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Home My WebLink About11804-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z. ! .2.6.9.9. ......... Date .... P,..u.g.u.s.t...1.6 ................... 19 .8.4. THIS CERTIFIES that the building ....O.n?.. f..a.m.±fi: y....d.~.e. 3:..~ 3.n.g. ...................... Location of Property . .1.3.5. 0.. ~.e.q ¥..Iq.&~. 3,...~.o.a.d. ............. ~.a. ~ t)..~.~.u.q k. ............... House No. Street Hamlet County Tax Map No. 1000 Section ...1.0.6. ...... Block ....1.0. ......... Lot 003 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... ~J.u.~y.. ~ .......... 19~.2. pursuant to which Building Permit No..1.1.8.0. ~..g .............. dated ..... 4!~2.Y.. 1 5 ............... 198. 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 ......... 0 n e..f.. ~ ~n;L.l. 7. qtF.e.% ~..± p~ .. The ce~ificate is issued to ROBE/~T A. I)Al~Ilq ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval . 1 ¢.-,S.Q-r 7.1 ................................ UNDERWRITERS CERTIFICATE NO.. #i~ 5 86 6 8 ? Rev. 1/81 Building Inspector BUILDING 'rOw~ SOUTH'OLD, N~ Y. BUiLDING~ (THIS PERMIT MUST BE KEPT ON COMPLETION OF THE WORK AOT~RizEI~) No. ~1~4 Z '~ate:....~ Per~nissior~ is hereby granted to ~: .... Zz.~. ..... -Bu,l?ing ,usueC.or. : .. ~ ~*. 6/30Z80 , ~ ~ FORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Sonthold, TEMPORARY Certificate Of Occupancy ~4n T, ZI 1 -~01 Date Decmeher 28 82 THIS CER"f [F1ES that lhe building ............................................... Location of Property 1350 West Nill Road Mattituck House No. Street H~mlet County Tax ~ap No. 1000 Section . .1.0.6. ....... Block , .1.0, ........... Lot 003 , S~hdivision .... X. .......................... Filed Ma~ No, X .... Lot No, conforms substantially to the Application for Building Permit heretofore filed in this office dated · . .d p.l.y...2 .......... '.. , 19 .8.0. pursuant to wlfi~h Building P~rmit No...1. ! .8.0.4. . ~ ........... dated .... d.u. ~ 7. J.5 ................ 19,8.2, , was issued, and conforms to all of the requirements of the applk:able provisions of the law. The occupancy for Milch this certificate is issued is ......... a privabe one-family dwelling.'~ Thc certificate Js issued to Robert & Karen Darin of thc aforesaid building. Suffolk County Department of Health Approval J.2.-:~ .Or.Z'l. ,..1.q/. ] 7/.8.2. ~ . .R.o.b..t :..A.'.........Villa' P.E. UNDERWRITERS CERTIF;ICATE NO ........ .N. . 5. .8 .4 .5.8. 7. ................................ *This CerbJ_flcate of Occupancy must be replaced with a permanent C.O. upon completion of work. Building Inspector Rev, 1/81 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11@71 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 natura( or topograohic features. 2.Final approval of Health Dept. of water suop y 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 building~ and installa* t/ohs, 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 bulrdings (prior to April 1957), Non-conforming uses, or buildings ahd "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. / ' C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land usa $5.00 3. Copy of certificate of occupancy $1.00 Rev, lo-10-7a Date ..... New Building ........... Old or Pre-exist ng Buil,ding(X) ......... = ZVacant Land Location of Property J 'J~ ,~)~ ~D~"l'~ I~ IILL ~ ' Hou~ No. Streec Ham/et County Tax Map No..1000 Section ... lO. ~ ....... Block ..... I.Q ....... Lot .... 8:O. 3 ...... SubdJwsion Filed Map No Lot No ' Permit No, 1.1 0 . ~. . . Date of Permit . Applicant.,, , ......... Health Dept. Approval ........................ Labor Dep[. Approval ......................... Unclear/tars Approval ........................ Plann[ng Board Approval .................. Request for Temporary Certificate ..................... Final Certificate ........ Fee ~ubmitted $..~ ....... Construction on above described building and per~iCmeets all app~cabl~o~es and regulations. ...' ' ' Ac FORM NO. $ TOWN OF SOUTHOLD Building Department Town Hall ,%uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and bm tted-~c,..~ut~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 disposa --(S-9 form or equal). 3. Approval of electrical installation from Board of Fire UndenNriters. 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. 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 featu res. 2, Sworn statement of owner or previous owne~' 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 / land 3. Copy of certificate of occupancy $1,00 use --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 New Building J Old or Pre-existing Building ............ Vacant Land ........... Location of Property ............ ,~; .................... House No. Stre{t ' Ham/et Owner or Owners of Property ..... .(~..(~.; · .7~; ~ ............................. County Tax Map No. 1000 Section .... [.O..(-9 ....... Block .... J.(~. ........ Lot ............. Subdivision .......... ~ ..................... Filed Map No .... .~. ..... Lot No, . .~ ......... Permit No..~' ... Date of Permit ........ Applicant .. · Health Dept Approval Labor Dept Approval ~" ' Underwriters Approval ................... Planning Board Approval ..... '7. ................ Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted .J...¢., .... Construction on above described building and p~jt ~eet, s all applicable codes and regulations. Applicant .... /'.~.~. ~. , ,~.~;_.,..~. ,/_~,<, ................. THE NEW YORK BOARD OF FlEE UNDERWRITERS ~ SURE^U OF ~-ECTR,C,T~ ~- 85 JOHN STREET, NEW YORK, NE~V ~ORK 100~8 ..t~ Nov--.her 29, 1982 ~pp,,c.tio.. no. o.f,. 186657-82 Pgl1804-ZN 5 8 4 6 8 7 THIS CERTIFIES THAT Robert A. Darin, 1350 West M~ll Rd., I~atticuck; N~Y. 106 10 not 003 in the following location; ~] Base,~ent ~ 1st Fl. ~ 2nd FI. Section Block ~a~.ml.edon Nove~er 22, 1982 and found to be in comellc~nce with the ~equirements of this Board. FIXTURE FIXTURES RANGES OUTLETS SWITCHES 19 17 EXHAUST FANS OTHER APPARATUS: 2-G.F.C.I. 1-Smoke Detector ~ R ( r V m C E NO. OF HI-LE~ AWG, OF HI-LEG INO'~F NEUTRA£S ~FA'W O' NEUTRAL Robert A. Darin 122 Darrow ~ . .. Greenlawn, N.Y.., 11740 /~;;~%~,,%~.~:red ,n any manner; return to the office of t~,e Boor~ if ~inc~recL ,nspectoys may be. identi,~ed c 1MEN~. tHIS COPY ~F -CERi~IO~I~S~ NOT BE JL~ER.D' · FORM NO, 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date ...... ~7~ ............... File No ................................ · 1 o::... ,~~, 1~ ~ ..... . . . . Subdivision ..... ~ ........ Filed Map No ..... ..~....~/.. Lot No ...... · .'-'~......~.. ~ /~ ~,:~ ~ I Bulldog Inspector RV 1/80 FIELD ~INSP~CTION COMMENTS FOUNDATION 1st) FOUNDATION (~nd) 2. ROUGH FRAME & PLUMBING INSULATION FERN. STATE ENERGY G~ODE FINAL ADDITIONAL COMMENTS: I I'~ Itl Z I$'- 10%' 1; 4." 0" 5"-0" II FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL' SOUTHOLD, N.Y~ 11971 TEL,: 765-1802 (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No./.[~ ~ .......... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted :~L~!_:, ~!- to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. h. 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 issue a Building Permit to the applicant. Such permit shall be kept on the promises 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 promises and in buildings for necessary inspections. (Signature of applicant, or name, 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 , .~(9.~ ~ ~T~. ,' ,~, ,t~ ~; ~. ,4., ~*~ .~!Q...~, .h.~. ~.~ ............................... (as on the tax roll or l~test deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... elmnber's License No. ~.~.~.. ~.~- '..~'5'.~J Electrician's License No.~. ./.~ .... lt. ....... F. ...... Other Trade's License No ...................... 1. Location ofland on which proposed work will be done. .~.[~ ....... I..3. ...... . ..................... .yJ. rt.. rv ................... House Nmnber Street [/~ ~ , ~.~ Hamlet County Tax Map No. 1000 Section .... [.0 ~.0 ...... Block .. J.Q~.O.O. ......... Lot..0.0.~0.0..0 ........ 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 .... ~. 9..N.a. ................... : ...................................... b. Intended use and occupancy . .0. U[..~.*.e3. [¢.']..~...~1.~..Mt-.~.~..~ ........................................ 3. Nature of work (check which applicable): New Building .... ~ .... Addition .......... Alteration ......... Repair .............. Removal .............. Demolition .............. Other Work ............... I (D ripti 4. Estimated Cost .......... j , . ........................ ' ....................... : (to be paid on filing this application) O. 151..~. N mb ofd Iii nits chfl 5. If dwelling, number of dwelling un. its ........... u er we ng u on ea eot .......... If garage, number of cars .... l:,/./.A ................................................................ 6. If business, commercial or mixed' occupancy, spec/fy natur!~ and extent of each type of use ...b/,/~ ..... } ....... 7. Dimensions of exist, ingstructure~,ifany: Front ..... ~:~t. ...... Rear ....~.:(t. ...... Depth .... ~:D ....... .~. 5'.' N b fSt i O.~..~. Height .... , ........ um er o or es ................................................ Dimensions of same structure with alterations or additions: Front ................. Rear ................ Depth .................... '.. Height ...................... Number of Stories .................... 8. Dimensions of entire new construction: Front ..... ~..~,. ! ......Rear ..... ~q.~...t . Depth .~.~J .... Height ..... I%.~ ....... Number of Stories ...... .o. tg.&". ............................................ 9. Size of ~lot: Front .. / .5'.~..o 72. ~ Rear /.'~./.' ~ . Depth . .,~.~: .q.~. ........ Zone 6[ use ....... 1. dxstnct m whxch premises are s~tuated .................................................. i 2. Does proposecl construction violate any zoning law, ordinance or regulation: ... [~ 0. ....... . ............... ~ , 13..- Will lot be regraded .... NO..: ................... Will excess fill be removed from prenuses: Yes fNo~} 14. Name of Owner of premises .I~O.~gT..-O^.el.u ..... Address t~e?~q,~, a[-~: ..... Phone No. 7.~.T:Zt.z~. Name of Architect ........................... Address .................. Phone No ............ Name of Contractor ......... i ................. Address ................... Phone No ................ 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 number or description according to deed, and show street names and indicate whether interior or corner lot. TATE OF NEWf~RK ~" COU~vFy 0 ;S.:! (~... ~ ,~ ..... ~~~... ~-~... being duly sworn, deposes and says t~,,~he is the applicant above ~a e of individual signing contract) . . . is the.. ....................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulY authorized to perform or have peffonned the said work and to make and file this application;, that all statements contained in this application am 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 ............ . .~, .day o;...~~ .... ~9~)~ ~r:od.,s~2,~ %~tlg (Signature of applicant)