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Home My WebLink About12260-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z. 1. ! .9.3.9. .......... Date ....... .S.e.p..t 9.m.b.e..r' .2.3. ........... 19.8.3. THIS CERTIFIES that the buildin~--new dwell lng 495 Harper Read West '' Location of Property 890 Wells Road Southold House No. ~ Street Hamlet County Tax Map No. 1000 Section ...0.6.3. ...... Block ...0.7 ........... Lot... 9.q? .........:- Subdivision..H.a.r.v.e..s .t..H.o..m.e.s.. E..s .t.a.t.e..s ..... Filed Map No. $ .3.3.7....Lot No... 9. .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .Ap.r.i..1..1 .......... 19 .8 .3. pursuant to which Building Permit No...1.2. 2. .6.0.. Z. ........... dated .... .A p.r.i. 1...1.6 ............... 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 ......... a p. rivate one-family dwelling. The certificate is issued to MAURICE & MARY ANN McAULEY ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval 13-S0-44, 9/14/83 Robt. A. Villa P.E. UNDERWRITERS CERTIFICATE NO .... N 612636 Building Inspector Rev. 1/81 permissio~ is hereby granted to: - BUILDING PERMIT (THIS PERMIT MUST BE KEPT, ON THE PRE/~IS~S UNTIL I~ULL COMPLETION OF THE WORK AUTHORIZED) !: Dote ,-..~..~...~e.....~ ............. , - ~ at premise-~ located at ..~,~.~z...'./...~.~.o. .... ~ ....... ,., County Ta~ Map No. 1000 Section w..~'"~.~......;. BlOCk ~.~ ~o ~,~,~,,o. ~,~ ..... ~r~..~ ....... ~.: ........ ~....~. Bull~lng 19spector. ~pproved by the FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, 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 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 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 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 / _/ Certificate of occupancy on pre-existing dwelling er land use $/.,,~/ $5.00 2. 3. Copy of certificate of occupancy $1.00 ,~,,. Date ...................... New Building ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property .~..,~..., ~.~.~ · ~'. ................ ~.~../.~. · Owner or Owners of Property ...~.~D/!t~.C~...~..?~....~'/.-~-./.4~/-'---- ....... ................. Countv Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. l .')?~.~ .... Date of Permit ,~/J~.~//~..,~App licant . ~..~.~..bJ~. ~-'t~,4~ · .~.~. · · .~:. · .~,,... Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .......................... ~/'.~~/~'~'~"' ~ . ~ Construction on above describ~ bi:clda~: and pe~~p~~~eg~'~a ~on~r.'~ Rev. 10-10-78 ~ ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRIC~ITY ~ ~,~ ~ '1~ 85 JOHN .STREET, NEW YORK, NEW YORK 100~8 ~.~ ~.,,~..o.~o.o./,,~ N 6~2636 THIS CERTIFIES THAT only the eJ~tricaJ equipment as described below and introduce~ by the appllea~t ~amed on ~he above application nu ~ber ~n ~he premises of wasexat~inedon 2~;1~ ~ 1~ andfoundtobeincompliancewiththerequirementso~thisBo~rd, FIXTURE OUTLETS SWITCHES FIXTURES RANGES OVENS DISH WASHERS ~8 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ~IMECLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E R V I C OT~. ER APPARATUS: 1-G,F. i. NO O CON{) OF CC COND, NO OF HI-LEG OF HI-LEG NO, OF NEUTRALS l~l~nd Electric ~). Lic#2~ This certificate must not be altered in any manner; return to the office of the Board if ENEf~/ be, idenfifle~-'by~tfi~ir credentials. COPY FOR BUILDING DEPARTMENT. TH S COPY OF CERTIFICATE Mt NER. FIELD INSPEC~~ON~' COMMENTS ~FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. STATE ENERGY qODE o FINAL ADDI COMMENTS: ]8'OU.M NO* 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ~.~..:../......./...~.. ............... , 19.2 ~,/ Approve~: ................................. ,1~... Permit No ~ ........... ./....~.....~.....~...~, ...~'...... Disapproved a/c ....................................... . .................................................... .................................................. ....... ................ (Building Inspector) Applicotion No.../...~.~....~...d?. .............. INSTRUCTIONS o. This application must be completely filled in by typewriter oe 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 buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 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 buildings for necessary inspections. ~' (SignatUre of applicant, or name, i~"~ c~po;~ii~i ........ .... ...... (Address of applicant) State whether applican/t//////~ o,w, ner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ................................................................................. ~ ................................................ I f applica,,g~s'~o~te, s~o~f~ o~uly, au_thoriz~ff icer. ' ~'"'i~' ~~'~icer) Builder's, Lic~se No, .,~,~ ....... ~ ............. Other Trade s L cense No ............................................... Location of land on which_y_.., ~, ,~,~pr°p°sed work will be done. Mgp No.: ........ .~..~...~...3....~. .......... r; ____5" Lot No......~. ................. Street and Number .... /..t~.~.~..,~.:.~..~..-J..C...~...~(.~..~..: ................... : ........... ~-,~.,.~...9'~./..,~../.~-~ ................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ........... ..j~...~..,,Q ~./~?.'.....~....~..,~.,x~.. ........................................................................... b. Intended use and occupancy ......... ~ .............. ~..~...c;..~.~...~ ....... :~..:.~..~..;... ............................................................. / 3. Nature of work (check which applicable): New Building' .................. Addition .................. Alteration ................ Repair .................. Removal .................. DemoHfior. .................... Other Work ..................................................... (Description) 4. Estimated Cost ....... J..~.?.~.....0..~.~., ........ :.. .................. Fee ..~...~.(...~......-TZ.. .................................................................. (to be paid on filing this application) 5. Jf 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 structur~ with alterations or 'additions: Front .................................... Rear ............................ Depth ................................F~eight ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... ~2 ................... Rear ......~.~ ............... Depth ..~.~.~¢~..~ ....... Height .../.~. .......... Number of Stories ....... ~. ........................................................................................................... 9. Size of lot: Front ..... ~J.~.,~..~..~ ........................... Rear ..... ~K~,..~..~ ............... Depth ...~.~.~.~.~ .......... I , 10. ~ Date of Purchase ............... ~ ..................................N~me af Former Owner ....~ ........................................... 1 1. Zone or use district in which premises are situated ' 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ ]3. Will lot be regraded .....~.~ .............. Will excess fill be removed from premises: ( ) 14. Name of Owner of prem.ses ~....~.~ .~ ......... AddreSS. ...... ~...~..~ ......... Phon~ ~ ............... Name of Architect .............................................................. Address ................................Phone No ....................... .~ :~~ ~' ,, ~ ~.~.~..~..~.~.. ~om~ of Co.t~oc~o~ .~.~ .... _~.d~....~ ...... ~.o,~ ~o ....................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block number or description according to deed; and show street names and indicate whefher interior or corner lot. STATE OF NEWF~K,, .~ .,Z ~c c COUNTY OF .~,4~.~...~'~'''~ r ........................ ~~L~..~..~.~.~k.~ ............... b~ing duly sworn, aeposes and s~ys ~N~me of individuql si~nin~ He is ~ ' ' ' or, agent, corporate officer, etc.~ of said owner or owners, and is duly authorized to perform or have performed the said work and to make and fil~ this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in }he manner set forth in the application filed therewith. Sworn to before me this -- l~. ~ o~ ....... ~ / _.. ~: .... ~~ /// . ~o,~ ~,,~. ............ ~ .......... ~o,,~ ...~~~.....~~ ............. ~ ,, ~ / / ~ ~ , ~ / (Signature o~ appuc~n~) q~T~ ~U~LIG, St~e of Hew NJ70 22 2~.., E. '76.3O VACANT) 't ,¢ / 0 >L ~s4:_4%__ j .......................... AT , ~--~~ _' ..... ~' '~-~e' se'~z~ aisoossi, aha ~ate~ s~D~i~ SUFE CO, ¢acil!t)es for 't;ni~ location have been , , ,ns~cte~ by ~is~artm~nt aud f%u~d Chief of G ¢ l~/ineerin~ ~%~~ t~.' , . ................ r~ ~VACANT) N JO 22 ~0"E 7~. BO OCCU?AHCY OR USE IS L~T~LM~Vi:UL 6[: OCCUPANCY OR USE IS U!NLAWFUL ;::OF OCCE?A~CY /tS NOTED 765-1B02 9 AM TO ,4 PM FOR THE FOLLOWING iN~cPE~TiONS: ~1. FOUNDATION . ~O R~UIRED FOR POURED 4. FINAL ~o ALL CON~RJC~O~ SHALL ~E REQUI~ME~S; OF TH~ N CO~ NOT RESPONSIBLE ~I~N OR COHESION ~APPRO~?~D AS NOTED ~FEE: BY: ~NOTIFY BUILDING DEP, ARTMENT ,AT 76B-~802 9 A~ TO 4 P~ FOE THE FOLLOWING I~FSPE~TIONS: L1. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE ~. ROUGH - FRAMING & PLUMBING ~. INSULATION 4. FINAL - Cq~'.~mRU~ioN MUST BE COMP~ rTE FOR C.O. ALL CONSTRUCTION SHALL THE REOL)iRrM~NTS OF THE N. STATE CONSTRUCTION & CODES. NOT RESPONSIBLE FOR DESIGN OR CON~RU~ON ERRORS, r t dq