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Home My WebLink About12462-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southoid, N.Y. Certificate Of Occupancy No..Z13159 Date January 22 1955 THIS CERTIFIES that the building ...A .b .o.v.e.. ~.r.o.u..n .d..s. ¥ .5_ .m.m. 5:. n..g..p.o. 9.1 .. .............. Location of Property ...6. ~ ~..T.h.e..r .e .s.a...D .r .±.v.e. ..... M a t t i t u c k House No. Street Hamlet County Tax Map No, ]000 Section ...1.1.2 ...... Block . .1 ~ ............ TLot .... 0.0.~. .......... Subdivision..D??,p...Hg.J_.e' . .C.p.e.e.k...E.s.~.: ...... Filed Map No..~.2.5.6....Lot No. /40 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... J [~.l.y.. 5 .......... ,19 .8 .3. pursuant to which Building Permit No. ] 2/462.Z dated . ?.u. g. /4 1983 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 ......... .... g~).qv. ~. gT. qt~l~,d..~¥.5_.rn.ntS, n. g..p. qg.~..,, w.Lth. ~l.e.q[~..aB.([ . p F.o.p.e..r..f.qn. 9.~.n.g ~ ....... The certificate is issued to JOHIq A. HOFER AND THERESA A. HOFER (owner, ~..~t~K ~IgIOX)X X X X of the aforesaid building. Suffolk County Department of Health Approval lq/A UNDERWRITERS CERTIFICATE NO ........... # N 6 ] ~ 593 Building Inspector Rev, 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF: THE WORK AUTHORIZED) N? 12462 Z Permission is hereby granted to: ....... ~zr~-~:.~.....~... ~_: ............ ....... ?~....~ .......... ..:.:~....,~....~ .......... ..... /:/. ~z~z~...,~..... ~ ........ ./~?~.~.. ,o ....... C~ .~..~.c~.-:.......~.~......c~.~.~.~.....~../.~./.~z~.~.....~.~ at premises ~ ................................ 7 ........ ' County TOX Map No. JO00 Section ..... ~..~'...~.. ......... Block ...... /..~... ....... Lot No....~.~ ......... pursuant to application dated .......... >Z~...~...~... ...... .~... ............... , 19 and approved by the Building Inspector. Fee $ ....... ~ ............. n I to Rev. 6130/80 FORM NO. 6 TOWN OF $OUTHOLD B~ilding Depertmet~t Town Hall ~)uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in Wpewriter OR ink, and submitte~'~J~c=tc 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 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. Commemial 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 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 on pre-existing dwelling Certificate of occupancy $§.00 2. 3. Copy of certificate of occupancy $ 1.00 land use --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date .... New Building ............. Old or ~Pre-existing Building ............ Vacant Land ............ ,/ Owner or Owners of Property ........................................................ Co. .//5 ........ . ... Permit ~ 7 ~gpplicant .~t No./~ ~. Z.. ~at~ o~ ........................................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ....................... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ,/~,, .................... Fee Submitted $ .............. ~~,. [~ Construction on above describable co:es and regulations. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 October 13, I987 TO WHOM IT MAY CONCERN Regarding Certificates of Occupancy #Z13729 #Zl3586 and #Z13159 I have reviewed the files and applications on the the Building Permits for these certificates and found that the corrections could be made. Victor G. Lessard Executive Administrator BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITy 85 JOHN STREET, NEW YORK, NEW YORK 1003B THIS C~RTI~I~S T~AT was examined on ~Y ~ ~ ~9~ and found to 6e in eompllance with the requiren~ents of this Board. DRYERS FURNACE MOTOES FUTURE APPLIANCE FEEDERS TIt~E CROCKS MULT .OUTLE. DIMMERS ' SYSTEMS NO. OF FEET SERVICE DISCONNECT- OTHER APPAEATUS: 1-O.F.C.Z. (~%v~aing ~ool) S E R AWG, OF CC CONO ! C E NO OF HI-LEG Tt~s ~rtificate cover~ omnpliance at ~the da~e of inspection only. F~au~e of um~val environements it is advis~le to have fr~ue~t tes~ ~d/~~ r~p~rs ~e by a q~l.ifi~ Electric Roy Chalmers ~cb~ Lane C/a~m~k, N.Y. 11725 This certificate musJ not be altered in any manner; return to,the off~ce of the Boord ~ incorrect. InSpectors m~y be identified by their credent,a~s. ILDING DEPARTMENT. THIS COPY OF CE I ANY MANNER. gIEL~ INSPECTION FOUNDATION {1st) FOUNDATION 2, (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: NEW SUFFo .. Lot ~9 HOT~" sUBD! VIS/~/ MAP ~ED (/I Th~ G~IC~ WEAR~T PUBLIC W~TER I,(~N =4~ILES t yoUNG & YOUNG 400 OSTRANDER AV~'FIUE' RIVERH~-AD, NEW YoRK '~-V~Y FOR SU :- ' 'LOT~/O 40 ' '" :';"' ':' ' ' ' ' FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL JUL. ,~ .,. / .o., SOUTHOLD, N.Y. 11971 .. /cfl/~ ,t~ .r.f Ct'.-.,'f TEL.: 765-1802 /~7~fOd' .... ...... ................................ .... ...... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 shali be kept on the premises available for inspection throu~hout 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 necessa~ ~,~ .,,- ..... '...'.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (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 .... ..~./..0...~..q .~.~..o./.dT..Z. icr ;% ~o,5-~/-/Z' ..~t.~C'F ~ ~3/. **'~ Plumber's LicenseNo ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done...~.~..~...../'~..~tT...~.~..~M...~..F....../~..{'.}'~.'.~.~..~.. .......... /County Tax Map No. 1000 Section ,//5 .t/Block ./'. ~. ......... .~Lot ~ ~ 7Subdivision .~.e.e~/0. dP./.~.. ~.F~ .~.. E~.~t.-~.6 ..... Filed Map No../7/?. 5.~. ....... Lot...q.(~. ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: - ,, ............................... a. Existing use and occupancy ..... ~5~,,.*: .-,~..,~.,(~A~.~.....~'.~. : b. Intended use and occupancy .... ~,~ .... .~. ..... ~.g~.~ ............. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alterat[on ........ :.~, Repair .............. Removal .............. Demolition .............. Other (Desdripffon) V/4. Estimated Cost ....... ~....~.. ........................ Fee. ~/.~.'~...~--~.. ........................ (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 ...................... Height ...................... Number of Stories ...................... 8, Dimensions of entire new construction: Front ............... Rear ............... Depth ............... }!eight.. .............. Number of Stories ............ ? ............................ ~ ............... Size of lot: Front ...... /.,'.0/ ............ Rear ..././.~. ............... Depth .../.~.~-. ................ [)ate of Purchase ...... ' ....................... ,~,e of Former Owner ............................. Zone or use district in which premises are situated .................................................... ' Does proposed construction,v)olate any zoning law, ordinance or regulation: . .~.~7 ........................... Will lot be regraded ..... /~.o. .................... Will excess fill be removed from premises: Yes Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect .......... ................. Address ................... Phone No ................ Name of Contractor ................... \ ...... Address ................... Phone No ................ 10. ~"1 1. ~"'12. ""13. 14. 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. rrl COUNTY OF. ~EFP.~ ..... ..... .~'[C~......,...O. ~..0.....~*~ .... ......... 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 saki 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 b~ performed in the manner set forth in the application filed therewith. Sworn to before me this / ~'}~. dayof .X7..U ..:... 19 ~.~.. ............. v ..... tary Public, ~.2-.../. ?,,../FTC'...."cJrC, Od~ .... Cou,,~y LINDA F. KOWALSR~ c~-- /~o'r,~R¥ eu~,r%i !~,-~4~?!s~e a ~e~ Ye~ '/' ................... ' ' ......... (Sig pplicant) 0uali/iedI in Suftolk County __ ~e of a ~¢OOl~lssioa Expires March 30~ lgl~d~L ,