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Home My WebLink About8792-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the 'Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z10458 April 16 81 Date ................................. 19... THIS CERTIFIES that the budding ......................... ~ ...................... 2145 Wunneweta Road Location of Property ... t~ 02.Q. Iq ~.a ~ ~..P.~.,. la.o.~ d., ........ qu..~ .c .h.q 6u..e.,..N.: .Y.. .......... House No. Street Hamlet County Tax Map No. 1000 Section . .1. ] .1 ....... Block . .0.8. ........ ' .Lot 02 0 Subdivision..N.a.s..s .a.u.. P...t :..C. 1..u.b..P.v. 9 .P.- ..... Filed Map No..1.5. 6. .... Lot No. ! .6.3. ......... conforms substantially tn ~he App![cai~on for Building Permit her~~ 'fifths office dated .... Au~u s.t~. 7 ....... ,19.8.Q pursuant to which Building Penni, ~---7[1Y81 8 Z August 12 76 dated Augu~.t. 7 ................... 19.8.Q, was issued, and conforms to ali of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... of the aforesaid BuHdinE. Suffolk County Department of Heal£h Approval .. UNDERWRITERS CERTIFICAT ............... i ..................... Building Inspector Rev 1/81 FOEM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, FI. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) 8792 Z Permission is granted to:/ ~'~' ...... ~~....~:~.....~......~ ...~.~.:.o.. ..... 2~.,..x~,,~..~~. ~~- ......... ~-~~.,....~..'.'.7. ............... Qt premises locQted ot ..................... ~ ........... ~.~ ................. ................................. ::: .......................... ~' ......................... *'""Z,"~'-' ........................... ~:.x~ ...... :~~......~:....~~. .....~'.,~.~ ........................ pursuont to oppl,cotion doted ...... -~:,_./~,__,~._~/I/.~?._..~_...~.__.,]9--'Z~..., ond opproved by the Building Inspector. Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southo~d, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor 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 installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building, 5. Submit Planmng Board approval of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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 informa- tion required to prepare a certificate, Co Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date .................. New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...~P. ~e..~,~.~..~¢<?~.~ ............. z.4~~ -~ ~. ~ ........ House No. Street ; -- Owner or Owners of ProperW ...~~; ~. ~Z~~.~. ~ .................... Counw Tax Map No. 1000Sect~.../~L ....... Block ...O.~ ....... ~ Lot..~ ........ Subdivision~X~:~.~,.7? ~ ~- ~.. ~ 'X ,~ [~:..~/~ .Filed Map ,/ Permit No/d~/,~.~ ,, Date of Permi~/7/.~., .Applicant .. ~,, .~ .... ~~. ,, U ~de~r[ters ~ppro~al. ~. ...... ~la~i~ Board Approval . ~ .~[~ ............. aeque~ for lemporarg Certificate ..................... [inal Certificam . . ,.~ ................ Fee Submitted $. ~..'; .- ..................... : Con.ruction on above described building and p~ meets all ap~ab~e ~o~es aod regulations. THE NEW YORK BOARD OF FIRE UNDERWRITERS plT~ BUREAU OF ELECTRICITY [~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT ~y t~ e~t~ ~u~nt ~ ~c~ ~ a~ int~ by t~ ~pl~ant M~ on t~ ~ ~t~R flum~ inthefollo~vinglocation; [] Basement [] lstFl. [] 2nd Fl. outside Section Block Lot wa~ examined on ~,'arch 6, ~973 andfoundtobeincompliancewiththerequirementsofthlsioard. RXTOnE F~XTURE$ RANGES OVENS EXHAUST FANS DRYERS FURNACE MOTORS I~E~EES TIME crOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DI~ERS SERVICE I~SCONNECT OTHER AF~ARATUS: S E R V I C E NO, OF CC, COND. A.W.G. NO. OF HI-LEG A.W.G. A.W.G. PER ~' OF CC, COND. Of HI-LEG OF NEUTRAL 2/0 ~[¢h&rd D. Gwydlr Van~ton Rd. Cutcho~ue, L.I. ~Z935 LlC.2O02 This certificate must not be altered in any manner; return to the office of the Board if incorrect. be identified 'credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BI ALTERED IN ANY MANNER. FOit~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ........ ...... ....... ...... ...... . Disapproved a/c ............................................................................................ Application No...~...~.....~... (Building Inspector) Date ..... . .~....//...~....//...~....7~......./...~., .......... , 19.~..~./~/.... INSTRUCTIONS a. This application must be completely filled in by typewriter or' in ink and sub'mitted 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, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c The work covered by thru application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector wdl 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 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 apphcant agrees to comply with all applicable laws, ordinances, building code, ho~using code, and regulations, and to admit authorized inspectors an premises and in buildings for necessary inspections. .~ (S{gnature of applicant, or name, if a corporation) (Address of applicant) State whether apphcant ts owner, lessee, agent, architect, engineer, general contractor, electricmn, plumber or builder ............................... ................................................................................ , ........................................................ Name of owner of premises If applicant is a corporate, s~gnature of duly authorized officer. (Name and title of corporate officer) Builder's, License No. ......... .~.~..[ .................... Plumber s ~cense 1,4o .............. .~.. ............................. 1 Location of land on which proposed work will be done. Map No. ..X.~...4 '~ /~ -~ ............................ Lot No ......................... Street and Number ...... .~..-.~.....~...~. ..... /...~.~...~.~.~...~.......~..~../..'~.,(T....~.~.. ......... ~.~.....~.~.../~...~.~..~...~.~ ..... ~..'...~...,r ............... Municipality 2 State ex~shng use and occupancy of premises and in'ended use and occupanc! of proposed construction: a Exisiting use and occupancy ............. ..~...~.~...~..Z.../.x~. '.~.. ....................... L ........................................................ ............ ........ ...... ....... b. intended use and occupancy ....... ...~...~...../~....~......~.. I 3. Nature of work (check which applicable) New Budding ............... Add,tion ....... 1/. ....... .. Alteration ...... Repmr .................. Removal .................. Demoht~or. .............. Other Work ............................................ (Description) 4 Estimated Cost ........~.......~.~...~:. .......................... Fe '-,~' ~ (to be prod on filing th~s apphcahon) 5. If dwelhng, number of dwelling units ....... . .~....'~....~.. ........ Number of dwelling umts on each floor ....... ..~...~..~.~.. ....... If garage, number of cars .............~.~../t ....................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ......... ~ ......... 7. Dimensions of ex,sting structures, if any' Front ....... .~...~...~ ........ Rear ........... .~...~....[ ........... Depth ....... ..~..~..../... / Height ......... /.Z/ ......... Number of Stones .......... .~...z~...~. .................................................................................. D,mensions of same structure with alterations or additions' Front ............... ~'..~/..~ .......... Rear .......... ..~'....~...~. Depth ......... ~'~.~..../. ......... Height .............. ./...7. ~. Number of Stones ............ ..~.....'~....~.. ..... ' ....... '......':~...~...~ ...... Depth ................... 8 Dimensions of ent, re new construct,on: Front ........... ,~..~., .............. Rear ~' ' / Height ....... /..~... ...... Number of Stories ......... ~.. (..~...~'~. ...................................................................................... 9. Size of lot Front ................. ,./...~.....f ........................... Rear ....... ./...~....~..:..~....7....~. ............. Depth ...-~ ..... ZL~.v:...r~-~ ....... -.. 10. Date of Purchase .............~...~.~, ...... 7.~..Z...Z~... ............ Name of Former Owner ............ ~..z~..Z..'~..~.z...~...?. ................. 1 1. Zone or use d~stnct ~n which premises are situated .............................................................................................. 12 Does proposed construcbon violate any zoning law, ordinance or regulation' . ............. z~...~. ................................. 13 W, II 10t be regraded ......... . ./~.,~.~... ........ Will excess fill be removed from premises: (~,'~') .Yes ( ) No 14 Name of Owner of premises ....-~..4~..~...~..~.....(~.:.../~...~....~..~..~.~...~..~..~.. Address ~/~' .~.~.//.¢.~.~.~...~....~.... Phone No..~.~...~..2..-~..?'...~.. Name of Architect .................................................... Address ................................ Phone No ....................... Name of Contractor ........................................... Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buddings, whether exating or proposed, and ,nd~cate all set-back dimensions from property hnes Gwe street and block number or description according to deed, and show street names and in&cate whether interior or corner lot ~'~/ - STATE OF NEW YORK, ~ c c COUNTY OF "~O~ ............ f ~ ~ ' ......... ~'.~.~ ........ ~ ..... ~.~.~ .............. be,rig duly sworn, deposes and says that he ,s the apphcan (Name of individual sign,ng contracf) above named. ~ ~--~ He ~s the .......................................................................................... ~ ................................................. (Controctoh agent, corporate officer, etc ) of said owner or owners, and ~s duly outhonzed to perform or hove performed th~ said work and to make and this opphcation; that oil statements contained in this opplicohon ore true to the b~st of h~s knowledge and belief; tho~ the work will be performed m the manner set fo~h m ~he opphcotio~ therewith. Sworn to before me this ............. ~.~. day of ................ ~g~ .... , 19...~.~ ........ : ................. ........ ......... , . ~ ~ ~ . ~ ~ / //- ELIZA~I~ ~NN NrV~LLE