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Home My WebLink About11736-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z1417.0 Date J.a?.. 17 ........... ,198.6.. THIS CERTIFIES that the building .... P. 9 O~L.,.. d..e.c.k..~..f.e.n..c .e.. ...................... Location of Property .1. 135..~uop~.lli~.l..ROa~l ................... ~r.~PILI~QI'.~ ........... House No. Street Hamlet County Tax Map No. 1000 Section ... 0~ ..... ;Block ..... .2 ......... Lot..~ ............. Subdivision.. Eastern Shores Filed Map N~.~ 52.3..4 LotNo 129 conforms substantially to the Application for Building Permit heretofore ~ed in this office dated June 2 117.3.6. Z ..................... ,19 82 pursuant to which Building Permit No. dated .... ?T.u.n.e...1.1 ................ 19 .8.2., 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 ......... .... · ngco.~n~. ~.vti~j. ng. P~.ql ,..d,~¢l~. i .I~ ~¢.I, ............................... August Larmann and wife The certificate is issued to ........................................ of the aforesaid building. Suffolk County Department of Health Approval N / A · UNDERWRITERS CERTIFICATE NO N 5 72606 . Rw. 1/81 Building Inspector BUILDIN~G; gERMIT I ' (THISr PERMIT MUST BE KEPT ON THE RP, EMI~ES UNTIL ~ULL COMPL~ION OF THE WORK'AUTHORIZE~) ~ ~ · ~ L ~ J.......~ : Z Cato ..~ ....... ,~ · P~rmission is hereby grab, ted to: ~ x"~ ........... ~'~ ........... · · '~ ¢ ~' J' ~'Lot NO, L.~... C6hhty Tc~X Map No. 1000 Sect,on ~"~'~'~"~v!"~' Blod~ t~' ' ' ' ..... p0~suant o application :dated ...... ,.;.~; ....:...~.,,:p.,,, 19. approved by the B0il~ing Ib~pector. ' ~ : ~ ~ FORM NO. 6 TOWN OF SOUTHOLD BuiidJng Department , Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and subr~itted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: 1. Final supzey of property with accurate location of all buildings, property lines, streets, and unusual n3~.ural or tooograohic features. 2. Final aoprovat of Heaith Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approva~ 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 'o~ Engineer responsible for the buiiding. 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: 1o Accurate survey of peoperty showlng 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 housin§ 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 pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 Constructio9 on a~79¥~ ~_,~r~ $5.00 New Building ............. Old or Pre-existing Buiti:iing(X) .._~ .... = /Vacant Land ............ Lo=,o o,' Property ..... tl-5.5 .............. Co, ntvTaxMap No..1000Section .,~% ........ Block .... ~ ....... Lot...~.~ ....... Subdiwsion ................................. fl Fi~ed MapNo. ..: ....... Lot No. ..' ........... Health Dept. Approval ........................ Labor Dept. Approval ......................... Unde~zriters Approval.. ~.~.~.Og ........ Planning Boa/d Approval .................. . Request for Temporary Certificate ..................... Final Certificate ................. L AT' .-, F_ ::u? TF_~ ,_X,~. J ~' MONL)I'4E'NT ~000708 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRIC TY~ 8E JOHN STREET, NEW YORK, ~0! 10038 THIS CERTIFIES THAT only the electr~nt~d b~l~~ b~ ~pp~on ~b~e apptication number in the premises of and found to be in compliar~ce w th the r?quirernents of this Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANE OUTLETS SWITCHES FLUORESCEHT 8 2 DRYERS E R V I C E NO, OF CC, COND, NO+ OF HI-LEG A W. O+ NO OF NEUTRALS A W G, PER ,8* OF HI-LEG OF NEUTRAL OTHE APPA TUS: 2-G.F,I. 's, 1-4.Skw t-[eeCer OF CC COND. (Swimmirg Pool) ~ cextificaCe covers oompliarme at ~e date of inspection only. ~ecauae of unuaual e~v:[zoza~eat;s i~ is advisable to have frequent ~eat and/or repairs made by a qualified permon. Prago glec,, Lane, (~ee~F-~c, N.Y, L19z~ e must not'be altered in return to the office ANY .~MANNER., FIELD INSFECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ODE ADDITIONAL COMMENTS: FINAL TOWN OF ~K)UTHOLD BUI~ DEPARTMENT 'TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Ex~min,d .~.~44a~.//. .... ,19~.? Approv//~ · ./.~· .... ,19~'~ermit No./../..~..~.~...~ Disapprq~d a/c ....... :...--.'7~... ....................... ~ 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 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 ~iving 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 Buildin$ 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 an applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ..... fi.:..n..e./4.4/.+ $, ,~: /Kc ......... ~l~t~ing address of applicant) ........ State whether applicant is owner, lessee, a~ent, architect, engineer, ~eneral contractor, electrician, plumber or builder. ........................... ZS..q/>., .~.e..~- .. ...................................................... Name of owner of premises...A?..~. !~..~'~..:'~.. 8..~..~...~...~..~. .... .~..~./.~..~.. ~..~...~.'. ................ (as on the tax roll or latest deed) If applicant is a corporation, signature o~f duly authorized officer. .... .... ..... (Name and title of corporat~ officer) Builder's License No ....... ]~ ................ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... l. Location of land on which proposed work will be done. ~.~//j.g'~....~.o.,~ ./~..~..f~./..~./-..~.7'...~..~./)..~.~...~.,~..~..cLt/..' ...,.: ........ House Number Street Hamlet County Tax Map No. 1000 Section ...... ~33 ....... Block ... ~ ............ Lot....2...~. ............ Subdivision~.~...C~.. ~..A,~.~.~..~.~...~..~..o..~.~. ,~ ......... Filed Map No. ~.. ?-..3..~. ...... Lot../.~.~ ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. ~.x~,n,,se and occup~cy.., h...~..¢. ~ ~ ..../..~. ~'.... '. ................. . ....................... . .... b. Intended use and occupancy ..... o..u..A/~)..~..~./. ~{~. ,~A/. ~, O ~w....~.../~. .~.. . .C.~ ..... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .. ..... Repair .............. Removal .............. Demolition .............. Other Work., .1°:~... , ,~ (Description) . 4. Estimated Cost .~./. OOo ,.o o Fee /~'~ ~ ~ -'-/~'f~ ['"'.~.'~'~,. ........................... (~' ~"%:,~.'r:' ~dv!./~ ~:,:~.' ~,~,~: "~' ;o;~¢s), (to be para on nhng this apphcatlon) 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 .................... .. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ...... 2.0. ...... Rear ,,, .~, .~, ........ Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner ............................. 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No.~..~. ~...~f..~..z=.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, ~nd, 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(YI~RK, , _ff ~ ~ COUNTY OF .~... '~'~ . ........... :.././7..~.~.. .... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is e .............. : ................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly author~ed to perform or have perfo~ed the said work and to m~e ~d file this application; that all statements cont~ned ~ this application are true to the best of his ~owledge and belief; and that the work will be perfo~ed in the m~ner set forth ~ the application filed therewith. Sworn to b~fom me this ........ ~...day of ........ ~ .... , 1~ N Public, .... ....~ ..... ~ .~~County _ ~~ ~~ }~ ~/~'~ ~' ~;e';; applicant) ~, 52.8125850, S~k (~./ : ~m ~vi'ros Msrsh ~,9~1 ~