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Home My WebLink About11740-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Cerlilticate O[ Occupnncy No.g. 1..1.5.5.6. .......... Date ..... .M.a?.c..h..2.2. .................. 19 .8.3. THIS CERTIFIES that the b~ldi~g .. p o~).1 ......................................... 70 Midland Parkway Location of Property 12975 ............... B..a. yy.~o.~..~.qa..d ...... Southold ['l[~t~s'e 'l(Io. Street ................ h3,'fll'oi County Tax Map No. 1000 Section .. 9.8.8. ...... Block . . 9.2 ........... Lot .... 0.1.3. .......... Subdivision..X. ............................ Filed Map No..X. ...... Lot No...X ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated · .~.u.n.e...2 ............ , 19.8.2. pursuant towhich Building Permit No. 11740Z dated ... d.u.n.e...1.4 ................. 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 ......... ...a.u. j_gg.r, qu. t3.cl..s..w.i.m.m.i. O g..p..g 9.1.. ............................................... The certificate is issued to GEORGE R. & MARGARET M. SULLIVAN (owner, le~m~ or-ten~rrt) of the aforesaid building. Suffolk County Department of Health Approval . .n../.a ..................................... UNDERWRITERS CERTIFICATE NO .......... ~. 5.7.1.~3 $ 9 ............................... Building In~pectqr Rev. 1/81 T~ ~O~ r BUILDING ~ D~PARTMI/N~ TOWN ~HALL SOUTHOLD, N~ Y. (THIS PERMIT MUST B~ KEPT ON ~,E PR~ISiS UNTIL COMPLETION OF THE WORK AUTH~RjzED) ULL Permission ' ~s hereby grant d to. .... .......... ............ · ...... ~O Coanty Tax Map No 1000 Section :;~,<,.~,.~..,..,.,;;, BIo~ ~,... . ...... LOt NO. ,.~.~ .......... ~,,.~hnnt ~n .nnli~nfinn dat~ ~ ' ~ . ~ .~ '. 19 and approved by the Building I~spector. ~ ~ ' ,~ ~$../~ ............. PERMIT INCLUDES APPROVAL TO ~'~Et,4OVE ~XCESS FiLL ": FROM ABOVE P~EMISES BY~ iR~G RAD~'i~G LOT TiON --' UC Rev. 6/30/80 :~ ' ' Eta'riding }lnspecfor FORM NO, 6 TOWN OF $OUTHOLD 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 subr~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 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 Res!dences and similar building~ and installa- tions, a certificate of Code compliance from the Architect oi- Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to Ap[il 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 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 New Building ............. ~Build[ng(~) ........... ~ ZVacant Land ............ County Tax Map No. 1000 S~ction ..... ~ ..... Block ...... ~ ~ ..... Lot .... ~ ~ ~ ........ Subd v s on...'.~ ........................... Filed Map No .......... Lot No .............. Health Dept. Approval ........................ Labor Dept, Approval ...................... ,,. Unde~r ~ersApproval .. ~. } ..... P]annin~oacdApprova~ .................. ~ ,.~ Construction on above described building and permi~meets aH ~pp~cabl~odes and requlations. "' /t THE NEW YORK BOARD OF FiRE UNDERWRITERS Hm~00663 BUREAU OF ELECTRICIT~ 85 JOHN STREET, NEW YORK NEw ~ORK 10035 .a,. AU~.~: 4, 1952 ~,..lic,,ti.,~ ~Vo. on fie 175477-82 N 5 7 1 8 3 9 THIS CERTIFIES THAT ; only the electrical equipment as described below and introduced by the applicant nan~d on the able application number in the premlses of L~orge SuLlivan, ~ayview ~A., ~in At Cur. of F~i~land Par~, Sounhold, ~.Y. in thefollowlng location; [] Basement [] 1st FI. [] 2nd FI. O~S~ Section Block Lot was examined on Zb~;~ 2, ~9~ and found to be in compliaJrce with tke roquirements of this Board. FIXTURE FIXTURES RANGES OVENS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT .1. 2 DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: 1-G.F.I. E R 'V C PER ~' OF HI-LEG E NO. OF NEUTRALS AWG Glenn R. ~ra~ley, }k)rton Ave., RED169, ~mcgi~uc~, N.Y. 119~2 Li¢~1227 GENERAL MANAC~ER This cerfl~¢ale must not be altered in {an}, manner;, re~urn ~o the off,ce of ~he 8oGrd ~f Jneo~reet Inspeeto?s m~y be ~denh}l~d 6y }h~r credenflols g. DATE t ~ , COMMENTS ADDITIONAL COMMENTS: FIELD INSPECTION 1. FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING 3. INSULATION PER N. Y. STATE ENERGY C,ODE 4. FINAL / FORM NO. I TOWN OF SOUTHO~.D BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765.1803 ...... ! .... :!i.! ............. .... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No..,/('Z~..~.. ....... Date .... .~/.2~....' ....... 19 ~..'~-- INSTRUCTIONS a. This application must be completely f'dled 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 bulldinge on premises, relationship to adjoining premises or public streets or areas, and ~'ing 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 Del~uhl~ent 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 Regular/ohs, 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. . . .~.:.g. ~./.~.~/. . ~.~.o. ~4 .... /~.¢.. ..... (Signature of apiSlicant, or name, if a corporation) (Msiling address of applicant) //~ ~,~-~__ State whether applicant is owner, lessee, agent, architect, en/ineer, general contractor, electrician, plumber or builder. ..................... . .~. ?. /. .~.e. .<., ................... .~ .......... , ......... ~. ................. (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 ....................... Other Trade's License No ...................... on which proposed work will be done...~.//~ .... ~, .~...~/./.~...~...Z~.~.,. .... : .............. 1. Location of land ../..z..q..7.. $.. ........... z~.~.~/~ ~. ~a....--.:... .......... -- ~.o..~ ~..~.~..,...~...,..~/ ........... House Number 7~ ~,~,arf~(~ ~26~reet Hamlet County Tax Map No. 1000 Section ..... / ...... O..~.~. Block .... O..~ ......... Lot...Of. .3 .......... Subdivision....--~.~.O.~'YP.~.~.. ~.~.~.l~ '~ 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 .......... Alteratio~n. ~ ........ Repair. .............. F/x' Removal .............. Demolition' .............. Other Work..~! (Description) ......... 4. Estimated Cost .JY....~./.D. c~O. t3 o Fee [.~. v/ ~?ri'~f~:~ ~ ~ (to be paid on filing this application) 5. If dwe!ling, number of dwelling units ............... Numbar 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. r)imensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... .. Height ...................... Numbe[gf Stories ...... 8. Dimensions of entire new construction: Front ..... ~ ~ ........ Rear .... .,5..(g ........ Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner ............................. 1 i. 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 .~.e. qc.~..S.u, l (.i ?. .c,¢:. .... Address ................... Phone No ................ Name of Architect ..................... Address ................... Phone No ..... ...o~$, .~ ..... Address ................... Phone No. ~..~ Name of Contractor 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 mmber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW/~RK~, 7 ~ ~ COUNTY OF~ .... ~'~ ....... .//~/..O."- '~' - *"~ ~.~. ff.. ~../~ ~ ~/... ~fJ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract~ above named. He is the ............ ~ ~ ~..~ ........................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly autho~zed to perform or have perfomed 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 knowledge and belief; and that the work will be perfomed in the mmner set forth in the application filed therewith. Sworn to before me this ......... ~...day of....~~~,..., 1~ Notaw Public, . ....... ~ ....... ~ .~-County ~ , ~ ~ ........... ~[tJ~:~..~ ~r~ (Signatu/e of applic~t) , ~. ~-812~50, Surfak C~ t