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Home My WebLink About5397-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. ~10.~ ...... ° Date ........ .&lll~. .... ~ ...... , 19. ?3' THIS CERTIFIES that the building located at . 3/t.8.8ound. A. ve ........... Street Map No..x~ ........ Block No .... ~ ..... Lot No. :a~.. 14a. tt~tuok ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ July .... 12. - -, 19 .?l. pursuant to which Building Permit No. ~97~' · dated ........ ,T~Ii~'...1.2 ....., 1971.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .]~l~lllezZ..bxl:LXcl~ng..(101'~z~ng. ttl~t~ ............................ The certificate is issued to l~nk .Sptxml~ ..... 0~x~l, ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval · ~,R, .............................. UNDERWRITERS CERTIFICATE No .... 1~[1~ ..................................... HOUSE NUMBER.. 1.~-~-~0 ..... Street .....8~111d. ~ ................................. · 'ng Inspector' ~ ' ' FOEM NO, ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5397 Z Permission is hereby granted to: .................. · .~.~...~.p~ ................................ ..................... Sau,~d..Avm. ..................................... .......................... ~ .t~ ¢'-,~k ............... ! ................. J~l'~ ]2 19.~..., and approved by the pursuan,t to application dated .................................................... Building Inspector. ............. :..~...¥.,..: ......... ; ............ :.,..;:' .'~ .................. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ..... ...... ........ ...... .......... . Di~pp~ a/c APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building(~ Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjo n ag prom sos 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 application. ~I~ 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 issue a Building Permit to the applicant. Such permit ~' shall be kept on the premises available for inspection throughout the progress of the wurk. e. No building shall be occupied or used in whole or in port for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY N~DE 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. ........... ~...~...~.~. ................ i ......... (Signature cf applicant, or name, if a corporation) Sound AYe "Mattituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Agent of owner of -rem se- Frank S~inale Name of owner ~ a ..................... , ...... . ............................................ If applicant Js a corporate, signature of duly authorized officer. (Name and title 'of corporate officer) I Location of land on which proposed work will be done. Map No.: 3C~X 3C~ ......................................... Lot No.: ........................ Street and Number ........... $~.{~.....h~.e]3i3,~...~.~.{~ .......... ..~...~.~.~.l~g~; . ~'.~ -- / / / 74 J .~ Municipality 2. State existing use a.nd occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Business Bldg (processing plant) b. Intended use and occupon:-, ...~.~,Rt.e......~',~..a.~J,~;i~ ........................ 3. Nature of work (check which applicable): New Building ~ ................. Addition ;l::lr,.X Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ................ '1.~.2~0......i~ ........................ Fee ....... ~....00 .................................................................... (to be paid on fi!lng this application) none . , 5. If dwelling, number of dwelling units ............................ Numoer of dwelling Units on each floor ............................ If garage, number of c~rs ............................................................................................................................................. 6. If business, commercial or mixed occupancy/ specify nature and extent of each type of use .,B..l~.~...:~....e.~..s. ....... 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 2 + 8. Dimensions of entire new construction: Front ......... ~ ........................ Rear .......... .2..~. ............. Depth ......... ~..~. .......... Height Number of Stories One 9. Size of lot: Front ............................ Rear ................................ '.... Depth ................................ 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ~13~t clls'b 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... 13.e., ........................................... 13. Name of Owner of premises .ff.l:l_&~...1,T._.~p~13~:~.~. ....... Address ......~..~.~t,...l.~.tl;.?..k.. ................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor same .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and ind cate a I set-back dimens ons from property lines. Give street and block number or description according to deed, and show street names and nd cote whether interior or comer lot. I"1 "t S0u I STATE OF NEWa¥,QP, d{,.~. COUNTY OF ................................ ............................................ ~.l~..tvi'~l.l'~; .................... ,.....being duly sworn, deposes and says that he is the applicant (Name of individual signing application) ' A e above named. He is the ................................ ~.~.I1.1;;....9,~.....9...1~..~. ................................ '~; ....................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and Is duly authorized to perform or have I~rm'~ the said work and to make and f · this application; that all statements contained in this application are/true to th~ best of his knowledge and belief; and that the work will be performed in the manner set forth in the appllcgflon flied thlsrewlth. Swam to before me this / ~.~ //[ / / Notary Public, ~.~~.. Co~n~' ~/ ~~'~a~ ~c'~'l~ 't') ............................. 804~529 BUREAU OF ELECTRICITY ~--- 88 JOHN STREET. NEW YORK. NEW YORK 10038 Date AUGUST 27,1993 .,lpplica~ionNo. onfile ~4928693/93 ~ ~665~ THIS CE~IFIES THAT in t~ fdlowin~ ~atiofl; ~ B~Mnt ~ Ist FI. ~ 2~ ~. GAR/OUT .~tion Sl~k ~t wexami~on AUGUST 16,~993 ~u~tobe~com~ce~ththeN~c~c~C~. DRYERS ] FURNACE MOTORS IqJTUIE APPUAH~ I~E~IIS RANGES R 150 CB NO....__CONO.OF.t. % AN~. ~ ~1. 1,ff2W IAr3W 3~'3W $,i''W OF CC. COND. DEFECTS RgMOVBO L~TT~R OF 8/13/93-! · OOKIHG D~KS OVENS DISH WASHERS .. .,.T.,.T,,S EXHAUST FANS DIMMERS JAMgS MANNING 124 BAST 38TX STREET This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. '~ ,<COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ,o.-si. NEW YORK BOARO,OF FIRE UNDERWRITERS ELECTRICAL DEPARTMENT ~ ' A.J. REED, GENERAL MANAGER RE,~PON D TOL. -. ,,~8N5 John Street [~ 41 State Street I [~ 570 Delaware Avenue J [~ 217 Lake Avenue [~2 ad NEW YORK, NY 10038 ALBANY, NY 12207 BUFFALO, NY 14202 ROCHES,ER, NY 14608 SYRACUSE, NY 13206 (212) 227-3700 (518)463-2122 (716) 884-1155 (716) 254-0141 (315)463-8552 THIS IS A REPORT OF (SEE BOX CHECKED HEREUNDER) A. [] NON-INSPECTION B. [] INSPECTION JOB LOCATION: APPLICATION NO.: I~O~ C.~. ELECTRICAL S, URVEY PERMIT NO.: OWNER/ TENANT ADDRESS .,It. NON-INSPECTION: We have received your application for an inspection of the electrical installation made by you at the premises named herein but we have been unable to make the inspection for the following reason: [] Floor location and name of tenant not furnished [] Premises locked, no entry possible. [] Floor location of building not furnished [] Other Inspector's Signature Date_ Please provide the necessary information or suggest arrangements for our access to the premises on the green form attached and return it to this office. Applicant's Signature Date INSPECTION OR ELECTR'IC~,L SURVEY: We have attended, ~at.~,he premise~ named herein to inspe~ tt~e electrical installatip'n and ¢egret that we can,not [~ssue:a certi4icate of compliance for the reasor~s),listed hereunder -] Cormealed work not'e~(peaed sufficiently for inspection. [] nstallation not completed suffi¢ie.qtly for inspection. E] Additional electrical ~ork found fd~ wh]bh,no application - {o.r mspectlo~n ha? bee~ received. ',~"El~'trical it~stal ation does not comply WitCh National ...... Electrical Code fe~ reasons'listed hereunder; ~ (see reverse si'de for explanation of c(~d~pg) i' KE~'TO ~¢ORM: Code nul~r pl;l'ri~ uf~l~r ~,L/~CK column lisf~d ind~c~q~I~.~AM~L~'B~C~'RED~ ~ & Service Co~bf~rcapac~ '~ ~ '. :"~;:~-'O~r . '~,~' BLACK .~"RED, , ~OOR' BLACK RED - FLOOR B~CK RED FLOOR BLACK , RED FLOOR ...... . ,. , . -, ,. I / ' ' ' · . l~spe~torsSignt~uJ'u~.,-,*~., / ~Jt Date ~ .... " - ' -* *--* ';. ~'/.;~,~ C,,c,"'*T ..... - '-.-.' NOTICE TO-APPt~lCAt, LT~leiase'sign, date amd ~eturn green c~py'df tills '; ' h: '~': , , form to request re-inspection when modifications have been made. APPLICANT'S SIGNATURE DATE NOTE: IF THIS IS A REPORT OF ELECTRICAL SURVEY, A NEW APPLICATION MUST BE MADE FOR RE-INSPECTION. BUILDING DEPT. ;OR. 3,REV.,,,O, THE NEW YORK BOARD OF' FIRE UNDERWRITERS ELECTRICAL DEPARTMENT ~ RESPOND TO: A.J. REED, GENERAL MANAGER -~85John Street I [] 41 State Street I E} 570 Delaware Avenue [] 217 LakeAvenue erial Road NEW YORK, NY 10038I ALBANY, NY 12207 J BUFFALO, NY 14202 ROCHESTER, NY 146081 SYRACUSE, NY 13206 (212} 227-3700 (518) 463-2122 (716) 884-1155 (716) 254-0141 (315} 463-8552 THIS IS A REPORT OF (SEE BOX CHECKED HEREUNDER) A. [] NON-INSPECTION B. [] INSPECTION C. ,~ELECTRICAL SURVEY [] Floor location and name of tenant not furnished [] Premises locked, no entry possible. [] Floor location of building not furnished [] Oth.er_ . Inspector's Signature Dote Please provide the necessary information or suggest arrangements for our access to the premises on the green form attached and return it to this office. ~ Ap~31icant's Signature Date B. C. I~I~PECTIO~I OR ELECTRICAL SL~R~rEY' We have attended at th; premises namdd herein to inspeqt tl~e electrioal ~ installation and reg~t that we can not issue a Certificate of compliance for the reasons} listed~hereunder ~ Concealed work not exp(~sed 9uffi(~iently for inspection. [] Installation not complete~d sufficiently foi~ ~nspection. [] Adl:lit!onal etectrJcal.~qrk~feund for~ wh i~t~'nb A~pp, cat on for ~nspectlon has been received ectrical in{tallatior~,qoes not comply ~V)l~h National Elect£ical .Code for ~'easons-listed hereunder.,~ (see reverse S de,~or~ exP aT'ti,on of co~ K~.'J~ORM: C?~I. e num.~,e~rf~,e~l,~ld~rr,~,,L~.CK column li~ I~ri~.~tt'~b#flld wl~:~~d ~.d~r~;~,~ · B~OK> [::'~ F~OR BLACK RED FLO~ .',B~CK R~' FLOOR B~C~ ,u: inspectorls Signatur(~.. :; :, NOTICE 7Q ~A~ICA~.T:,,,P. ease~s~gn,~date and ~etura gmeR (~epy of~thiS,:'''~ ". ~ ~' .- ~ -,'~ ~ form to request re-inspection when modifications have been made. APPLICANT'S SIGNATURE DATE NOTE: IF THIS IS A REPORT OF ELECTRICAL SURVEY, A NEW APPLICATION MUST BE MADE FOR RE-INSPECTION. BUILDING DEPT.