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Home My WebLink About12283-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy ACCE. SSORY THIS CERTIFIES that the building ............................................... Location of Property .3.8.7.9.5..M.A..~.N. ,R..O.A.D. ........ PECONIC House No. ''' 'S'tle~i ....................... County Tax Map No. 1000 Section 085 .Block 0.5 .Lot 018 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated APR. I..L..1.2. .............. , 19 .8.3. pursuant to which Building Permit No. 12283Z dated . .M..ay..2. .................... 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 ......... ... F.o.~. ~..~gr~.qu~t~tr.~. lg.~ ~0.~.n.g ........................................... The certificate is issued to . ~..]7gNK .C I C~gI~O}V.~.G~td~n~},;~£~ ..................... of the aforesaid building. Suffolk County Department of Health Approval ..... N,/.A ................................. 59ot 7 UNDERWRITERS CERTIFICATE NO{P~ding.5 ........................................ Rev. 1/81 Building Inspector -12283 Z permission is hereby granted to: TOWN OF BUILDING TOWN' H~LL SOUTHOI~Di'N. BUILDING PERMI!~ / ~: (TH S PER~IT MUST BE KEPT ON THE P IS S UNTIL LL COMPLETION 0F THE WORK AUTHORizEDi; ot p~emise~ CoUnty To:x ~op No. 1000 Section .:...~:, Block: Building I~spector. No. ;.~'~..~.... ......... ~pproved by the FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG, DEPT, TOWN OF SOUTHOLD Instructions A. This application must be filled in typewriter OR ink, and submitted i~ ~ 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. B. For existing buildings {prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty 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 $5.00 2, Certificate of occupancv on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 $15.00 4.Vacant Land C.O. $5.00 .~. Date . ?.,. /.~.~..~.' ........ New Building ............. Old or Pre-existing Building .... .~. ..... Vacant Land ............. Location of Property ../'~/~/~')..~,~.~:~.~', ........... 4~.~./~-,. House No. Stt'eet Ham/et Owner or Owners of Property .. .~. ~.. ~/'~/.~-~ . ~,~.~ 44J/c~ ~:, .~. ,. County Tax Map No. 1000 Section .... ~.~.. ....... Block ..... .~ ....... Lot. · .~.. J~ .~-~...'! ~. · """-- Filed Map No ~ Lot No '- "" Subdivision .......................................................... Permit No. /.o~. ~ 4~.~:~ate of Permit ~.~//~/.~ .Applicant. ~L~.~. ,~,,~. Health Dept. Approval ./VET....~..~_~..~(_¢.o'. ........ Labor Dept. Approval ../'/~.~..~.4 ~, .~( ...... Underwriters Approval .... O..~'. ................ Planning Board Approval . . .W/re,/: .~vf/~[~*. ..... Request for Temporary Certificate ..................... Final Certificate .... .~.. ............... Fee Submitted $ ..... ~.,~ ................... t//~ /.~.,~} Construction on above described building andp~rmit meets all applicable codes and regulations, Rev. 10-10-78 -- TOWN OF SOUTI~OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May Concern, Please complete the enclosed application for Certificate of Occupancy and enclose a check for $5.00 (the fee for the C.O.) and I will be able to complete the Certificate of Occupancy. Thank you so much for your cooperation in this matter. Dorothy Sec. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment as ~scr~d belo~ and i~ttroduced by the a~pllcant trained o~ t~ ab~ application number in the premises of F~uk Ci~icz III, 180 N/S ~ute 25, P~o~C, N,Y. was examined on ~"oh ~0 ~ 19~t and found to be in cornpllance with the require~nents of this Board. FIXTURE OUTLETS RECEPTACLE~. 4O FIXTURES RANGES EXHAUST FANS SWITCHES DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: Mot~r~ i-F S E R V I C E A.W G, NO, OF HI-LEG A W.G. OF CC COND OF Hi-LEG NO OFNEUTRAL: A W G, OF NEUTRAL Rulm~d Electric Go. P. O. Eox 143 Mattltuck, N.Y. 1195f:~ Ltc,, 242 This certificate mbst not be altered in any manner; return to the office of the Board if i~corr~ect, lnspecto COPY FOR [ , THIS COPY~ GENERAL MANAGER may be identified by their credentil FIELD I~SRECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. Y. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: MORTON BUILDINGS, INC., warrants buildings which it erects as foilers: For a period of 40 years to absorb repair or replacement costs, including m~teria! and labor, if any preservative treated timber columns fail due to decay or insect attack. FOr ~ period of l0 years to repaint ar replace free of charge any r~f or side p~nels on which the paint has separated from the panel due to cracking, peeling or checking. For a period of 5 years to repaint or replace free of cha~e any roof or side panels on which under conditions of normal weathering: Chalking has occurred in excess of 8 units on side panels and 6 units on roof panels (ASTM D659). Fading has Occurred In excess of 6 NBS units. Corrosion due to acid rain has resulted in red ru$~. For a period of 5 years to repair free of charge any roof leaks due to defects in material or workmanship, except those occurring where the building is connected to an adjoining structure. For a period of five years to repair, or in its discretion, %o replace free af c~trg~ ~he building framework, roof and side panels and sliding dDors, if directly damaged by snow cr wind loads. ~rton Buildings does not agree to repair damage by flying or failing objects, damage to interior walls, ceiling, p~rtitions, overhead d~or$, e~uipment or contents, cr preparation of the site. ~,OTE: MORTON BUILDINGS GENERAL SPECIFICATIONS AND WARP~ANTIES apply unless indicated differently on specific ~ob drawings or supplemental infOrm4tion. ~ - No. 2 or better southern yellow pine 6"x6" square posts used in Morton Buildi~ m~e pressure treated with pentachlorophenol in P9 oil to a ne~ retention cf .5 pounds of ~%~ckloroph~nol per cubic foot of wood. ~C~0~%/D IN C0~{C~di'fE - POSt holes are dug ~ feet deep, k5 pou~nds of ccucrete mix is poured i: ~e ~!e. A %" x 9" rod is placed through the post 3" from the bottom. An additional ~5 l~un4~$ of concrete mix is poured around the base of the post. ~?L~$~A,W~9~ - Splashboards are No. 2 and better southern yellow Dine 2"x8' S2S ~nd center ~tched, pressure ~re~ed ~rith pentachlorophe~ol to .3 pound retention. One rc-~ is f~rnishe~ for buildings on a level grade. .~C~ ? ~E~.- Factory assembled with 18 or 20 gauge steel truss plates as required. Trusse~ ~ designe~ by a registered professional engineer for roof loads as required by lceal con~ttonm a~d building ~C~N_~G- Knee braces at each tru=s-col,=nn connection. 0.035"xi%" b/gh tensile s~eel ~onal, X-bz~clng in ~.]1 corners. Lateral truss ties as needed. ~0OFL~G A~{D SIDING P~.,-ELS - 0.019" min., 1¼ ounce zinc coated steel with an additional b~kmcl-on millcone finish. Color is I mil thick on exterior. ~- IYle-formed trim of 0.019" min. steel with silicone finish on corners, gables, ridges, ~ri'~Z,%~ - 5" box ~ype gutters, colors to match trim, on both sides of the bui!~J3.ng. 9_V~9~ ~OOP~ - Alu~inum fran~s with sectional panels of translucent fiberglass. ,%~- 38"~7'1" panels of 8 oz. translucent fiberglass foru~ecl into s~une p~ttern as r~ofin~ and ~idiug panels. ~O~.~v~G~ V~.~ILA~.~ON~ J~D ~ECTRICAL ~J.O]UC - By others, not part 6f these plans. BUILDIr~GS, INC. FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ~.~.~f~. ......... , 1 .~..~ Approved .......... l .dmermit No../ 2a.f Application No.. t/~-~d .~.~. ..... Disapproved a/c ......... ~ ............. (fTC... / APPLICATION FOR BUILDING PERMIT Date 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. Suck 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 necess.ary inspectigqns...% r~ ~ c,.. ............. ~)O ~O ~( (Mailing address of applicant) [ ~10'~ ~'q ~ [ 'q' ' ' ' lumber builder State whether applicant is owner, lessee, agent, architect, engineer, general contractor, etecmcmn, p or . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) fi! Builder s Lmense No .................... /I Plumber's License No .........~. .............. Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. · .~ ~ .-!.~.. ~ ............... . .T~.. 7.~....'m. ~: .~...~. .......... .~...c.c,,,,.~. House Number Street Hamlet County Tax Map No. 1000 Section . .~.~ ........... Block ... ~ ........... Lot .... [ .~. ............ Subdivision ........... ~. ......................... Filed Map No .... ¥ .......... Lot ..... :V. ........ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy ...-7~..~..~..d~..... ~ ...... .~.. . ~.1 ~ 3. Nature of work (check which applicable); New Building ...~ .... Addition .......... Alteration .......... Repair .............. Rem6val .............. Demolition .............. Other Work ........ ~ ' (Description) 4 Estimated Cost ~ ~ i '~' C~ ............ 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, commerciai or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Nuraber 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 ............... Height ............... Number of Stories 9. Size of lot: Front ..........., ........... Rear ...................... Depth ...................... 10. 13ate of Purchase ........... ; .................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded ......... ' ................... Will excess fill be removed from premises: Yes 14. NameofOwnerofpremises "'i ................. Address ................... PhoneNo ................ Name of Architect .......... i ................. Address ................... Phone No ................ Name of Contractor ......... . ................. Address ................... Phone No ............... 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. .... · ..~..L_~a~a~..~2~r~ ._~ ........... being duly sworn, deposes and says that he is the applicant (Name of individual signing ch~/tfa~t) above named. He is the .................. ~ ~ ............................................................. i (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 be performed in the manner set forth in the application filed therewith. Sworn to before me this tlO~t~ .,o~SSO Sut'o'~ ¢ou~'. 0. -- ~/g~ature of apphcant) i-r1 ~z 0 0 0 Co 0 F m II