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Home My WebLink About12057-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 ~.o.w. ~w.a~5~ ................................. Location of PropertyUoaso' ' County Tax Map No. 1000 Section ... ~ 02 ..... Block.. .... ~ ....... Lot ..... O.q.O .......... Subdivision. ~Sg~nd. Ea~.~ .......... Filed Map No. ¢~5~ .... Lot No ..... q ~ ....... conforms substantially to the Application for Building Permit heretofore fried in this office dated ... Xo~emhe~. ~ ~ .... ,19 B2 pursuant to w~ch Building Pe~it No... q 2.O~g ............ dated ... ~.~ omb~2. G ............. 19 ~, was issued, and conforms to a~ of the requirements of the applicable provisions of the law. The occupancy for which t~s certificate is issued is ......... Pot a new one ~amily dwelling ~ ~he a~eresa~d building. Building Inspector Rev. 1/81 BUILDING DEP~RTMENI~ TOWN HALt, ~ SOUTHOI. D, N. ¥.~ No. BUILDING PERMI? · (THIS PERMIT MUST BE KEPT ON 'FHE PRE/~IsES UNTIL I COMPLETION OF THE WORK AUTHORIZED) 12057 Z D% ........... ,. ........ Bull~lnO I~$pec~r. FULL · . . Per~msion ms hereby granted to.~ .................... ;..,~,..~ ............ ~.,..~,..;~....,...~?~ .............................. ~ ............... ~ ........................ ,~ ................... ~*, ......... /~...~ ........... ; ......................... ~OU~ I0~ MOp ~0. IUUU ~o~tlo~ ........................ DI~K ..... ,? ............... ~ ~0. ~ ....................... pu~Oant to application dat~ .................................... ....... ~..~....;;...., 19,....~;, and appr~ by the ; au{Iding 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 featu res. 2, Final approval of Health Dept, of water supplv 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-e_xist!ng" 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 certificate. C. Fees: 1. Certificate of occupancy $5.00 / / 2. Certificate of occupancy on pre-existing dwelling ~r land use $/~'/ $5.00 3. Copy of certificate of occupancy $1.00 o ate . ./vl . _;L T, / q g 3 .. New Building ~ Old or Pre-existing Building(X) ~ ~Vacant Land Location of Property I~ ~O (~.o~.~, L-w-l~c~'~.~t..~' .... ~.,Cz~...~cp]CL~-¢, ..... _ .......... .............................. Street tj Ham/et House No. Owner or Owners of Property . ..-7..CD... ~.~% ~'~ ~.~.~,,. ;6~._._ ~.'~-. ~..v~.... ,(,~.. p. ...................... County Tax Map No. 1000 Section .. · ~.G~ ~ .2.. ....... Block ...O..~- ......... Lot O t 0 Subdivision ~,'~)~\~y~.. ~-~:~r~ ~ .Filed Map No./-P..~ .~.~ .Lot No. ).3. 't_ll (~rl .~.. Date of Permit .......... Applicant .~..1.'~-:.~'..~-..~....~O. ?..~.~..~.. Permit No ................... Health Dept. Approval [~L ~O .[..-~.~. ......... Labor Dept. Approval Underwriters Approval . .I/~. ..................... Planning Board Approval ......... .. ........~ .., Request for Temporary Certificate ..................... Final Certificat~./~ .... - ......... - Fee Submitted $. : ~O Rev. 10-10-78 1000681 THE NEW YORK BOARD OF FIRE UNDERWRITERS 'C~q BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 .ate23, p.licatio Na.o. i' N 607136 THIS CMRTIFIES THAT only the el~trical equipment ~ described belo~ and intmduced by the applicant ~d on the above application ..~ber in tl~e prer.~ses of Mohr~g & ~, N/S of Cro~ 1~ l~d 135~ W/0 ~td ~., Cutch~ 102 8 15 in the/allowing location; ~ Basement ~ l~t Ft. ~ 2nd FI. Section Block Lot was examined on ~[~ 20 ~ 1~ and faund to be in co~npliance with the requirentents of this Board. OUTLETS 22 SWITCHES 19 NCANDESCENT FLUORESCENT 22 NO OF CC COND PER 1 OTHER APPARATUS: ~ht~mre Appliarice Feed'~rs: 1-2#14, 1~-2#12, 1~3~8. 1-G.F.I. 1-Smoke Detector R V I C OF CC. COND. l/0 AWG OF HI.LEG OF NEUTRAL 1IO Par~unt Elect. Co, 2041 $~elley Place. · ~ast Meaclce], N.Y,, 11554 ~[C. #533 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be iLO}NG DEPA credentials. FIELD~iNS~,ECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & FLUMBING 3. INSULATION FER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:~ APPLICATION FOR BUILDING PERMIT · INSTRUCTIONS · This application muSt be co,mplet~ly ,f'ffi. ed m by typewnter or m ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale, i~ a~o'l'dtng to schedule. b. Plot plan showing location of lot and of bulldinss on premises, relationship to adjoining premises or public streela or areas, and 8lying 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 Buildin~ Permit. d. Upon approval of this application, the Bulldin~ Inspector will issued a Building Permit to the applicant. Suoh pormit 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 whatewr until a Certificate of Occupancy shall have been ~ranted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depar~mant for the issuance of a Buildin~ Peamfit pursuant to the -~a~il, ding Zone Ordinance of the Town of Southold: .Suffolk County, New' York, and other applicable Laws, Ordinances or ~lations, for the construction of bulldinss, additions or alterations, or for r~moval or d~nolition, ~s herein _/he applicant a~rees to comply with all applicable laws, ordinances, building codl~t~louai~l code, andJesulations, and to it authorized inspectors on premises and in building ' tio~~,~ for necessary mspec '" i~~~~ ~ ...... .~.~ ~. ~. ~... .., Ol.ai~ address of ~p~ir. ant) .......... State whether applicant ~ lessee, agent, architect, e 8ineer, general contractor, electrician, plumber or builder. tax roll or latest deed) If applicant ~oo~l~om/n:~.~ure o/f~uly authorized officer. ...... Builder's License No .......................... Plumber's License No....'~..~...~?. (~..~.../'~... ..... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .. ~..~.~. ........... e~...~. ~. ~.~ ~..~..~. ............ do. ~. ~,~.~.... House Number Street Hamlet ~- ' .......... County Tax Map No. 1000 Section ../..~ ........... Block O~:~' Lot ~/~ Subdivision.. ~.'.~t//~g.~.. 4~./~'.~ ....... Filed Map No..~.~..~ .~.. Lot. ~/~'~ (Name) .................. 2. State existing use and occupancy of~_.ppremises and intended u.~d occup, an~._c~y of proposed construction: a. Existing use and occupancy ........ ~ ' . ............ 3. Nature of work (check which applicable): New Building ....... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... t~.~.i ~../iff. ~ (Description) I (to be pad on Filing this application) ' 5. If dwelling, number of dwelling units .............. Number of dwelling units on each floor ............... If garage, number of cars ...7-,~ ......................................................... .......... 6. If business, commerciai or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ............................................. : .......... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... .. Height ...................... Number of Stories ...................... 10 D t ofP rch ' Nam of Former Owner · a e u ase ........... . ................. e ............................. 11. Zone or use district in which prdmises are situated ...................................... 1.2., Does proposed construction, violate any zoning law, ordinance or regulation: ~O .............. 13. Will lot be regraded .... ~,~.¢~.,; ................... Will excess fill be removed from premises: 14. Name of Owner of prelllises . .?~./t~(~ l~F~.~Adaress . ..:~ ~ .~/g~...~-45~...l~Phone No. Name Of Architect . .SI. ~)~.~t~/~la~.t ...... ,.. Address . :~?~..<~¢.~... Phone No. Name of Contractor .. ~?0~2)'.~][. ~?g~]']~g:D~(Y.f~ddress ...~/.(eO..d..,/~: (<~. Phone No. PLOT DIAGRAM Locate clearly and distinctly allI 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 NEW Y~K,// county ................. ~ ......... being duly sworn, deposes and says that he is the applicant above named· He is the; .......... .~.~.~?.{ %'¢.fl~.. ............................................................ i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly 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 manner set forth in the application filed therewith. Sworn to before me this .. .......... / /~L =$927 ' ~iUFFOLK COUNTY HEALTtt DEP~Th~T SU~Y The sow~e di ~-,~:~x! a,~'~ water BUp~Iv ~T CUTCHO~U~ o~rE' NO~ 9, 1982 . , ~ ....... ~a~e be~m ~WN OF SOUTHOLD SCALE: / . = 50 ' t~sp~>c~,' ~'~ '~' 'n ~ ~.. SUFFOLK COUNTY, NEW YORK NO. 82- 710 HgAL~ OEPARTMENT-DATA FOR APPROVAL TO C~STRUC T T~ ~m~ FO~ W~O~ ;~ SU~E~ ~S ~' ~~] ~'6S~ANdE R AVENUE , YOUNG a YOUNG SUBDIVISION ~R ~ILED IN tH6 OfflCS 0~ rHK CLERK Of AtO~ W. YOO~G~ ~07~O~At SUFF~K COUN~ ON ~P~ J6, 19~Y AS FILE NO. 65JZ AND LAND SURVEYOR N.Y.S. UCENSE NO. 12845 HOWARD W. YOUNG, LANO SURVEYOR ~ ~ L~T~ ~ W~L(W)I~PTIC TANK(ST)a CES~OLS(~) $H~N HERE~ N.~ S. LICENSE NO. 4589~ IL --$9.27 ' ~ ~ ,, _;~ ~ . . ~ ~ ,hmJld ~ .oted that sm~e th,S ,~ ~ ~ I~ snoum in an ' ~' r ~' ~ 's located . agr~c~tu~ ~~ ~/ ~ -~- , ..... ' SURLY FOR ~FOr~ COUNTY e~E~T ~ H~A~H SE*WC~S ~/~ ~/~' /~' ~ ~ ~0 - t ~ ~WN ~ SOUTHOtD SC~L~, / ": ~0' O,TE~~S ~r. NO._ ~ SUFFOLK gOONTV, NEW YORK ~o. .o~ e~ cO. sm~.~ ~o ~e~ v~uo ~u~ co~ HEAL~ OEPARTMENT-DATA F~ A~RO~STRUC T N~E~ A~ ~ ~ELLINI WITHIN lDO PEET OF THIS PROPERTY INSTItUTI~. GUARANTEES ARE ~T T~SFERABCE ". ' YOUNG 8 YOUNG NOTE: ALDEN ~W. YOUNG~ PROFESSIONAL ENGINEER 5UBD/VIS/ON M~P F/LEO/N THE OFF/CE OP THE CAE~K OF AND LAND SURVEYOR N.Y.S, UCENSE NO. IZ845 SUPF~K COUN~ ON ~PR. $G, 19~ ~S FILE NO HOWARD ~ YOUNG~ LAND SURVEYO~ R=25.00 ' yL =39.27 ' ~ ~ ~' ~- . ~OT ~0. I~, **H~GH~A~D ESTATES" ~o~ AP~ovk, t. O~ Cat,S,RUCtiON ONlY ~WN ~ SOUTHOLD SCALE; / "= 50' DATE HS R~.F. HO._ , SUFFOLK COUNTY;, NEW YORK ~O. ~T B~ ~OH~IDE~D TO ~A VALID T~UE COPY HEAL~ ¢EP~RTME~T-O~TA FOR APPRO~L TO C~STR~T ~ m ms ,~u~c~ ~ ~uE ~CE C~, eOV~- *oO~ss --' ~' Bi I YOUNG 6 YOUNG RIVER~AO, NEW YORK NOTE: ALDE~ W. YOUNG~ PROFESSIONAL ENGINEER SUBDIVISION MAP FI~ED IN THE OFFICE OF ~E C~ERK OF AND LAND SURVEYOR N.Y.S. UCENSE NO. 12845 SUPF~K COU~ ON ~PR. Z6 , /97~ AS FILE NO. 6557 HOWARD W. YOUNG~ LAND SURVEYOR ~ ~ L~T~ ~ W~LtW},~tC TA~IST)a CES~OLS(~) IH~N HERE~ N.Y.S. LICENSE NO. 45893 ~E ~ F~E~ ~AT~S ~00e OATA OeTm.Eo F~ OTHERS 0 OCCUPANCY OR USE IS [JHLAWFUL VilTH~T ERllFICATE OF OCCIJPANC¥ '1 76~-~0~ '9 AM TO ,:L PM FOP, TH[ FOLLOW'IiNG [ N ¢,~'FCTION'S: 1, ¢OU~PATION - TWO REQUIRE~ ~0~ P~U~ED CONCRETE ~. ~'U~ - FRAMI~!G ~ ~UUMBIN~ 3. 4. FINAl_ - C~NqTR'UCr]~ ~UST BE CmMmF~ FOR C 0 AL~ ~ON~%RUETION SHA~L MEET TR~ REOUI~¢MEN~ OF %HE N Y. ~TATE 'C~STRUCTION & 'ENERGY ~D~S. 'NOT ~ES~O~IBEE FO~ 'k Lt%V A Tt 0~ '0; F I : 40-0 7.4'; ilo'' _-') I L~LT'f E. :=' ' L · ,' ,.r ULS. L ¥ oI:WPe / l~ copper tubing is used for water distributing , syslem~ piping shall be ~c_.o[ types K or L only ' T'-7t ~ST %LOOE:- -pLAk; 'o ;: z-,o 3 z-~o. .... %'- ............................. "f:'7 0 0 ,ko b A'T i 0 1,3 ' %'L I'- O' '.1 i L_ ~*F 'T >'4"-- l'--o'