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Home My WebLink About13742-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13720 Date Augus g 7 1985 THIS CERTIFIES that the building B a r n Location of Property .~Qg. Q0~ .L.g,i~.E ..... CUTCHOGUE /-t3~)~o ato. ' ......... 'S't/o3i ....................... h 3~/ol County Tax Map No. 1000 Section ...0.9. 7. ...... Block ...... q. ........ Lot 1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · .~ a. r 9.1a.. 6. ............198..5. pursuant to which Building Permit No..q .3.7. 6. 2. .g .............. dated . lqarch..6 .................. 1965., 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 ......... ,~.~r~ ........................................................................... The certificate is issued to LEONARD & BERYL DANK (o~vner, ]~'[eXo~ xcz~qq~JX X X of the aforesaid building. Suffolk County Department of Health Approval ........ .N/fi. .............................. UNDERWRITERS CERTIFICATE NO ................ ~./.& .............................. Rev. 1/81 Building Inspector ~OI~M NO. ~ TO~N OF $OUT~OLD BUILDING DEPARTMENT TOWN HALt. $OUTHOLD, N. Y. BUILDING PERMIT (THIS PER~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 13742 Z Permission is hereby granted to: //~ ~/~ .~.~.~.i~.~......1~....~...~. ............ ' ....~.~..~...I.....~..~ ............................................ _ ....~~.~.~.:.~.:.....!..~..~.~.~.~. to...~.~.....~ C~.~:..~. I ;> ~ at prem,ses located at ............................... ~~,'~,~ .......... co~.~ Tax Map .o. ,000 Section ..... -~.~..-I. ...... ,,ack ............ ). ........ Lo,.o ..... ) .................. pursuant to application dated ..~.~..~ .~. / ........................... , 19.~..~., and approved by the Building Inspector. BuJlding~l~nspector Rev. 6/30/80 FORM NO. 6 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 i~ ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of properW with accurate location of al~ 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: I. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 $ Z 5.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date. '- ' "f .1 Z../../¢.4 .... New Building . ~.~.~J ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~.' .~). .... ~..~.. ¢~-. ~..~;¢'T ............, ........... ~ ~ ./~...~--~.d.~-~. .... Owner or Owners of Property ................ ~,.~ . ~j ~ ....................... o q'7 ./ /. County Tax Map No. 1000 Section ............... Block ............. Lot ............... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. [~.?..~/.~.'~. Date of Permit .......... Applicant..~¢--~Z~..~, Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...~.. .................. Fee Submitted $ ........................... Construction on above described building and permit meets all applicable codes and regulations. Applicant .................................................... Rev. 10-10-78 FIELD INSI~ECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY qOD FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BIJILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined.. l/~.ad~. &..~. .... , 19~..~'. Approved'. :'.~t~..~...., 19~..~. Permit No. I .~...-7. ~.~..z~q" Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No .................. INSTRUCTIONS State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... .~..~.o.O..~...~.: ~. Ia..~...~...B~-P~q k,..~.-.~. [~O. g ................... (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.. ~-~-=. .............. ,,.',L. Electrician's License No.. ~-ff--~..'] ........... Other Trade's License No ...................... Location of land on which proposed work will be done ....... ~.St .5,: k~O ~./...0~O .'TC~'~.O~f.0. ~. ............. .... ........................ C.. ................ .c.. ............... House Number Street Hamlet County Tax Map No. 1000 Section ..... 0..q.r/ ......... Block .... I .............. Lot ...... t ............. 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 .. [ .-. ~.~.~. I.t,..ti...~.t~..~..L.L.[~..(....~.. IX.. Pr6 ~. $C0.G.'DJ..~.~.....~.{N.~.~.I.~..~... b. Intended use and occupancy .~..~..~-...~..X~...~... 9.).L~.....~... ~.~..1~....~.t/! .t-.~..I.~..~...-7 ............... 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 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 cod~e;-, and regulations, and to admit authorized inspectors on premises and in building for necessaw ~gl~e~ions. ,.~ . [,~,~[. C~' (Sig~ture of applicant, or name, if a corporation) O 4A g . .q.: (Mailing address of appllq:ant) ~;~ ~. ?!~ i ~ (Description) 4. Lstl~ated Cost ............................... Fee ............................... ' (to be paid on filing this application) 5.If dwelling, number of dwellingiunits ............... Number of dwelling units on each floor ................ If garage, number of cars .... i ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ./~.~.~¢¢/~Y/J. ~.~rk...o.~.~.. ; · . ~ . ~d~0 .,~ 7. D~ensions of existing st~ctures, if any' Front ~ Depth ....... '.~ ...... Rear . ~.~P. ................... Height .. ~ ~ ........ Number of Stories ... ~. ................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ..................... HeiSt ...................... Number of S~ories ...................... 8. Dimensions of entire new cons~ uction: Front ... ~TP. ...... Rear .. ~ 5. ~ ....... Depth . ~ ~ ........... Height ... ~.~ ........ Nun ~ber of Sto~es .... ~ .................................................. 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................ Name of Foyer Owner ~.~.~..~eCt~ ..... 1 1.Zone or use district in which pr ~mises are situated...~.. R.~ZD~... ~(~f~A~. ................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ........ ff~ ................ 13. Will lot be regraded ......... · ~ ............... Wall excess fill be removed from premises: Yes 14. Name of Owner of premises ~ ~ ~g. Address~/~.~ .~W~.~. Phone No. 7~g. ~].~. Name of Architect .......... ................. Address ................... Phone No ................ N~e of Contractor ......... ~ ................. Address ................... Phone No ................ P~T DIAG~ Locate cle~ly ~d distinctly ~l] build~gs, whe~er existing or proposed, an& indicate ~l set-back d~ensions from prope~y ~nes. Give street ~d block ~umber or description according to deed, and show street n~es and indicate whether interior or corner lot. STATE OF NEW YORK, S.S COUNFY OF ................. ............................. ~ ................... being duly sworn, deposes and says that he is the applicant (Name of individual signihg contract) above named. , (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 be performed in the manne~ set forth in the application filed therewith. Sworn to before me this .................. , ...... y ' . ............... 19... : . No 4707878, Suf;ol!4 0at, at~ ' ' k "X (Signature of applicant) THE SUFFOL SUFFOL SER¥~ iCONSTiR DATE: H. S. REJ SUFF~ DIST. DEED: L TEST, LICENSED LAND SUR~t~YORS GREENPORT NEW YORK ': ~:::::=':*:~:C STATEMENT OF INTENT THIF'WAYER SUPPLY AND SEWAGE DISPOSAL SYSTEMS ...FOR THIS RESIDENCE. CONFORM TO THE STANDARDS OF DEFT. ,ICANT : , --, : SUFFOLK COUNTY DEPT. OF HEALTH SERVICES -- FOR .. _ APPROVAL CONSTRUCTION ONLY' ~": DATE: ' ' "~ : ' ":: '"'~ H. S. REF. NO., I i - .~O- ~ - ..... SUFFOLK CO. TAX MAP DESIGNAYION: DIST. ~ECT. BLOCK OW~ ADDRE~: SEAL : :~ -: 7~5-I,80~ ~ z'~ T2 z ?,& 2OR THE FO7 p"L.:7-:'7 CON(.2<:, 7 2. ROUG'4 - =~/~M~N~ ? P: 4. F~N~L - CO~',':' '-- :"N MUST BE C~>''~' 7~5 ~CR C. O. ALL CON~'~R:;C~G''' S'~ALL MEET THE REOt~'REF*~ENZS OF THE N.Y. STATE CONSTRUCTiOn4 & ENERGY COD~S. NOT RESPDNS~BLE FOR DESIGN OR CONSTRUCTiO~~ Il.