Loading...
HomeMy WebLinkAbout9714-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy z10070 No .................. Date AugUllt 1.1 ~ 19 130 THIS CERTIFIES that the building ................................................ .1095 Sleegy Hollow Lane, Southold, New York Location of Property ~s~ ~oi ...................... '~$~/e~t' ....................... ~$~/e} 78, 10.14 County Tax Map No. 1000 Section ............ Block ............... Lot ................. 6551 '12 Subdivision. Sleepy Hollow .Filed Map No ......... Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... M..ay...1.(~, ....... , 19..7..~ursuant to which Building Permit No....97..1.~... ~ ............ dated May 10 19 78 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Private One-family Dwelling }telen M~ Rabe The certificate is issued to ..................... [o~n'o'r,'~ ................... of the aforesaid building. 8-S0-48 Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO .... 46~662 .......... ._2'~" ... ....... Building Inspector Rev 4/79 FOI~M NO. ~ 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? 9714 Z Permission is hereby granted to: .../..~.-..~. .......... ./~.!:~z~..:..~/..~-.::i.~.~./.. ................... .~,/c ....... k(~:.!...~.:...t'/. ......... t~.:......~:.~..~.~ ....... pursuant to application' dated .................................. ~.f~./.!.~........=.~..., 1~..~....., and approved by the Building Inspector. F ~. //~ ~__ Building Inspector FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, 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. Fina~ approva~ of Health Dept. of water supply and sewerage dispose~-(S~9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and ~imilar buildings and installa- tions, 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. 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 featu res. 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupency $1.00 $5.00 New Building . ~../~ .I,.~'. ..... Old or Pre-existing Building ............ Vacant Land ./4 ~'~") ....... Location of Property../. House No, ' 'Stre;;' ' / Hamle't Owner or Owners of Property .../'L.~"L. ~.~..._/[~ .... l~./~ .'BJ~ ................................ County Tax Map No. 1000 Section . .~.3:~1 ....... Block .... ~ ...... Lot... J~. ~. ......... Subdivision ................................. Filed Map No ........... Lot No ............. Permit No,C~.'].[ .~. :~. Date of Permit ~'~' J(~/~8 .Applicant ..~, .~..&.. Health Dept. Approval . .~ ~ ...... ~. ~ ........ Labor Dept. Approval ...................... Unde~riters Approval..~. b .,~. ~ ~. ....... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . ~ .................. S.bmitt.d ................... Construction on above described building and permit meets all applicable codes and regulations. / - Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 B.,e Janua~'y lqo 1080 AppUco,io. No.o./,icg¢~?94 N 463662 THIB CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ~}elen Rabe, 31eepy hollo~ La. in the foiiowlng location; [] Basement [] Ist Fi. [] 2nd Fi. Section Block Lot was examined on J a ,ltla l?y 10 S ].9 !~ ~ and found to be in compliance with the requirements of this Board. 3,,.E.L ...U..,?E' SERVICE DISCONNECT i NO. OF S RANGES SPECIAL REC'PT R TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLE1 ~ OF CC. COND. NO. O~ HI-[~G A.W.G. OF HI-LEG EXHAUST FANS DIMMERS E NO. OF NEUTRALS O~ NEUTRAL Thermal comfort0 Inc. 25A Carlough P.d. BOhemia, ?;.Y. 1171~ ~1e.903-~i G~N~RAL MANAGER Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. 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. ORDER TO REMEDY VIOLATION (owner or authorized age{.n.~..of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance Other Applicable Laws, Ordinances'or Regulations / (state cha(acter of violation) (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the I,aw and to remedy the conditions above mentioned forthwith on or before the ................ :......~..:::; ....................................... The premises to which this ORDER TO REMEDY VIOLATION refers are situated at ...County of Suffolk, New York. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. / TOWN I-IF 90UTHOLD OFFICE OF BUILDING INSPECTOR TOWN CLERK'S OFFIO£ SOUTHOLD, N. Y. 11973 TEL. FO~M ~qO~ 1 TOWN O~ BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~xamined ......................... Application No .... , ............... ...................................... ......................................................................... {~uildin~ APPLICATION FOR BUILDING PERMIT Date ................................................ , 19 ............ INSTRUCTIONS o. This application must be completely filled in by typewriter or' in ink and submitted in triplicate to the Building it~spector, with 3 sets of plans, accurate plat 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 applicatioa. 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 port for any purpose whc~ever 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 o Building Permit pursuant to thc Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances re' 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 builde~ Nome of owner of premises iq~' ,¢,'Z If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No................../0~"~ ................................... Plumber's L,cense .......... Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: .~.~.-~../ ...................... '.. Lot No../..")~ ................ Street and Numbe .............. ~.. .~.~ ............................................................................ Municipali~ 2. State existing use and occupancy of premises and intended use ~nd occupancy of p~op~ed construction: o. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy..PJ,.¢/..~..~-....~...~''~'~..~ .................................... ....................................................... property lines. Give street and bio whether interior or corner number or description according to deed, and show 3. Nature of work (check which applicable): New Building'. ............ Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior ..................... Other Work ................................................ . .... (Description) 4. Estimated Cost .... .~...~./.¢~...~..0....~...¢..,0 ............................. Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .,.~..~L~. ............ Number of dwelling units on each floor ..¢.f~....~. .............. If garage, number of cars ....?~......./J~.....~. ................. ....................................................................................................... 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 sgme structure with alterations or additions: Front ........ ~O.,/ ........ .¢. ........... Rear ..,.~...i......O. ......... Depth ...... .~....~...~.-....~.....~. ...... Height ....... ./....~...f. .......... Number of Stories ....~...ffJ~,.~ ............. 8. Dimensions of entire new construction: Front .................... . ............... Rear ............................ Depth ........................ Height .................... Number of Stories ................................................................................................. I ................... 9. Size of lot: Front ............. /.~..~)..../'. ............................. Rear .......................................... Depth~...~...~. ............ ~ ......... 10. Dote of Purchase /.~ ~1 ~ ..... /~.,~4.!~1., ........... Name of Former Owner~-.~.~)...l,~'./c.~,,~r.¢/.~...¢.¢..~.., ........ 11. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .~.,..gl. .............................................. 13. Will lot be regraded ...~..~.,,~. ................ Will excess fill be removed f~rBn~ ErC,~i.ses:,(, ,.}~Yes (/~) No 14, Name of Owner of premises ¢:*J.~..LC.c/C....../~.&,~../.~..~.~.. ...... Address W~...~4¢,.~,~/..... Phone Na.t)~,~.?~'.~-..~.~... Name of Architect .............................................................. Address ................................ Phone Ne ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing ar proposed, and indicate all set-back dimensions from names and indicate STATE OF NEW ~RI~J ~ ~ ~ COLJNTY~~~.~~'~ .... ~~ .............. ............ being duly sworn, deposes and says that he is the applicam above named, He ,s the ............ ~~ ........................................................................................................................... (Contractor, agent, corporate officer, otc,) of said owner or owners, and is duly authorized to perform or have per~ormed the said work ~nd to moko and file this application; that oli statements contained in this application ore true to the best of his knowledge and belief; and th~ the work will be performed in the manner set forth in t~e o~plicotion filed therewith, Swam to be. fo~ 'me t~is ~ / ROD£R~ICK VAN TUYL. FI. C. EDUCATION LAW, SUFF. CO. DEPT. OF ~ HEALTH ~J~V IC,~ ~ ~ ~ '~,'TA'rEMENT OF IN'r'~N'r DATE: THE WATF..R SUFlPLy AND I~rWAGE: DIEPO~AL SYSTEMS FOR THIS RESI- DENCE WILL CONFORM TO THE STANDAJ~DE OF SUFFOLK CO. DEFT. OF H~LTH, ,.~ U ~. f~ C:~ .L. K_, 71'Y? APPROVED AS NOTED DATE=~-/~ ' ~' ~ -~[~-f~flZ_~ 9AM to 4PM FOR REQUIR. MAIN ROAD 1 OM [6' RC, PTq, 8~.,( 8?-( ~TO~,TAtt ~ ! .... ,T=0UN OAT 1ON VENT' FO. ON Z" P. AT c K 5 ~m¢ ' - / ~OLIO / 8'RC,WALL 5'HI(~H ON 8'x' 16' P,C. PT~, --"--.., 7.0 EZS~SbALTA6 g 'z.w 6 . f¢gY/v,©,¢'710.,*¢ ,.OZ..¢,,'~/ ""'"'"°""""'" .. p.o w o ~_q __q~.O_~_ 7'0 · o< CO/,, ~,,.. rj =- ~- -¢' " --"t~'" .z; - --' ---.-i-"-.. -.-, -- '~' '-'"- - .... ."FT. 4655 ENGINEERS SOUTHOLD, N Yr 'l'~I/' I 4 oF ',~ L L_ 'b ARCHITECTS & FNGINEERS /777 /_ 0C4'/-£-,:..) /,v. IALBERT '"'"'~'~'~' ~'' "" ~ ': ARCHITECTS & EN HL E ~ ~655 MAI~'~ ROAD