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Home My WebLink About13710-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...z.~.3.3. 7.2 ......... Date April 18 19 85 THIS CERTIFIES that the building ...... .~.c.c.~.s..~9.r2(' . .B.l.d,c~: ........................ Location of Property . .8..4p.5. ......... .Cpx La.rip CuLchocjue house t~o. ' ........ 's't;,3i ...................... h3;oioi County Tax Map No. 1000 Section . .0.8..3 ....... Block ...0.3. .......... Lot 008 Subdivision X .Filed Map No ....... Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .k'.~.b. :...2.7. ....... , 19.8.5. pursuant to which Building Permit No. 1371 q g dated ..... ?.e.b. :...2.7. ............. 19 .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 ......... .... .~.q¥.e..a.n., .E.x.~.q ~..~.n.g..B..u.i.l,d..~.ng..a..n.d..P.u..e. 9. ?, 9.u.n.d.a..e.J-.°.n.. g.n,d.e.r., .~.~... ........ The certificate is issued to ................. p~qs. ~9.~.~I. ,. ~0.~.~..a..s.g.53.~ .............. {owner, le~o~,~t~ten~nO of the aforesaid building. Suffolk County Department of Health Approval .......... N../.~. ............................ UNDERWRITERS CERTIFICATE NO .................. P. ?.n.d.J:..n~ ........................ Building Inspector Rev. 1/81 FOF, M NO. ~ TO~N O~ $OUT~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDIHG PEIU~IT Ct'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CON~PLETION OF THE WORK AUTHORIZED) 13710 Permission is hereby granted to: ~..,~...~.~....~,..~ ........ L.~.~Z ,, ......... ~~...~.....~....~~~.....~~ .......... ......... ~~~....~~ : .......................... ,. ...................................................... ,,~,,~,~,,~,, ....... ~....,?~...~..~.~.....~~ ................................... .................................. ~. .... c.¢ ...... ~.......~ .................................... ~o~ ,~ ~ ~o. ,oo0 ~,o~ .~..~ ............ ~,~ ....... ~. ........... ~o~ ~o ...... ~ ............. Building InspectOr. F,:,~.'.~..,:~ ~'..... Building Inspector Rev. 6~30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY ' APR I 8 TOWN OF sOUTHOLD Instructions 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 ali 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" land uses: 1. 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: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $7L5. 0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 , /~/~--~S'- Date .......................... .~. NewBuildin§ ....~'~........ OId or Pre-existing Building ............ Vacant Land ............. Location of Property ..... L(3. ;~J..~ .L..~. ~t./~ .~ .~. ~ ~' q ~._, House No. Street Hamlet Owner or Owners of Property ................. County Tax Map No. 1000 Section ..... ~'..~ ....... Block ..... ~. ........ Lot....~. ........... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./.~. ~./.(-~"'~-, Date.. . ' ' ' .... of Permit~)-.-. %7..-.~A~plicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ..................... Request for Temporary Certificate ..................... Final Certificate ....................... nFee Submitted,~),,3oOC:~$. -'~ O'5~'"~ ~-~ ~~r~ Construction on above ~erm described building and ermit meets all plicabl codes d regulations. Applicant ............ ~ ........................ THE Bate April 22, THIS CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK NEW YORK t0038 App',ca,on"o.o..f,,e 327 18 N 688235 only the electrical equipment as described belo~v and introduced by the applicant named on the abo~ e application number in the premises of Jotm Doroso~i~ W/$ Cox aLm~e, Cutchogue, N.Y. in tke followi~g location; [] Basement ~ 1st FI. [] 2.d FI. ,Section Block Lot was exa~nlaed on April 18, 1985 and/Bund to be in compliance with the require,~ents of this Board. FIXTURE OUTLETS DRYERS ~ECEPTACtES 6 SWITCHES FIXTURES RANGES COOKING DECKS OVENS FANS FLUORESCENT VAFO~ 3 3 FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FRET SERVICE, DISCONNECT OTHER APPARATUS: Panelboards: 1-~cir. lOOa~s. S E NO Oi~ERCC~.COND. OF ~C~)ND R V I C E NO, OF HI-LEG A W.O. NO OF NEUTRALS /A W O. OF HI.lEG I OF NEUTRAL John Doskoaki W/S Cox Lane Cutchogue, N.Y. 11935 11 Pe~__ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspector's may be identified b their credentia ~ ~ 'run~u'aun~u=~'~ii~mI~i.I~I~UPYOFCERT~I, F CATE MU~T NOT BE ALTERED,, ~ . ,~ , .... ~ , ~ NANYIM._.AN___ FIELD INSPECTION CObIMENTS FOUNDATION { 1st) FOUNDATION (2nd 1 ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ADDITIONAL COMMENTS: ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N,Y. 11971 TEL.: 765-1803 Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG. DEPT. TOWN OF SOUTHOLD INSTRUCTIONS a. Tins 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 tins application may not be commenced before issuanc~of:~uilding Permit. d. Upon approval of th~s apphcatlon, the Bml&ng Inspector will issued a Bmldmg PSrm~t 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. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general: contrac_tor_ el~¢tricia,n., plumber or builder. ......................... :'; .................... Name of owner of premises . .& ~.. ~.. ~.~ (as on the tax roll o~T~e~ILDING 765-1802 9 AM TO 4 PM FOR THE If applicant is a corporation, signature of duly authorized officer. FOLLOWING IN~ECTIONS: ,J, ~UNDATION - ~O REQUIRED .............................................. ~ ~URED CONCR~E (Name and title of co,orate officer) g. ~H - F~ING & PLUMBING Builder's License No ...... ~. [~.. ............ Plumber's License No ......................... E]cctdcian's license No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done... ~.~ 5'.{...~.~ ...... Gu.¢ l 9. C, ...... ....... .......................................................................... House Number Street Hamlet County Tax Map No. I000 Section ... Block .................. Lot....~. ............. 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 .. ~.rS ~ ~.'~ ........................................... 3. Nature of work (check which ~pplicable): New Building ..... ' ..... Addition .......... Alteration . .? ...... Repair .............. Removal .............. Demolition .............. Other.2/l~ .~ .... .~.~.~... 4. estimated uost .... K.> ................ Fee... o'~...'.~<..~< ....................... (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 cars . 6. If business, commercial or mix}d occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front. ,g .o'. .......... Rear .............. Depth../.tZ". ......... Height . {/I .t ......... ,, .'Number of Stories ........................................................ Dimensions of same structure With alterations or additions: Front ................. Rear .................. pth~} ~ ' ight . De ,~.~ .~. ............. ;... He ...................... Number of Stories ...................... 8. Dime~J~sloTerifire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ Size of lot: Front .... J t~r~.~.~ .......... Rear ...................... Depth ....... ' ............... Date of Purchase ' . ..... Name o/; Former Owner ............................. Zone or use district in which premises are situated .... ~.-'. ............................................. Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ....... i/ttiQ .~ ............... Will excess fill be removed from premises: Yes No Name of Owner of premises .; .................. Address ................... Phone No ................ Name of Architect ............... Address ................... Phone No ................ Name of Contractor... ii ~ ~)~2[ i'i i ........... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from 10. 11. 12. 13. 14. property lines. Give street and block number or description interior or corner lot. acco~lil~d~f~,,glld, show street names and ind!cate whether STATE OF NEW YORK, ! S.S COUNTY OF ................. : ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) i above named. He is the r/ [ (Contractor, agent, corporate officer,etc.) ~ of said owner or owners, and is drily 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 be performed in the manner set forth in the application filed therewith. Sworn to before me this : ............ ? ..... ~..day or ............... 19 .~..~' ~ ~ Notary Public ........ ~...~:. · .~.~..~..~L-.. County: ~ HEI.EN K DE VOE ................. '~' .............. ~~' ! ..... NOTARY PUBkIC, State of New York (Signature of applicant) No. 4707878, Sttffelk Couoly__ ~ Tel, m Exoires March 30, 19_.,~x..~