The URL can be used to link to this page

Home My WebLink About11929-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17975 Date APRIL 27, 1989 THIS CERTIFIES that the building ADDITION Location of Property 500 PRIVATE ROAD #18 SOUTHOLD~ NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 54 Block 01 Lot 13.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 22, 1982 pursuant to which Building Permit No. 11929-Z dated SEP~ER 26~ 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 ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to ESTATE OF JOSEPH BASEL, JR. (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N-592059 - FEBRUARY 2~ Rev. 1/81 1983 Building Inspector BUILDING DEPARTMENT~ TOW~ ,HALI~ ~ SOUTHOLD, N~,Y. BUILDING PERMIT ~ (THIS PERMIT MUST BE KEPT ON THE PRE~IS~S UNTIL'I JLL COMPLETION OF THE WORK AUTHORIZEp) Permissio~ is hereby gra6ted to: ............. ~ ........................................... ~ ................................... ,...., ....... ~.z~..~,~.. . pu~uant ia application dated ~ 19, o~ ~pprov~ by the Budding Ihspector. Fee $./......'~.. .............. Rev.' 6~30/80 ' "? ~Building~'lnspectOr TOWN OF SOUTHOLD BUILDING DEPARTMENT TONN HALL SOUTHOLD, NEW YORK 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEW CONSTRUCTION ....... OLD OR PRE-EXIST~G BUILDING ...... VACANT LAND ........ Subdivision ....................... Filed Map ........ Lot .......... Permit No. l~.~ .... Date of Permit .......... Applicant ................... Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Fee Submitted: $.. ~.~ Certificate ..... ~ ....... ¢o 17995 rev. 10/14/88 :tooo~l. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTR C T~ ~n the following loeatlon; ~ Basement ~ 1st FI. ~ 2nd ~. Section Block Lot was examined on ~ ~ ~ ~ and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT VAPOa 5 9 4 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT' S E R " V I C E OTHER APPARATUS: OP CC. COND. OF HI-LEG NO OF NEUTRALS A W, G, OF NEUTRAL Paul Su~s Town Harbor Lane fi::althold. N.Y. 11791 This certificate must not be altered in any NG )EPARTM to the office of the Board if i THIS COPY Lic#2S2 ANY MANNER. FIELD I~SPEC~ION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS BUILDING and REMODELING ROOFING and SIDING RDBERT L. HYATT, INC. SOUTHOLD, NEW YORK 11971 (516) 765-3390 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [/~NAL REMARKS: DATE INSPECTOR FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved. ? .~...'~..."~.. .... 1..(~. Permit No../../7..~..~..'~ Disapproved a/c ....... : 77'7. -~i ~ ?... ' ........ ~ ........ / ~ APPLICATION FOR BUILDING PERMIT Application No..././.~..~..~. ........ INSTRUCTIONS 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 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 building for necessary inspgC~ns. ~ /,~ ~, ,, ~ (Signature of applicant, oT-ri~ml/e, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... ............................................................... Name of owner of premises . .~/..~. ~.~'../¢.~. :~,. .~..~. ~z..~ ...................................... ... (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... ~ ................... Plumber's License No...~.' . . ~ [.~. .... ElectrlclansLlcense No..~...1~....~F.g~>(..' . , . [ ~ .. Other Trade's License No ...................... 1. Location of land on which proposed work will be done. t/-~.... .............. r~ 7~ /ti ,~ /~!.......o.~ ?.'~..3~.-.~.~ ....../~/ %~., .... ................. ............................................... House Number Street Hamlet County Tax Map No. 1000 Section .~..7¢ ............. Block ...~. .............. Lot../.~.~..'.'i ...i .... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of pxremises and intended use and occupancy of proposed construction: a Existing use and occupancy ,~.~J~../:~..~:..~..~./~. ............. ;....'A.'. !'.';' ................. b Intended use and occupancy ./.~..~ .~ [~..~. C..~-....0ql..'. ~.. 3. Naturelofwork (check which applicable): New Building .......... Addition ......... Alteration .......... Repair .............. RemOval .............. Demolition Other Work ~t- ' /.(_,o ~00 .,(~.~ o~,/, (Description) 4. Estimated Cost .... .~...'~ .... c ..................... Fee ................................. (to be paid on filing this application) '; ', 5. If dwelling, number of dwelling ~nits.. ~P..~..~. ...... Number of dwelling units on each floor ................ If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify na~ture and extent of e,,ach type of use ........... t .......... 7. Dimensions of existing structures, if any: Front..3 .q .......... Rear ~..~o. .......... Depth. ~.~ ........... ~.' um P./~. Height N bet of Stories. &- Dimensions of same structure with alterations or add~tmns: Front/~ ................ Rear J.a ................ Depth,~.~....'Tr...6t..~:7. .......:.. Height ~¢° ..................... Number of Stories..~..~..~ ............... 8. Dimensions of entire new constrhction: Front/.6..t:t.~. ........ Rear .d~v ............ Depth &.~...~...q..~ .... Height~ :~'.' ............ Number of Stories ...................................................... 9. Size of lot: Front i Rear ...................... Depth ...................... 10 Date of Purchase Name of Former Owner 11. Zone or use district in which pr~mises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ...~.Q. : .~. ........ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ~i ~'i ~ ~41 ~i ~ t~ ~.L-Address ~..o. ~.~.~. r,~. ....... Phone No. Z ~..J~-. ~ ~. 7:/... Name of Architect..zlf.~ f~)' ....... .T'." ............... Address '~ 2~'~ :~ ~ ~i~ mameofContractor, ii 21 ;i&ill'Ph°n N°'.PhoneNo. PLOT DIAGRAM Locate clearly and distinctly alll 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 YORK~ ,~ !o o COU,N~ OF..5.q/5..~70. CA.. ~'~ · ' 'J"~3 ~. '~~ ................... being duly sworn, deposes and says that he is the applicant ! (Name of in,ual signing contract) above namea. He is the (Contractor, agent, corporate officer, etc.) of sa~d 9Whet or oW~ ~d is duly authorized to perform or have perfomed the said work and to m~e and file ~is appli~fion;~ [hat al~tatements cont~ned ~ this application are true to the best of his ~owledge and belief; and that the work will b~ perfomed in the m~ner set forth ~ the application filed therewith. Sworn to before m~ this ~ ......... , .... .... '7-;_': ....... ' ..... Nota, Public, ~~ ~' ~~ C~ ~ ,~ ~ :