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HomeMy WebLinkAbout12402-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ..... ~ J.2.5.2 ~ ...... Date ............ .J .u .n.e...8 ..............19.8.4. THIS CERTIFIES that the building ...... .o.n.e. ? .f .a.m. i. .1 ¥..d.w.e..1.1.i.n. ~ ................... Location of Property ....2.4.5 ........... B.u..d.d.V.s.. ~.o.n.d.. ~9.a.d. ............ .S.o.u.t.h..o.t.d ..... House No. Street Hem/et County Tax Map No. 1000 Section .... ,5.6. ..... Block ,....5 .......... Lot .... .5 ............ Subdivision ........ Wi..1.1.q~...Pp.i.n..t .........Filed Map No. 4652 .Lot No. 3 conforms substantially to the Application for Building Permit heretofore ~ed in this office dated ..... l~ .ay..1.~ ......... ,198.3.. pursuant to which Building Permit No... 12402Z dated ......... .J.u. 1. 7. ~q ............ 198.3. ., 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 ......... .... NO~d..p.~ ~. y ~.1~.~. 9 p..e.-. ~g[n.i..~,~r..d.~.e..]. ~..i.n.g, ...................................... The certificate is issued to ................... ioV,,,b;. 't~_~de'_; '_;_.L;.~ ...................... of the aforesaid building. f H lth App 1 ' Suffolk County Department o ea rova ........... UNDERWRITERS CERTIFICATE NO ....................... ~J.6.3,q 595 ................... Building Inspector Rev. FOF, M NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, iq. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 12402 Z Permission is hereby granted to: .// .... .... .,.d~....... ~...~.~..~...~.~..~..~.. .... ~.~,z~.~...=.~.~:.' '- .......... ,o ...... ~~..~......~~.......~z~z -- .............................. ..... ~ ........ : ................... ~...: ................................ ; ................................. ................................................. ~ .~ ..................... ~..~. ..................... ~ ..................................................................... CounW Tax Mop No. 1000 Section ..~ ........ Bilk ...... ~.. Lot No ....... ~.~. pursuant to application dated ....... ~ ........ Z~ ............... , 19.~ and approv~ by the Building inspector. ~'~ Building Inspector Rev. 6/30/80 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 qf all buildings, property lines, streets, and unusual natural or topographic featu res. ~ 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 b, "~inqs and installa- tions, a certificate of Code compliance from the Architect or Engineer respo~m ~ ,or 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 featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of bu ildings. 3. Date of any housing code or safeW inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: I. Cert f cate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling J 3. Copy of certificate of occupancy $1.00 land use --Pre-Existing C.O. $15.00 Vacant 'land C.O. $ 5.00 Date .4 /9+ New Building.............~ Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~R' .~.- ~5~-~O'S l~o~O ~-~ S House No. Street Hamlet Owner or Owners of Property ./~oC~I~'Y ~::~ ,)l~t-J,~'~ ...~t~-,~- County Tax Map No. 1000 Section ....~..G ' ... Block Subdivision ,~. .............................. Filed Map No ........... Lot No .............. Permit No.[ .~.~ ~.D:' Date of Permit ~. ],5" / ~ j5 Applicant Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval .~ .~.~.z47.~.~.~. .......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...~. ................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations, · Applicant...~ '"i '"2--2~r'~''~i .... 7~,..--~., F I E I~O !N-~PECTION 1. FOUNDRTION /~s%) COMMENTS FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: 1001071 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NETM YORK 10038 THIS CERTIFIES THAT only the electrical equip.tent as described below and introduced by the applicant named on the able application number i~ the premises of Aubrey Wanzor, Budd~s Fond E.d., Southold, was examined on F ab ruary A 6 s and found to be it~ compliance with the requirements of this Board. FIXTURE FIXTURES RANGES .'OOKING DECKS OVENS DISH WASHERS EXHAUST FANS 25 31 DRYERS MULTI-OUTLET SYSTEMS NO, OF FEET OTHER APPARATUS: 1-4..5 K.W. Hot Water Heater 1-GFC£ 1-Smoke Detector E R V I C E A. W.O. NO OF HI-LEG A, W G G & S Elect. P. O. Box 215 Souchold, N.Y., 11911 LIC.#578 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors :_ C0P~' F.9~ p_U~D[N9 D~Ep~R~TMEN. T..7~!S COf~ OF ¢ A, W, G I NO' OF NEUTRALS OF HI-LEG be identified b) MANNER. 4 00-17-1 FormerJy GA-4 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION TRANSMITTAL SLIP /' FOR ACTION AS INDICATED: [] Please Handle [] Prepare Reply [] Prepare Reply for Signature [] Information [] Approval [] Prepare final/draft in Copies [] Comments [] Signature [] File [] Return to me '" 76~-180Z BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST /~ ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION ~/]/FRAMING ~,' REMARKS~ FINAL INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. I' ] FOUNDATION ZND [ ] INSULATION,,, []FRAMING ~/~FINAL ~//" REMARKS: DATE H.S. NO. STATEMENT OF INTENT 'A THE WATER SUPPLY AND SEWAGE D SYSTEMS FOR THIS RESIDENCE CONFORM TO THE STANDARDS O~ SUFFOLI~ CO~ DEPT. OF HEALTH SEF: Is} ~ E .~~ APPLICANT 0 SUFFOLK COUNTY DEPt. Of HI SERVICES -- FOR APPROVAL CONSTRUCTION ONLY DATE: '-~-~ H. S. REF. NO.. APPROVED: SUFFOLK CO. TAX MAP DESIGNATI DIST. SECT, " BLOCK DEED: L.~C)~_ P. '~49 ,-.,: :'.- TEST HOLE sTAMP FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined.. 7/.'~. ........ ,19 .~. ·'~ Approved...~./.?'. ........ ,1~...~Permit No./.~..~..~..~. J Disapproved aJc ......... ~ .............. ~ ....... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No. Jo~...~..c~..~ ...... 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 tmtil 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 applicantg or name, if a corpdration) L~.~..~..C9.~5~T .C. ~.~. g !<..~h'..S~o. ~- ~.~..~.~. ~\'~ ).~gT./ .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~..O.1~. t.~.~.T..~. ~./.~.~. P...').~..N..~.T./~...-%. ~...x~/.h. ~[ ~©.~d, .......................... (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..5..E.L.~. ................... Plumber's License No...7.0.6. ~-?. ................ Electrician's License No. ~.-.7..~. 7 .~. .............. Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .. .... !x...r>,.. , .S..o. ?. T. D. ........................................... House Number Street Hamlet County Tax Map No. 1000 Section ....O..b..-.~. .......... Block ....~. ............. Lot ~.~...~-~ ............. Subdivision..."b/. ~ .~.¼ .o..'-L,/..~..o./.~.~. ................ Filed Map No..4.&..~.2: ....... Lot ...~. ........... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . ~. }.."~ ?..T. i~.....L.O..W. ................................................ b. Intended use and occupancy . . .o.N..W..l~./h...ixg. I.L..W~.' . .~..X~..~..L_.~.I..~..C-~ ................................. 3. Nature of work (check which applicable): New Building ...... Addition .......... Alteration .......... Repair .............. Remoyal .............. Demolition .............. Other Work ....... ,' (Des on) 4, E~timat~cl Cost ?9~ ~_~O~ o~5)O ~.. ............................................... Fee ......................... ~ (to be paid on filing this application) 5. If dwelling, number of dwell~g ~nits .............. Number of dwelling units on each floor...1 ............. If garage, number of cars ...~.., ............................................. 6. If' business, commercial, or mixed occupancy specify nature and extent of each type of use ..................... 7 ..... if any: Front Rear Depth · D~nensions of existing structures, ............................................ Height ............... Number of Stories ........................................................ Dimensions of same structure wi~h alterations or additions: Front ................. Rear .................. Depth ' Height Number of Stories 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ......................................................... 9. Size of lot: Front I00~ Rear .. 1 ~>..o.-.~5I. ' Depth .[ .6.q.' 10. DateofPurchase 4/ 4-/~ Name of Former Owner .~..IC4g~0~D M~ 11 .. Zone or use district in which premises are situated..I~. ~..% ~..~.~ ?. ¥.1 .~.~....~. ................................ 12. D. oes proposed construction viol~te any zoning law, ordinance or regulation: . ~ ............................ 13. Will. lot be regraded . .I9 ...... i ................... Will excess fill be r0moved from premises: Yes t/No Name of Architect .......... ................. Address ................... Phone No. Name of Contractor .[~°.~.~)%*~..~.O.N~..o.t:~ : . Address:Zl~°C°r~Kqcata~ ~-~- PhoneNo. 5~'~ '4[1'(; ..... PLOT DIAGRAM Locate clearly and distinctly all i buildings, whether existing or proposed, and. indicate ail 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 Y,()RI~ COUNTY O~~~'/'C~-. , iS'S .... · ~i~; c~3;ZC;~,,... -~ .......... being duly sworn, deposes and says that he is the applicant above named. He is the .. . (Contractor, agent, corporate officer, etc.) of sad owner or owners, ~d is duly authorized to perform or have perfomed the said work and to m~e ~d file ~is application; that all statements contained ~ this application work will be perfomed in the m~ne set forth in the application filed therewith. ....................... .day of ....... ~-...., 19 ........ Nora. Public State of New York ..... i ~o. 52-0344963 Suf~oik Cou~ (~ature o=appnc~t) ~mmiaalgn Expires Mamh 30, , SUFFOLK CO. HEALTH DEPT. AIr. OVAL TAX M~ ~~T NEW Y~K SUFFOLK CO. HEALTH DEPT. APPROVAL H. S NO. ...... -,L~J~:%[ .~ [" C ~ '~ STATEMENT OF INTENT ) 9.6'~- ~I~ A i i [~ , '" X / t- '~ .... "," THE WATER SUPPLY AND SEWAGE DISmSAL / ~ SYSTEMS FOR THIS RESIDENCE WILL [p . .t.LE'4~' ," DEED: L.70~ e U~ js ,I ~, -- ....... TESTHOLE STAMP I. LOT NO'D. ~EF'~r~ ~' M~p OE- W BLOW POINT, FORM NO, 3 ToWN OF SOUTltOLD BUILDING DEPARTMENT ToWN CLERK'S oFFICE soUTltOLD, N .Y. NOTICE OF DISP.~pPROVAL File No .............. eLd*se T~ NoTIC~ that your application aatea .. ~7''''/' ~ ......... 19 ~- Location of Property h3~;' ' ' ' co,~ ~o. ~0~ s~, ..~ ..... .~o~ ..- - ...... Subdivision~.t/~/i~. F~ed Map No. . ' .. ~...~..~. - is returned herewith and disapproved °' the f°ll°wmg ~°unds~5~ /~r/~a .... ... .... · .dD~g~., .... . .... ~...~ ~...~ ~.~¢.r~....~/..~'z~ .... . wo , ..... Bu~d~g Inspector ToWN OF SOUTHOLD BUILDING DEPARTMENT ToWN CLERK'S OFFICE SoLrlItOLD, N.Y. NOTICE OF DISAPPROVAL ,~t~.. ~-./~ .......... "~ ?~ File No ................................ .j~.7,o~<c.,~r .M.(7:c..../z',eZL.. ... ,,~..,~.~....Z. ~.. ......... l~ ~.~. PLEASE TAKE NOTICE that your application dated ' ' ......... .... :" County Tax Map No. 1000 Section . .(~-~ ..... Block ...Q~ ..... Lot . ~ ~- ..... Subdivision~.~. .. ?(.... Filed Map No.. · . ..... Lot No ............... is returned herewith and disapproved on the following grounds· .~. -~<<TZ~/'~' · .,4~ . · ~G~'7 .... ~.~....~/..~x~z~....~z...~...~.. ... Building Inspector .Rmgulatory Affairs Unit ~ ~rea~r tham 300' from ~vemtoried tidal wetlands. ural slope. ~'~,,',, ,'~'.,.. .,' ~E-',. r~ ,,,,. , - , , r ~, ,, , ,.,.,~:,?*¢:z.,~ , . ,. . , ,, .. , .. .... ~. , , , ..... , . , , ~ I I . , ,,~_ . _ ~_~, ~, . ~% ~ ;.,- "'~ ':..'" .', .'", I~ ¢~oy ,~ ~r~*:d i /~' % __ 'o~o~//' __._L . ~ ___~.~ ~ . ..:~ ,~: ¢' · ~.,~ ~ ~ O~~ -' . , II , , ~Z~// ~ ?/. ~~ ~/. o// ' IF~pper tubing is used '~ ~ '. o ~/ ~ .............................. ' for Water distributing O&AO &OAO ~ ~ /~ I¢ ~ ~ i - ! ...................................... ~ , system; piping shall be ~. ,: 0 ~ ~ ~ ~ ~ ~ ~ t T ~ g IA ~,are ~ ~ APPROVED AS NOTED ¢ ~ Ig~ ~l /~ ~1 765-T802 9 AM TO 4 eM FOR TH~ ' ' USE IS UNLAWFUL ,o~,o~,~ INSPECTIONS: ~,[G I1~ ~1, I'~OOt°°O ~/ 1. FOUNDATION . TWO REQUIRED ' ' ' ' ' "'" """"-"'-"""'"'"'" ......... -'-'--"""-'"'""-== ~ o m e p I a n n e r s i n c ~' "~" ==~= ' ....... '"" ....... "'"-"-" .......... -'"'"'-" ........... I 4 I [ I I E 12' t 0'~ (.4' , ,i, 54.o" , 270~ $ I I I / L~''~r '*'~ --- I ; ~t T~ r-~4 r~,~. II , I ~~ - ~_-1 I v-4 b* +< 11 44 ~___~ ............. ~-- l~ ~ ~ ................ ~--{ .... ~--~ .... 4 , -, ._ .... _ I ~ : , ' I I - ,~ ~ : /~.~ ..... , , , - , , I "-: --~ - , = -- i Ir..-- ,-C' ..~, ' ' ' ' F ' ~ ' ' ~ ~ c~ ......... ~' I ' I I i~iR ~ ~ { I -. . ' ¢~ -- - s .... ~ ¢ .............. ~ r -' 2703 ~~="~ -"'-'-'"---"-'"-'-'-0' ..... "'-""--- ....._..._ planners inc