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Home My WebLink About9712-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. Zi1238 .......... Date .. 0cl:ober. 6 ...................... 19 THIS CERTIFIES that the building ................................................ Location of Property .375 . Kraus. Road,. Matttruck ..................................... House No. Street Ham/et County Tax Map No. 1000 Section . . J ,3.2 ....... Block . .0..5 ........... Lot 006 Subdivision ....... X. ....................... Filed Map No. X .Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated · Hay. It ............... , 197Jt. pursuant to which Building Permit No. 9.TJ~2z ................ dated . t, fay. g ...................... 19.7.8, was issued, and conforms to all of the requirements of the applicable provisions of tile law. The occupancy for which this certificate is issued is ......... ....... a. $~*imming. pool. &. fence ................................................. The certificate is isstied to . William a Mary Ann Gremter .................... ?o¥.'o;, ..................... of the aforesaid building. Suffolk County Department of Health Approval . N/A ...................................... UNDERWRITERS CERTIFICATE NO.. 1'131)20.63 ......................................... Rev. 1/81 Building Inspector FORM 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) Date ..... ~a~ ....... 8e ................................ , 197~.., Permission is hereby granted to: ............ .............. to......,............Build a...........s ~kmzhing..p. 9..o..,1...~ .. ~.e;~.o.e ......... .............................................................. at premises located at 295 Kraus .R...o.~..d. ........................ ....................... .~..t;~t,.'l~ck~ Ne~ Yoz~k .............................................. pursuant to application dated .M.~. ............ .~. ............................ 197~..., and approved by the Building Inspector. Building Inspector FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall 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 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 fromthe 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 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 inspecti,o,n of buildings or premisest or other pertinent informa- tion required to prepare a certificate. 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 New Building ............. Old or Pre-existing Building(X) . _.~_ .... ~/Vacant Land ..... : . ...... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ....... Date of Permit .Applicant ~/~ Health Dept. Approval ........................ Labor Dept. Approval ...................... ,.. Unde~riters Approval ~ ~ ~ ~-~ Planning Boar royal .......... ....................... d App ........ Request for Temporary Certificate ..................... Final Certificate ..... Fee Submitted $ .~:. ¢~ .~-~ ................... Construction on above described building and pe~L~,e~s all app~i, cable~des and regulations. PP .: .~" .... : ............. '.,¢.,4--.__ .......................... · .,,.,:-?.(:: .;.. ,;.. :, .: TOWN OF SOUT] OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 Applicant This is to advise you that the job under Building Permit No. (\-~. issued to ~,~S~ On ,~:~']~. fo'r ~.~'~,~ ]~.~'~' is completed a final' inspection has.\has n~ -been do~e. and In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form(s), return same to the above office with a check for $5.00 payable to the Town of Southold. Please indicate to whom the Certificate of Occupancy is to be malled, and arrange with this office for an inspection date. Thank you for your prompt attention. Very truly yours, Victor Lessard Administrator VL:ec Enclosures THE THIS CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 9700, only the elee ' eq ip as erl in ~ ' ant o ' ' n r l~ ' ,f inthefollo~ingl~a~n~ ~em~R ~ IstFI. ~ ~.d F*. ou~s ~ de was examin~ on and found to ~ in compliance wi~h the ~qu~r~m~nts of th~ B~. RXTUR$ RXTUR$$ RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES 3 DRYERS FURNACE MOTORS FUTURE I~i)ERS TIMECLOCKS UNITHSATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF SERVICE DISCONNECT S E R V I C E NO. Of CC. COND. A, W.G. NO. OF HI-LEG A. W, G, OTHER A~ARATUS: l (Swlmmlno Pool) This certificate covers compliance ef %he date of Inspection only. Because o* unusual envtronmengs if Is advlsabt. to h~ve freoueat t~st and/or repairs made by a ~u~tlfled person. Warner 194 Woodla~n Av~. St. Jam~s, L.t. 1178n tlc.31OE / This certificate must not be altered ~n any manner; return to the office of the Board if incorrect. Inspectors may be identified COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..... [v~.~.....'. 1.8 ................... t9..?.8.. Approved May 8 19..?..8... Permit No. 9712Z Disapproved a/c (Building Inspector) Application No APPLICATION FOR BUILDING PERMIT Date ....... .~.:.~ ../~.~. ........................... , ] 9..?~.....~... INSTRUCTIONS a. This application must be completely filled in by typewriter oe 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, 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 applicantr. Such pen'nit sha~l 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 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 ir~pections. ......... ........ .... ........ .............. ~ ~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~.-c..~-~-~-~ '"'": ......................... t ....... ~ ................. ~ .............................. 2.;';;':c;:;;; ':L ';;'; '; '; ....... '"'" (Name and title of corporate officer) Builder's License No ............... ..~,...,/~..~...~.. ..................... Plumber's License No ................................................. Electrician's License No ....... ./..~/.,~...~..~..-~.!.~..?' ............ Other Trade's License No ............................................... 1. Location of land on which proposed wgrk will be do)3e., Mqp lx~o.: ...,~.~....~ .................... ~ ...... Lot No ......................... Street and N m ~ ~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .... ~:. ....... ., .................... ~......~ ...;. .................. ~ ......... 3. Nature of work (check which applicable): New Building.. ................. Addition "i-4/ ~-~ ........ Alter, orion ......... ;'"' ¥2 Repair .................. Removal .................. Demolition .................... Other Work'~~.~, .. ~ (Description) u 4. Estimated Cost ....... .-,~..,.~....,....,. .................................. .... ............................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dweIling 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 ........................ Height .................... Number of Stories .............................................. 7 ..................................................................... 9. Size of lot. Front ......... J ............................................. Rear ....................... Depth .../'. .................... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ] 1. Zone or use district in which premises are situated ..................................................................................................... ]2. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded .............. ~.;...~. ....... Will .,e~,cess flit be re~%oved trim,premises: ( ) ~ ( ) No '4 ........ Name of Owner of premises .~..~..~ .~ ......... ...~...~.r.~sress ~..~.,~.~ ........... .1~,..~P~one No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ 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 whether interior or corner Iol c o F. ...... ..,~~......being duly sworn, deposes and says that he is the applicant (Naq(eJ of individual signing contract) above named. He is the ................. ~.. .............................................................................................................................. (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 applicatign are true to the best of his knowledge and belief; and that the work will be perfo~e~ in the manner set forth in the ~plication filed therewith. Sworn t~ me this Not~ vBblic, ....~~.~ ............... ~ounw ....................... ~..~..r .......................................................... [ / -/: ~ ~ -~ () Z/ ~ ~n ~ (Signature of applicant) W. Yo Sc~L:: 40 = I" MON: r~ ~ LDING - c~IIONS: r~K RtQuiR' H'-N ~R -~ ACKFILL~NG.. FCUNDA. ~' H,~AL ~,,~OVeRING.~ip, LIN" OTTO ~'. L~ce~sED ·