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HomeMy WebLinkAbout11969-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...ZJ .'16.Q9 ........ Date ........... .~PT.~.i...q 3 ............. 19..8.3 THIS CERTIFIES that the building ...Add~.¢i0~. ................................... qqO Oakwood rd. Southold Location of Property/:/3~s~ ~'o[ ................................................... Street 0'1 County Tax Map No. 1000 Section 059 . .Block 02 ..... Lot Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated October 7 I9~..2. pursuant to which Building Permit No. .q~. 96~Z dated Oc~;ober '18 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 ......... Addition 5o existimg building The certificate is issued to ~homas & Lillian Bannon (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. ~ 59'1729 Building Inspector Rev. 1/81 TOWN OF ~OUTHO BUILDINO DEP~RTME TOWN,HALL : BUILDING PE~I~ (THIS PERMIT MUST ~E KEPT ON ~HE PRE'ISleS UNTIL ~ULL COMPLETION OF THE WOR~ AUTH6RIZED~ PermissioO is hereby granted to: ....... at premis~s located at ..../..,/~.c? ..... ~ ......... ~ ......................................................... , ................ ~.~..¢. ~ ....... ~ ~ ~ ........ Coun~ Tax Map No 1000 'Section ·Bock ~.~.~,.,,[~t No~ · ' ~-- .... ~ . , . ~' 19 and ~approv~ by the p~r~uant to apphcahon dated ................... ~ ...... ~, ..... 8u~l~ln~ In~p*ctor. ~ $,.....~ .............. Inspector FORM NO. TOWN OF $OUTHOLD Building Department Town Hall Sou~ho~d, ~. ~P ~,C~ ON FOR CERT1FICATE OF OCCUPANCY Instructions This ~ppHcat[on must be fitted in typewriter OR ink, and submitted ~n duplicate to the Building Inso~ tar with [~e followin~; for new buildings or new usa: . 1. Final sup/e,/ of prcperw with accurate location of all bu[ld~ngs, property lines, streets, and unu% 2. F~n~ aoprovai of H~¢,~h Oep~, of wa~er suBoly and sewerage disposai--(S-9 form or equal). 3. Approval of elec~rica~ ins~ailauon from 8o~'rd of F~re Unde~vriters. 4. Commercial buildings, lndus~riai buildings, Multiple Residences and sfmilar buHding~ and inst~H dons. a certificate of Code compfiance from the Architec~ ? Engineer respons~Uie for the buiIdin 5. Subm[( P~annin9 Board approval of completed sJ[e plan raGu~remen[s where appficab~e. Fcr existing buildings (prior ~o April ~957), Non-conforming uses, or buildines a~d pre-ex~s~mc ~8nd uses: 1. Accura(e ~ezey of peoperty showing all prooer[y lines, ~r~ets, lopographic features. ' 2. ~wom s~a~emen~ of owner or previous owner as ~o use, occupancy and condition of buildings. 3. Da:e of any housing code or safety ~nspect on of buHd[ncs or premises, or other pertinen~ inform~ dan required to prepare a ce~ificate. 1. ~a~ificate of occu~3nc,/ 2. Cardfics~e of occupancy on pra-ex~sdng dwelling or land usa S5.00 3. Copy of certificate of occupancy //,/,/./,., .... Ne',/ Bud no Pre-existing Building ~/Vacant ' ~ · ............ Old or (Z) ........ Land Location of Property ... ......... ~-Jo~ Hou~ ~Vo. S~reer ' Owner or Owners of Property ~.?~.~. ' /~'~,~',~ Harn/e ' .............. County T~ M~o No ~000 S~c~o~ O ~ O ('~ .................. Block Lot Subciv[sion ................................. Filed MapNo .... ~ ...... Lot No..~ .......... HeaI[h Dept. Approval ~¢ ........................ Labor Dept. Approval .~¢.( ............... ,.. Underwriters Approval ....... Planning Board Approval Request for Temporary C~if cate . .Final Cartificate' s / ........ - ......... Constr~¢,tio~n above described buildu~g and per~it'~e~-ts all ap~[~c35 ~ ~ ~ '~)- .- ,~ou_s and regulations "--" ............................. 1001093 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1OO3~ ~g J~ 3~, 1983 ~4~/~ Date Application No. on file · .,s c~.~,~,~s ~.~ N 5 917 2 9 only the electrical equlprne~t as ~scribed below and introduced by the applicant ~d on the above application number in the ~re~ises of was examined on ~;!~ ~7 ~ ~ and flound to be in compliance with the requirements of this Board. OUTLETS RECEPTACLEE SWITCHES CA__TM FLUORESCENT 7 16 ~ a'~aD;"YE~S'w / o,t FUEHNPACE M~aC:OESa, p F~T~E A.PtIN./CE SERVICE DISCONNECT 40. OF ~ ~ ~PE J OTHER APPARATUS: l~.F.i. RANGES ;PECIAL RECAP V~ETER R EQUIP. COOKING DECKS OVENS DISH WASHERS TIMECLOCKS ] BELL UNIT HEATER! MULTI-OUTLET EXHAUST FANS DIMMERS V I C E PER ,e, OF CC COND OF HI-LEG OF NEUTRAL x ~- 3 4 COPY FOR BUIL~ING DEPARTMENT. THiS C~PY QF cERTI IC~T: ~ MANNER, FI~LD'I~SPECTiON COMMENTS FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. STATE ENERGY GpDE FINAL ADDITIONAL COMMENTS FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ~ (..~. ...... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 inspections. //.~ __~ // ....... .................. (Signature of applicant, or~ame, if a corporation) ...... ~x.~..c.~/~.. ~,,..~X,/.J.. ~.~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....~ .~.~ .~/... c.~.~./:~ ..~.~.>. ................................................................... Name of owner of premises . ~../7. o~ (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... ~.~.~,.*. ................. Electrician's License No...-?.~ ./...../9.~?.4~. ....... Other Trade's License No. -- 1. Location of land on which proposed work will be done ............... / .................................. .... /./.~. ........... a~.>.~,~.o.~. .... .~./: ...... ~.~1~.~/~.. ................................. House Number Street Hamlet County Tax Map No. 1000 Section ...~.~. ......... Block .... ~..~. ......... Lot.. ~..'~.. ........... Subdivision ..................................... Filed Map No ............... Lot .......... . ...... (Name) 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~../~ ~ . b~ Intended use and occupancy .... ./.. ~/ ....................... '.. 3. Nature 'of work (check which applicable): New Building .......... Addition ./)f ....... Alteration .......... Repair .............. RemoVal .............. Demolition .............. Other Work ............... 4. Estimated Cost --/~, ~. ..... : ......................... Fee .......................... (to be paid on filing this application) 5. If dwel!ing, number of dwelling units .... ff. .......... Number of dwelling units on each floor., dl...4' .~. ,zT/.... If garage, number of cars ..... Z'.. ca .~ .............................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structure~, if any' Front ~,C.z Rear . .~.~ ~ .Depth ...~.'~.. t.. Height . . ./~'.-. ~. ........Number of Stories ..... /. ~ ........................................... Dimensions of sa[ne structure with alterations or additions: Front ,,*~'. f Rear ~.~ '~ . Depth ..... 5(.~ ............. '.. Height ...... /..BT. ............. Number of Stones .... ~.~r.~,.cl/ .......... 8. Dimensions of entire new construction: Front ... ,,ff. '~. ........ Rear .... .g.~..r ....... Depth ..../Ff. f ....... Height /. ..... Number of Stones · /o'~,~ ~. · · 9. S~ze of lot: Front .... Z~. ..... ........... Rear ....... ~oT. ........... Depth ....,('./'~ f. ............. 10. Date of Purchase .. ~/.,~//~..;~z ................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated 12. Does p~oposed construction violate any zoning law, ordinance or regulation: .../~/~ ...... 13. Will lot be regraded .... .~/~. · · ~ ................... Will excess fill be removed from premises: Yes No 14. Name df Owner of premises 77~... . ./J..~.*.o qo ....... Address ,4.~. ~ i.v:. ¢e,;cf~...~.~.. Phone No .... ~. :w... ~ Name of Contractor ......... ................. Address ................... Phone No .... ri .....'.* ..... 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 Cumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEV~'~ K -- ...........~~; ............. being duly sworn, deposes and says that he is the applicant above named. He is the ..................... ~. i"i. ~ ................................................. / ~ (Contractor, ag)nt, corporate officer, etc.) of sai~ owner or owners, and isc[u mtho~m or have performed the said work and to make and file this application; that all statements con't ined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manne:~' set forth in the application filed therewith. Sworn to before me this ..... ...... /..,:~;t.w..-; ..... day ofl...(. · .~/.~____ .... ,19.. ~::~ Notary Public, ......... .~. .....,~.~~ County ................ ' , ~:' s~'[~[[%'~::t;f~.., ,,; [}~,.0., TM /(Signature of applicant) AP;~©';~D AS NOTED DATE~/~/t~'//~-~.P. ~- ~ FEE:~/~-~' BY: ~ ~ NOTIFY BUILDING DEPART/~Ei~T AT 76§-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ]. FOUNDATION b TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - OONrSTRU-~-ION MUST BE £OMPLFTE FOR ¢ 0. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS.