5 a. Tkis 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 a detailed description of layout of property must be drawn on the diagram which is part of this appli- 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 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 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 Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. applicant agrees to comply wlth all applicable laws, ordinances, buil~ding, code, housing code, and regulations, and to authorized inspectors on premises and in building f°r necessary in~ c~/~36: 7~/:~/ ~) ...... ~.~.~...~.-.~: .-~,.:--. .... . ....... ~Signature of applic/!p&~Sr ~(~if a corporation) ............. .................... ... ...... (Mailing address of applicant) whether applicant is~-~ --°wner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. : 2; ir ;;2;,:"" - '¢; '.).': ': ;'z ¢;'5 '; ............ ....... /' ............ ('a; 'o'~' t'h'e' ;a'x' ;o'li ;) i:t;}t' ~;e'd') ....................... is a corporation, signature of duly authorized officer. Builder's License No... (~ ..................... Plumber s License No.. , .~. ,~. ~'..~. · .~ Electrician's License No ....................... County Tax Map No. 1000 Section . ./...D...~., ........ Block .... ¢. ? .......... Lot .... ./../ ............ ./47. (7,~...~. !...(iq.a~ ......... Filed Map No..~.~ .-7. ~7.(4./... Lot.. ?..~ Subdivision. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy ...................... xz ....... -/trY .................................. .. , / .~",..,/.) ~-e_Fj', A ~ Intenaea use and occupancy ..... /. ......... ' ................... .ff ............................. 3. Nature of work (check which applicable): New Building .. ~.. .... Addition .......... Alteration .......... Repair . :.;~ .?;.g ! ' ~ · .. ,~.... Remora .............. Demolition .............. Other Work ............... ~0OO ' ~..~/~. c:rr~ (Description) 4. Estimated Cost ............... ' ....................... Fee ........................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ~ ........ Number of dwelling units on each floor ................ If garage, number of c~s ....... I'. .............................................................. 6. If business, commercial or mixed Occupancy , specffy nature and extent of each type of use ..... . .............. 7. D~menslons of ex~stmg structures, ~f any: Front ............... Rear .............. Depth ............. Height · { ........... Number of Stories .. . : ................................ ._ Dimensions of same structure wit~ alterations or additions: Front ................. Rear .............. Depth . .: ................... ; Height ...................... Number of Stories ................... 8. Dimensions of entire new constm~tinn: Front ... O ~. ........ Rear . .~. ~ .......... Dep~ &~. m .~. Height .' ~ l .......... Numb0r of Stories...]/~ ff~. ..................................... 9. S~zeoflot: Front ...~ ~O ..... ; ......... Rear .... [~.~ ............. Depth ~2&... J~.2~ ..... 10. Date of Purchase . .~WK: . ~.~ .......... Name of Former Owner .......................... 11. Zo[w or use district in which ~remises are situated ~ ~. ~ ~ ~ ~ g~ .............. 12. Does proposed construction vlo~a~ zoning law} ;}3inanc~ ~r;guiat;o :' 2~ ~. 22252: 13. 5ill lot be regraded ...... ~? '~'~ .... ~ .~_:r..,... Will ex%e>s fi~ b%r~mojed from premises: Yes 14. ~ame of Owner ofpremises[~{~/g(d. Address ~q~ .~T/(ffs.~Ktr~one No ................ Name of Architect .......... [ ............... Name of Contractor ~[]2~.~.~.3~(~ . .Address ............ ..... PhoneNo ........... . Address eer. ' .. No. . 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 humber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY~.//~/2..~ ~' r:~"" ~.OF . S.S .... /v/~.//~ .~P~. · '. '~J .' · '. '.~5~.)· ................ being duly sworn, deposes and says that he is the applicant (Name ~l~ind~dual signing contract) above named. , He is the ......................................................................... : ' (C f fi ) i ontractor, agent, corporate o cer, etc. of said owner or owners, and is dhly authorized to perform or have performed the said work and to make and file this application; that all statements cogtained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manoer set forth in the application filed therewith. Sworn to before me this ..... day :Bf.. NOTARY PUBLIC, State of New ',"or~ k; Teml Expires U~rcfl $0 1~.~2 ' T/TLE NO 8408-2750/6 ~0~ --0~ /o~ SINGLE FAMILY DWELLING ONLY SURLY FOR JUFFOLK couNTy DEPARTMENT OF HEALTH SERVICES LOT NO. 14, "HIGHLAND ESTATES" AT CU~CHOGUE ~0~ APPROVA~ OF CONSTEUCT~ON OH[Y ~N ~ ~OU~HOLD SCALE= I"='~0' ~AT~ H5 REF, NO,~ - ~ .~u~tzgo ~L~g~T~O~ O~ ~mT~O~ m m~S GUARANTEED TO: SURVEY · A VI~ATION ~ SECTION 7209 ~ THE CH~GO T/~LE INSURANCE ~MPANY ~ ~o~ ST~[ E~C~TI~ ~PROVED ~ ~ copies ~ ~lS s~vEY NOT ~A~G - $URVE~R~S INKED SEAL OREMSOSSEO SEAL SHALL ~E ~R~ FO~ WHOM THE SU~EY IS PREPARED HEAL~ DEPARTMENT-DATA F~ APPRO~ TO C~STRUCT A~o ~ H:s aEH~LF ~ THE T~TLE C~P~Y, eOV~N- MTHEWATERSUP~A~SE~E OI~AL $Y~TEM~IIR~IOE~ MDISTANCE$ S~WN HEREON FROM PR~ERTY LINES 'l El ] YOUNG ~ YOUNG ~~" AVE~E ~ ~ ~ 7'. 1~ ~ ~ ~9--_. ,.,v~.~AO.... ALDEN ~,YOUNG, PROFESSIONAL EN61NEER EUBO/V/S/ON W~P ~/~0 /~ rH~ OP~/CE OW r~ CLE~ OF ~/ A.O LAND SURVEYOR N.Y.S. UCENSE N0.12845 SUFFOLK COUNTY ON APRIL ~G,/gXXA~ ~/L~ N~ G~3Z ~ ~/ HOWARD W. YOUNG, LAND SURVEYOR a~ L~T~ ~L(W),~IC TANK(StJIC~OLS(~) ~N ~NE~ ~ N.Y.S. LICENSE N0.4589~ ~E m~ FIE~ ~TI~S ~ OR DATA OBT~KO F~ OTHEnS TITLE NO 8408-~7501G . $ '/ . , ~-~~~___ ~ ~_ ~ /~ . . ~0~ ~ ~ ~T~ ' SU~ FOR AT CU~CHOGUE ~ ~e ~onal ~ ~t. er $~l~ ~WN ~ SOUTHOLD SCALE: /"='~0' tnspect~ b~ t, hi ] dep~t~n'~ ~ found SUFFO~ COUNTY, NEW ~RK NO. 84'~/ ~.o be satisfac%o~ ~. ~ ~. ~ .~UTH~IZEO ALTE~TI~ OR iOOITION ~ mis ~ARANTEED TO, ~ ~, ~j * IUNVEY aAVI~ATI~M ~SECTION HEW YORK STATE E~CATI~ LAW ~0 sunv~'s 1NK~O ~*~ OR ~MIOSS~D S~ SHALL H~ D~P~R~M~H~-DATA ~ APP~O~ TO ~STH~ ~ Kn~ ~n WHOM TH~ SU~EY ~S ~n~P*nEo ~L. I.~ ~ ~ ~ OS~NDER AVE~E YOUNG YOUNG ~,~.~ ~o~ NO~: I~ MONUM~N~ & ~ S~K~~J ~DEN W. YOUNG, PROFESSIOHAL ENGINEER SU~O/V/~/ON MAP ~/~ /N ~[ OF~/C~ O~ ~ C~[~ O~ AND ~ND SURVEYOR N.Y.S. UCENSE NO. 1~845 ~U~O~K COUNTY ON AP~/~ ~/9?7 A~ ~/~E N~ E~X HOWARD W. YOUNG, L~ND SURVEYOR ~ ~ c~ ~ ~c(w),~lc ~(~ cg~s(~) ~, ~l~ N.~ $. LICEN$E NO. 45893 BRANDIS & SONS JNCo 1046 OCC ? t CY OR t;i! ' OF OCCUPANCY SOLDER USED IN WATER S UPPL ):' S YS~'~,~M CANNOT .EXCEED 2/10 of 1% LF_.~AD. .PLUMBER CERT[FICAT!O2g ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY Itc copper tubing is used for water distributing ay* em~ I. q4 ,g shall be of types K or L only A,P~R~"~D AS NOTED FEE~_C~ ~0 BY: NOTIFY ~UILDIN6 DEPARTmEnT ?~S-1~0% 9 A~ TO 4 P~ FOR THE FOLLOWI N~ I~~ECTIO~S: 1, FOUN~ATIO~ - T~O REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING ~ PLUMDING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETF FOR C, O, ALL COIqSTRUC~ION EHALL MEET THE REQUIREMENTS OF THE N.Y. ~ATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR D~IGN OR CONSTRUCTION ERRORS. ~ Main Road Hinge 477-0400 L '!¸ [ [5'0" J E ["{' 0II Phone 477 0400 Main Road GI~'E'-IiN~PO~,'. NY. Il944, ,:[ 3'¥ \ \