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Home My WebLink About12352-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z.q fi.c).80 ....... Date ........... Oo.~.aber..6 ........... 198.3. THIS CERTIFIES that the building... ADIIITIO2~ ................................... Location of Property .... 7.25. S2eaery. ~,a~ae ......... Sou.t.hold ......................... House No. Street Hamlet County Tax Map No. 1000 Section ..... 065 .... Block .... 121'!. ........Lot ....... Od..~. - Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Nay 9 ' 19~..~. pursuant to which Building Permit No. ~12.352Z dated .... ~.? .y.· ·. · ·........3~1 ..... ... 19 ...83, 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 ......... Addition to an existin~ one family dwelling The certificate is issued to PHILIP & LOTTIE BARTH ..................... john'o;,'l~,s~do'dr'tb~a'n'O ...................... of the aforesaid building. Suffolk County Depa~ment of Health Approval .... ~/4 UNDERWRITERS CERTIFICATE NO N~868q . Building Inspecto Rev. 1/81 BUILDING- PERMiT~~ (THIS PEPJvlIT MUST BE K£PT ON THE P~.E/~IS COMPLETION OF THE WORK ^uTHOPJZED) ~S UNTIL FULL ? Permission is hereby granted to: ~ ............ ....... ,o....C.O~..,~..~.~/.. ........ ~z~....~~......~:.~:..~~ .t p.m ~.~ ~.t.~ .t ...~, ..... , .....~.-...~. . · : ......................................................................................... ?'"'t .......t ........ ~ ........................................ co~ ,ox. u,p Uo. ~ooo s~,o~ .,..~K~: ..... ~ ~.~ ~g'"'"~}~t~°'~ ~ ,.Oz.~ ......... Building Ihspector. Fee ;...~. '.~T .......... Rev. i6/30/~80 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 a~l property lines, streets, buildings and unusum natura~ 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 / 2. Certificate of occupancy on pre-existing dwelling ~'r land use 3/5'/$5.00 3. Copy of certificate of occupancy $1.00 Date .... ~'..'~.~../'~..~. ............ New Building .... ~: ... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . ?..~..~...~, .~'./~..~.~7/.., .L.~. ~ ~ ~ -[~/L(o House No. Street Ham/et Owner or Owners of Property .~.~./.L.,. ~...¢...~..7-. T.¢.~-.=~ ..~.~ ............................ County Tax Map No. 1000 Section ../~ ~ Block ~ j Lot. Subdivision .... ;..~ ........................ Filed Map No .... ~. ..... Lot No....~. Permit No..~0~-~'~' Date of Permit .~.~y?~.~.~...Applicant...~'.~[.L. ! .~....~....PfT~-~..~. ............ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval...~.~ ............. Planning Board Approval ...... ../ ............. Request for Temporary Certificate ..... / ............... Final Certificate ....................... Submitted $ Fee ....... THE NEW YORK BOARD OF FIRE UNDERWRITERS 'l~ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK'1OO,35 a.,. 0ct;obese /4, ~983 Jppt~¢.t~o.~o.o.Z.~ 233562-83P~12352 N THIS CERTIFIES THAT only the e~trical equipment ~ described be~w and introduced by t~ applicant nu~d on t~ above application number in the premises of ~h, P~lip & ~t~ie, 725 Te~y ~, S~ld, N.Y. O65 01 017 in the following location; ~ Basement ~ 1st FI. ~ 2nd FI. Section Block Lot was examined on SepC~er ~9 ~ ~)8~ and found to be ia compliance with the requirements of tbis Board, FIXTURE FIXTURES RANGES COOKING DECKS OVENS EXHAUST FANS OUTLETS 1 DRYERS FURNACE FUTURE APPLIANCE FEEDERS TIME'LOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF PEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: S E NO O i~E RCC,~CON D. AW, G, OF CC COND, C AW.G, NO. OF HI-LEG OF HI-tEG NO, OF NEUTRA OF NEUTRAL Philip Bargh 725 Terry Lane Sourihold, N.Y., 3.1971 This certificate n~ust not be altered in any manner; return to the office of the Board LDiNG DEP~ OF CERTIF GENERAL MANAGER Inspectoh may be identified by their creden~ ) IN ANY MANNER. FIELD INSP~CTI~ FOUNDATION (1st) F'OUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. STATE ENERGY COMMENTS FINAL ADDITIONAL COMMENTS: ~!Et~ YO&K STATE DEPART~E~!T AF E?IRO~q~E~!TAL Cq!)SERV~TIO~ Regulatory Affairs Unit Building 40, SUNY Stony Brook, NY ll?gC NO PERi,IT ,,.ECESSA. - TIDAL ~.~,-~.t.u~ ACT Henry G. Uilliams Commissioner Dear J~l~r. ~r$o ~r~_~ ~ A review has been made of your proposal to: Location: ~o~kL ~ ~ ~2~ Te~ L~ , I~n o~ It has been determined that no permit is necessary under Article 25 However, any additional work or modifications t~the pro3ect may a permit. It ~s you~ respons~bH~ty to not~y th~s o~ce ~n writing ~f such additional work or modifications are contemplated. Assuming you have obta~ne~ an~ other agpl~cahle pe~ts, you may ~tocee~ w~th your project. .... Very truly you~y, ganiel(O. Larkin Reqinal Permit ~d~inistrator gJL:R?!T:ll FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .~..q~7 · · ', 19 ..~.' Approved. · .~.~7.~7.. .k~.....,1~..~. Permit No..Z~.~..~SJ.z ,, Disapproved (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No.../~a~.~. ~.. ..... 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 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 inspe~cti~ns. ~ ~ (Mailihg address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general cqntractor, electrician, plumber or builder. Nameofownerofpremises...~.~...~..~..~ ................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Builder's License No.. ~.~.~.. 9.~-,.~c~.-..~wt I C Kt-6't-v~ ti' '> ~7 Plumber's License No ......................... 5o~P. C4 ct. ~,~ c~ ~ ~ (~ ~ ~ }4)21 Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ............................... ................... ................................ ................... House Number ~ Street Hamlet Co~ty Z~x ~ap ~o. ~000 S~tio~ .... ~ ¢.~ ....... mo~k ..... .0. ~ ......... rot .... O .( ~ ....... ~ S~bdivi~io~ ........ 6 ............................ Filed ~p ~o ..... ~ ......... rot.. ~ .......... ~ (Name) 2. State existing use and ~ccupancy ~f premises and intended use and ~ccupancy ~f pr~p~sed c~nstructi~n: a. Existing use and occupancy ...~. ~~ ....................... : ........................... ...... : ........................... b. Intended use and occupancy 3. Nature of work (check which applicable): New Building .......... Addition ......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ' OzTi~__c/..~r). (Description) 4. Estimated Cost ~.~-~9Z9 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 naturerand extent of e~J~,type of use ............ r' ........ 7. Dimensions of existing structures, if any Front....~.q~. ........ Rear ~..~ ........... Depth . .2:~. .......... Height ............... Number of Stories ........................................................ I)imensions of same structure with alterations or additions: Front .. Rear .... Depth .~ : Height .~.. fl. ........ Number of Stories . 8. Ihmens~ons of entire newconstructmn Front .... ~'. ....... Rear . fo..~- . Denth . Size of lot: Front ' Rear Depth Date of Purchase ........... i .................. Name of Former Owner ............................. Zone or use district in which premises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ......... : ................... Will excess fill be removed from premises: Yes No Name of Owner of premises .[?~.~. [ ~...~..aC.~... Address . ~>: .0....~.0.~ .I ~ .... Phone No ................ Name of Architect .......... ................. Address ............. .~?i;.. Phone No ................ Name of Contractor ....... i ................. Address ...................Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all' buildings, whether existing or proposed, and, indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether 10. 11. 12. 13. 14. property lines. Give street and block interior or corner lot. STATE OF N~ORK~ COUNTY O ..... (Name of iffdividual signing contract) above i3amed. being duly sworn, deposes and says that he is the applicant He is the ................................. ~ ........................................ (Contractor, 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 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 ............. ...... .... Notary-,Publ, ic, . ...... ~ .... ~ .... ',,,~/--~-~-~. County ./) ~/ ~ I~LIC State of New York, .................. , ¥4~m Ex~ires M~rch ~u, ,, } ,' ,,'., ", ,:", :::' 1i 'F,O~ ,, 2. ROUGH 3. IN~ULATION:~%, ". '4'. FINAL - rBE,, COMPL~ FOR C.,O.:,: ALI 'ION