The URL can be used to link to this page

Home My WebLink About13703-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z14045 Date December 2 19 85 THIS CERTIFIES that the building .... ~. 1..6 .e?.~. ~ ~ 9P ................................. Location of Property 200 Hickory Drive Cutchogue hSdfo hiol ....................... 's't/e~i ....................... County Tax Map No. 1000 Section .... J .0.4 ..... Block 8 .Lot Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · .. F·e.h, . 3.3. ......... , 19 5.5. pursuant to wh/ch Building Permit No... ! .2.7.0.3..Z ............ dated ...... F..q 1~ ,..1.3 .............. 19 .0.5., 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 ......... ....c.ha..~ ~?..~. ~.n.d.q~..< .~.n.d...t.q~. ? ?.t.q~...a.Z.t.e. C .a.~.~.o.n., .~.o.~. k.;..4~c k..a~ d ~.t.~.~ ....... The certificate is issued toNICHOLAS W. BUBANY ..................... ioYn'& 'i~' g&~ ~ ~ ~ .................. of the aforesaid building. Suffolk County Department of Health Approval ..... ~/.~. ................................. UNDERWRITERS CERTIFICATE NO ............. .$~.N.7. ! .7.7).6. ........................... Rev. 1/81 Bmld~ng 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) No 13703 7_ Permission is hereby granted to: ~~..L~......~.~.~ ~ ......... .~../.,: ~:'::~,~/~:~ ~'~..~..:.~..~..~.~¥..:~.~ ............................... P.4..~.'~,,.~..~,....~ ......................................... o, p.m,,e, ,~ ot .......... . .;,,~.~?. ............ i.,.~:.,.. ..~-~, .......... h..~,'.~ ................. ................................ .............................................. County Tax Map No. 1000 Section .../...~....../'~.. ...... Block .....~.... ............ Lot No ...... ~ ................. pursuant ,o application dated '.~...~ ......... ./....~.. .................... , 19~...L~., and approved by the Building Inspector. Dulldlng Inspector Rev. 6/30/80 FORI~ NO. 6 TOWN OF SOUTHOLD Bu ilding Depertment Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 2 g 1985 BLDG. DEPT. TOWN OF SOUTHOLD 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. Fina~ 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 instatla- lions, 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" land uses: I. Accurate survey of p~operty 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 ~.Vacan~ Land C.O. $5.00 New Building ..... '..~....... O~d or Pre-existing Building . .~... Vacant Land ~ Location of Property .//~'.~.-~'..~.~. ~.. ~.. ,~2x~x'~',~ ~/~ ]//~ .(~..Z'~... ,z~.~ 4~-:.. ~.-.,..~..~... House No. Street Hamlet qwner or Owners of Property . . /'[//~"//-~Z/¢'~' /~0, ,Z~'U~/.~..~.. ........ County Tax Map No. 1000 Section ..... /.~.L~, ..... Block ........ ~. ..... Lot ..... ./ .......... Subdivision ................................. Filed Map No ........... Lot No .............. 'Labor Dept Approval Health Dept. Approval ................................................. Underwriters Approval .~.7.1. ~ .~..~. ~. ........... Planning Board Approval ...................... Request for Temporary Certificate ......... -"7 ........... Final Certificate . , .,,~'.~..~. Fee Submitted $ ............................. Construction on above described building an~e~;mit~ ~"~ ,~/~meets al~a[~plicab,[~ codes and ,regulations. al THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY V 85 ,JOHN STREET, NEW YORK, NEW YORK 10038 ..,e ~ov~r i~, i~ ~p. llc..o. No.o.~.e 36e?~a/~ N717746 THIS CERTIFIES THAT P~13703Z only the electrical equipment ~ ~scrlbed belo~ and introduced ~y the applicant ~med on the able application number in the premises of was examlned on ~1~]? J,~ i9~ and found to be ln compliance with the r~quirements of this Board. FIXTURE SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS FtUORESCENT VAPOR i5 2 7 DRYERS FURNACE FUTURE APPLIANCE FEEDERS TIMEC~.OCKS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: T, cack Lighting S E R V I C E NO. OF CC COND A W G NO OF HI-LEG A, W G P~R ,O' OF CC, COND, O~ N~UTRAL A, W, G iNO OF NEUTRALS OF HI-LEG Nicholas W. ~bany 246 -16 Vi~l Za~t Ave Dou93mston~ N Y 1].36;~ This certificate must not be altered in any manner; return to the lhe d if incorrect. GRNEI~AL MANAGER ! :/ Per 1]. /'~:'/',,/ may be by their credentials. ~IER. FIELD INSPECTION FOUNDATION (1st) FOUNDATION ROUGH FRAME & PLUMBING INSULATION FERN. STATE ENERGY ODE (2nd) FINAL COMMENTS ADDITIONAL COMMENTS: ppro ed ..: ........ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ., 19~.'? ., 19 .~?'. ~ermit No.../. ~.. Received ............ 19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERIVIIT Date .../?.. tc..~Zv?ry' ...... 1917./7 INSTRUCTIONS 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. 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 througghout 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, l, ........ ..... ...... (Signature of applica6t, or name, if a corparahon) ..... ~.aX. . ?~. ~.:4/. ~¥. F:~.~?~.?$', .~.'~. .//.~'(:.~. . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber o~ A PROVE. AS No'rEJ? Name of owner of premises., j~.?.c ~ . . .~.~..~(~Z~. ................ ;.'.'-~-~fi~'~:¢ · · ',' '~ 'Z-; ' ' '/- ' .2 ...... r (as on the tax ~ ~afe~dgefl~.P. ~ ~fl /~ If applicant is a corporation, signature of duly authorized officer. FEE:~ .BY: ~ NOV'FY BUILD'NG DEPARZM~NT AT (Name and title of co.orate officer) FOLLOWING iNSPECTIONS: ,' ]. FOUNDATION - TWO REQUIRED Builder's License No... ~.~'7 .............. FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING ~ 3. INSULATION Plumber's License No ............... 4. FINAL - CONSTRUCTION MUST Electrician's License No ....................... BE COMPLFTE FOR C. O. ALL CONSTRUCTION SMALl. Other Trade's License No ...................... THE REQL,REMENTS OF THE N.Y. STATE CONSTRUCTION 8 r~,-~ · ' ' e done CODES N~T RESpoNcj-~ - -~ 1. Locatmn of and on winch proposed work will b .............. : .' ........ ~; · .'. ~ ...... ' ............... · ..................... .... ..... House Number ree / ~ ount No. ,000 .. J. (.7... C7.. ... ............ .... (. ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use.and occuPancy of proposed construction: a. Existing use and occupancy ..... ~.. b. Intended use and occupancy ......................... , ~,. ....... ~. · ~ ......................... 3. Nature of work (check whiLli[a~lblicable):~*~ New Building .......... Addition .......... (Alrerauon_.~ ........ ~} ~ ~ ~ :,~[ ~ (Description) 5. If dwelling, number of dwetling pnits ............... Number of dwelhng units on each floor ................ If garage, number of cars ..... j ................................................................... 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. D~ens~ons of exmmg structures, ff a y: Front .............. Rear .......... Depth Height ............... Number of Stories ........................................................ D~ensions of same structure wlth alterations or additions: Front ................. Rear .................. ~ Number of Stories Depth : HeiSt ...................... 8. Dimensions of entire new constructm : Front ..... Rear ....... Depth Ileight ............... Number of Stories ........................................................ 9. Size of lot: Front .......... ~ ........... Rear ...................... Depth ...................... 10. Date of Purchase .......... , .................. Name of Fo~er Owner ............................. 1 1. Zone or use district in which pr~mises are situated ............................... ...................... 12. Does proposed construction violate any zoning law, ordinance or re~lation: ................................ 13. Will lot be regraded ........ ~ ................... Will excess fill be removed from premises: Yes No 14. Nme 0f Owner of premises .................... Address ................... Phone No ................ Nme of Architect...............! ............. Address ................... Phone No ................ Nme of Contractor ........ .................. Address ................... Phone No ................ PLOT DIAG~M Locate. clearly and distinctly ~ bufld~gs, whether existing or proposed, and. indicate ~1 set-back d~ensions from prope~y lines. Give street ~d bloc~ number or descgption according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNTY OF ................ ........ , ................... ~ ..................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .................. (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and file application; that all statements co~tained ~ this application are true to the best of his knowledge and belief; and that the work will 'be perfomed in the m~ner set forth in the application filed therewith. Swam to before me this J ~O~RY P~BL[C. State of New %rk / (Signatur~ of applicant) N0 4707878. Suff01~ Ierm i'xpues March 30.