HomeMy WebLinkAbout12076-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. Z12309 Date March 2
.................................................. 19.84..
THIS CERTIFIES that the building .. a.c~c]i~:fi.qo, fi. Al.~c.a.~. Spp.-zr .ag.r.i.q .u.l~.u.r..a.1..b.l. dg.
Location of Property ... 4 1.7.0 ................... I~0i.~x~. N.e.c.]~..L.a.n.e. ....... .P.e. qq .n.i.c...
House No. Street Ham/et
County Tax Map No. 1000 Section .... 0°~ ..... Block ...0.~ .......... Lot . ... ~}'1 ,j .........
Subdivision ..... X ......................... Filed Map No .... X. ....Lot No...X ...........
conforms substantially to the Application for Building Permit heretofore fried in this office dated
.... .D.e. qe..m~..e.r...6 ..... ,19 .8.2. pursuant to which Building Permit No...~ .2 .0 .7. 6. . .g ...........
-dated .... D..e.c.~.m.b..o.r...1.6 ........... 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 .........
The certificate is issued to PATRICIA PHILLIPS M~kRCO
(owner,
of the aforesaid building.
Suffolk County Department of Health Approval .. ?.E.r 9 r.R.,...1/.2.6./..8.4.,..R. 9.b$.....~:..V.J: ~.~.a.,.. P. E.
UNDERWRITERS CERTIFICATE NO.. N 6 17 6 3 5
THIS IS A NON-HABITABLE, AGRICULTURAL BUILDING.
Building Inspector
Rev. 1/81
TOWN'OF $oUTH0i
BUILDING DEPARTM
TOV~N ', HALL
SOUTHOI~D~ N. Y.*~
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL
COMPLETION OF THE WORK AUTHORIZED)
I~ULL
N°. :12076 Z Do~e .... ~ ...................... ? ............ : ............. .
Permission is hereby granted to~ ..
ou~uant to app caton dat~ .......... , ..... ............... '.-,. ..... ly....4.., ana' approve'by the
Building I~spector.
Fee ~i ........ ; ...............
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 propertv 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"
land uses:
1. Accurate survey of peoperty showing all property lines, streets, buildings and unusua~ 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 or land use
3. CopV of certificate of occupancy $1.00
February 1.0~ 1.98~.
Date ....................
" ~/o6/, ~'c~ ,~ 7~ x Vacant Land .............
New Building ............. Oid or Pre-existing Building ............
dian Neck Road, Peconlc, Ne .Y.qr.k
4170 In .................................
Location of Property Srrear Ham/et
House No.
Indian N,e,c.k Farms, Inc .............
Owner or Owners of Property ............................
098 01. Lot ,05 ...........
County Tax Map No. 1000 Section Block ....
Subdivision ................................. Map No ............... Lot No ...............
PermitNo. ];2076Z Date of Permit 12/16/82Ann ~nt Garrett A. Strang .....
1190103 . .Labor Dept. Approval ..............
Health Dept. Approval .........
Underwriters Approval N617635 . .Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ........... .x ...........
Fee Submitted$. 5.00
Construction on above described building and permit meets all applicable codes and regulations.
Applicant ..................................................
GARRETT A. STRANG, as Agent
420 - ~ ts¢.oo
Rev, 10-10-78
1000771 THE NEW YORK BOARD OF FIRE UNDERWRITERS
r~ ~
BUREAU OF ELECTRICITY
~- 85 JOHN STREET, NEW YORK, NEW YORK 10038
o. te Sept:ember 23, 1983
THIS CERTIFIES THAT ·
only the electrical equipment aa described belo~v and introduced by the applicant named on the above application number in the premises o~
Indian Neck Farms, S/S Indian Neck Lane, Peconic, N.Y.
in the yollowing location; [] Basement [] let FI. ~} 2nd FI. Section Block Lot
,~aa examined o. September 19, 1983 and found to be in cotnpliance with the r~quiretnents of this Board
FIXTURE
OUTLETS SWITCHES
OTHER APPARATUS:
FIXTURES
FUTURE APPLIANCE FEEDERS
s
RANGES
EPECIALRECP1
CT2N O; Js
TiME ~LOCKS~ BELL
OVENS DISH WASHERS
T K W, AMT K. W
UNIT HEATERS MULTI-OUTLET
SYSTEMS
NO. OF FEET
C E
EXHAUST
DIMMERS
OF CC. COND OF HI-LEG OF NE ALS OF NEUTRAL
1/o
1-G.F.C.L
1 ~b~aloke Detector
M~tors: 1-F.
1-4.5 K.W. Ho~ Water Heater
Electric Room Heaters:l-2.5 K.W., 1-1.5 K.W., 1-1.25 K.W.,
P. O. Box 143
Mattituck, N.Y., 11952 LIC; ~242 ~EN~AL MANAGE. ,, ./ ~ m
COPY FORBglLDING DEPARTMENT THIS COPY n~ ~ntl~ ~-----~ .... '~~m~me~m~ J
765-1802 .
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PI:BG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
REMARKS:
[ ] FINAL
DATE
INSPECToR
765-1802
BUILDING DEPT,
INSPECTION
FOUNDATION 1ST []ROUGH PLBG.
FOUNDATION 2ND []INSULATION
FRAMING []FINAL
REMARKS:
DATE
INSPECTOR
FIELD INS'~EC~ION COMMENTS
FOUNDATION (1st)
FOUNDATION
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 76,5-1802
Examined,~_ff, xff~,../.6'7..-, 19 .~6;~
Approved ~/..~../.6. ..... 19~..~.'' Permit No../..~.~.-.CIZ .~..~'~.
Disapproved a/c ...... : ..................... ,~ ....... //
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Application No../..~.~..//_7..( .........
Date December 6 19 82
INSTRUCTIONS
a. Tins 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 promises 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 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 code, and rpgulations, and to
admit authorized inspectors on premises and in building for necessary inspection~ ~
(Signature of applicant, or name, if a corporation)
.B 9.x.. ! .4.1.2.. S. 9.u?.h. 9.1.d.,' .N..e.w..Y.o..r .k..1.1 3 y.1 .......
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Architect, - Owner's Agent
Name of owner of premises ..... .P.a.t.r..i.c.i.a...P.h.i. 1. ~..p.s..M.a..rg.o' ..........................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.................... .NAn. ......................
(Name and title of corporate officer)
Builder's License No ..... N.. 9.t' .S..e.l.e.c.t.e..d .......
Plumber's Licensd No .... N.. 9.t' .S.e..1.e.qt.e..d .......
Electrician's License No..N.. 9.t..S.c..1.e.qt.e..d .......
Other Trade's License No. N. 9.t..S.c..lp.c.t.e..d .......
1. Location of land on which proposed work will be done ..................................................
...... .4.1.7.0. .I.n.~%~t~..Ne¢l~..Road ....... l~.econ.ic, .............................................
House Number Street Hamlet
County Tax Map No. 1000 Section ...... O~g ......... Block ....0.1 ............. Lot...05 ..............
Subdivision ..................................... Filed Map No ............... Lot ............... (Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .... A. g.r.i.c.u..1 .tAr. a..3_...B.u..i.l.d.i.r~g, i .....................................
b. Intended use and occupancy . . .A.g.r.i. qu..1.t.u.r.a..1...B.U~J~J,~g .......................................
3. Nature of work (check which applicable): New Building .......... Addition . X Alteration x
Repair .............. RemOval .............. Demolition .............. Other Work ...............
(Description)
4. Lmmated Cost ......... $ .1.0.',.q Q 9 ..................... Fee ........ $. 1..5 ...0.q .......................
(to be paid on ~ing this application)
5. If dwelling, number of dwelling :units ............... Number of dwelling units on each floor ................
If garage, number of cars ..... ...................................................................
6. If business, commercml or mxxe. occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structur6s, if any: Front ....... 20f.t ..... Rear ... 2.Qt~: ....... Depth .... ~ 7;~.t. .......
Height ... 2 ¢;f.t... ...... Number of Stories ........ 1. ~ ..............................................
r)imensions of same structure with alterations or additions: Front ..... 2. .0.f.t... ...... Rear ....2.0.f.t... .........
Depth ..... 2.0.f~t;, g ~-Jl .... .. Height ..... 2 $ ~.t .............. Number of Stories ..... 1 ~ ...............
8. Dimensions of entire new constrUction: Front ............... Rear ............... Depth ...............
Height ............... Number of Stories ..... . ...................................................
9. Size of lot: Front ......... .6.0.3' Rear . . J .0. Q t) ~ Depth .2 .80.0 '
10. Date of Purchase ........... ; .................. Name of Former Owner .............................
11. Zone or use district in which prSmises are situated....A.r .R.e.s.i.d.e..n.t.i.a..1./.A.qr..i.c.u.l.t.u..r.a.1. ..................
12. Does proposed construction viohte any zoning law, ordinance or regulation: .............. N.o. ................
13. Will lot be regraded ........ ,Nq> ................. W/Il excess fill be removed from premises: Yes X No
14. Name of Owner of premises ...P.~g..M.e[r~9 ....... AddressB. Q .x . .3.8. 3. :, .P.e.qqn..i9.. Phone No..7.3A-7~.8.8.9. .....
Name of Architect 9.a.r.r.e..t.t. ~....s.t.r.a..n~ ....... AddressB. O..x..1.4.1. .2..S.qu..t.h.o.l.~hone No..7.6.5.7.5.4.5.5. .....
Name of Contractor . N.Qt¢. ~.e.3,~ .t.e.d. .......... 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 aumber or description according to deed, and show street names and indicate whether
interior or corner lot.
SEE ATTACHED
STATE OF NEW YORK,
COUNTY OF. S.uffo&k ....... :S.S
.......... Garr.ett. k...Strong ................... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named, i
He is the ......... ~rch.itecg..-:,. A~nt:~..O. wner ....................................................
(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 manner set forth in the application filed therewith.
Sworn to before me this ~
I~u~^~[l', ~IN N~t~tl_~ Garrett A. Strang (Signature of applicant)
NO15%RY ~UllI. IC, State of New Yor~
No. §2+8125850, Suffolk Cou~J.y/
~ Term ~(pires March 30, 195~-/,t~"
OCCR~ANC¥ OR
0 APPROVED AS NOTED
~0~0 3 5~ GARRETT A. STRANG /~A~.o
I
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~"' · ' ..__ ,~',-~...'~ ~--' _., ~ :~~-I '
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~ r water distributing
d
~., architect
Main Road P,O. Box 1412 Southold N.Y. 11971
~ 516- 765 - 5455
GARRETT A. STRANG
architect
Main Road P.O. Box 1412 Southold N.Y. 11971
516 - 765 ~ 5455
TITLE
GARREETT A. -~TRANG
(~ ~'~ architect LOCATION
~ ~ Main Road P.O. Box 1412 Southold N.Y. 11971
~~~ 516- 765 - 5455-.,~--
GARRETT
erchitect,
A. STRANG
Main Road P.O. Box 1412 Sout,hold N.Y. 11971
516 - 765 - ,54,55
Z
~J
GARRETT A. STRANG
architect
Main Road P.O. Box 1412 Southold N,Y. 11971
516- 765 - 5455
/ I ,
,~ ~UFFOL~ COUNTY D~PART~[bJT
~"' Al STRANG
~ ~ ~ ~ ~A N : Main Road P.O. Box516 - 7651412 Southold N.Y. 11971. 5455 DATEDRAW..I