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Home My WebLink About12026-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z. ! .3 ~.1.2. .......... Date . .d,u..n .e..1. t ....................... 19 .8.5. THIS CERTIFIES that the building ...... ~,D. D..~,T,~.O.N. ................................. Location of Property ....... ).qq...K.e.v.w..~.n..B..o.u.i.e.y .aF.d ........... .~.p.e.e. np q~..~ . House No. Street ...... County Tax Map No. 1000 Section 053 .Block 02 .Lot 025.1 Subdivision ?ECONIC BAY BOULEVARDFiled Map No .Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated · .Nov .8. ............ 198..2. pursuant to which Building Permit No .... 1.2..0.2.6.Z. ........... dated Nov 19 1982 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 ......... ADDITION TO EXISTING FISH MARKET. The certificate is issued to ....... J.OJ~N. ~....I~ $~I?.~ .................................... (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval N/3. #N590493 UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 Building Inspector TOWN OF ~o~ow BUILDING DEpARTM~N~ TOWN HALL SOUTHOLD, N.Y. BUILDING PERMITi (THIS PERMIT MUST BE KEPT ON ~HE PREMISgS UNTIL ROLL COMPLErlON OF THE WORK ^uTHORIZED) ~ Z N°. 12026 Permission is hereby gl o~ Premise~ located County Tog Map No. 1000 Section ...~....~. ........... ~ BloCk .,..~ ..............or No. ~., .................. ... ~...., 19....~ d ~pprov~ by the Building I~*pe~or. : ~";"~ ............ 7 :; ~ ~, FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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. 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 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 o 00 3. Copy of certificate of occupancy $1.00 / 4.Vacant Land C.O. $5.00 //. Date ...... ~./,/, /. ................. New Building .... ~X~. ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .... .4~,-.~..d). ..... /~'~(,~./.~x.,..~....~_j~..~. ~ ............ ~ ./~_~...~;~e~,~.K~ Owner or Owners of Property ....... ,~,(~ ,~,~. ............................... County Tax Map No. 1000 Section .. ,.~/. --.~-. ~. ...... Block.. ~..?~. ........ Lot..~...~. ?.7/'. ..... ~ub~ivision . ..; ..... - .......' ........... , ...... ' ~wap . ~ .......... ~ ............... Permit No./.~..O..~..~...~.~Date of__,~P~it/.~.~.~'~'...App licant...~/~'./(¢'. ~'Z' .~.-~¢-~' .~.~/ .......... Health Dept. Approval ...... .~././. ,C ............. Labor Dept. Approval .../Y./.~. ................ Underwriters Approval .~.. ,~..~..~...~z.'..~..~. ...... Planning Board Approval.. ~./.~..: ........... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ "~ ~'~ ............... THE NEW YORK BOARD OF FIRE UNDERWRITERS '1J000~63 BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ..,~ J~,~z =o, zos3 ,p,~,~.,o.~.o.~,~ z~?s/~ N 590493 THIS CERTIFIES THAT ~ only the e~ectrlce$ equipment as described below and introduced by the applicant named on the able appllcat~on number in the premises of i,~ the folto~ing toc~tio,~; ~ B,se)nent ~ 1st Fl. ~ ~nd FI. Section B~ock Lot was examined on d'~ ~7 ~ ~3 and found to be in compliance with the require,nents of this Board, FIXTURE FIXTURES 6 7 3 3 3 DRYERS RANGES OVENS EXHAUST FANS SYSTEMS NO, OF FEET E DIMMERS OTHER APPARATUS: E R V I C NO~£OF C~C~'COND' A W O OF CC. COND, A w, G J NO, OF NEUTRALS OF HI-LEO J OF NEUTRAL 310 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their cred&ntials. FIELD INSPECTION SOMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: N CO. ,.' FORM NO. 1 ~3c~.~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1802 Exatnined ~.O.-~...?..~. ..... 19 .~..7~~ Approved jd?~..~..../. ?. ..... 19 .~.~. Permit No. Z/~..~. . .~. '~ .~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No..4.~). .2.~ ....... Date ...z/~.~..~. .......... a. This application must be completely filled in by typewriter or in ink and submitted to the Building 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 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 throughout 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 ox 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 building for necessary ~. ~ ~ ~~,~.. .......... /~ ,n. ature of applicant, or name, if a corporation) 'c(¢(Mailing address of ffpplicant) .... '*' ~ ...... 6' .............. ,.~ ' q'.?" ......... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder, Name of owner of premises..~....'~--....~... ~ .... .~.' .... . .~...&~..~'~..~..'....~..c ..................... ~// · (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..... ~.~./.~. ............. Other Trade's License No...~..~./~ ............ 1. Location ofland on which proposed work will be done ~-'~o-~ ..~.~(t~.,.~,.~,.h. _~,~J:...~...~..¢~./~f~ House Number 1 ¥ ~ '~..~ ~.. /:,*,.~ . County Tax Map No. 1000 Section ..... 5.?. ......... Block ....... ~ ........ Lot...~. ~.'.( ........... Subdivision .?~., .r,,~YPY, ,~,..~.0~ ,~ ............... FiIedMap No. (I.~..~. ......... Lot .!.~. !..~...~.... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. E×isting use and .... .................. b. Intended and .... .................... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration Repair .............. Removol .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost ...................................... Fee ...................................... ~ (to be paid on filing this application) 5. If dwelling, number of dwelling ugits ............... Number of dwelling units on each floor ................ If garage, number of cars ...... , ................................................................. 6. If business, commercial or mixed Occupancy, specify nature and extent of each type of use ..................... 7. Dimensinns of existing stmctures,lif any: Front... ~..~..~ ....... Rear .............. Depth . ~, .'~. ....... -... Height O.~-.O. .r .......... Number of Stories .... /. ............... ) .................................. Dimensions of same structure with, alterations or additions: Front .~..d. ............ Rear . ¢~..'2r. f ............ Depth ' Height Number of Stories 8. Dhnensions of entire new construction: Front ...~2.~,.r. ....... Rear ...~. {-." Depth ~ f Height ,/~' ........... Number of Stories ....... ] ................................................ 10. Date of Purchase ..... '] fi' ~'~'' i ................. Name of Former Owner . J'~.or~ .~.4'/(;....~ .ff-.~ .2(.e ..... 12. Docs proposed construction violaie any zoning law, ordinance or regulation: ... ~(J.o. ......................... 13, Will lot be regraded . .~.0 ..... i .................. Will excess fill be removed from premises: Yes No Name of Architect ....................... ~Z).././h Address ................... Phone No ....... ./.~/.~..V. Name of Contractor ..... ~. ~ [,.~. . ............. Address Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and block nUmber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEURIX, .,~/ ~ S COUNTY ~.. ~ ........ co~tract~ - ' ~" being duly sworn, deposes ~d says that he is the applicant above .named. ~ He is the .......... ~ .............................................................. ~ (Contractor, agent, corporate officer, etc.) of s~d owner or owners, ~d is duly authorized to perform or have perfomed the said work and to m~e and ~e this application; that all statements contained ~ this application ~e true to the best of his knowledge and belief; ~d that the work w~l be perfomed in the m~ner set forth in the application filed therewith. Sworn to before me this NoD~ Public, ....... ~ ...... ~~~.. County // ~