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Home My WebLink About11651-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 .... ~ t?.o.v.e.. ~.o.~r~ qt..~.o.~ $..~..ti q 9.~ ................: House No. Street Hamle~ County Tax Map No. I000 Section 0.77 .Block 04 .Lot 020 conforms substantially to the Application for Building Permit heretofore filed in this office dated dated ~..~ ¥..1.~., .................... 19 .~.~., 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 ......... .Abov. e groun.d poo.1 & deck. ROBERT T. ALBERTSON The certificate is issued to ........................................................... (owner, I~o'~. Y~K O~tY~ X of the aforesaid building. Suffolk County Department of Health Approval ............ .iq./.~ .......................... UNDERWRITERS CERTIFICATE NO ~ 7 7.7 9 3 2 ....................... Building Inspector Rev. 1/81 TOWN OF $0U~HOLIJl BUILDING DE"ARTME~T ~ Town HALL SOUTH'OLD, N. Y. ? Per~iss~onqs, hereby gionted tO: (THIS PERMIT MUST BE KEPT ON TI~.E'PI~EMisE~ uNTIL F~LL COMPLETION OF THE WORK,AUTHORIZED) ~.~e ..... ,,,..~.~.....Fz ..................... , ~.. at p~em,sea ............. .......· ...~...... .................... , .......... , ' ' ',. ,~'~. , .~',~..~..,/~..7... / ~.<~..X...~./...h...:~.~ ........... ~..,.~.....:~ ........... ~z~.:~...,.~.~ .............. CDu~ty Ta~ Map No. 1~0 Section ..... q::.7..~'~.?L,i.,~k~',i.,.:~.~",~.~Lot No. ~'~;~..,~., ........... pursuant to application dated ....... ~.Z...'..~.;~:...,~...., 19~and Opprov~ by the Butl~ing Ifispector. : ; ~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town H~ll Southold, N.Y. 1 lg71 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted mlmmmamm 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, Multipre 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 p~operty 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. Copv of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 New Building . . .~ ....... Old or Pre-existing Building .~ .. Vacant Land ............. Location of Property~.D. ~ .~../.(~-.~../, -~.//.~ House No. Street Ham/et Owner or Owners of Property . f~ ~4~,, :~-.. ~f~ ~.~4 ~ .................. County Tax Map No. 1000 Section ...q.~. 2 ..... Block .... ~. ~-/, ..... Lot ..... (. ~. ~ ..... z ......... Filed Map No. ~'/~// ......... Permit No. 5'/ .... Date of Permit, pplicant .~:~::...: ..::,:.~::~¢: .... Health Dept, Approval ........................ Labor Dept. Approval ..................... Unde~riters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Rev. 10-10-78 7 Construction on above described building and permit meets all applicable codes and regulations. cant , . - ~ .... , ................... , ;~/-~ ~, lOOO378 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1 BUREAU OF ELECTRICITY STREET, NEW YORK, NEW YORK 10038 ,,.,e : N 777932 THIS CERTIFIES THAT Robert Albertson, 2330 Brzgantlne SDr, outside in the followlng locatlon; ~ Basement [] ;st Ft. [] 2nd FL Section Brock Lot , . Octeber 30~1986 FIXTURE FIXTURES RANGES OVENS EXHAUST FANS EWITCHES FLUORESCENT SYSTEMS NO. OF FEET E OTHER APPARATUS: E R C (Swimming Pool)This certificate only. Because of unusual environments it is and/or repairs made by a qualified person. NO OFNEUTRALS1 covers compliance at the date of inspection advisable, to have frequent-test Stoves Elec., Inc. P.O. Box 126g Southold, NEY., 1197] GENERAL MANAGER Per- This certificate must not be altered in any man~er; return to the office of the Board i[incorrect, Inspectors ma), be identified by their credentials. COPY tar BU~ kD NG DEPARTMENT THIS COPY OF CERTIFICATE MU$~ NOT BE AL~TERED IN/ANY MANNISR, OF OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765~1802 To Whom This May Concern, We are unable to complete your Certificate of Occupancy because .of Lhe following reasons. /5/ An application for Certificate of Occupancy is not on file. No Underwriters Certificate on file. /5/ The check is(outdatedJnot on file.) /~/ No Health Dept. Approval on file. /~/ No final inspection has been made. Please contact our office on Thank you for your cooperation. Building Permit Building Dept. this matter. Z ***/5/ No Plumber solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FIELD INSF~TIO~ FOUNDATION (1st) FOUNDAT.ION (2nd) ROUGH FRAME & FLUMBING IflSULATION FERN. STATE ENERGY CODE FINAL DATE COMMENTS ADDITIONAL COMMENTS: FORM NO. 1 TC*~' ~ 0," SOUT:-iOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ~. (/. ..... 1 ,~, ,~ Disapproved a/c ....... ' ........ ~ ................. ', · ' (Building Inspector) APPLICATIO~i FOR BUILDING PERMIT INSTRUCTIONS Application Noff/'Tff../. ........ a. Tins application must be completely filled iu by typewriter or in ink and submitted in triplicate to the Build Inspector, with 3 sets of plans, accurate pict plan to scale. Fee accordiug 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 ou the dia~am which is part oi~this ap cation. c. The work covered by this application may not be commenced before ,issuance of Building Permit. d. Upon apprc.'al of this application, tim Building Inspector will issue a Building Permit to the applicant. Such pen sbalI be kept on tile premises available for inspection throughont the work. e. No buildJag shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Oecupar s!:all have been granted by the Building Inspector. APPLICATION IS I-tEREBY MADE to the Building Department for th& issuance of a Building Permit pursuant ~.o Building Zone Ordinance of the Town 'of Soutbold, Suffolk County, New York, and other applicable Laws, Ordinances P, egulations, for the coustruction o[' buildings, additions or alterations, or fo.~emoval or demolition, as herein describ The applicant agrees to cmnply with all applicable laws, ordinances..buj.14fnadSode,~~h¢~sing codec, and regulations, ~nd adtmt authortzcd respecters on pretmses and tn bmldmgs for ne . ~ ~0, R~Tn¥' 'i~ ~ 'c~);poration) .. ......... (Mailing address of applicant) State whether applicant is oxw~er, lessee, agent, architect, engineer, general contractor, electrician, plumber or build (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate offi~ Builder's License No ........ .~.~-..~.7 ........... Plumber's Licens~. No ......................... El~ctrician's License No.' ...~...~: .f/Tr.. .......... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ House Number Street Hamlet County Tax Map No. 1000 Section g. ................. t~/-~ Block . ,.0..~. ........... Lot..~. ~(~..-). ...... Subdivision (Name) 2. State existing use and occupancy of premises and intended us~ and occnpancy of proposed construction: E i ting use and occ pa y Nature of work (cheek whicli applicable): New BuLlding . . .' Repair .............. R.cmoval ......... Demolitlon .............. Other Work ............. If dwelling, ntunber of dwell ng nnits ............ (Description) (to be paid on filing this application) Number of dwetling units on each floor ............. If gorage, number of cars .. ~ ................................................................ If business, commercial or nixed occupancy, specify ~ature and extent of each type of use .............. Dimensions of existing structures if any: Front ' Rear Depth Height ............... Number of Stories ................................................... Dimensions of same stmctur~ with alterations or additions: Front Rear Depth ................. I .... Heiglit ...................... Number of Stories ................. Dimensions of entire new cot struction: Front Rear Depth Height ............... Number of Stories ................................................... . Size of lot: Front ' ' Rear Depth Date df Purchase ........................ ~.... Name of Former Owner .......................... Zone or use district in which )remises are situated ' ' Does proposed construction ~ iolate any zoning law, ordinance or regulation: ............................. ..... . ...................... Will excess fill be removed from premises: Yes lq Will lot be r~o.ad~d ...'. Name of Owner of premises .................... Address : .................. Phone No ............... Name of -\rchitec! ! . Address Phone No Name of Contractor ....... i: .................. Address ................... Phone No ............... PLOT DIAGRAM Locate clearly ~d distinctly !all buildings, whether existing or proposed, and. indicate all set-back dimensions fro: p~operty lines. Give street and block number or description according to deed, and show street names and indicate wh~th, ;ntcrior or corner lot. ~TATE OF NEW ~ORK, ' (Nanie ofindMdual si~ning contract) .... above named. Ilo is the ' (Contractor, agent, corporate officer, etc.) o'r said Owner or owne~, m~d is d~dy~ . at thonzed to perform or have performed thc said work and to m~e and file fl~i applicati0n; Qmt all staD2mcnts con tamed in this application are true to the best of his knowledge and belief; and that th work will be performed in the man,er set forth h~ the application filed therewith. ~'wor'n to before me this VARITYPER FORMS LAYOUT SHEET II -L