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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-23573 Date MARCH 29, 1995
THIS CERTIFIES that the building REPAIR & ALTERATION
320 CASE'S LANE &
Location of Property 27320 MAIN ROAD CUTCHOGUE NY
House No. Street Hamlet
County Tax Map No. 1000 Section 109 Block 5 Lot 6.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated DECEMBER 9, 1994, pursuant to which
Building Permit No. 22535-Z dated DECEMBER 19, 1994
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 A REPAIR & ALTERATION TO AN EXISTING COMMERCIAL BUILDING AS
APPLIED FOR.
The certificate is issued to CUTCHOGUE-NEW SUFFOLK HISTORICAL SOCIETY
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Inspe or
Rev. 1/81
FORM NO.3
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)
W 22535 Z Date........ vx-a-lq 19 7
Permission Is here ranted to:
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..~s.z. .......,,n/,.. s`
to .
2 .r
O'ple .......6./.~............. I.......
..M............................................................. Ick at premises located at..... .73. 1. . r
County Tax Map No. 1000 Section <....4~ Block .........i;:~ Lot No. ~'...f
pursuant to application dated (F 19.... and approved bythe
Building Inspector.
Fee ,
f
~ .............P............
Building Inspector
Rev. 6/30/80
f
1OLM NO. b
t- ( TOWN OF SOUTHOLD
BUILDING DEPARTMENT
` i TOWN HALL
MAR 3 199 765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
'i J iii ','"3.
06,''N, ~ ! ; tC11 a'a '
A x " This, appiicati'o'n,'must,.b'e. filled:' in by typewr~ ter OR 2nk;.and •s•ubm;.tted~to the building,
inspector with, the following:;:for`n6w''bui'lding;or new use
r,, n
1. Final survey of"pYOperty with"accur'a e` Tocation o-e ,,AI1 build ingeproperty „lined; ,
streets, and unusual natural or topographic features. 2. Final Approval from.Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 17 lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
' 6. Submit Planning Board Approval of completed site plan requirements.
B,. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
pre-existing land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2.. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25,00;'
Additions to accessory building $25.00, Businesses $50,00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4., Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential 1$15.00, Commercial $15.00
Date ..1.~ 1.~~.r.5
New Construction.... Old Or Pre-existing Building
Location of Property. Qfl.2).a_Q...)_)_.).y7kVA .............~.~i ~
House (No. Street q ~ Hamlet
Onwer or Owners of
County Tax Map No 1000, Section... Ql....Block i5 .........Lot.... ~
Subdivision ....................................Filed
Map. .Lot.
Permit No.... a253 Z,D1ate Of Permit ..../jq.Igy. ..Appl3cant~N~~Rk?~ S N° ;
C 1 Y' FsOil O uJA1a p
Health Dept. Approval... ...................Underwriters Approval...).` '1..,,.,,,,,,,,,,,,,
Planning Board Approval..~~,,,,,,,,,,,,,,,,,
Request for: Temporary Certificate........... Fi Certicat
Fee Submitted:
g9a5~
L ~APPL ANT
fro-
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h~o~OgpfFO(~~OGy
o ~
Town Hall, 53095 Main Road y x Fax (516) 765-1823
P. O. Box 1179 • .F Telephone (516) 765-1802
Southold, New York 11971 y~ol dap!
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 22, 1995
Environment East Inc.
P.O. Box 190
Peconic, NY 11958
Re: Cutchogue-New Suffolk Historical Society
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons:
xx An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
xx The check is not on file. $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984).
BUILDING PERMIT # 22535-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
i
• - ,YR-s'N 3M*o4•
THIMBLES AND WALL PASS-TN
UL LISTED INSUL-FLUE
INSULATED THIMBLE
f ra zs i 2 The Insul-Flue Thimble was the The Insul-Flue Thimble is
first to gain the UL Listing.
designed to pass through a
Considered by many to be the maximum wall thickness of 'r
' easiest thimble on the market An additional 8" Extension Ri
to install, it is available for 6" is available. The snout
• t and 8" pipe. Use it when you protrudes 13" into the room.
need to pass through a When cemented with Flue Cc
combustible wall and into a (page 95) to the original ring,
' masonry chimney. It will need a the Thimble can pass througl
15"- or 17"-square opening for walls from 7" to 15".
use with 6" or 8" pipe, Complete instructions
respectively. accompany each unit. A
e' Pictured here is a cutaway view brochure with diagrams is
of the Insulated Thimble. It is available upon request.
shown with a piece of black Don't turn your back when yo
stovepipe already installed see the 18" clearance violated.
(black pipe not included). Install an Insul-Flue Thimble
and make the situation more
safe. (49)
1, 71
r F < ~
~ i s^3
,
UL LISTED NEAT-FAW SAF-T THIMBLE UL LISTED INSUL- INSUL-PLUG [
Ileat-Fob's excellent Saf-T 'T'here are two models of Saf-T FLUE INSULATED You can use the Insul-Plug to
Thimble also has the UL Thimble: one that adapts to
Listing. 5"- and (i"-diameter pipe, and WALL PASS-THRU seal up an old thimble hole
The Saf-T Thimble mounts one that adapts to 7"- and 8"- that's not going to be used
directly to the chimney, rather diameter pipe. Both thimbles The Insul-Flue UL Listed anymore.
than to the wall nc-rt to the need a 16" wide by 17" high Insulated Wall Pass-Thru The Insul-Plug is constructed a
chimney like the Insul-Flue opening for installation. (shown assembled) is the only ceramic material. It's available
1I"mole does. Please specify clearly which one one of its kind on the market. in 6" and 8" diameters. Simply
That wav, if the chimney settles you want when ordering. Full It allows you to pass a stovepipe insert it in the old thimble
and pills away h om tile' house installation instructions are clear through a combustible opening and tighten the
t h,gipcus sumeUmes), the included with each Saf-T wall with only a 15"-square expansion screw on the face of Thimble, opening s for 6" pipe or a 17"- the Lisul-Plug. This will cause
Thimble stays attached rather ( 9) the Insul-Plug to expand in
than creating a dangerous square opening for 8" pipe. diameter up to''X<", thereby
breach. Please note that if you are making a tight fit in the
The I lent-Pab'I'himble features making a connection to a thimble. Once it's in place, we
solid-pack insulation and has a chvnney through a combus- recommend sealing the outside
unique system whereby the tible wall (in other words, the edges with Flue Coo, page 95.
insulation section telescopes chimney is built right up
irauard toward the wall. 'this againsta either ft e t f4s)
two
allows for easy adjustment for Insulated You'd use either le the two
wall thicknesses of 4"- Thimbles featured on
this page. (4!)j
Bice Lisl pgge number follnics cacti description.
82
r
DA 7z
;I oor-r~hGrrr~_
'IDATION _ II
:DATSON I c
(2nd) _
& II o ~;I
R FRAME
..:4 fir. r ' d.. ?•.a- ~ I . a'. _ ~ . (C'~
LATION PER N. Y. II I~
STATE EIIERGY II
II \
CODE
' H
FIVAL i
ADDITIONAL CO!-1`fE11TS: y
x
N
-7
i
yyyT. ` P'
Forte
' Environment East, Inc.
3075 Indian Neck Lane
x
P.O. Box 190
Peconic, New York 11958-0190
516-734-7474
NEAR 3 0 PP5
a a s~~ z
gad,
r
A~3-35ft
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ I ROUGH PLBG.
[ ]FOUNDATION 2ND [ ] IN TION
[ ] FRAMING [ FINAL
REMARKS: 6~ cis
DATE INSPECTO
• • • • . •
t2 M f2 3 SE OF
lS U IS FORM NO. 1 ~ET 5 O OF F PLaS
DEC..........
OF SOUTHOLD SURVEY
1994 9 BUILDING DEPARTMENT CHECK
TOWN HALL SEPTIC FORK
4
SOUTHOLD, N.Y. 11971
BLDG. PT. TEL.: 765-1802 t:OTI F'd ;
TOWN OF SOUTHOLD ;i ,
f ~CALL
Examined , 199r ~f MAIL TO:
mtl
Aroved 1.
pp 0 .....I 19~. Permit No.. _ .
Disapproved a/c
R (Building Inspector) CG9
P CATION FOR BUILDING PERMIT
Date 19CT
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 throughout the work.
e. No buildigg 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.
tJVrROty.M `!T....EAX T... ~N.C:........
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
C? EN?~/4t- C0~4TRfeTq fZ
Name of owner of premises ~!lJ fGEkOCyIJ~~NEY~I Su~~ L tG ~EISIpR1<- Ct~u t~C! t.
(as on the tax roll or latest deed)
If appl cant i a r o r % igr a tj duly authorized officer.
^I C - ~
ame and tit e o 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. .
2'13 2O ma.(V~ (Zd CS fie 2s G~ oc~.vg.............
House Number Street Hamlet
County Tax Map No. 1000 Section ~ P.rep.l........ Block 5 Lot E!
Subdivision ........1?T: . ..Filed Map No. Lot
(Name)
2. State existing use and occupancy of premises and untended use and occupancy of proposed construction:
j
a. Existing use and occupancy 6.W S-6(-~ .
b. Intended use and occupancy ClS L~ , .
3 Nature of work check whicapplicable): New Building Addition Alteration , •
Repair o.............. Demolition Other Work
4. Estimated Cost .........l.0o:.o L) (Description)
Fee .
(to be paid on filing this application)
S. If dwelling, number adwellinSunits , , , , , , , , , , , Number of dwelling units on each floor
If g.
g a . number of 6. If business, commercial or mixed occupancy, specify natufe and extent of each type of use l
7. Dimensions of existi
Ong structures, if any: Front W , , , , Rear , . , Depth Number of Stories I .
eight th alterations or additions: Front , ~'1 Q , Rear , .
Depth ht of same structure w Height Number of to , ,
8. Dimensions , , , , , ,
st
of entire new co~ny
Hepht ruction: Front ...N/.Y.:...... Rear Depth
g
N, Vof Stories . . . . . .
9. Size of lot: Front . N ( Rear . . Depth . • • . • . . . • • • .
.
0. Date of Purchase Name f Former Owner .
11. Zone or use district in which premises are situated R'
12. Does proposed construction violate any zoning law, ordinance or regulation: N
13. Will lot be regraded
N Will excess fill be removed from premises: Yes N
14. Name of Owner of premises CV$C$Wq~ - Z ,rytis ic,ccQ Address Phone No. .
Name of Architect Couaci~ Address . Phone No. .
Name of Contractor ~,r})v ; eit5T !c • Address f : JAQ. P:Qqqr!i~ . , Phone No. 1s j?4 74
15. Is this
If property Southold within 300 feet of a tidal wetland? *Yes........ No.........
* own Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all 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.
I,
i
STATE OF NEW YO
CO Y OF. ~ S
(Name of individual signing . . ' ' ' ' • • being duly sworn, deposes and says that he is the applicant
contract)
above named.
He is the .
.
. .
Contractor ent corporate officer, etc.)
~f said owner or owners, and is duly au 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
vork will be performed in the nja"er seIt forth in the application filed therewith.
iwom to before 1 me this
...........1........ of cCwtbea/... .
Jotary Public, , • • , , , , ,
~ County `
ORERT I. SCOTT, JR.
o. ~r.~
RY1`119 Suffoate aNq1Y
ature of applicant)
Term Expires may 31,19 _TJn (
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APPAS NOT D 3F
DATE: B.P. # '
FEE:"/22 1*9- BY: Tt,r.'e1i ~:r.iw e, flPp NOTIFY BUILDING OEPA T
785-1802 9 AM FOR THE
~fi'g FOLLOWING INSPECTIONS:
1 FOUNDATION - TWOREQUIREi Hf~d J~4 4~.. wf + DEC ~ 91994 ,
FOR POUREC CONCRETE Ivlli ,71 F•"P,PPI =~a•-m Lv r FOUGH . FRAMING & PLUMBING e J : ~'~,uUpil L N' o rjd 9 a r~.~. ~d
!k: I" SUI A71ffN96"5~5~,, nom, x TOWry p 500 HOLD
1-IMnl. rb1,3'Yr^UCFION MUST
U COMPLET E FOR C.O,
PAL CON'S'TRUCTION SHALL MEET
51, I, THE FIFOUIREMENTS OF THE NY. 51,E
SPUF CONSTRUCTION & ENERGY
(IDOES. NOT RESPONSIBLE FOR
GFSR;i1 OR CONS "I RUCTION ERRORS UNDERWRQUI CERTIFICATE
REEQUIRED a
lAi4tp~:~~ ~EtF~
QQpOFESS/ONy~ LV `C~~/ OUL, ~~J I V1~\~ LJ
UWyS~PpPER A y, F - _
yyB ~Z BGALE ~-,p^' 11PPPOVEQ DRAWN BY ~WC
DATE 12 , 4'.~4'
DL- C) zana a
N~TNE STAtEDF DRAWING N MBE
ENV zOMMErr"( EAre7 1~4~• ~4-~,
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