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Home My WebLink About13793-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Zfi.~. ].4,0. .......... Date January 10 19 86 THIS CBRTIFIBS that the building ,...0.n,e...f .a.m.i. 1. y..d.w,e..1.1.i.n.~: ..................... Location of Property q 380 BRAY AVENUE MATTITUCK House No. Street Ham/et County Tax Map No. 1000 Section . ! .2.6. ....... Block ...0.7 ........... Lot .... 2.9. ........... .............................. -, 861 No53/Northern ½ SubdivJsionGEORGE I TUTHILL & OTHERS .Fi]ed Maprqo ......... Lot .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · ~.a.~.c..h..1.9. ........... 19~.5.. pursuant to which Building Permit No...1.3793~ ............. dated .... ~. a. ? 9.h.. 2. .6 ...............198. 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 ......... .... 0[~¢..f. am:i..Ly, d:q.e.~ 1 il~g ..................................................... The certificate is issued to EUGENE A. CSICSAK ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval ...... 1. ~ .-.~.0.-: 2. ~ .3 .......................... , UNDERWRITERS CERTIFICATE NO .............. N.. ? .~ 5.3.4.. 9 ............................ Plumbers Certificate 10/4/85 of 54 Rev. 1/81 Btfilding Inspector 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) 13793 Z Permission is hereby granted to: ........ ....... ...~.~....~.~ .......................................... ' . .It ~:z... ...~..~~....~..~ ......... ~ ........... ,o ~...~.~.. . . (L~... . ~:~..~,~ ...... at premises located at ........ ~ ..................... County Tax Map No. 1000 Section ..... l..~..(4a ...... Block O-'~ Lot No .......... ~ ........... 0ursuant to application dated ........ .~.~...J...~/. .................., 19..~...~..~..~ and approved by the Building Inspector. Rev. 6/30/80 .FORM NO. $ _ . TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 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. v~/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, ~ndustria~ buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building, W.~ 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 pZoperty 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 $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 .J~. ,~. Date . ..~. ................ New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ./.~. ,~, O /'~J t-/ /~ V~ House No, Street Ham/et Owner or Owners of Property ................ · ................. County Tax Map No. 1000 Section .... l ..~,.~. ......Block ...(?.~ ......... Lot .... .-~..~ ........ Subdivision .~.~. ~ .~...t..5~.¥~.tC,~..~.o.~\e.x? ...... Filed Map No, ...~..! .... Lot No..~.-~..,..r~.~.~.~.. PermitNo.(~,~,,~.~------------------~- Date of Permit ~-~'4'~ .Applicant ~'c~¢,6~' /f, Health Dept. Approval,...........-~c~- ~o-,~..~.,.....,..LaborDept, Approval ........................ Underwriters Approva ..N..q ........... Planoing Board Apptova .. ................ Request for Temporary Certificate ..................... Final Certificate . .~. ·. · ................ Fee Submitted $...,-~...~. ,O ................... Construction on above described building and permit meets ali applicable codes and regulations. Applicant ......"~..(~t.'. ~..~,~....~.'. · .~... · · ,~'-~. .............. Rev. 10-10-78 GARY FIANNeR OLSEN COUNSELLOR AT LAW P.O. BOX 706 · MAIN ROAD · CUTCHOGUE, LONG ISLAND, NEW YORK 11935 · PHONE 516 734-7666 September 28, 1988 Re: Cois and Meo with Dime Savings Bank Our File # 904 Dear Vinnie: Enclosed please find a copy of the Certificate of Occupancy in re the above matter.~ On September 23, 1988 you called my office stating that if we would bring in the Original you could change a11 copies to Laurel instead of Mattituck. I do not have the original in my file. Can you send me a letter stating that the property is located in Laurel? Very truiy yours, GFO:lmk Enclosure Southold Town Building Dept. Main Road Southold, NY 11971 Attn: Vinnie FV NNER VICTOR LESSARD EXECUTIVE ADMINISTRATOR (516) 765-1802 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD October 3, 1988 Gary Flanner Olsen P.O. Box 706 Main Road Cutchogue, NY 11935 Re: Letter of September 28, 1988, Cois and Meo Certificate of Occupancy 9Z14140 Dear Mr. Olsen: Be advised that the one family dwelling at 1380 Bray Avenue, Suffolk County Tax Map $ District 1000 Section 126 Block 07 Lot 29 issued to Eugene Ao Csicsak on January 10, 1986 is in the hamlet of Laurel. Very truly yours, VRW:smw SOUTHOLD TO~FN BLDG. DEPT.~ Ordinance Inspector TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. /~3Z~ Owner~-~/~f' /~,~__~ (please print) Plumber ~A%-~c ~.~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's signature)~ Sworn to before me this .tary Public JOAN A. JACOB~ ARY PUBLIC, Slate of New No, 4702900 Qualified m Suffolk County CommlssJon ~xplfe$ Morch 30. i9 Notary Public, ~/~oun FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION FERN. Y. STATE ENERGY qODE FINAL ~nr~~MMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS ].0003~ BUREAU OF ELECTRICITY ~ 8,5 ,JOHN STREET, NEW YORK. NEW YORK 10038 Date ~O~m'O~ ]-, ~.,~ ~.~..o.~o.o.~.~ :~'~/~ N 7 5349 THIS CERTIFIES THAT only the el~trical equipment as described he~ and i~trod~ 6y t~e applicant ~med o~ the ub~e epp[ic~tion z~umb~ in the premises oJ C~e Csisc~:, W/S ~y A~ue C/O 5th. Str~, ~, 25 ~ P~nic was examined on 0~ ~ ~ ~ and found to be in compliance with the requirements of this Board. FIXTURE OUTLETS ~ECEPTACLES SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FLUORESCENT ' SERVICE DISCONNECT OTHER APPARATUS: 1-G.Fo I. ~-~x~ke S E R v I C ~O.%EC~%COND, A w ~. NO, OF HI-LEG AW, G, OF HI-LEG NO, OF NEUTRAL~ C~x~Jftle Eltmtrlc Contz'o ~~zJ This certificate must not be ~ltered in a~y m~nner~ return to ~he office of the Board }f incorrect. Inspecto(s may be ~denhfled by their cred~ials, ~ q0P,~ F0~R qU:, LDING DEPAR~TME ~1 any MANNER. 'FORM NO. 1 ToWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEl-..: 765-180:3 Examined..~.adh~..~..~.., 19g.~/. Approved ....~ ¢Aq~q. [~.k,., 19~.¥'. Permit No..). ~q .q.~..~ Disapproved a/c ..................................... . . ~.r~.~ . .t.z.o .............. (Building Inspector) APPLICATION FOR BUILDING PERMIT IN STRUCTION S BLDG. DEFT. TOWN OF SOUTHOLD Received ........... ,19.. · Date ............. 19 .~ ~- 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. buildhi s on premises, relationship to adjoining premises or public streets h plnt t~lan showing location of lot and of , g .... drawn on the diagram which is part of this appli- or a~;as~ ~dgiving a detailed description of layout oI properly must ue ,~ ......... 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 througltout 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 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. ~,..~ '" i~i'g~k{~nt, or name, if a corporation) t~oo X '-/ ~ '-t /v~t . .)... .......... (Mailing address of applicant) Stat~ whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......... O..u0 .................................... - w C:_q/C. ................. /_~t.J ,. ~ ,,~' - . ........................... Name of owner of premises ................. (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 .......................... Plumber s L~cense No .................... Electnman s License No ....................... Other Trade's License No ...................... of land on which proposed work will be done .................................................. 1. Location . ./~.~.~...~?. {2.k~ FSrzSo Cs(- v ..................... ................... Street Hamlet House Number , County Tax M~,ap No. 1000 Section~ ..... ~' · '~' ....... Block O~7 Lot . .Z...~..~ ....... i' ....... : ....... Subdivision .(.~.~...~.~. O5...,~. /~'.t ./-!! ./r.Q: .O..7~..~.~.~q... Filed'Map No. ~.~ .i .......... Lot ..... ,o~. ~..5(. - - (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . g~¢~..~?. · M .~..o ................................................... ............................... b. Intended use and occupancy ...... ! ................... 3. Nature of work (check which aPplicable): New Building .......... Addition .......... Alteration '. :Repg..r.: ~' ~ ' 2:. ~ . .... Rem~vali .............. Demolition .............. Other Work ............... (Description) 14:-'-Estimhted.Cost '~-~/ ~ d! Fee t ....? ,- ' ,: ~ ' ~. ; I ~'~ (to be paid on filing this application) 5. If dwelling, n~mber o~'~llin~ units... ! ........... Number of dwelling units on each floor ................ If garage, number of cars .... .................................................................... 6. If business, commercial or mlx{d occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... 'Height ............... Number of Stories ........................... ~ ............................. Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... ]... Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front ...... .~.o. ...... Rear . .~Q .......... Depth . ~ ....... Height . ~ Nmhber of Stones ... ............... 9. Size of lot: Front ...q.~ ..... i ............ Rear ....~..~'. ............... Depth . l.ff..~. ..... ...., ........ 10. Date of Purchase .......... i ................... Name of Former Owner ~4~.~.Y'. . .c.~?.Nqq. gq~. [ ./14B?..~... I 1. Zone or use district in which p~emises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . tq.O .......................... 13. Will lot be regraded .. ~1~%....' .................... Will excess fill be removed from premises: Yes 14. Name of Owner of premises . .~-~.~.~..er~....~: .~'..~! .~. Address ~ .4..2~ .~gX'~;~)q~. Phone No.."] ~g.~r (,.~. · .~'"~-~.. Name of Architect .~¢q .'{~...L.¥.~.¢~C ............ Address ~...~..*,ag..tC&q'~'q,~v. Phone No. ¢?t~'-. ?.?t//. ..... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether · 8. property lines. Give street and bloct interior or corner lot. STATE OF NEW YORK, COUNTY OF . ......... ~! \o ~17' ............................ ~ ..................... being duly sworn, deposes and says that he is the applicant ~ (Name of individual sighing contract) above named. He il the ................ ..... i .................................................................... I (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 10e performed in the man,er set forth in the application 'filed therewith. Sworn ,to before me this HELEN ¢ NOTARY PUBLIC, State or New York .......... '(~7' ~ ~ ' ', ........................... ~, N0, 4-t01878, Suffolk COUtl[~ / (Signature of applicant) ] ! ler'm Expires [~Aarch 30, 19--~ 7~: ~~F I FT H "W NOl~£z EL EVATION$ ARE R£FER£NC£D TO AN A$$Uk~£D DATU/~ , ¢ LOT5~ 0£54 GEORGE / TuTHkL~ ~,OTHERS TEST BOR/NG SEC TION ONE A T ZA(]REL TOWN OF SOUTHOID SUFFOL. K COs IK Y. SING'LE FAMILY DWELLING ONLY SUFFOLK COUNTY DEPARTtAENT OF HEALTH SERVICES [:OR APFROVAL OF COF$$iRUCTION ONLY The water supply and sewage disposal to the standards o~ the Suffolk ~ount~ Dept. of Health Services. APPROVED CE~ 7'/?/EO 7-0.. CHICAGO TITLE IN~ CO. eng~neenng pc. 40 west main street riverhead, new york 11901 (516) 369-1~7 Se~.Z~,I984 JobN~ 84-660 1000-126-07-29 Scule: I"=~0~ NOTE., ELEVATIONS ARE REFERENCED TO AN ASSUMED DATUM / O0 ~l~e ~ewase disposal ~ud water ~ppl~y tacilities for this location h~ve bee~ ~mspe'et~ by this dep~tment ~ fo~ ~ie~ ~ ~e~6~l ~eeri~ LOT55, NOR THERLY HALFo£ 5~ SUBDIVISION MAP OF GEORGE I TUTHILL ~ OTHERS SEC T/ON ONE F/LEO A r LAUREl- TOWN OF SOUTHOI-D SUFFOLK CO; N. Y, TEST BORING EL2$,0 CERTIFIED TO: CHICAGO TITLE INSURANCE NORTHFORK BANK ~ TRUST FOR EUGENE A. CSICSAK FINAL UNDER CONSTRUCTION LOC ADDITIONS I0 - 3 - 85 5- 4-85 2 -2t-85 sealend .surve. ying 8, englneenng pc. 40 west main street riverhead, new york 11901 (516)569-1717 Sept. 28, t984 JohN~' 84-660 1000-126-07-29 Scale: 1"=30r' copper tubing is used woter distributing sJy°srtem; piping shalJ be o{ types K or I. only APPROVED AS NOTED NOTIFY BUILDING DEPARTMFNT AT 7~5-1802 9 AM TO 4 PM FOR ...... n CONCRM7~ SOUTHAMPTON [UMRER 2~8 - 471 $OU~HA~,PTON LU~BER COR~. 2~78 - 4,711