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Home My WebLink About12265-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. 7J.2075. Date Novembe. r 18 . ........................................ 19...83 addition THIS CERTIFIES that the building ................................................ Location of Property qb00 Parkway Southold House No. Street Ham/et County Tax Map No. 1000 Section .0.7. ~) ........ Block . .. 1. .0 .......... Lot . Subdivision .... ~9.u.t.h?.g9.d ................. Filed Map No. 21.41 .Lot No. 9 conforms substantially to the Application for Building Permit heretofore Fried in this office dated March 31 19~83; 12265 Z ..................... , . pursuant to which Building Permit No ...................... dated . .4 pr3.~. ~. 5 ................. 19 .8.3., 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 ......... an addition to existing dwellin, g The certificate is issued to . , TttOY & ANN BAYD. ALb.. (owner, levee o~-te~a~O of the aforesaid building. Suffolk County Department of Health Approval ..... ~l/A. ................................. UNDERWRITERS CERTIFICATE NO ~I 6. l 9 ~ {~ t~ Rev. 1/81 Building Inspector Pen TOWN:OF 1 BUILDING TOW~ H'&I~L ~ i sOUTHOLD; N~: ¥' i BUILDING ~: ~ (TH S PE~IT ~UST BE ~EpT'ON THE, PR~AI$~S UN~!L ~ULg COMPLETION OF THE WORK AUTHORjzED} ~ :~ ~ ' Z Dote ...~....~......., ............. ,. .......... , 19.. ~issio~ is hereby granted m: ~ ~.i, at piemise~ located at Cour)ty Tax Map No 1000 Sect on (~. ..... ,..~,~. BlocK-.~. ~.~.. ...... [Lot No. ~.....~.,.~ pursuant ~o: application dated ........ ::..,i...:~...-, I and ~pproved by the Building Irtspector. ~ Rev. ~6/30Z80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in wpewriter 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 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-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 $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land use 3. Copy of certific,ate of occupancy $1.00 --Pre-Existing C.O. $15.00 Vacant land C.0. $ 5,00 0onst, z'tzc'~ ,~(t~_itiozz to e~ietizzg Ih~e3.1i~. New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property .%6QQ ................... ~e, rl~a~' .................. 8eut, ho],d,, .~.Y ..... House No. Street Ham/et Owner or Owners of Property . .~:e3~ .a~4 .~n .Be3r4c3,e, ...................................... County Tax Map No. 1000 Section ...?.q .......... Block .... lq ......... Lot .... Qb~ ......... Subdivision.. ?..e,.~ .o.f .S. qq~l~w.o.q~. .............. Filed Map No, .2,~ ..... Lot No ..... c~ ........ Permit No, . .%~;~6.5 .~. Date of Permit .~'/.],,5/,~3..Applicant .... C~ee~e .~ ,.3~e,u,e~: ................ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval .................... Request for Temporary Certificate ..................... Final Certificate ..................... Fee Submitted $ ............................. Construction on above described building andp/~rmit meets all apFilicable codes and regulations. A p p I ica r~ ~..~_~ J~/'.~.~ .... ~ .............. Rev. 10-10.78 .- . lOOlO.~3 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY THIS CERTIFIE~ THAT only the etectri~al equipment ~ described below and ~ntroduced by the applicant named on the able application number in the premises of in the following locati~;. ~ B~e~ ~ 1st FI, ~ 2nd FI. Section Block Lot ~as examined on ~0~ ~ ~ .L~ and ~ound to be in compliance with the requiremet~s of this Board. RXYUgE$ RANG[S OVENS DISH WASH~R$ gANS 2 7 4 2 DRYERS MOTORS E APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E R OTHER APPARATUS: C NO OF HI-LEG NO. OF NEUTRALS I Gary 42D ~onsell CutchOgue~ N.Y. 11935 2941 This certificate must not be altered in any manner; return to the office of the Board if ,inco[rect. Inspector's -:NT. THIS COPY OF ~ may be,identified by (MANNER. N. S. B9'40'00' V,,'. /8~..7'0 TEk ~ .~EL:',,'I~ f it C FIELD INSP~CTIO~N FOUNDATION FOUNDATION 2. ROUGH FRAME & COMMENTS (lst) (2nd) PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No/2~- Date .. ~tarch...31 ....... , l~B3. · INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 wh. ole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by th, e 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 appl{cable Laws, Ordinances or Regulations, for the constmcfion 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. ........ Gear. ge .$ .... Bauer. ...................... (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 ..... .T.r.o.y..a.n.d..A~. ~..B.~v.d.a.l~. ................................................ (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...Ni' .~.m.i.t.h.~ ............... Electrician's License No. ~,G.a.rF...D.o.rp.s~J. ......... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .... :~,t~'.k.,. ~xa7 .................................... ..... .o. ,wa ... S ou ho , House Number Street 70 Hamlet County Tax Map No. 1000 Section ..~. ~.. Block ~ / d) Lot. ~. Subdivision....M.ap.. 9.f...S.o.u.t.h?~pg.d ............ 7' ' · Filed Map No. . .21¢!, ......... Lot .... .9 .......... ' (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... . .~r~te .Home ..................................................... b. Intended use and occupancy Bame. ..q~-//. ~,-ftSk,~,-~ 3. Nature o~work (check which applicable): New Building .......... Addition . ~ ..... Alteration .......... Repair .............. RemOval .............. Demolition .............. Other Work ............... ,~ (Description) 4. Estimated Cost .... ~i&i tio~ 20,000.00 Fee.~. ~. ,. (to be paid on filing this application) 5. Ifdwelling,_numberofdwellingunits.$gqJ~.~P....r.i.. Number of dwelling units on each floor ................ If garage, number of cars .................... ,~. ........................... : ...................... 6. If business, commercial or mixed occupancy , specffy 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 constraction~ Front ..... : ......... Rear ............... Depth ../_f~ Height .. . - Number'of gt, ories ..... ,~. , .... ..~ . .~'..?...' : · ' ........... ','" '-'-: :,,~; ............ ?'.-C ?~.L 9. Slzeoflot: Front ...................... Rear ...................... Depth ...................... 10. [)ate of Purchase ........... .................. Name of Former Owner ..... //..,~:../~..~ F.~..~. ...... 11. Zone or use district in which premises are situated .............................. ~.~.r.,-~7.~.,q...~-~;./..~.Tfi..'. 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... : ................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ~.~.97...a.n¢..Ann..B..~r~..~1. gAddress ~rk..~.~7... $9¢~9~Phone No. 765. ~8¢2 ....... Name of Architect .......... ' ................. Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines· Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. See gap Sumre¥ Addition. 8x8 and 16'x18' 352 e~uare feet. Foundation, Footings, cement blocks, For crawl area. 2' 0rawl, with cement floor 9 Anderson Perma shied Oaeement windows. 1 entrance door and combination door. Inaulation. 3 1/2"!in walls and floor. 6" in ceiling. Oone~ruet$on to match existing building, with pitched roof. STATE OF ~ORjK///~/ ,~ . · · ~-~-'" ~==~'_ ~ -~'z'~ ~ ', ..... ~ ........ being duly sworn, deposes and says that he is the applicant (Name ~ individuai signing contract) above named· He is the .......... ; .......................................................................... ~ ~ra~gent, corporate officer, etc.) of said owner or owners, ~d is dul~ O~r~c~form or have perfo~ed the said work ~d to m~e ~d file this application; that all statements cont~ned M this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~ne~ set forth M the application filed therewith. Sworn to before me this No~Public,~..j ~ .... '~ .~County ~ ~~~ '~7 ' / (Si~ature o f applicant ) ' T~rm [x~ires March 30, / k