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Home My WebLink About12233-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. g. J .1.7.8.3.. Date July 16 19 $3 THIS CERTIFIES that the building ................................................ Location of Property . .6.0.5. ................. S..e.a.~.q9 .d' .D.~.$ .v.e ............ .S.o.u..~.h.o.l.d. .... Hou~e No. Street Ham/et County Tax Map No. 1000 Section ...0.7.9 ...... Block .. 9.? ........... Lot ..... 0.6..? ......... . Subdivision .... S.e..a.~p. qd...A.c.p.e..s ............ Filed Map No........25 75 .Lot No. ........27 ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .H.a.~.c..h..1.6. ....... , 19 .8.3. pursuant to which Building Permit No...1.2..2.3.3..Z. ........... dated ..... .i.p.~. $ .1..7 ............... 19 .8.3., was issued, and conforms to all of the requirements of the applicable provisions of tile law. The occupancy for which this certificate is issued is ......... ~ PP~¥.a%~ qD~.-.fa.~lY dwelling. The cerfificate is issued to DAVID G. FEAVEL & his wife, MARY ANN (owner, les~e'~t"te,'ta~O of the aforesaid building. Suffolk County Department of Health Approval .1.3.-~S07.36.............................7/13/83~ Robt. A. V±lla:.P.E. UNDERWRITERS CERTIFICATE NO ..... P e n d in g Rev. BUILDING TOWH HALL $OUTHOLD~ N. Y. BUILDING PERMIT <THIS PERMff MUST BI: KEPT oN TUE '~P-,E~Is:Es UNTIL. COMPLETION OF THE WORK AUTHORIZED) ' · 12233 Z Permission is hereby granted ULL 6~~ ~ ~.~ ~1/~ ....... ~o ............ ~ ........................................................................ ~"-'...'~ ........... ~ ........................ at pt~isen~ I~at~ at ...................................................... ~..-.:....'.~ ........... ~~~~} ............ ~...,-~ ............... '~" ......... ~' ............... ~5 ........................... ~ ~ ' . ..~ .~ · . .........~ } ......... ~.~-~ .... ........ Bull~lng I~e~r. - - Fee ~ ........ ~ ............... : Building FORM NO. 6 TOWN OF SOUTHOLD Ruilding Department Town Hall Southold, N,Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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: I. 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. 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-existi~g" 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 on pre-existing dwetling/r land use $ Certificate of occupancy $5,00 2. 3. Copy of certificate of occupancy $1.00 Date..~/~. -3/~ ~ .. New Building ....... Old or Pre-ex[sting Building(X) ......... ~ tVacant/and ............. Locat,on of Property. .......... ...... Hou~ No. Stroot ~ . CountyTax Map No. 1000Section ...~ff ........ Block ..... .~. ....... Lot .... ~..~. ....... Subdivision..'~.z'~Z...~.~'..~. ~'~ FiledMapNo.~.~..~.~...LotNo...~.....~. .... Heelth Dept. Approval../3".~.~..'. ~.. ~ .... Labor Dept. Approval ...................... ,.. Underwriters Approval .......... Planning Board Approval .................. ,. Request for Temporary Certificate ..................... Final Certificate .... Fee Submitted $ .................... Construction on . above described building and permit~ meets al~ app~cable_~o~s and regulations. Applicant. ~~~___~,ff_.. ~.~..~ ................. £ ,O"It-) 10010 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITy ~- 85 JOHN STREET, NEW YORK, NEW yORK 1003~ Oate July 1Et, Z983 ,~p~,fic,,tlo, No.o,,/i,e~.l?~--8~ N 609826 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of David ~e~vel~ ~a~ood Dr., Sc~zthold~ N.Y. in the following location; ~ Basement X[~ 1st FI. [] 2nd FI. Section Block Lot was examined on Jiffy ~.4 ~ ',~ and found to be in compliance with the requirements of this Board. FIXTURE OUTLETS 25 DRYERS IECEPTACLES 39 SWITCHES FIXTURES RANGES OVENS FLUORESCENT EXHAUST FANS OTHER APPARATUS: SYSTEMS NO. OF FEET S E R V C E No. os cc COND,r A,W.G. NO.O~ HI-tEG A.W G NO. OF NEUTRALS PER ~ O~ CC. COND OF HI-LEG 1 OF NEUTRAL 1 ~otors: 1-F. 1-G.F.C.I. 3-~oke Detectors TELEPHONE: 477-040O PENNY LUMBER MAIN ROAD, GREENPORT NEW YORK 11944 Name Address Order Dete PRE-HUNG INTERIOR DOOR UNITS ,/ Main Road Greeoport, N. Y. 119~4 477-0~00 ....... Delivery Date PENNY LUMBER ~,S~UN ao~o. aox ~7 GREEN, PORT, N.Y. I1~ Job LEFT HAND RIGHT HAND 2 Door Bifolds [] RH [] Fold to Right Hinge Right · Fold to Left Hinge Left OPEN DOOR TOWARDS YOU FIELD INSPECTI~N FOUNDATION (1st) FOUNDATION (2nd) COMMENTS o ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: I~e4 Roo~ iJ I~ copper t.ubing is used for wate~r di~tributing 'sys~en~; piping shall be of types K or L only Room I, FORM NO. a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL ToFile~,.,~,,, -~-'---~,~~--~-,. ............................... ...~./.~.::. ................... ..... ~~ ~...~.~. - PLEASE 'FAKE NOTICE that your application dated ..... '-~~.....Z'-.6: ...... 19 ~ Location of Property ..... , ......... ~ :. · ._ ...... ' ........ ~ .~. ~; .: ~ County Tax Map No. 1000 Section ..... ~ .~ ..... Block .... ~ ~ ...... Lot ...0.~ ...... is returned herewith and disapproved on the follow~g gro~ds..~~.~. ~~ . .. ~~..~~.. ~...~~~..~ .................. Build~g Inspector RV 1/80 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION ZST [ ] ROUGH PLBG. FOUNDATION 2ND [ ]INSULATION [ ] FRAMING FINAL INSPECTOR FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-18013 Examined. ~../~./ ......... ,19~.: Approved ........ ,12. , e it · ~ o ~ ~ ~ ' ~ /~ (Bdilding Inspector) APPLICATION FOR BUILDING PERMIT Application No..~'~"?~.'.~.~,'"~.. ....... INSTRUCTIONS a. Th/s 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 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 necessary inspections. (Signature of applicant, or name, if a corporation) ~./..~ .:z...5.~ .~..r.././.~...x..¢...~./. ..... (Mailing address of applicant) State whether applicant is ow.~ner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .. ~*..'~-. ...... a. ~.W£.g .................... ~ ................................ Name of owner of premises .. ~..,~..L~../.b .... .ff'.:...~.~..~..&f..~..~. .......................................... (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 ...................... 1. Location of land on which proposed work will be done .................................................. .. ~ .o. ~ ............ 5~?.a.~. ~., ~. ~/~.z. .............. .~4~ ~././. (~...~ ................ House Number Street Hamlet County Tax Map No. 1000 Section ....... '.~..~. ....... Block ......... .7. ....... Lot Subdivision .~..~/~..L~...~.~..~...../~...4.~..~../ ........ Filed Map No. 2.O~..Z~.. ..... Lot...4 Z ....... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construct/on: a. Existing use and occupancy . .6~.: :~.4-.~:../~..~..~..~ ...... .~. ?..~. ..... ~..~, .C<~../~..~ .' ................ &~. use and occupancy . : .................. .'-. .......... b. Intended / ~Additi 3. Nature of work (check which applicable): New Building ......... on .......... Alteration .......... Repair .............. RemOval .............. Demolition .............. Other Work... ~. ........... ~.~ .~ (Description) 4. Est/mated Cost ..................................... Fee ~. .................. . (to be paid on filing this application) $. If dwelling number of dwelling knits i. · ../.iiiii ...~... Number of dwelling units on each floor If garage, number of cars ..... i ~. ........ 6. If business, commercial or mixed occupancy, specify~re~ extent of each ty~ofuse ..................... 7. Dimensions of existing structureS, if any: Front ......... ~ .... Rear ...'~A~... ..... Depth...~.. ........ Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .......... Height _. ; . Number f Stories , . _ 8. Dimensions of en ire new construction' Front ,~ Rear Y ~ h ~ ~' ~,^~t ' ...... ~d "~-' .............. Dept ............... Height .... ,~ ........ Number of Stories ..... .-",-~ ....................... .~. 9. Sizeoflot: ~r~nt .... /...O~., .......... Rear ........ ./..~4.. ......... Depih 'i. ~),~q~5 ............ 10. Date of. Purchase ..... .,f,~..~fl...~.~. ~--, .......... Name of Former Owner .~..~.~.&~.~'~ i .~..~.'~.'/.' .~.' 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed co, nstruction violate any zoning law, ordinance or regulation: ..... .~..~. ............... i3. Will lot be regraded ......... i.. ~e3~...,, ............ Will excess fill be removed from premises: Yes 14. N,,a~e of Owner of premises l).~.q;(.~...~:', t~.z?.~?.~.Address .~.O./.Xq~..f'..a.~.~44d. PhoneNo' ..~..~.~". y.,,~..~.? N,,~me of Architect ......... : .... Address ................... Phone No C&Qff a.~]~'o~..~ ' ' N,une of Contractor .......... !. ............... Address ................... Phone No..~. ~@.~ll-. ?..o. 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. STATe oF YOU,d s.a COUNTY OF ........... ~4.o ~'~ ......... "~:~A.~I~I~...~,~.. · .~.~.~.~)~. ....... being duly sworn, deposes and says that he is the applicant (Name of individual signinglcontract) above named. He is the O ~~. ' ' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly aOthor/zed to perform or have performed the said work and to make and file this application; that all statements containe.d in this application are 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 ........ . .~..( .~f. ....... ,.al.ay of~.--"-, ~' .. ..... , 19~.4 .. '. ............. No. az~a (Signature of applicant) Qualified in Suffolk Coun~ ,~) o~ I ! , O[pAR'fH[NT OF HEAL'fH '\ ~' E [~'J~- ' Y STATEMENT OF s.~ao~,.oo.a~ i I M~ t:mL ~ T' ' 125,0 .......... THE WATER SUPPLY AND SE'WAGE DIS/IO~AL o ~ZJ~VEY'[_:~ FO[2.. SYSTEMS FOR TInS R~S,3~#C£ W~LL ~i DAV! D J l/ki2~ At J~ CONFOR. TO TNE $?ANDA,.~ ~ TI-I. ~ I o ~ ' ?- ~,? r- , / '~ 8 '~ b .~ t~. '~.~. SUFFOLK CO. D£1rr. OF HEAL. T" SERVICES. . FEAVE f ~__~\ SUFFOL. K COUNTY DEPT. OF 14~ALTH "~-,,~ ~ - ( . ~ .. ~ .................. ~ ~ ,~, ~ ~ -~ DATE: , ~ . , , ~ ~'~~ ~K CO. TAX MA~ ~AT~: / -o, .... ~ '. ~ ~ SCALE-~" 1' ~rHotg ~,V. I, ~OT..... , NO~, ~EFE~ TO'~Ap 0F ~EA~ Ac ....................... ~E~ ~ECr, t, ~/LE~ ~ ~'~:~T~ ~Yt~ B~_{ H~VV GREEN~T N~ Y~K '? ~2JO 125,0 ~ A P SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DtSl~I~AL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE /~.,T-.A"~DA~,;.I~S O~F~ THE (si , , SUFFOLK COUNTY SERVICES -- FOR CONSTRUCTION ONLY DATE: H. S, REF. APPROVED: DEPT. OF HEALTH APPROVAL OF GREENPORT NEW YORK