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Home My WebLink About11612-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..g. 1. 1. .2,.6.1 .......... Date ...... 9.c.~.o.~..er..1.8. ............... 198..2. THIS CERTIFIES that the building ................................................ Location of Property . t). .9 `9.3 5. .............. .~.qr .~h. ?.o..aC ................ .... House lye. Street Hamlet County Tax Map No. 1000 Section . . .0 .5.1 ....... Block .0. 3. ............ Lot .0. 0..8..&.. 0. 9.9 ...... Subdivision ..... .X ......................... Filed Map No..X. ...... Lot No...X. .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·. ~i.~.CD..3.1 ......... , 19.88pursuant to which Building Permit No...1.1.6.1.8..g ............ dated .. gl~.~. J, [. 2 .................. 19.8.8, 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 ......... ·..a.1. ~..e.z'.~.~.$9pp..g. 9..a.n...e.x.i.~. ~..~p,_~ .o.p.e.-.f ~..m.J..]...~...d.~.e. 1..1 .:tp.~: ..................... The certificate is issued to ..... .S.~. 1...C.a.t.o..l..~ .......................................... (owner, of the aforesaid building. Suffolk County Department of Health Approval ... g.o }..~..e .q.u.t.? .e .d ......................... UNDERWRITERS CERTIFICATE NO ........... ~. ,5.6.5. Q .2,9 .......... 7 ................... Building Inspector Rev. 1/81 'vow. oF s0u~"% BUlLO'NG O~PA~LT~mT TOWN HALL SOUTH'OLO, N~ Y. BUILDING P,I~RMIT (THIS PERMIT MUST BE KEPT ON THE PREMISE~ UNTIL F~LL COMPLETION OF THE WORK AUTHORIZED) N:°. llgl2 Z Date ... ~.~,./.../,.....~....~....; ........... , 19. Permission:is hereby granted to: · i . ..,.,.,.~?../.....~,~.~/d...: ...... :.,..~ ............ - ~..~~...,~..~,.,,. .............. ,~ ... . . ~... . .~ ~~~ ...... ~.,. .~.~~. .. ?~ ........... ........... ~~ ....... ~~&~.: ....... : ..... :;......=,~.~, :. .......................... ~ ~,,~,o~,~ L..~.¢¢~ ........ ~~.:~.~%.~.....~ ......................... ............................................................................. ,..,....~ ............ ~~..~.~ Coufi~ To~ Map No. 1000 Section~..J ....... ~: Block ,~;~..,..;... Lot No.~.T~ ~ur*Oont t~ opplic~tion datod ......... ~..} .... ~nd ,pprov~ by the Build, lng Ir~sPecto~, iOOi071 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY E~ 85 JOHN STREET, NEW YORK, NEW yORK 10038 .ate ,~U~ ii, i~z AppIicatlo,,~Vo.o,,~ile i6z~-82 N 565029 THIS CERTIFIES THAT only the electrical equipment ~ described bel~ and interlaced by t~ applicant na~ed on t~ abdve application nu tuber in the premises of ~ ~la, ~/~ ~e ~, Old ~ 1~. a ~ ~., ~ld, N.~. in the following location; ~as~ment ~ 1st FI. ~ 2nd FL Sectiott Block Lot was examined on J~ ~ ~ ~9~ and found ~o be in compliance with the ~equiremenL~ o~ this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS D~SH WASHERS EXHAUST FANS OUTLETS FLUORESCENT 14 35 17 14 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C OTHER APPARATUS: Elec. Room Heaters:i-Skw 1-G.F.I. 2-Smoke Demeanors *' w. o. CC. COND NO, OF HI.LEG OF HI-LEG OF NEUTRAL N.Y. 11971 Ii~=578E Thls certificate must be altered in an office of the Board if incorrect, ,COPY FOR BUI THIS COPY ANy MANNER. Memorandum from.... BUILDING INSPEC'FORS OFFICE TOWN OF SOUTHOLD Town HALL, SOUTHOLD, N. Y. 11971 765-1802 /0/4 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 from the 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" ladd uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusua~ 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 dwe[ling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date New Building ............. Old or Pre-existing Building(Z) ........ =/Vacant Land Location of Property ...... ~ ...... .,=~.... House No. Street Hem/et Owner or Owners of Property .~L County Tax Map No. 1000 Section . .. ¢~/ ......... Block .. ¢~. .......... Lot ~¢~ 7.~.-.~¢.~.. Subdivision ................................. Filed Map No. ~ ,Lot No. ~ ......... Permit No ........... Date of Permit . .Applicant ..... ; ........................ Health Dept. Approval .... .~. ............ Labor Dept. Approval Unde~r,ters Approve..~¢~.~.~ ........ Planning Board Approval .% ~ ........ Request for Temporary Certificate ................. Final Certificate'~.. Fee Submitted $ ........ ~'. ~ Construction on above described building ~[n~ perm}t~m_eets all app~cable~codes and regulations. Applicant. ............................. Memorandum from BUILDING INSPECTORS OFFICE TOWN OF SOUTHOLD Town H~d.L, SOUrHO~D, N. Y. 11971 FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 1000121 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~- BS JOHN STREET, NEW YORK, NEW YORK 10038 O.,e Febz~ary 8, 1983 App,c.tlon No...ft. 202643--83 N 5 9 2 5 0 4 THIS CERTIFIES THAT ~al Caiola, North Road, Southold, N.Y. in the following location; [~ Basement [] 1st FI. [] 2nd Ft. Section Block Lot was examined on F~ 3, I~ ~83 and found to be in compliance with the requirements of this Board. FIXTURE OUTLETS IECEPTACLES SWITCHES FIXTURES RANGES OVENS D~SH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET OTHER APPARATUS: 2/0 OF NEUTRAL ]./o Paul ~ Tow~ tiarbor Lave Soul:hold, N.Y., 11971 L.~. d282 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be credentials. DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY ¸Ii FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ., l~./.6ffPermit No. Examined .~.~./~..'...¢~.~*.... ^ppro,,ed APPLICATION FOR BUILDING PERMIT Application No../t.~.[.A.. .. ....... Date ............ , INSTRUCTIONS a. Th'is 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 stre~ or areas, and giving a detailed description of layout of property must be drawn on the dia~am which is part oPthis cation. c. The work covered by this application may not be commenced before issuance of Building Pe~it. d. Upon apprc:al of this application, the Building Inspector will issue a Building Pe~it to the applicant. Such peru shall be kept on the premises available for inspection throughout the work. e. No buildiug shall be occupied or nsed in whole or in pa~ for any purpose whatever unffi a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for th~ issuance ora Building Pe~it pursuant to t Buildiug Zone Ordinance of the Town ~f Southold, Snffolk 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 T~e applicant agrees to comply with all applicable laws, ordinan~uilding code, hons~code, ~d regulations, ~d admit authorized iuspectors on premises and in buildings for nec~sa~ i~specti~ __ ( ~ /(Si~ature ?f applicant, or name, if a corporatton) , / H~ ~ ~.' .- ( ...... ~ --'"~' ' ~n~.~:~.,,~....~.x~ ~ ~ .._ ....... (Mailing address of applicant) State whether applicant is oxw~er, lessee, agent, architect, engineer, general contractor, electrician, plumber or build N,'un¢ of owner of prcnliscs ..................................................................... (as on the tax roll or latest deed) If applicant is a co¢oration, signature of duly authorized officer. (Name and title of colt)orate officer) ~ X,~ ~ ,,~ mmber's Lieens~ ~'o.. %.~O..~. .............. Elactrician's License No.' ...................... ~-"~-'~ ~/~ ¢~d c Other Trade's License No -- -- Location of land on which proposed work will be done ............................. ~ ................. ..... f ............ . ..... ,...G.. ................. House Number Street Hamlet County Tax lVlap No. I000 Section ....~...\ .......... Block .¢~...~ff~.. ............ Lot~.~..47-..~..O.S .... Subdivision ..................................... Filed Map No ............... Lot .............. (Name) 2. State existing use and occupancy of premises and intended usq, and occupancy of proposed construction: a. Existing use and occupancy ..... .~ ..................... b. Intended use and occupancy ............. ~...~M-,gTS..'.'.';~. ......... ' 1. Nature of wort: ~check wi:ict,[applicab e): New Building .......... Addition ..; ....... Alteration ,.. .... Repair .... Hi ....... Removal ·: .......... Demolition ........... Other Work .............. ~/~ ~--Ot9 (Description) ' Estimated Cost... .... ~.. .i.. .~. · t .................. Fee .......................... , .......... , ] (to be paid on filing this application) If dwelling nunlber of dwelling unitsi . . Numberofdwellin nits on each floor ............... Ifg mb f ' arage, nu er o cars If business, commercial or mixed occu >ahoy, specify h0ture and extent of each type of use .................... r'~L' ' Dimensions of existing structures, if ar y: Front... Rear Depth Height ............... Nmnber of Stories ....................................................... Dimensions of same structure with alto rations or additions: Front ..., .............. Rear ................ '. Depth i He gl Number of Stories ~ Dimensions et'entire new construction Front Rear Depth Heigt~t ............... Ntm~ber et] Stor/es ............................... ' }. Siz,. of lot: Front .~,~'~:..~'.t-&x.'9.~4 .... Rear ...................... l~epth ............. ,.,.. .. ). Date df Purchase . .~t'x ~ .~1.'9. ~.l.5'e~.-a. .......... Name of,Fore, er Owner ~ ~"~.¥.~. ¥~,..~'?~.~_e,.~q~ .... 1. Zone or use district 'n wh'c ~ pro nises ~re~ s'tuated ~: .~'~,\ ~..~-~lrT.'l ~ .-~,,,r-x e-_,o~\~c,.,'i-e,, L Does proposed constructmn v~plate an~, zoning law, ordinance or regulation: .'~i"~{D ......................... t. Will lot be regraded ...... .~'~.,o'....]. ............. Will excess_fill be removed from t~remises: Yes . L Name of Ox.n.r of pie,nibs . t>,~..~:~..~,~..\.e~ ........ Addr.ss., ........ Phone Name of Arc tact A-o.~..?o~ .,.,q¥2-) ~ .L'i,.~ ...... '.. Address gl.e.~t.' ~.~.{x.,?~>.,.~..~L~rs~,Phone Ma Name of Contractor ~e,..\ ~t:,:3 A ..... Address ~q~,.~'~,e... Ph ........................ one r~o ............... Locate clearly and distinctly rdl build[ roperty lines. Give street and blo~k numb~ .terior or corner lot. PLOT DIAGRAM ~' '.gs, whether existing or proposed, and. indicate all set-back dimensions fron : or description according to deed, and show street names and indicate whethe lATE OFNE~YORK, . SS ~¢ .... · ', 'i i } '' ~ .............. being duly s~vorn, deposes and says that he is the applicant ' ( ' ' ' ' 'g~ '~g onlract) ~ow: named. e is the ............ i ................................................................ i ~ (Contractor, agent, corporate officer, etc.) f said 0,~ner or own'e~, ~d is dt~ly authorized to peri'erin or have performed th~ said work and to m~e and file )plicctionl; l]mt all statements conitained iq this application are true .to the best of his kno~vledge and belief; and that the · 6rk will be performed in the manner set forth h~ t ~e application Hied tt, erewith worn to before ale this ~ ' ' ,:: , c_ c Ccm~gisl~~ ~e,,l . , " ' / , ,' (Signature of applicafl't' ,b' ~0, 2)00 s: 'fi~,', ~l 0 · t-,/.,v: /'7'r1. tOOO~ ,m.cT. FoLLOWiNG INSPr:cTIONS: 1, FouNDATION "TWO REQUIRED FOR pOURED coNCRETE 2. ROUGH - FRAMING & pLUMBING 3. INSU~¢tON MuST FINAL - co~TPUCTION ~' BE CoMpLF%E FOA C O. ALL coNSTRUCTiON SHALL MEET THE REQUIREMENTS OF THE N, Y. sTATE coNSTR~cTION ~ ENERGY T REsPONSiBLE FOR co s.