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Home My WebLink About12001-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate O[ Occupancy No. Z. .1.5.0.2-8. .......... Date October 22 ..... 19 .8.6. Addition THIS CERTIFIES that the buildhxg ................................................ Location of Property ;..P.v..t:..R.d.:..E.a.s..t..E.n?.. Fishe.rs Island Mouse tVo. ,.,etreet Hamlet County Tax Map No. 1000 Section 1 .Block ,2 .Lot 4 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore tided in this office dated ·..QOL....211 ........... 19 .8.2. pursuant to which Building Permit No..1.2.0..0.1.~ .............. dated . .blo¥,..4 ................... 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 ......... ·., Co~str~t. ~igio~% .~o, .e,x.$.s,t.i,n.g. accepsory storage building The certificate is issued to DENIS O ' BRIEN ..................... ?olgn'oi., ~if~k~f~'M .................... of the aforesaid building. Suffolk County Department of Health Approval .......... N/A ..~.. UNDERWRITERS CERTIFICATE NO N520980 N485968 Building Inspector Rev. 1/81 BUILDING DEPARTMENT TOWH HALL SOUTHOLD, N.' Yo BUILDING :PER~iT (THIS PEPJV[IT MUST BE KEPT ON:THE PP, M~ES UNTi~:FULL : COMPLETION OF THE WORK AUTHORIZED .~.o ~.~oo~ z ~,e..~~~ · · '"~ ............ "' ~....,,,.~'~ PermissiOn is hereby granted to: . ~ ............ , ~ ..... BUilding Inspector. ~ee ,....Z.~. .......... at premises .t ...................... Count7 ~ax Map No. 1000 Section ..... ~./...:... BIo~k::,:, ,:,,. pu~suant~ to application dated ..... ;..~i... Rev, 6/30/80 .~...~ and approved by the Inspector FIELD INSPECTION ~, COMMENTS FOUNDATION (/st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS 1~t~. BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 100318 THIS CERTIFIES THAT otdy the eleetrlca! equipment as described below and introduced by the 9pplieant named o~t £1~e above a~ollcatlon number ir[ the premises of ir[ the follotvi~g loc~tlon; [] Basement · ~.,~..~i.~don July :tO, 1.980 HXTURE OUTLETS SWITCHES and found to be in compli~e ~ith the require~nents of this Board. RXTURES RANGES OVENS DISH WA~ERS EXHAUST FANS DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: R V I C NO. OF HI-LEG 2/0 L Z/O Fisb~s IsLand, N~I. O&~90 ~c. 1297 g ll This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified COPy FOR BUILDING D~TMENT. THIS COPY OF CERTIFICATE', ~U~T NOT ~N ~Y THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipntent as described below and introduced by the applicant neared on ~he above application r~u~mber in the pretnises o] ¥~. &, ~s. ~s O'Brian, Ease ~d, Fi&~rz I~lend, N. Y. i,~ the followlng locatlon; [] Basemettt ~ Ist FI. ~ Smd FL Section Block Lot was examined on ~y ~9 ~ ~9~ ~dfot~.d to be ~n compliance with tke requlrernents of this Board. FIXTURE OUTLETS SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS NCANDESCENT FLUORESCENT DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIMECLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C OTHER APPARATUS: El~c. R. oo~ l~t:ers:,3-2, Panelboard/s ~ 1-2~ir. 100~:, 1~16c~ 1-5~ $~a Services Plsher~ Island, N. Y. 1 06390 L~m ~23 2939 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspecto be identified b~thek.,,,er'edentials. COPY FOR BUiI.D'NG DEPARTMENT. THIS COPY OF C,ERTIFICAT~ NtUSl~ N~T B~[A~T~RE~IN ANY MANNE.. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- t802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted .a ~ 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 disposai-(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" land uses: 1. Accurate survey of property 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, C. Fees: 1. Certificate of occupancy $5,00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O. $15o00 Date .O~tobe.~. 9, 1986 NewCons truc t i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ............................................................. House No. Street Ham/et Denis O'Brien Owner or Owners of Property ............................................................ ty pN 1000S ti 0o4 Coun Tax Ma o. ec on.........,.,..001. Block .... ...........02 Lot.. ............ . . Subdivision ................................. Filed Map No ........... Lot No .............. Permit No!2.0, ,0,1,~ ..... Date of Permit . .1. 1. ,/.4/.8.2~Applicant .. ?, ,a.~7. B:. Oood. hu~ Health Dept, Approval ........................ Labor Dept. Approval ........................ Underwriters/~pproval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .... 5, P.q .................... Construction on above described building and permit meets all applicable codes and regulations. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .~...~...~....., 19~.'J Approved .~.~. ~.... ~ .... , 1 ~...]~fPermit No. 'v/~.~...~./f..~ Disapproved a/c .............. ~'. ......... ~,~ ...... , / APPLICATION FOR BUILDING PERMIT Application No..~.~ · .(~)./ ....... INSTRUCTIONS a. This application must be 9ompletely filled in, by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan t~o scale. Fee accorc~ing 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 of property must be drawn on the diagram which is part of this appli- 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 issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throug~hout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy 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 codlq, and regulations, and to admit authorized inspectors on premises and in building for necessary in~p c~ns. g / ~ ~r-"" ' ... ¥ .............. (~ignature of applicant, or nAinen if q corEora~n) ×. / 7./.. ..... (Mailing address of applidant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises..~ .... ~.~ .j ..... ~.... )~~..'v .,~..~..&.~), .~<' ~- ..... [ (as oxJJ~he tax roll or latest deed) ~) 5' '¢0 e" or'? ~). "/9. If applicant is a corporation, signature of duly authorized officer, r'"*P/xb,-- (Name and title of corporate officer) Builder's License No. ~~.'7..~..~... ~-~ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ., ) . . ~. ...... House Number Street Hamlet -',t o . ............ County Tax Map No. 1000 Section . .~d.: .,. ........... Block ..................Lot. Subdivision ..................................... Filed Map No. ..: ......... :. Lot ............... (Name) . . . 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~-~~ .~,/~.~.-~~ b. Intended use and occupancy . .~..-w-... ~ ............................ 3. Nature of work (check winch apphcable): New Building .......... Addition ...... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... .~.) : ~,~ ~ (Description) 4. Lstnnated Cost ...... ~..~.~.. .... Fee .. .1., .C)... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ..... ; ................................................................... 6. If business, commercial or mixe~ occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structurds, if any: Front ............... Rear .............. Depth ............... Height ................ Number of Stones ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8, Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ........... : ........... Rear ...................... Depth ...................... 10. Date of Purchase .............................. Name of Former Owner ............................. 11. Zone Or use district in which pr4mises are situated...~ ................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lo~ be regraded ......... ! ................... Will e. xc~ss fill be removed from premises: Yes No 14. Name Of Owner of premisesq~.~.~'\o:..~-....O..~ ~{,.~r) Address~J.~.'~.{¢..C.~j:u-.-.~.: .~.:. Phone No. ~.~...-. ~-~.~..'(~.. Name of Architect ........................... Address ................... Phone No ................ Name of Contractor ........................... Address ................... Phone No ................ PLOT DIAGRAM ~I]I~T9 -O~'[?' .t~.~.-.~. I. ~ .... ¢'' '. ..... ~...~.~ X~.~....Lr-..:...~...o-.~..Jr.~.~,..y ............. being duly sworn, deposes and says that he is the applicant ~ (Name of indivi.dual signing contract) above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manne~ set forth in the application filed therewith. Sworn to before me this ........ . .~. !. ~ ....... day ofi..~.~ ..... ,19 .~. Notary Public, ..... : .......~ .~.. Coun Notify public, State of New Yor[ (Signature of applicant) No. 52-9509185 ]Q. ualified in SgJJolk Coul~J~::~,~ t ~ ?~r 2 × ~" 9. s /6," O. C, ~ lq LL 3b a