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HomeMy WebLinkAbout6608-zFOEM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMEI~T Town Clerk's Office Southda, ~. Y. Certificate Of Occupancy 6 No. 2;632 ...... Date .. Yeb ]0.. , 19~. THIS CERTIFIES that the building located at Sauna Ave & Pacific ~t Street ~3ap No. Xx~ Block No. ~ .. Lot No. xxx .. 14att.lt.~.ck N :Y conforms substantially to the Application for Building Permit heretofore filed in this office dated Eay 29 , 19 7.3 pursuant to which Building Permit No. 6608Z elated May .. 29 , 19 73 , was issued, and conforms to all of the require- raents o£ the applicable provisions of the law. The occupancy for which this certificate is issued is B. ui~ess, b. uildlng..-..ba.~..: .... The certificate is issued to Nortk Fork Bank 6 Trust Co (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.R. .. ., UNDERWRITERS CERTIFICATE No. 1~ ]~29~ ..... Apt. il .i.Q..]g.7.br .......... IIOUSE NUMBER 1.2gl .0 .. Street .8.o.u33~.. Av.e. ......................... 750 Pa¢ifi~ St TOWN OF SOUTHOLD 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) 6608 Z Permission is hereby granted to: ..~....:~....~.~ ...... .¢....~....~_, ..... ..~...~......~....~.....~,~,.~.....~...:/~,~, ~ pursuant to application dated ............................... ...~.....-J~, 19~., and approved by the Building Inspector. Fee $....Z,.~....._.~..,.O.'~-. FOltM NO. 6 TOWN OF $OUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This apphcation must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: I. Final 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, Mulhple Residences and similar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed s~te plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as te use, occupancy and condihon of buildings 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent formation required to prepare a certificate. C. Fees: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3 Copy of certificate of occupancy $1 00 New Bt4ilding ................ Addition ....~ ...... Old or Pre-existing Building ................ Vacant Land .............. Location Of Prope ....... ...... ..... ........................................................... Ow.er Or Owners Of Property ...... ~k. Cl;:b..('~.t.~.....~L'~C~./~L(,,....~4.~l.[C~..~...'~'/~.~'.....~t ......................... Subdwision ................................................................ Lot No ............. Block No ............. House No .......... Permit No ..~...~...~....~....~.. Date Of Permit ~.~.~.~Applicant Health Dept. Approval ............................................ ~bor ~t. Approval ................................................ Un, le~riters Approval ..~....J.~.~.~.~ ................ Planning B~rd Appr~al ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ..... '~.., ......................... Construction on above described building and permi~.~ets all appli~le coc~ and regulations. Swam to before me thisApplicant ................. ................ day of ............................................ (stamp or seal) Notary Public .................................... County THE NEW YORK BOARD OF FIRE UNDERWRITERS ak BUREAU OF ELECTRICITY ~' 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,.,e A.,.ll 197, A.,,c.,,o. No.o.,,,e 71993 THIS CE~IFIES THAT NoPth ~o~k Bank & T~ust Co., 8/8~e ~ound Ave., 1UO e/o ~ao~r~o ~at tituckA ~..~o. April ~, 197~ andfou~tobeincomplia~ewiththerequirementsof~h~. RXTURE RXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES 35 31 7 8 27 DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS TIME CLOCKS uNIT HEATERS MUtTI-OUTLET D~MMERS SYSTEMS SERVICE DISCONNECT S E R V I C E NO. OFCC. COND. A,w.G+ NO.OF HI-LEG OF NEUTRAL OTHER A~ARATU~ Electric Furnaces: 1- 32.9 kw Panelboard/e: 1-19ci~. 200amps. 1- 5 Ton A.C. Unit Sandst~om elec. Co., Box 1~15, Aquebogue, L.I. 11931 Per_ COPY FOuR B~UILD!NG DEP_ART~M~.~,,. THIS COPY OF ~ERTI~FI .CJJ. T~UST ~T B~EE ALTIRED ~IN AHY MJU~N, ,~ E~_~ ..... IrORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19./..2" Pemit No. ~ ~ /~ "-' Z-- Application No ......................... y..,...~ 1 APPLICATION FOR BUILDING PERMIT ~ ~ Do,e .......... .......... ............ . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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, a~ld[ giving a detailed description of layout of property must be drawn on diagram which is part of this application. ~/ ~' c. The work covered by th~s apphcat~on may not be commenced before ~ssuance of Budding Permit. J ! d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit,shall be kept ~n~ 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. Disopproved o/c ...... ~ ............. ;~ ................................................................. ......... ...................................... (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 buildings for necessary inspections. (Signature of applicant, or name, if a corporation) .................. {Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...... .~l~R~ ....... . .~-.~l~......~s.U..~J~.....~...~.l~.l~.~ht.....~.~:. .................................. If applicant is a corporate, signa~s~j'e of duly authorized officer. .............. ........... .~. Name and t~t~e ot'eorporate omcer~ Buird~r'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. Map No ............................................... Lot No ......................... Street and Number ..~...~.......~.i~.~-¢K~....~..t~.l~...J~;...t..P~J..~d~..l[~....~r~'~ ...... ~..Mi~..l~..t..~.~..~ .... Municipality 2.State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ r~ J~l~..~ .~J~,.. ~, ...1~. f .~. ).~.e. ..................................................... Intended use and occupancy ................................................................................................................................. ure of work (check which applicable): New Building ....................... Addition ............. Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... 4. Estimated Cost L/500D '~,~- ~ (Description) ............................................... Fee ............. z .................................................................................. (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 mixed occuoancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front ..... ..~...¢~.. ....... Rear ..... .~...~., ............. Depth ....~.~. ........................ Height ............... .~w.~t .................................... Number of Stories ...........t~...~...~I ...................................................... Dimensions of same structure with alterations or additions: Front .....~..~,...~ ............. Rear .......... ~.L..~[ ....................... Depth ........... .'~..~.. ........................ Height ............ ..'~....~. ..................... Number of Stories ....... ~!..~...~.. ...................... 8. Dimensions of entire new construction: Front .....~..¢1[ ............ Rear ....... ~k.~ .............. Depth ...~.~ ....................... Height ............ .'~..~. ............................ Number of Stories .................... .1~.1~'. ......................................................... 9. Size of lot: Front .......... ~...~3 .................. Rear ............. [~..~ .................. Depth ....,...~w.~'~. .............................. 10. Date of Purchase ..... ..................... Name of Former Owner ....... ~.l~.~J~t~.~...,.~.~t~...~. ................................ 1 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does ~roposed construction violate any zoning law, ordinance or regulation: ....][~1~ ................................................. 13. Will lot be regraded i. I1~..~. ..................... Will excess f_ill be removed from premises: [ ] Yes [~ No 14. N ams of Owner of pre miSes ...~..~ ..~ ~.J~ ....~,,,..~'I.~.~,.L I".~,l~.~..)..~.~"~ ........ ~..~'.~J~..'...~..~., .[~ ~'~ .~./_ ,, ~J.~ddr~s) ' ~ ~ (Phone No.) Name of Architect ~*r~`'~/`~j~.~..~.~.~`~*~'/~..~.~A~:~`~L~.~t*~T~~_ ___ ___ (Phone No.) .... (Address) Name of Contractor .~l~).~D...~...-~..~..J~.~..}...~l~.~.f.'~'..~f...~.l..~ .............. .~.~.~1..'....~.2~.,~ ......... (Address) (Phone No.) 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 wheth- er interior or corner lot. STATE OF NEW YORK,__ ~ ) COUNTY OF .'-'-~..~..~...'~... ,~..~..~.. .......................) SS , ......................... · ~11~.--.1~...~-.,.~...~.....~.-~i,~.~..~ ................... i beir{g' duly sworn, deposes and says that he is the applicant above named. {Name of individual signing contract) ~ 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 arp 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· ' [~--I /~lav o£ ~'/~T~'~Notary Pub c nthe ~tete o~N~w Y0~ "~"~ ' ~/~ '~ T"~'*~'-~'~ NO. 52-~040§'~ Notary Public, ~ ..~.....~..~ ..2~....T~.~.E~)iee¢l~t!~~ 30, 192~.j' .............. .~-....~...*;;~ ................ .2--.-.-; ......... ...~...~.~ .............. ~ fMgnature o7 appticant] I H r I I · i .1_ WOtg, l<. A~EA Q~ .~AQD~JON:...TO COM PUTEI~/O?F CF__ BUILDING FOI~ T~E NO, IH FORIA BAK/,tz, AND TEijST CO. MATTITUC~N.Y. ' t=LOOg, PLAKI- APPROVED AS NOTED DATE: ~,'~Z~ ~'~O...~ 7~-.~ ' FEE: 7.~.5° '~y~ NOTIFY BUILDING DEPARTMENT 765-2660 9AM TO 4PM ED INSPECTIONS: 1. BEFORE BACKFILLING TION OR START FRAMING 2. BEFORE COVERING 3. FINAL WHEN JOB COMFLETEg , ~,,,,,,~ rED '1 WE~T EL~¥ATIOk~ o · MOF~TFI E. LEVA~TIO~ ' · F_.A~3- ELI~VATIOI~. TO COMPUTE&/OFFIC? 5UILDING FO& T~E NO&TH ~L ~ V~,TIOM · FO B 1/-., BANK AND TBUST CO. MATTITUCK N.Y. '..~N~L~O:,':bWO~D~W. ARD,~,~,-. ARCH : :}~:.EOEIiN. ROAD,, '~ESTBURY~, NEW YORK I l~gp B~6-3B4.6053 .,~ ~ ~ , U &O U i',J D ADDITION Ak/' NUE- 0 0 SIT= ~. PLA l,-J · ,? WZ4, TO COMPUTF,.R/OFFICE tbUILDIIflG FOI~ TIlE NORTH FOi~K BANK ANP T d P!AECA~T R814,~. LIMTEL. B~LCOK ¢R ~. L.~ GILL ~",l'-o" ~E~. NO'rE .. F,,'4E OP ~APDL~- Z'E~O #1'Z,D W111-1 LiP ~, 'Z"~,V'&" ~E C. TIO N (~) FOR LOCATION OFSECTIoN$ TI~UBT CO. MATTIrTUCK, N.Y. MAy ")3 RE. VI.~Gp ~,E. CT~ON 4- ,. IwOCIDWARD, AIA, ARCHITECT ':I~0a'[N'ROAD, WESi'~B'!~t~, NEW YORK 11590 516-334-6053 OR'aWING NO.