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Home My WebLink About11985-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Zqq6q0 No .................. Date ............. Ap.~.it · .q~ .......... 1983. THIS CERTIFIES that the building ....A~..cessary. ................................. Lo ti fP ty 9080 Sound Ave. l~attituck ca on o roper ............................................................... House No, Street Ham/et County Tax Map No. 1000 Section '122 ...Block 02 .Lot OOq Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in tiffs office dated .... 9.e.~.°..~.e?... ? ~ .... , 19 82 pursuant to which Building Permit No. q q 98~Z dated' ...October...26 ............ 19.8.2. , was issued, and conforms to all of the requirements of the appiicable provisions of the law. The occupancy for which this certificate is issued is ......... The certificate is issued to ...B.~a. ~.3_.~.~...S.e~.k..o.... [dv(,n'e'r,'l~,s's~o'[~r't~/~dn't] ...................... of the aforesaid building. Suffolk County Department of Health Approval lxl/A UNDERWRITERS CERTIFICATE NO. 3I 59677q Bmldmg Inspector Rev. 1/81 N? TOWN ,OF~ BUILDING DEPART/~H? TOWN ,HALL SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON YH,E PREMISES UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) 1~1985 Dote ............................ · ...... Permission is hereby granted to: Building I~spector. ro~_~__. ....... '7 ........ ~ .................................................. """ ~/~.x/~ . ~ . . S~ [~ .......... ' ................................ ............... / .................................................................................. :.. ....... ~-.;...? ..... . .~: . · ~, Cou~ Tdx Mop No. 1000 Sech~ ................... t ..... Bilk ~..~ ............. .~ ....................... pur~ont to application doted ~4C~:~:~:.~.~.'..;~;....:, ,9~ and ~pproved by the FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, 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 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. ,,' Fees: 1. Certificate of occupancy $5.00 l 2. Certificate of occupancy on pre4existing dwelling o/ 3. Copy of certificate of occupancy $1.00 / ]and use ¢'/S'/$5,00 Date.. t/////P3 New Building ............. Old or Pre-existing Building(X) ......... : rVacant Land ............. Location of Property . .,.~. ,~,,-,~.~/. House ivo, Owner or Owners of Property Street Hamlet County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Health Dapt. Approval ........................ Labor Dept. Approva~/ ...................... Request for Temporary Certificate ..................... Final Certificate ...... ~. ......... Construction on above described building and p~it'm,~ets all apJ~cable~odes__ and regulations. A p p lic anat,. ................. Rev, 10,10-78 FIE[,D IN~SPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. ETATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: Sound Avenue Mattituck, New York 11952 (516) 298-8440 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORI~, NEW YORK 10038 THI~ CERTIFIES THAT Scaly Se~, t~ven Rd. ~7 ~. 48 Fac~o~ Ave., ~Ci~, ~.Y. in thefollowlng location; ~ Basetnent ~ 1st Fl. ~ 2nd FI. Section Block Lot was examined on ~g~ ~, ].9~ and found to be in compliance with ~he requirements of this Board. FIXTURE OUT'TS 6 FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS 6 4 2 FURNACE MOTORS T~MECLOCKS UNIT HEATERS MULTI-OUTLET DIN%I~,ERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C NO. OF CC. COND A,W.G NO OF HI-LEG A,W.G. NO. OF NEUTRALS A,W.G. PER ,~ OF CC COND, OF Hr-LEG OF NEUTRAL OTHER APPARATUS: Goodale ~'.cC. Cont. RILl ~ t~A Main Rd. MatCituck, N.Y., 11952 Lic. ~783 This certificate must not be altered in any manner; return to the office of the Board if incorrect. -~,~ cO~Y~Q~ PU ~D[~G DEPARTMENT. THIS COPy OF CER~TI~ may be i~ credentials. ' MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 .... lgZ Permlt No../ .... Disapproved a/c ....... (Building Inspector) APPLICATION 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. e. 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 i~p~ections. /~ ,, _ _~i pplica~ ' ,~O~~corporation) .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 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..~Q/. :. ............... Other Trade's License No ...................... House Nmnber · Street Hamlet Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intend~u~se an~d occupancy of p~posed construction: a. Existing use and occupancy .... n;.. ~.~ ..... ~.~.~...~-~. t/~ ........................... b. Intended use and occupant ... ~' ~ 3. Nature of work (check which applicable): New Building ~ Addition Alteration Repair .............. Remo~ai .............. Demolition .............. Other Work ............... 4. Estimated Co ......................... beeT:.: ................................... (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 ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... i. Height ...................... Number of,Stories ...................... 8. Dimensions of entire new construction: Front. ,/~.'.. ....... Rear .... ./.~..' ....... Depth ...~..~../' ....... Height .... ~ ......... Number of Stories ....... ~ ....... , ......................................... 9. Size of lot: Front .... ./~...' ........... Rear . .~'. ~.4~. ............... Depth .... /~.,~.. ' ~. 10. Date of Purchase ................. .Name of Former Owner ..................... 11. Zone or use d~stnct ~n winch premises are s~tuated ~;~-~.~,~ .~...,~f~. 12. D~es pr~p~sed c~nstruct~n vi~te any z~ning ~aw~ ~rdjnance ~r regu~ati~n:~ . . . .)f~. . .~. . . . / ................... 13. Will lot:be regraded ........ ,~ .......,~ ........... Will excess fill be remo,ved from premises: Yes No 14. 5amc of Owner of premises .~(~'~,~...'~T'. ..... Addre~ .~.. ....... Phone No ................ Name of Architect . .,~ ~...~ ..... ~2. · ·, .......... Address ....... ;.., ......... Phone No. Name of Contracto~j~. ~ ....... Address ."2~~.. .... Phone No. ~. i'~.'.2 ?. ~.-~. ~ i PLOT DIAGRAM Locate clearly and distinctly all :ibuildings, 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, :S.S ~ '-'---"~J~c'~';'~'o'*( .......... being duly sworn, deposes and says that he is the applicant above named. ' He is the ...................... ~ ................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly 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 Notary. Pubhc,~..~'.. ~ ........... County ,--~ ~ /