HomeMy WebLinkAbout7214-zTO!~I OF $OUTHOLD
BIJ~.BIN~ DEPART~.NT
Town Clerk'e Office
Southold, N. Y.
Certificete Of Occupency
No. Z..6~..0.8. ...... Date ........... .A.g.r.:~.....~.6. ..... , 19.7~.
THIS CERTIFIES that the building located at . .Youngs. Road .............Street
Map No.. ~ ....... Block No... ~ .... Lot No, . .xxx, .Orient...N,][., ...........
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ...........Ape':L1.. ,t0, 19. ~ pursuant to which Building Permit No. ?~.1.1~..
dated .........apr ..... 3fi ..., 19.7~., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which t. hi.~ certificate is
issued is .. P. ri.vRte..(accel.scurry.)..$¥;~.~. ~..~g. p.o.o~,. ~.f.$ .h..f.e.n..c.c..E..tg.~ ...........
The certificate is issued to . Fr. ank. Fagar~ ... 0~er ................................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval N...R, ...............................
UNDERWRITERS CERTIFICATE No.. N.1~05.1.1 .... .0.qt;. ~)... 1. 9..~:. ................
HOUSE NUMBER .... .1.b,6~ ..... Street .... Yatmgs. ~ ...........................
· ' ~' '~:< ........... ~':: ' ': ' ' ' '1' .........
Building Inspector/
FOB~ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFF1GE
SOUTHOLD, N~ Y.
BUILDING PERMIT
trillS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 721~ Z
Permissio~ is hereby granted to:
Ortaut;...~r~ek~g..~..~,onsf,~..P-o.....~.C..~.rank Fagen
................. ~i~J ................................................
to~.$.~...~...~w~ ..~g~l..~.. ~.eac~ ...................................................................................
at p~mi~s I~at~ at ~g~..~ .................................................................................................
........................................... ~r~t ......................................................................................................
pu~uant to a~lication d~ .........................~r~. .......~0 ....... , 1~....., and approved by the
Building In~tor.
F. ~.!~.~.~. ..........
TOWN OF $OUTHOLD
BUILDING DE.P,.ARTMENT
TOWN CLERK S OFFICE /,~'/>~'
~SOUTHOLD, N. Y.
.............
Oisopproved o/c ............................................................
(Bu~ d~n0 nspector)
APPLICATION FOR BUILDING PERMIT -l~
April 30 7~ ~
Date ................................................ , 19 ............ ~
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 Jot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application.
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 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 Deportment 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 Lows, 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.
Orient Trucking & Construction co
(Signature of applicant, or name, if a corporation)
Orient
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, en2ineer, general contractor, electrician, plumber or builder.
builder
Name of owner of premises .~.~T*~l~..~.~,g.~ ........................................................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No .....................................................
Plumber's License No .................................................
Electrician's License No...~..:....~...:J:.l..~.~...~.] ...................
Other Trade's License No ...............................................
1. Location of land on which proposed work will be done. Map No.: ...... ~ .......................... Lot No. ~ ................
Street and Number ...... ~D~S..~O&Cl. .......... 0rJ. et~t ..........................................................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Exisiting use and occupancy ........ ~w~ll.t.~g .....................................................................................................
Intended use and occupancy same with p. rlvate sw~mmlng DO01 ~ ~ ~ --
3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .~'..
Repair .................. Removal .................. Demolition .................... Other Work ....g~t,~R~T~..~.~..9~, ...................
(Description)
4. Es. mated Cost ............... ......................... Fee ...........................................................................
(to be paid on filing this application)
$. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................
If garage, number of cars '
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................
7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth ....................
Height ........................ Number of Stories .................................................................................................................
Dimensions of same structure with alterations or additions: Front .................................... Rear ............................
Depth ................................ Height ............................ Number of Stories ................................
8. Dimensions of entire new construction: Front ................. .~ .............. Rear ........ .~.~ ............... Depth ....~2 .................
Height .................... Number of Stories ......................................................................................................................
9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................
10. Date of Purchase ........................................................ Name of Former Owner ............ ..~....~......~. .............................
11. Zone or use district in which premises are situated ..!.t~.~.~...Cl.£S.~ ...............................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: 1:1.O .....................................................
13. Will lot be regraded ..........~.~,$ ........... Will excess fill be removed from premises: (~r) Yes ( ) No
14. Name of Owner of premises ~.~'.~l,T~...~ll ........................ Address ......... (~'~,ffD,~ ......... Phone No .......................
Name of Architect .............................................................. Address ................................ Phone No .......................
Name of Contractor ...0.~'~.e.~...$.[.~.~.~...J:.~.j~...~....~..o.~.~..t..... Address ...... .0..?..J:...e.~ ........... 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
whether interior or corner lot.
STATE OF NEW YORK, [ c c
COUNTY OF
......................... .................
(Name of individual signing contracf
above named.
duly sworn, d_.e?,g~seS ~c6~c~ys that he is the applicam
.~_.,~--'~Vff
He is the ............................................ .°...°..~...~.~.~..9..t;...°.~ .......... ~-:~.~ ....................................................................................
(Contractor,~corpol~ate officer, etc.)
of said owner or owners, and is duly authoriz~J-~c~ perform or have performed the said work and to make and file
this application; that all statements cont~r~d in this application are true to the best of his knowledge and belief; and
that the work will be performed in thecti~nner set forth in the application filed therewith.
Sworn to before me this
............... 3g.....~cJay of ........... ' ........ ~l;~., ............. , 19 ~..
J,(~'ignature of app~:lnt)
JUDITH T. BOKEN
~otary Public, State of New York
No. 52-0344963 Suf[oJk
Commission Expires March $0,
FORM NO. $
TOWN OF SOUTHOLD
Building Department
Town Clerks Office
Southold, N. Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building
Inspector with the following; for new buildings or new use:
]. Final survey of property with accurate location of o~l buildings, property lines, streets, and
unusual n~turol or topographic features.
2. Final approval of Health Dept. of water supply and sewerage disposol--(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
installations, o 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:
1. Accurate survey of property showing oil property lines, streets, buildings and unusual natural
or topographic ~eatures.
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 pe~i~nt in-
formation required to prepare a certificate.
C. Fees: 1. Certificate of ~cupancy $5.00
2. Certificate of occupancy on pre-existi~ dwelling or land use $5.00
3. Copy of certificate of ~cu~ncy $1.00
, ..... ................
N w Bu'lding ................ Addition ~ ............. O~ or Pre-existi~ Building ................ Vacant Land ..............
Location O' Property .,.~.~5~ ~0~0 -~[~ .' ~ ¢.
Subdivision ................................................................ kot ~o ............. ~l~k ~o ............. Hou*e ~o .............
Permit No.....~XJ..~ Oote O{ Pormit .~4~.~..Applicont .... ~..~ ~ ...........
Heolth Dept. Approvol ............................................ kobor Dept. Approvol ................................................
.................... ........................................
Roquest For Tempora~ Ce~ificote ........... 2 .......................... Finol Cortific~te ~ .......................
eo Submitted $ ..... .~..~O .................
Applicont
........ .........................................
Swam to before me this / '
[.~.~.. d~ o~ ...~.~(.4..,...L~.C.
Note~ Public ...~.~.~[ ~ County No~,~ Public Stere
.......................... No. 52-7267800 Su~ol~ Coun~
THE NEW YORK BOARD OF FIRE UNDERWRITERS pA r.
~)(~?P3~}~ BUREAU OF ELECTRICITY
~- 40 FULTON STREET, NEW YORK, NY 10038
Date AUGUST 27,1998 Application No. o.£,le 16642398/98 H 061115
THIS CERTIFIES THAT
only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of
VALESKA FAGAN, YOUNGS ROAD, ORIENT, NY
in the following location; [] Basement [] 1st Fl. [] 2nd FL OUT Section Block
was examined on AUGUST 20,1998 and found to be in compliance with the National El*ctrical Code.
Lot
FIXTURE
OUTLETS
RECEPTACLES SWITCHES INCANDESCENT FIXTURES
FLUORESCENT
OTHER
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS
AMT, K.W. OIL H,P, GAS H.P. AMT. NO. A.W.e.
SERVICE DISCONNECT NO. OF S
AMT. AMP. TYPE ~6~ I m 2W I e SW 3e 3W Se 4W
OTHER APPARATUS:
RANGES
MT. K.W.
~PECIAL REC'PT.
AMT. AMP,
,. R
TIME CLOCKS SELL UNIT HEATER~ MULTI-OUTLET
SYSTEMS
AMT. AMPS. TRANS. NO. OF FEET
V I C
OF C~. COND. OF HI-LEG
EXHAUST FANS
AMT. I H.P.
DIMMERS
SWIMMING POOL-1
*NO VISUAL DEFECTS: "An electrical
sarve¥ has been made of the exposed
electrical equipment in the
premises indicated." "No obvious
unsatis~actory condition was found.
A~DRIA ROWSOM
BOX 119
ORIENT, NY, 11957
GENERAL MANAGER
Per 11
ThiH cefflflcate must nof be altered In any manner; return to the office of the Board If incorrect, th~oectors may be h:lenflfled by their credentials.
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.
THE NEW YORK BOARD OF FIRE ~UNDERWRITERS
BUREAU OF ELECTRICrT~- -I~ L i' ~,
[~ ES JOHN STREET. NEW YORK, NEW YORKiioo3E
~te October 2~ I07~1 ~pp~.t~.~o o.~ 765'~.~1' -; ';
· ' · - 190511
THIS CE~IFIES THAT
in the follmeing location; [] Be~ement ~. let Fl.
we~ examined o, 0etober P4, 19lq
HXTURE FIXTURES
[] 2nd Fl. OUtS~!.de ~ection Block
and found to be in complianVe with the requirement8 of this B~.
OVENS
EXHAUST FANS
OUT.TS SWITCHES FLU~E~ENT
DRYERS FURNACE MOTORS
DIMMERS
OTHER APPARATUS:
~:~ ~'.!nE Pool)
!~eet ion only.
~,?, ~ave freq~mnt
This certificate covers compliance at the date of
Because of unusual environments it ts a~vleable
te~t and/or repairs made by a qualified person.
; !-:e Siliris
L.I.11939
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MU$1r NOT BE, ALTERED IN ANY ~NN;A.