The URL can be used to link to this page

Home My WebLink About11897-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No... g..fl .'L~.q-8 ........ Date .......... Msy..3 ................. 19 $.~. Addition THIS CERTIFIES that the building ................................................ Location of Property . .'1.~.8. 55 ....~Iaii,r,. Rd ................ Orient House No. Street Hamlet County Tax Map No. 1000 Section 0~1 ~ . .Block 0'1 .Lot 04 0 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ~ .u.g.v:~.~...~.0. ...... , 19 .~..2pursuant to which Building Permit No ..... q. ? ~.c).~..g. .......... dated ...~.e.l~..~ .e.m.b.~ .~...q. ~. .......... 19~.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 ......... .... ~..~.~.~e...~. ge..e.k..~.~. ¢.~.~.~.~. v. ?.o...e.x.~.s.~..t.n.s .¢.~?.z.z. $.~. ........................ The certificate is issued to ...G....~@ .~ ~-.e.7....&..I:,.u. 9y. ?.1?9.mp.s.o..~ ........................... (owner, lessee or tenant/ of the aforesaid building. Suffolk County Department of Health Approval .... .N/.4 .................................. UNDERWRITERS CERTIFICATE NO...~..~..99.G.~.9. ....................................... Building Inspector Rev. 1/81 FORM ~0. TOWN OF BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.. Y. BUILDING- PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) N°. 11897Z Date Permission is hereby granted to:/-/ ........ ~2~.....~,,.....:./_~.~,~......!. · .....C~c/.~.~..:~:,,¢. ......... ~.~7 . . . . x .¢~- x ~-~2 '~~ ...~ ............ '.. at premises ,ocamd 8t ..... ~.¢.M..¢.~ ........... ~.W/~. 'X"'}'/'~'t ...... . ....... ......... ................ ; ........................................... , .................................... Cou,~ Tax Map No. 1000 Section ,. J Bl~k .... ~. ........ Lot No.~/~ ......... pursuant ~o application dated ~ .19~,~;., and approv~ by the Building Inspector. Fee $ ...... Rev. 6/30/80 FOP, M NO. 6 TOWN OF SOUTHOLD Bu[~dlng Depar~men~ Town Hall Southold, N.Y. 11@71 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and subn~itted 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 Heaith Dept. of water suppiy 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 building~ 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 buildines a~d "pre-existing" land uses: ~ 1o 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.. / Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on poe-existing dwelling 3. Copy of certificate of occupancy fiend use ~/5~$5.00 //~¢,¢~; f,o~,-- / Date ........ Ne:*/ Building ............. Old or Pre-existing Building(:~) .. ........ =/Vacant Land -' ... Hou~ ~¢o. S~ree~ Ham/et Owner or Owners of Property ........... ~. ~.~,M~ .......... ¢ ....................... County Tax Map No. ~000 Sec~ on 0/~ Block ~ / - Subd[vis}on ................................. Filed MapNo..:; ....... Lot No...l Heat[h Dept Approval ........... Labor Dept Approval Unden~riters Approval ........... Planning Board Approva~ .................. Request for Temporary Certificate ........ '-:-;T'F:'R ...... Final Certificate ,,, ~,- ......... Fee Submitted S ~, ~ Construct[on on above described building and per"ir'meets all app[(cab e~Codes and regulations. Appiicant 1000773 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~- [}'~ 85 JOHN STREET, NEW YORK, NEW 10035 THIS CERTIFIES THAT only tile electrical equipment as described below and int~duced by the applicant named on the above application number in the premises of Wesley C. '~aon, ~n ~1. S~e'v~ ~., ~i~t, N.Y. ~ .~a.anea o,~ ~r~ 14, 1983 .,d yound ~o be ~, comptlance with the requirements of this Board. FIXTURE i FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES INCANDE~CENT~ FLUORESCENT 2 DRYERS SYSTEMS NO. OF FEET E E V I C OF NEUTRAL Ar~ur Kt~oede Main P~oad Orient, N.Y., 11953 LICe ~2334 11 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspecto,rs may be identlf[ed COPY FOR BUILDI~NC MU~ IN ANY MANNER, credentials. FIELD INSF~CTIO~ COMMENTS FOUNDATION (1st) FOUNDATION 2. (2~d) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL ]OMMENTS FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 APPLICATION FOR BUILDING PERMIT ^pp,ication No. . .P.7. . ...... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) ... ~z../.¢~.. 4).~ ~x~.. ~...l/. ~>.7.... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer con electrician, plumber or builder. k (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ...... /.~..~..~.. ........ ~.~...~o~ ................... .O.r. ! ~ ....................... House Number Street Hamlet County Tax Map No. 1000 Section .... .(-?.~.~. ........ Block ....O, .~. .......... Lot...t~.(..~. ........... 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 .... ~..-(L.~ .~ ~. ................................................. b. Intended use and occupancy ...('.~.;..~....~..'.~ ............. ' .................................. · 3. Nature 0fwork (check which applicable): New Building .......... Addition .. ~ .... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost ...................................... Fee ........................... (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 mixed: occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front.. '1 ............ Rear .............. Depth ............... ~'ght ............... ' 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 ............... Num_b_er of Stories .................................................... ?. · · 9. Size of!et: Front ....... ~...~9.~..t ........ Rear ..... ~3 ............... Depth . .-~ .O.~../..--..~.~.~ .... 10. Date of Purchase ........... i ................. Name of Former Owner . .~)ra-A'~h .~ ................ 11. Zone o~ use district in which premises are s~tuated. ~.~--.~ t ~ q-eOb ~ .................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . .~ ...... : ................. 13. Will lot be regraded ........ ~ ................ Will excess fill be removed from premises: Yes _ 14. Name of Owner of premises ~..LO: .~ *~:--.-~.$..6',:~.... Address ~')C-~'c~.c~ ~1 ~. i~c~.. Phone No. ~ ~.-7.Z. ¥~..~,... Name of Architect ....... 7~', i ................ Address Phone No. Name of Contractor .QO~..~. 10.,...~.q .,7..~2-4~.... Address i ~'~i~¢;i~).~ i Phone No. PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and, indicate all set-back dimensions from property lin~s. Give street and block number or description according to deed, and show street names and indicate whether interior or coruer lot. STATE OF NEW/Y~K., ~// ~ ~ above .... i.~~.named.(Name of individualC~''~si~[d~: ~'ract) . . berg duly sworn, deposes and says that he is the applicant He is the .........................................................................................~o~ir~'gent, corporate Officer, etc.) of s~d owner or owne~, ~d is duly ~ed~rform or have perfo~ed the said work and to m~e ~d file ~is application; that all statements contained h this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~ner set for~ in the application filed therewith. Sworn to b0fore me this No~Pu~lic; ~..~... ~.~ County ~ ....... ~ ~ ,u tlC, Stat~ el ~ ~ ......... . . ~~[~" (S~gnature of apphcanO ,? OCCUPANCY OR · USE !~ UNLA,Wi:UL DL*~ K ~ ~a, pP. OVED AS ~65-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ~. FOUNDATION ' TWO REQUIREO FOR POURED CONCRETE , '2, ROUGH - FRAMING & pLUMBIIq~i (3. INSULATION 4, FINAL - co~T~UCTION ~E COMPLETE FOR ~LL CONS'T~UCTIOIq THE REQUIREfiAENTS OF ~'I'ATE CONSTRUCI'ION coorS. Nov uEsuo~su~ ~- DESIGN OR