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HomeMy WebLinkAbout13663-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15934 Date ....J.u.l.~r..8.,. 1987 THIS CERTIFIES that the building . .A.d.d..i .t.i. qn. ..................................... Location of Property ..... 1.2. 7. .0.0...N..e ~.,..8. u..f .f.o. 1.1.~..A.v.e. :...C.u.t..c .h.o.g.u..e .................. House ~1o. Street Hamlet County Tax Map No. 1000 Section 116 . .Block 06 .Lot 014 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated J an. 3, 1985 pursuant to which Building permit No. 13663 z dated J.a..n....8. ,...1.9.8.5. .............. 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 ......... Addition to existing dwelling. The certificate is issued to WILLIAM H. STILES ..................... ?oYn'e~,xt~l~X~i~ x .................... of the aforesaid building. Suffolk County Department of Health Approval N / A UNDERWRITERS CERTIFICATE NO N 8 146 17 -- N 8 14800- - N 8 1480 1 PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 1~0~ 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) NB 13663 Z Dat~ ........ ........ ~-~. '~,~...,...~....-./..........L/..~/~- ..... ~.,,..,_ ~. ,.. ~o ....~.x/-,c,~,~..~... ~.~......~gL.~.....~...~ ....... .~. ~,/~1,~ ~/ ,~,.'~, ~ ~ / ....... ........................... ........ ....................................................................... o, p,omi,s ,~o,ed o, ...~..~.~..~.~......~..~L~~...~,~..: .................. County Tax Map No. 1000 Sect onl.~..L..~.. .......... Block..:..~..,...~.. ........ Lot No. ~./.....~... .......... // . · ~~.....~ ................. , pursuant to application dated Building Inspector. P,, ~.~ ..... .~~/_~~~ ........ Building Insl:~ctor Rev. 6/30180 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hail Southold0 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. B. For existing buildings {prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing a[I property Bnes, streets, buildings and unusuat 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: Additions $25.00 1. Certificate of occupencv New Dwelling $25.00, Accessory ,$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewCons truc t ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .. 12700 New Suffolk Ave. Cutchogue House No. StrEet Ham/et WILLIAM H. STILES Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section I ]6 06 0 ]4 ............... Block ............... Lot ................ ,Subdivision ................................. Filed Map No ........... Lot No PermitNo. 13663Z Date of Permit Applicant ., William ~ Stiles Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on ~,~ ~ Z above described building and,,permit~n s all applicable codes a reg~ations. Applicant .............. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY BB JOHN STREET, NEW YORK, NEW YORK 1OOS~ THIS CERTIFIES THAT only the eleclrical equipment as described below and introduced by the applicont named on the above application number in the premises of William Stil~ $/S New ~u~olk in the followlng locatio.~ [] Bazen~ent [] Ist FI. zvas examined or~ June 1, ] 987 [] 2nd FL Section Block ) Lot and found to be in co.~pllonce tvith the re,I ~ire.~ents qf this B~o~ard. 8 31 12 J B COOKING DECKS OVENS DISH WASHERS EXHAUST FANS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E R V I C )THER APPARATUS: 2-s~ok~ Detectors NO OF HI-LEG A, WG OF HI-LEG NO OF NEUTRALS OF NEUTRAL CutChOg~, N.Y, 11935 Lie. 2670E NAGER I~spect~rs may b~ ~e~t~ied by their credentials, FOR BUILDIHG DEPARTMENT. THIS COPY OF CERTIFI~TE MUST NOT BE ~LTERE~ IN ANY ~NNER. This certificate must not be altered in any manner; return to the office of the THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS ~ERTIFI~ THAT only lhe electrical ~ulpment ~ ~scribed be~ ~ i~trod~ced by t~ ~pplica~t ~med on the a~ve application ~umber in the premises of Nm. ~le~, ~ Suffolk Avenue, ~/0 ~oore~ Lane~ Cuccho~ue~ ~Y in the fotto~in~ locatlon; ~ B~ement ~ Ist Fl. ~ 2nd FI. Section 8l~k Lot ~s exmnined on J~ Ol ~ ~ ~ and Jound to be in con pllance ~' th the requirements ~f th~s Board. FIXTURES RANGES OVENS DiSH WASHERS EXHAUST FANS FIXTUEE OUT.TS SWITCHES PLUORESCENT DRYERS NO. OF FEET DIMMERS OTHER APPARATUS: R V I C OF CC. COND, 3/O AWG, OF HI-LEG NO OF NEUTRALS A, WG OF NEUTRAL ~.J. Electric This certificate must not be altered in any manner; return to the office of the Board GE[qI~ItAL MkNAGER Inspect~rs mdy be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE 'ERED iN ANY MANNER. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~jj BUREAU OF ELECTRICITY ,i~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 o~y the electrical ~uipment ~ ~scrib~ be~ and int~duc~ by the applicant ~ed on the a~ve application nu tuber in the prem~es of Nilliam Stile~ ~q~W ~uffolk Aven~e, $/O Golf C0u~se/~ay Rd~ Cu~chogue, NY inthefollowin~h,cation, ~ Basement ~ I~,FI. ~ grid FL S~tion BI~ Lot d~[l~ OJ.} ~ andfoundtobeincompllattceu~iththerequirements~fthisBoard. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME,CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: ~anelboard~; 1-1Zcir., i25am S E R V I C NO, OF NEUTRALS OF NEUTRAL ~.J- Electric Cu[cho~ue~ Ng Per_ ~" , ~ This certiflcote ~ust not be altered in any manner; return to the office of the InspectOrs may be/dentif ed by their credentlo[s. COPY FOR BUILDING DEPARTMENT. TfIIS CO~ OF CERTIFICATE;MUST NOT BE ALTERED IN ANY ~NNER. FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & FLUMBING INSULATION PER N. Y. STATE ENERGY CeDE FINAL ADDITIONAL COMMENTS FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 · ' TEL.: 765-1803 I TQW~-b¢ SOUTHO[-~ Examined ._.~:~%.......°~. ......,19~.~. -~ ~ Received ........... ,19... DisapproVed a/c .......... -: ................ /// ......... ~, (Building Inspector) APPLICATION FOR BUILDING PERMIT ...,,~... Date -.~. ........ , 19~.. INSTRUCTIONS a. Tlxis 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 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. ' ..-~ c~__,~- ...... ............. (Signature of ap!~Iicant, or name, if a corporation) · 7..7~'.!.?.~ <:..~.~,..~:~.~,,...C'.~::..,~.o? ~ ~ ~ ~, (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· ..................... :% ..... . ........ : ................................................ Name or owner of premises .. ~:..).~.,.c{ ~4,... ~.. '~.~. ~-,~...~ ............................................. (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 License No .... ~ ...... ~.. .~ ......... Electrician's License No. Other Trade's License No ...................... 1. Location of land on which proposed work will be done ............................... .~ .................. ../.z?a ...... /~ ........ .::~ :~.~-/~'../,q ~.~., ..... ~.~,.~.4, o.~ ~.~. .................... HouserNum ber Street Hantlet County Tax Map No. I000 Section t'r'~ Block a~/ Lot OF 5z( Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... ~.~..L~ .e~ ~ .~.~ ~. ............................................ b. Intended use and occupancy .......... ~'l...(>.~ .... ,:,, . .................... 3, Nature of work (check 'which a~l~hcable): New Building .......... Addition ...... ~ Alteration .......... Repair .. "~I~'~e~val',: ............ Demolition .............. Other Work ............... (Description) ,,.. l st ated ,:cst....... l. ..................... Fee ........................... ' "',~"r,, ~ (to be paid on filing this application) 5. If dwelling, number of dwellingiunits ............... Number of dwelling units on each floor ................ l'f garage number of cars 6. If business, commercial or mixe~ occupancy, specify nature and extent of each typ? of use ..................... 7. Dimensions of existing structures, if any: Front ~ O.~, . Rear ~o d> Danth '~,Z~ / Height .... ~.~-~. ..... Number of Stories. '~ ...... · . ~. . ' ' ' .'%.':.': .............. ,''t .............. ;,, .......... Dhmens~ons of same ~tructure w~th alterations or additions: Front ..... ~ .~. ......... Rear . .~. ~. ......... Depth ......... ~ ......... i" Height ..... ~ ff.....~ .......... Number of/Stones .... ~-,,...,...; ?.. 9~, .... 8. Dimensions of entire^ new constrUction: Front ..... ,,-,-] L/ ....... Rear ].~ . . Depth .~[,.O ~ :. ?ight .~/ of St~ries ..... : ..~L~' ..... ,...~ .......... -.. 9. Sizeo~lot Front ~ Rear. ~./..0 ' i);~i~'"_~-~'~.'/' ........ 10. Date qfPurchase . i.................. Sgrne of Form, e,r Owner ~D~]t.~.~,. ;Y:'.~Z~ ~ .... ~:r ~ .... 11. Zone or uae district in which pr~mises a~e sit ~a~ed . ~e- ~ ~q[e~l~.[r~'- L , !2 Does proposed construction, violate any zoning law, ordinance, or regulation: ... ~N~.o. ....................... 13. Will lot be regraded ..... .~1.6 ................. Will excess fill be removed from premises: Yes 14. Name of Owner of premises ~L)[.I.l?a,,..~.-/.;Zes. Address . ~_~o3F. c~o~.~,,: .e~'... Phone No. ?~..~.Z~;~:~.'~.:?-~,. Name of Architect ......... ; ·. · , .... Address ................... Phone No ............... ,, ;,;:¢; .... Name of Contractor . ,~.~,,*y'.q.t~. ,~t:.~ Address ~.,.Cw['.c,14o~q~e~. . Phone No..730 PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ± . , .... "~ ..~.~ ~~. .......... being duly sworn, deposes and says that he is the applicant u~ame oi mmw~ual s~g~lng contract) above named. , He is the ..................... ~,~~_,..~<. ................................................. ~ ........... of said owner or owners, and is du!y' authorized to perform or have performed the said work and to m,.ake and file this applicationj that all statements contained in this application are true to the best of his knowledge and behef; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ..... ~ ......... day o .. Notary?glplic, . ............... Ne, 52-8Z2§850, ~k ~,~ founty' ,~ (Signature of applicant)