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Home My WebLink About11576-zFO RM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..7,.1.1. 1.6~ .......... Date ...... ~.¢¢.u.~g...3.1 ................. 19B..;~. THIS CERTIFIES that the building ................................................ Location of Property . ."( .0.0 ................ l.~g.g.l~.z~.~..~.~n. 9 ............... qr.~.o.r!~. ....... House No. Street Ham/et County Tax Map No. 1000 Section . .q 1 5 ....... Block ...Q9 .......... Lot . .0. Q ~ ,.0.qD ....... Subdivision..h.~.n..d.t~..~.n.d .................. Filed Map No. 5.9. Q~ .... Lot No...~I ........... conforms substantially to the Application for Building Permit heretofore f'fled in this office dated ..................... , 19 ~.2~ pursuant to which Building Permit No ...................... dated . . . 12I.a.'r.h. t3...9 ................. 19.8.2. , 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 ......... ....,..p. : .cb?e. ......................................... The certificate is issued to ............... ~ .a.m.e.s..~1:..~¥ .r'.c~.k (owner, of the aforesaid building. Suffolk County Department of Health Approval . .1.2.-. ~ 9.-.1.6.. UNDERWRITERS CERTIFICATE NO ......... ~ .5,7.3~.6.~ ............................... Rev. 1/81 Building Inspe~[or - - ' [ vom~ so~ · TOWN OF,SOU~H~L~ · BUILDING DE~?RTME~Ti; , SOUTH'OLD, N~ Y. L (THIS PE~IT MUST BE KEPT ON :THE:PRE~)S[ ;UNTIL COMPLETION OF THE WORK AUTHORIZED) Ne ~576 z F~LL ;! Permission is hereby granted to: · ............ Co~6~ Tag Map No. 1000 Section .~ ...... ~.~.-....:... purs~ont tb a~iicotion dot~ Building Idspector. ~a~d ~pproYed by the FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hail 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 al{ 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 p~an 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 inspection of buildings or premises, or other pertinent informa- tion required to prepare a bertificate. 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 .i~U~. _ !.~. /¢o~,,~', New Buildlng . .V~... ........ - ............ Old or Pre-existing Building{X) - =/Vacant Land .......... Location of Property . . ~,,~:)~... ~/¥ l'-'/--J;~ ~ ~ ........ ~ · . .................. ...... O. ..... '... House Ho. Street Ham/et Owner or Owners of Property . . . [:~.1~1 ~_~,~....,~.J~, 1~ ~ ~:; C tyT M No 1000S ti ' BI k Lot ' ' oun ax ap . ec on .... , .......... oc ............................ Subdivision.. ~,~;F/¥.O.-,~...,~.../y'../-). ............ Filed Map No..'~:~.q?.,..Lot No. ~. ........... Health bept, Approval ........................ Labor Dept, Approval ......................... Underwriters Approval ......... Planning Board Approval .................. ~.. ~ Request for Temporary Certificate ..................... Final Certificat~ ,, ~ .......... * Fee ~ubmitted $.. ~, .a ~) .................... Construction on above described building and permi'(mee.ts all app~cab?_.co.das and regulations. c.o, ,a.a. '45q t ~ooo37a THE NEW YORK BOARD OF FiRE UNDERWRITERS BUREAU OF ELECTRICITY ~-~l~ ~,lj~l~ ~4~ 1~ 88 JOHN STREET, NEW YORK, NEW YORK 10038 N 57398B THIS CERTIFIES THAT in the following location; [] Basement [] 1st Ft. ,~.sex...i,~edo. AuguscIg, 1982 Ft. 3rd ~1, Section Block Lot and found to be in cornpliaAce with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS OUTLETS SWITCHES FLUORESCENT VAPOR 31 46 32 31 EXHAUST DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: Motors; 1-F 2"G.F.I. 'S ~-~llDke De~ecF. ors S E R HO. OF RC~COND, A w.G. OF CC. COND 1/0 V I C NO, OF HI-LEG A. WG O~ HI4EG E NO OF NEUTRALS A, W, G OF NEUTRAL 1 1/0 Charles ~4. ~all 760 iong Creek Drive, ~oucb~ld, N.Y. 11971 This certificate must not be altered in any manner; return to the office of the Board If Incorrect. Inspectors COPY THIS COPY, G...R^t ,^S^S~R Pe~ 11 , './'. ' moy be identified by their iN ANY MANNER. LAWRENr~E M. TIJTHILL March 2,1982 Rasidence Mr. James Syrcek Land's ~d, Orient Point Desi?n temoerature Design degree days l~side 70o~~ 6,000 Outside 10°F Area Insulation "U" 8F Floor R-Il .O8 910 i, Jalls ~-19 .05 1,955 Ceiling R-30 .03 828 R-19 .05 260 ~indows (Dbl Glass ~hermal~.69 453 Doors per code .40 46 thfiltraticn (Volume) .018 18,710 Fireplacei ( 20 cfm es) ~OSS 38o 5,850. 1,490 ?8O 18,750 1,100 20,5OO Glass 19% of wall area Weatherstripping all windo~,~ and doors Furnace to be 75% min. efficient Meating and Service lines to be insulated as per code ~xterior duct and non-combustible doors ~e be provided for fireplace Doors, Ther~osta~, Mot Water Meat~r and Caulking as per cods FIE~D INSPECTION COMMENTS FOUNDAT%ON (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: SUF~0LK COUNTY H~LTH DEPARTMENT DAT~PR 1 8 1973 'facilities For th~s location have been inspected by this ~epa~tment.and found '~ be satisfact°ry'~.Z_~ ~ ~htef o~ General Engineering ',~ DRIVE t. '> ~.z~'~'oo"~. - o -~ S,~6'3?'O0'tV. ~ 100 - AKSC~N !C'O. 0 ~OEM NO. ! TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...................... ..'.~/~. ........ , Approved ....................... 2..~.....~.'....., 19...~..L4~ermit No ..... /..(..~..Z..G....~.. Disapproved a/c .' ........... ~....'::."..~..¢ ..................... ~ ................... ............ ............ ............................. (Building Inspector) Application No. ,]..!,,..~-~.,E ........... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter art in ink and submitted in triplicate to the Building Inspector, with 3 sere 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 os 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 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 Occupat~cy 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 nam?, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................. ............................................................................................................. Nome of owner of premises ....~..~..~.~.3 ....... ~.~..~..%.%.~ .......................................................................................... ~plican~ is a corporate, signature o~uly authorized o~ice~. Builder's License No ..................................................... Plumber's License No..~...~....~...~~ Electrician's License No.~...~ ....................... Other Zrade's Ucen~e No ............................................... 1. Location of land on which proposed work will be done. M~p No.: ................................... Lot No. ~ ........... Street and Number" ~.~ '~OO ~(f ~"~: ...... ~'~ .................................................................................................... Municipali~ 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 ..~.~.,,~{.~.~..,~.~G,/.~G.= ......................................................... 3. Nature of work (check which applicable): New Building .... Addition .................. Alteration ................. Repair .................. Removdl .................. Demolition .................... Other Work ..................................................... .~.~ ........... : ............ ..~...../..:L- ~ ..................................................... (Description) 4. Estimoted Cost ...... ,~..,?....., ......................................... Fee , ~,to be paid on filing this application) 5. If dwelling, number of dweiling units ........ ~ .............. Number of dwelling units on each floor ......... -- . . .' if garage, number of cars ..i..~...~..~..~, ....................................................................................................................... 6. If business, commercial o4 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 structu? with alterations or additions: Front .................................... Rear ............................ Depth ................................ i Height ............................ Number of Stories ................................ 8. Dimensions of ~entire new cbnstruction: Front ...... .~....~.....( ................. Rear ...~9...~.......O. ............ Depth '~ Height ..,,~..~.. .......... Number of Stories ..... ~ .................................................................................................... i ....... 9. Size' of lot: Front ......... ./.~.~. ...................................... Rear ...~...~..~.. ........................... Depth ..../.~..~. ................... 70. Date of Purchase ..... /..~...~f/. ...................................... Name of Former Owner ,4(.~.,.~/.~.,f,..~..~.~.~,~.,~'~4~,~.,~,/,,. ..... 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~..~. ............................................ 13. Wil! lot be regroded ..... ~...~. ....... W l excess fill be removed from pre/~ises: ( ) Yes 14. Name of Owner of prem ses .~./~...~..~...~.....,,,K'...U...~..~.=~,T¢.~,~,,,, .....Address 4~.~./~./;f:.Y/)~.,/~.~ Phone No. ~_~;.~.;.~..7....~..~ Name of Architect ,L..~.~...'~, ..~.u..-~'..~.6..u~.. ..... Address .............................. Phone No ......... ~ ............ Name of Contractor .'.-~....q.~'..cc.o.....~..f4.~...S.k.,..~..~..~. .......... Address .,,/.,,~.~.m~;.ee~T../~.~ Phone PLOT DIAGRAM , Locate clearly and distinctly ~11 buildings whether existing or proposed, and indicate all set-book dimens ohs from property I'nes. G~ve street and block number or descnption according to deed, and show street names and nd cate whether interior or corner lot, STATE OF NE~YO~, , ,Z }S.S COUNTY ~&'. ........ .... ~,:,...~.~..~..JmT~.~.....~....~.~,...,being duly sworn, deposes and says that he is the applicam. (Nome of individual sl:gning contracf) above named, Fie is the (~ ~ .~.;"~'~-~'-~ .~. ~ 'z~ ~...'vT' (Contractor, agent, corporate officer, etc.) of said owner or owners, end is duly authorized to perform or have performed the said ,work and to make and file this application; that all' stotemehts contained in this application are true to the best of h~s knowledge and belief; and that the work will be performed in[ the manner set forth in the application filed therewith. Sworn to before me this ~ ,~, ....... ....... ................................ ~ ~ / ELIZABETH AN~ NEVI~E ,- ~ / .OTAR~ PUBLIC, State of Hew YO,~ ' I Term Expires March 30, iNSPECTION REPORT -~'~umbeF Jx szreet) (blhnicipality Sub, division_ ~~.~ plap No, ~'W~ .Lot(s) ' (type) / {owne~-ten~) Admitved by:, ' Accomp~ied by: ~ ~- Key available SufFolk Co. Tax No. Source of request Rd.~arks: Inspected by: Time Start (~'Of end /l .dS ::/%