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Home My WebLink About11894-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. g ~.,L378 ......... Date ..... I:>e.ceml~.e~...1 f ............... 19 .8.2. THIS CERTIFIES that the building ................................................ Location of Property ...l@ 70..Ole. ,J..ule. l.~ar~e.~..MalzJ:.J.t;uc]¢ .......................... House No. Street Ham/et County Tax Map No. 1000 Section . 122 ....... Block . 0.4 ............ Lot...0.0.6. ........... Subdivision .................................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..Aucust. 31 ....... , 19 82. pursuant to wltikh Building Permit No...l:.l..8.9.4.g. ............ dated .... Se.latzemb~Z:. 8, .1982 .... 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 ......... ..... ~ons~-r. uct:..J, ngraund, s.w±mm&.ng, pr).c~l .................................... The certificate is issued to ...Crohn..It&as ........................................ of the aforesaid building. ,, Suffolk County Department of Health Approval ..... N/g. ................................. UNDERWRITERS CERTIFICATE NO ..... 5309~ ...................................... Rev. 1/81 Building Inspector N°. ; TOWN ~OF SDU HO~!; BUILDING D~PARTMI~N~ TOWN HALL SOUTHOLD, N~Y. BUILDING Pi~RMiT ·~ (THIS PERMIT MUST BE KEPT ON" THiE PREMISES uNTIL ~U,LL COMPLETION OF THE WORK AUTHORIZED) 8 9 4 Z Date Permission is hereby granted to: ~ ' it-''~ ........ ?...~..~ ...... L/..~...,i....i. ...... i ....... :.!. ,o.._~,.:.,.. .............. ~ ....... ...~ ...,,:.~ ..... ~_.. ~. .... ~.:...:.-... ........... .~.~~.~.~..,...... ....... ~ ....... .~ ............. ' z '~---~ ', ~' i . ' .................. o, p ,e, ,e, '=te~ ot . Z. . . . . . ' .Z. O. ........... ~..~ : . . ~. . . . ~ Z~. . . . . Z~,~.~ . . . . . , . .__. . ................. ....................................................................................... ,u;s;ant. ~0 application dated .~ ~: .~.~..,.:: .,,~ .19~and~ ;pprov~ by the Building Ipspector. L Rev 6/30/80 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 sub~ tted n 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. 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 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 or land use $5.00 3. Copy of certificate of occupancy $1.00 New Building ....... Id or Pre-existing Building(X) ......... ~/Vacant Land "' Locat,on of Property ...................... .... ....... .... ......... Owner or Owners of Property .......... County Tax Map No. 1000 Section . ./~,,, .~. ....... Block ............... Lot ............. ~,~6ubdivision ....... Oiled Map No. %; .... Lot No..' · Health Dept. Approval ~ Labor Dept Approval Underwriters Approval ./~.....~..~..~. 2 ~..~. · .... Planning Board Approval .................. Request for Temporary.C,.e~tificate ..................... Final Certificat~ .... Fee ~ubmitted $ .... ~...'~.. ............... Construction on above d~scribed building and/rm~ll app,~b[e~co~o~,n_~regu lations. 1000663 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY N ~ YORK THIS CERTIFIES THAT only the electrical equipment as described below end introduced by t~ applicant na~ned on the a~ove application n,mber in the premisez of Jo~ }k;~, Old Jule ~,~, Ne~ S~ol~ A~, a ~ ~,, in the following location; ~ ~,~.~ ~ ~t r~. ~ ~,d rt. ~ - I~L was examined on .~.~ 6 ~ ~ 9~ ~ and found to be in compliance with the requirements of this Board. FIXTURE OUTLETS DRYERS FIXTURES RANGES OVENS DISH WASHERS FANS NCANDESC~NTiFLUOR~SCENT SYSTEMS NO. OF FEET E OTHER APPARATUS: E R v ~ c NO OF CC. COND NO. OF HI-LEGJ A. W g NO OF NEUTRALS A, W. G p~R ~ I O~ HI.LEO OF NEUTRA£ Gler~ R~ Bradley RFD 169 - l-brton Ave, ~xtti~m~k, ~.Y. 11952 lic. 1227 GENEI~AL MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY F~R BU~LD~NG DEPARI'MENI. T~I~S ~COPY 01~ CER;¥~F, ICAI'E/VlUST NOT BEtALTEREI), IN ANY MANNER. ~IEL~ INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY COMMENTS ~ODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TCWN OF SOUT','IOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 APPLICATION FOR BUILDING PERMIT Application No. ,(~/~..~ ...... ". .' INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi 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 premiaes, relationship to adjOining pmmia~ or public stm~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which ia part of'this cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon apprc'.'al of this application, the Building insl~ctor will i~ue a Building Permit to th~ applicant. Such peru 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 Oeeupan shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for th& issuance cfa Building Permit purauant to t Building Zone Ordinance of the Town ~f .Southold, Suffolk Count, New Y~ and other applicable Laws, O. rdinanees Regulations, for the construction of buildings, additions or alterations, o~/for ~moval or d~moll~ aa h~mt.n describe The applicant agrees !.o~ comply with ]11 applicable laws, ordinane~, bui~ling j/ode, housing eod~ and r~.~UlatioA~s, and admit authorized iuspt:ctors on prenfises and in buildings for necessary in~ ~~C,/ · .... ...... (Mailing address of aPplicant) State whether applic:mt is owner, lesse~tarc!fitect, engineer, general contractor, electrician, plumber or build. N,'une of owner of premises ................................. (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...~ ............... Plulnber's ,Licens: No.,....~ .................... Electrician s,License No.' ~.~..].~... } Z?<.. 7 Other Trade S Liceh;e "o .... ~. ~ ........... 1. Location of land on which proposed work will be don~ ............................... ........ House Wumber · Street Hamlet · 6 County Tax Map_tNO. 1000 Section .t../¢~'.. ....... Block ..... .6/ ........... Lot ......... Subdivision · · .0. [~'.. ~'~..'g-..~ ..... ]... Filed Map No ............... Lot (Name) 2. State existing use and occupancy of Dmiscs anIi:tended us~and occupancy of proposed construction: · ...... ""!.:"' .... ......... ' ............ 3, Nature o£ work (check which applicable): New Building .......... Addition .......... Alteration ......... D' ' ion .............. Ott er Work .............. dC ~' ., F EstLi rote os .................... e ............. ~ .......... (~o b~ pMd on filing this application) ;. If dwelli~g, number of dwellin~ units ..... ~ ........ Nmnber of dwelling units on each floor ............... If garage number of cars ' ;. If business, com~mercial or m/xed occupancy, specff~tum and extent of ~ach t~'p~ of use ................... L Dimdns~ons ofcx~thlgstmct~res, ~Fnny: Front.. ~..'~ ...... Rear .~ .~ Depth . ,~ ..... Height ............... Nt~mber of Stories ......... I ............................................. Dimensions of ~an~e structure with alterations or additions: Front ~ Rear Depth ...................... Height ...................... Number of ~tories ......... .......... L Dimensions of entire n~w construction: Front ............... Rear ............... Depth Height ............... Numar of Stories ............................... ' ...................... ~. si~ o~m: ~o~t .... /~..~.~... ......... a~ar .... ~.~.~. ....... 7' ~t~ . ~.O..~ ..... 1. Zon~ or use district in which prmnis~ are situated..~..~ ..................... ~:'... ~ ........ ~. ~Does proposed construction violate any zoning law, ordi ~anc~ or reg~ lation: ............................. L Will lot b~ regraded ...... ~. ~ ....... ~ .......... Will excess fill b~ r~moved from pr~mises: ~ ~ ~ Yes .... ........ ................... ............ ~ o~Co~r~~~V:'P~". ~a~ ~ .......... ~o.~ ~o.~.~ o. PLOT DIAGRAM l. ocat¢ clearh., and distinctly all buildings, whether existing or proposed, and, indicate all set-back dknensions from roperty Lines. Give street and block number or description according to deed, and show street names and indicate whethe~ .tefior or' corner lot. rAZ~ OF N~W ~9 !b ' ou,wv OF.,,. ;~'.CjW....O.t..~ S.S . (Name of indMdual signing contract ~ov,2 nalned. ' · ' '(C~,ntracto~co~i~or~te officer, etc.) .............. e ~s the ................... : f said bwner or owners, and is duly authorizei~d to perr~or have performed thu said work and to m~e and file ~i~ )plication; that all statements contaiaed in this application are tree to the best of his knowledge and belief; and that th~ 'ork will be performed in the manner set forth h~ the application filed therewith.. worn to before me this