The URL can be used to link to this page

Home My WebLink About7236-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTME~NT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z ~) ~2 Date THIS CERTIFIES that the building located at $..~..OHS..OB...B.O~..d ............ Street Map No....X~. ........ Block No. xX .Lot No conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ~ .... 6..., 19..7~. pursuant to which Building Permit No. dated biay 6 19 ~ 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 Pl~lvate accessory (storage & Bal~) bu~ld~ng The certificate is issued to..R.°.b.e.~.t...H.°..lW.a..~......0~..e~ ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE No..N. :.R., ....................................... HOUSE NUMBER...8.~..~ ........ Street...S~.~..o,~. ?.o.n...I~.. .... .C~ .t?.h.o..~.. ........... FOB, B~ NO. 2 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) N? 7236 Z Permission is hereby granted to: .............. ~a.me~p~; ........................................... ~o ~.~..~...~n..~..~.e.~ ~..o. ry....(.b.a..~p..)....b..~...~.~,~g .......................................................................... at prereises located at ....~::ohso~..~Q&d~ ........................................................................................ ..................................................... CUtC~OgU~....]i.~.. ........................................................................ pursuant to application dated ............................. ~....~ ............ , 1~....., and approved by the Building Inspector. Building' Inspectorl ...~ ro~H NO., , TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT -~ .... ~ TOWN CLERK'S OFFICE ~ ' (,~' Ix*mined ......... , ]9 ........ ~i~pproved ale ................................................~...~.~~.~.~ ................................................. ....................... ......................... .......................... APPLICATION FOR BUILDING PERMIT Date ............................ .~..~ ............. , 19 ............ INSTRUCTIONS ~'~ I I lJ)'~ -J ~ (j~ a. This application must be completely filled in by typewriter or* in ink and submitted in triplicate to the Building~J 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 m 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 o 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 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 applicaht) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................. .................................................................................. Name of owner of premises .....~.C~.~.~,.~:~.~.....~....~..~..~. ~:~J.~'.....~.. .......................................... 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 ............................................. Other Trode's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No ......................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy ........ ..~.....~.?..¥.')..~IC.......~I~.~.~. ...................................................................... 3. Nature of work (check which applicable): New Building .................. ~ Addition .................. Alteration ................. · Repar .u~.. Remova ..................Demolition .................... Other Work .................................................. ;. ~(~,~ ~;~/-~ Ob /,q ____C3~ (Description) " 4. Estimated Cost .....~...(~....,.?.?..~....: ................................ Fee ..~...~.....:...-~_,,, .'"' ............................................................. (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 c~rs ...... .I. ..................................................................................................................................... 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 .................. ....... = ~1.' - ,-t-' ............. 8. Dimension~of~,ffire new construction: Front ......... ~ ....................... Rear ..... ..~..~i ................. Depth ....~.....(~.. .............. Height .~Z...~.. Nu.rnber ot Stories ...... ~ ...................... ...~.~.~.~..~:~.~..~.~1.~..~..~.~..k7.?...9.~`~..~..~..`~T....~.~.~..~-j~.~. ................. Size of lot: Front ..........!.~ ..................................... Rear ............ !..?,...0., ................... Depth .,...~..,,.~....~...i .............. Date of Purchase ........................................................ I'J~me of Former Owner ....... ,,'~..[....~ ................. Zone or use district in which premises are situated ..................................................................................................... Does proposed construction violate any zoning law, ordinance or regulation: ..... ..~......C}.. ...................... ~,~ ............... Will lot be regraded ......1. ............... ~_Will excess fill be removed from prem!~es: ( ) Yes ( ) No Name of Owner of premises ..~...~..~.?....!.....~....b...~...~....fl'....?...~.... Address ..~.....~...?..?...'~...¢'~...~.....~.... Phone No ....................... 10. 11. 12. 13. 14. Name of Architect .............................................................. Address ................................ Pho_..ne No ....................... Name of ~-o r c or ............................................................ ^ddress ........................... ~ mane ....................... 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~DRI~//J ~ ~ ¢ S / COUNTY OF ............................. z.~.:~7-~..¢.~....: ................. ~.being duly sworn, deposes and says t~t he is the applicam (Na~Z~ -;i~ing cant rac~ ................................... ................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and file this application; that all statements contoined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this ................. ........ ............... ,' No,~ ,,b,~,. .................................... ~ ............. co.,U r~...L....~..r~~.~~'" ---. ~ .......... (Signature of applicant) FORM NO. 6 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: 1. 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, Multiple 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 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 all property lines, streets, buildings and unusual natural or topographic features. 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 in- formation required to prepare a certificate. C. Fees: 1. 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 Date .~...,-"'"'~ ('~ '-~ ~.. New Building ..... ~..:~.. ...... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ...... ~I;Z'.Qh.8ozz..~.Qa~. ....... 2F,0.!...~ou.tlz..Balcl.~z].~...~.].~.¢e .............................. Owner Or Owners Of Property ......... ~,...~.0.'D.~.~.~...~.0.~.v. sJJ,,h, .................................................................. Subdivision ............ ~[ozae .......................................... Lot No ............. Block No ............. House No ............. 1974 Permit No. "'72'3~ ........ Date Of Permit ..~a.y..6;....Applicant fl-tet~n...!~.~...He~.~m~nn. ...................... Health Dept. Approval ............................................ labor Dept. Approval ................................................ Underwriters Approval ......... ../~...;....[~...' ........................ Planning Board Approval /x/' I ~k_, Request For Temporary Certificate ........................................ Final Certificate .................... X. .................... Fee Submitted $ ..5.,.DD,, ........................ Construction on above described building ancl.~p ~ ,refits all app~j~, j~,~regulations. App I ica nt . .~..k"--~,f:~.~/~/,,~,~......~.....~..k..L/~. ~¢~... .......... Sworn to before me (stamp or seal) THE NEW YORK BOARD OF FIRE UNDERWRITERS tab BUREAU OF ELECTRICITY ~ es JOHN STREET, NEW YORK, NEW YQ~K 10038 ,... J,,, A.,,.,o...o.,,,. N 166569 THI~ ~E~IFI~ THAT o~y t~ el~t~ ~u~ment ~ ~d~ ~ ~n~ b~ t~ ~nt ~ pn the a~~ ~ t~ p~m~es of Robert Ho~ath~ ~U~ ~Fo~ffSOn'~o,, ~uu w/o CuCchogue, ~.Z. in the /oll~ing ~otion; ~ S~ement .~ Ist FI. ~ 2nd Fl. Garage .~..~do. June 17, and fou~ to be in compli~ce with the r~ulmments of ~hls B~rd. fiXTURE SECEPTA I WIT HE I RXTURES OUTLETS CLES S C S iNCANDESCENT[ FLuC~EsCENT 12 13 3 12 DRYERS FURNACE MOTORS FUTURE APPUANCE IEEE)ERS A/RT. ' K, W, OIL H, P. , GAS H P A/~T NO A. W G RANGES K.w. R EXHAUST FANS DIMMERS OTHER APPARATUS: TIMECLOCKS BELL UNITHEATSRS MULTI-OUTLET SYSTEMS A~T, ~V~ NO. OF FEET ~S, TRANS. C NO. OF HI-LEG A.W.G. OF HI-LEG Panelboard/s: 1-3ckt 125amp W.B.Ruland MattttUck, N.Y. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. THE O. te June 21, THIS CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10033 19 ? ~ App,ic.,~. No. o,/i,, 7 3 7 6 a 3 N 166573 Robert Horvath, n/s~o35 Strorhson ~a., zuu--w/o ~a~awln y~aoe, Cutchogue, L.I. i. ~be/ol~o~i.~ toc. tio.; [] ]Baseme.~ [] ~.~ FL ~e..~i.~o. June 17, 197~ RXTURE I ~CtE OUTtETS ECEPT S SWITCHES INC~N~SCENT RXTURES FLUORESCENT SERVIC~ DISCONNECT [ NO. OF S 1 200 CB and found to be in compliance with the requirement~ of this Board. TIMECLOCKS BELLIUNITHEATEIIUNITHEATERS MULTI-OUTLE AMT. AMPS. TRANS. ~ SYSTEMS NO. OF FEET tl IOTHER APPARATUS: EXHAUST FANS DIMMERS R V I C E A, W.O. NO. OF HI-LEG A.W.O. A, W. G, OF CC. COND. OF HI-LEG OF NEUTRAL 3/0 W.B.Ruland Mattituck, N.Y. 11 COPY FOR BUILDING THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. /AAF Op- I~UJAW $1~1 ~ J . . / .~or~~T a/AA~¥ d;kl'h,l, ~.- I.i O R VAT 1-i "? ~ ZoO ,~'? HAMMOND 24' x 36' ALL PURPOSE BARN REPRODUCTION, RESALE, OR USE OF THESE PLANS FOR PERSONAl. USE PROHIBITED BY LA~f MAIERIAL LIST 15 yds. Grovel 4" Floo~ F~II 14 yds. Concrete Floor and ~:ootlng 85 8" x 16" Cone*eta Blocks - 6 Corner Blocks - minus an1' added 38 2" x 4" lc 12' Top - Bottom - Loft Plases and Loft Wall Studs 154 2" x 4" x 8' Wall Sluds - Rafter Ties - File WalJ 18 2" · 4" x I0' Gambrel Studs HAMMOND BARNS Box 584 New Castle, Indiana 47362 S~'A~E OUT' F/leST FLOOR pLA~I I~'--~-~-~-~-~z- %1¸ ~£ TII IL