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Home My WebLink About11550-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ... 9.n.c...f .a.m.~. ~. 7..~.~.e..]_ .],.~.n. ~ ...................... Location of Property ......... 6.1. ? 9..H.o. r ~9.n. . [., .ap.e. ............. .~ .o.u.~. h..o.l,d. ............ House No. Street Hamlet County Tax Map No. 1000 Section . 9,5.4. ....... Block ....... .0.3 ...... Lot ....... .0.1.7. ...... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .J .a..n.,...1 .2 .......... 19 8..2. pursuant to which Building Permit No..1.1. 5. .5.0.Z .............. dated ...J.a..n.,.. 1. 2. ................. 198..2., 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 ......... .... 9.n.c.. ~..a.ra.~.z. 7..dy.e..~ .~.~.q ¥ .. .................................................... The certificate isissued to RICHARD & SUZANNE GILBRIDE fowner, Y~,Y~c.~YoZ of the aforesaid building. Suffolk County Department of Health Approval 1 2- S 0- 01 UNDERWRITERS CERTIFICATE NO .... N 5 83 0 1 1 Rev. 1/81 Building Inspector BUILDING PERMI1, (THIS PERMIT MUST BE KEpT ON THE PT~E/~ISI~S UNTIL COMPLETION OF THE WORK AUTHORIZED) i N°. 1~1550 Z Dat. , I~ULL Permission is hereby granted to: ~t ptemh*$ located at .......... ~ ......... Cou/~ty Tax Map No. 1000 Sect,on ...~.....:. BlocE {~,.~.; ........ ~Lot No.....~.~..7. ...... pursuant ~ application dated .~~_~:..~......., 1~.~., and approved by the Building I~pe~or. ~ : ~ Rev. i6/3a/~80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A, This application must be filled in Wpewriter OR ink, and submitted I ~ 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 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 pZoperty 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 New Building ..... ~.'~ ...... Old or Pre-existing Building $15.00 Date... ~-~. · . '?./! ! J .~..~:~. · ............ Vacant Land ............. Location of Property ....~. ...................................................... House No. Street Ham/et Owner or Owners of Property ..... ~..%k. ¢.C ~... ?...~. d. :~.~..~?..~. .....~ ~ ( ..~. I)?.CC ............. County Tax Map No. 1000 Section .. ~'.0..~.~. ........ Block ...... .(~. [~ ..... Lot ..... .(~.1.7. ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No..]./.~,~:~.C/..~. Date of Permit .~./l[ .~.-.Applicant . .~;.c.~..1/J.. [6. ?.Ll~.~.~.~3. :~ .... Health Dept. Approval . J.~.'..~:Q.'; ~ ~ .......... Labor Dept. Approval ........................ Underwriters Approval . ~. ~.-~. ~ O. ~ .~ .......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted ............................. Construction on above described building and per,it meets all applicable codes and regulations. Applicant.. . : ' . ............. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELEcTRI,GIT~Y 85 JOHN STREET, NEW YORK, NE~W yORK 10038 ~ November 11 1982 Gate ' A..lica,,onNo. o.fii, iee~99-8~ N 583011 THIS CERTIFIES THAT ~t 11~0 only the electrical equip~nent ~ described below and introduced by the applicant named on the ab~o application number in tl~ premises of Richard Gilbridge, Hortons La 6170, 8ou~hold, N~Y. i~ ~he followlng location; ~ Base,ne~t ~ lsZ Fl. ~....~.,.i.~do. November 4, 1982 FIXTURE OUTLETS i5 ~ECEPTACLES SWITCHES FIXTURES [] 2nd Fl. Section Block Lot and found to be in compliance with the require,nents of this Board. RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS DRYERS SYSTEMS E OTHER APPARATUS: 1-G.F.C. I~ 1-Smoke detector E R V I C PER ,~ OF CC CpND, NO. OF Hi-LEG OF HI-LEG NO.O~.NEUTRA AW.G, OF NEUTRAL 1/0 Richard W. Gilbrtde 6170 Hortons La. 8outhold, N.Y. 11971 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 THIS FIELD~IN~%ECTION COMMENTS FOUNDATION (Ist) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY G~OD E FINAL ADDITIONAL COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Ex m,nod ..... ^pprov d ....... I Permit Disapproved a/c ....... ; ............... .Y7 ........... (Bui~ting Inspector) APPLICATION FOR BUILDING PERMIT Application No././..~.~. · ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi 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 stree or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap~ cation. 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 pern shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or nsed in wbole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION IS HEREBY NIADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town ~f Sonthold, 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 describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors ou premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) ....~.?.../&<: ~...?.e..~,...~:q~.,.<,i>... ......... (Mailing address of applicant) State whether applicant is mvner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build. .... d u/mc K .................................................................................. Name of owner ofprc,nises H~ff../Z)/,'~ ~,(Z~/~. (¢"~ (as on the tax roll or latest deed) If applicant is a corporation, siguature of duly anthorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License N,~) .... .-~.. ~'. d."~..' ............ Electrician's License No.' ...................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ House Number Street Hamlet County Tax Map No. i O00 Section . .O~q'~... ' .... Block .... ~..~ .......... Lot....C?/? ......... gq/.~./P'<~ Filed Map No Lot ~- Subdivision (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................. / New ~;,,;f,~ia~ .,. ~ .... 'Addi{~on ' A(fc'r'at~r~'~ ,. Repair Remo~'al Demolidoa Other ;Vork ~ ~/ ~ ' (Description) ~:¢a~a~dCo,~ ......... ,~/gP~ . .............. .. . ~e . . ............... .......... . : (to be paid on filing tills application) If dwetling, number of dwelling ~nits . :. ~.~ ..... Nmhbcr of dwelling un,ts on eacil floor... O.M.C ........ If garage, number of cars ... ~fi~ ~ If business, commercial or mixed occupancy, spec~'y hatnre and extent of each type of use .................... .... ' Front ~¢~ Rear Depth Dlmensmns of emsnng structures if any: ' : ..... lteight Num bet of Stories' Dimensions of same structure with alterations or additions: Front ~¢W~ ........... Rear ................. Depth .................... :.. Hei~tt ...................... Number of. Stories ....................... ..... ........ ..... ......... ~.q ~. .... Num~ber of Stories - -" Height ....... /~ ..... ,..' /~0 ' pth ~6 Size of lot: Front.. .. ..........Rear ...................... De . ..- ............. Date df Purchase ..................... Name of Fo~er Owner ;. · .; ..... ' ..... - ...... m wh ch pr{m~ses ares~tuated ' ~ ~ ~e Zone or use district .... o - ': Does proposed construction violate any zoning law, ordinance or regulation: .~O ..... ...................... Witl lot be regraded .... ~O...' .............. :...~Wlll excess fill be removed from premises: . Yes Name of Architect .~q~'P..~q~ ~q~ ....... ... Address .................. :Phone No.. ~~... Name of Contractor ~ %e~. Address - Phone No PLOT DIAGRAM Locate clearly and distinctly all~ buildings, whether existing or proiSosed, and. indicate ,all set-back dimensions fi'om /property lines. Give street and blockinumber or description according to deed, and show street names and indicate whetiler atcrior or corner lot. , ' , °' .".. i S.S .~¢..k./~ p-.k .MY.,..~..[J0gl.0.?.i ................... being duly sworn, deposes and says that he is the applicant (Nanie of indMdual signing contract) ze named., stile .................. , ..................................... ~ .............. ~ .. ............. : (Contractor, agent, corporate officer, etc.) aid owner or owners, and is didy authorized to perform or have performed the said work and to m~e and file tlfi~ .~plication; that all statements contained in this application are true to the best of iris knowledge and belief; and that 'ork will be performed in the manner set forth in the application filed therewith. worn to before me this i ........ I..~ ........... day 6f ....... ,J,,q~¢~q./2.{.t, ........... 1957-. Public : Co nty otary , ............... ' .................. ti