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Home My WebLink About12772-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificnte Of Occupency NoZ13066 Date December 14 .8.4 THIS CERTIFIES that the buil ding... O..n .%. f. a..m.5.1, y...d F.e. 1. ~ .i.n.g. ...................... Location of Property . .2.~.9.5..~..ep.r.y..Jp..L.a.n.? ............... Peconic House No. Street ...................... County Tax Map No. 1000 Section 0 74 .Block 1 ..... Lot 4 4,2 Subdivision Peconic Knolls 6607 . Lot 1 ............................... Filed Map No ........ No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated ·. ,~.o.¥....9. ........... ,19~.3.. pursuant to which Building Permit No..~ .2.7.7.2. .Z .............. dated ..... N 9.v....~ 9 ............... 19~.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 ......... ·..q~..f.~r~:~v..~.e.~.l. $.ng ....................................................... The certificate is issued to Robert T. & Mary Jean Webb ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval ..... 1.3 .- ~.0,-, 1. ~ 7 ........................... UNDERWRITERS CERTIFICATE NO. N 6 6 6 1 1 3 Rev. 1/81 Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, andsubm~tted-.~,' ' '-'=~^'~ ...... 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. B. 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, bgildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owne~ 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 dwell ng/ land use 3. Copy of cert ficate of occupancy $1.00/' --Ftc-Existing C.O. $15.00 Vacant land C.O. $ 5.00 New Building . ..... ~ ....... Old or Pre existing Building .......... · . Vacant Land ............. Location of Property .... ~'. [ ~.'~'~.. · · .~-./~ ~.q,~..L'~ ................ ~ CO~O ~ Hou~ NO. Street Ham/et Owner or Owners of Prope~ .~.~ ~ ~ H~...~:~... ~ ~ ...... County Tax Map No. 1000 Section ...qZV Block / Lot ~ ~ Subdivision. ~:~" ~ ~.. Q ......... Filed .~.'Z...Lot No .... ~ ......... Permit No. J.?.?.~ %ate of Permit l>j.~: l~Applican, ~:. ~.~:~1~ .J¢'~,. ~,~d Health Dept. Approval ................... Labor Dept. Approval ........................ Request for Tempora~ Certificate ..................... Final Certificate ....................... Fee Submitted $..~ .......................... Construction on above described building an~ p~rmit meets all applicable codes and regu lations. ...... 1000174 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~-1 BUREAU OF ELECTRICITY [~o~e~L?.be~ 1, [~JO., STREET, NEW YORK. N~d~038 THIS CERTIFIES THAT only the e~ct~al ~ulpment ~ ~cdbed be~ a~ intr~uced by t~ applicant named on the a~ appJica~n ~um~r in t~ pr~mises of Robezr ~ebb, w/s Henry ~ne~ Pec~n~c~~ ~Y~ in the ~oll~in~ l~atlon; ~ B~ement ~ 1st FL Lot w~examiaedoaOC~, 25~ 1984 FIXTURE OUTLETS 32 DRYERS 0~4 1 [] 2nd Fl. Section Block and~ound to be in compliance with the requirements of this Board. ~ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS EXHAUST FANS FLUORESCENT 48 35 MULTI-OUTLET SYSTEMS NO. OF FEET OTHER APPARATUS: E R V I NO' Oi~E~C~COND OE A'Wcc COND.O NO.OF HI-LEG 4/0 C E A. w, G. NO OF NEUTRALS A.W.G. OF HI4EG OF NEUTRAL Motors: ! fr~ac, bps. 1 GFCI= 1 smoke de~ector-- Eiec. room hemmers: 1-253 3-2.0~ §-1.5, 3-1.0~ 2-.75~ 4-.5KW-- ~eco glee Corp..~lmff Cornell 325 Willow Point Rd. Southold~N.Y. 11971 This certificate must not be altered in nny manner; return to the office of the Board if incorrect. Inspectors may be COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNF:R FIELD I~SPEOTION FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N.. Y. STATE ENERGY qODE FINAL DATE COMMENTS ' ' ,,, ,,~ ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION i?~ FRAMING FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FINAL REMARKS: DATE ~//~//,, ~/' INSPECTOR FORM NO. 1 TOWN OF SOUTHQLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765~1802 Approved ,4~2(. Disapproved a/c .......................... (' 7~ ..... (Building Inspector) APPLICATION FOR BUILDING PERI~,'IlT Rec e ~ veal. ]~.~.. 9 · . Date.../?'./. 5}, ......... 19~..dff INSTRUCTIONS a. Tiffs application must be completely filled in by t3,pewriter or in ink and submitted to the Building Inspector, with 3 ;ets of plans, accurate plot plan to scale· Fee according to schedule. b. Plot plan showing location of lot and of buildings on promises, 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 Ibis appli- :ation. c. The work covered by this application may not be commanced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit ;hall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pa~t for any purpose whatever until a Certificate of Occupancy ;hall 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 3uildiug 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 alteratkms, or for removal or demolition, as herein described. the applicant agrees to comply with all applicable laws, ordin,a,n,,c~es.3,~.ilding code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in bnilding for necessa~f)~sp~o~, ~ ,>, 2 ,,~.~'~ , ,. (Signature of applicant, or name, if a ~o{'poration) (Mailing address of applicant) State whetixer applicant is owuer, lessee, agent, architect, engineer, gcneral contractor, electrician, plumber or builder. , ·. O c 0.0 ...................................................................................... · obcc -c.lea Name of owner of premises .~ ................ : ........ Y) .... ~ ...... ~ .................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Nmne and title of corporate officer) Builder's License No .... 7.-- .................... Plumber's License No ..... e~.~.~ .~f?'] ............ Elccu'ician's Licanse No... ~.~.'~"r~'.'~'~ ............ Other Trade's License NO'7-. .................... Location of hind on which proposed work will be done .................................................. ............................................................ Ilouse Number Street Hamlet County Tax Map No. 1000 Sectiou ...O. 7~ t.t ......... Block ...] ............... Lot.. {~¢..¢ .......... Subdivision . . . (.C.~ / (-'~ . . ~O 9. ~''~ ~. Filed Map No. ~' ~ ] ~ Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...~(~C(,~V~5. J.Q~ ................................................... ..................... b. Intended use and occnpancy .... ?:~ C h(~..~,..r3,-;[')3.~.,~ ........ ... , ~ ...... 3. Nature of work (check which applicable): New Building ...'~ ..... Addition .......... Alteration ......... Repair .............. Removal .............. Demolition .............. Ottmr Work .............. ~ (Description) 4. Estimated Cost e~. cD CD ~ eD Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ...~ .0 .~.-; ..... Number of dwelling units on each floor ............... If garage, nmnber of cars ... ~ er> .............................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimensions of e. xisting 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 ..................... .', . Depth .......... 8. Dimensions p,f entire new construction: Front .... '.~j~ ...... '~ 2,~ Height . [~. ........... Number of Stories... ~P.~{.,. i .......................................... · 19.}.'.$~c ......... Rear .... I.~,.I....~. I .......... ~epth .L..~. ?.,.3...~'. ........... 9. Sizeoflot: Front . b [.z :xi/}'".~'' . .......... Name of Former Owner ,~c2,c~.le.~q..~. rx.~/'rO.d-.~. ..... 10. DateofPurchase .............. I 1. Zone or use district in which premises are situated .................................................... 12. Do~s pre. posed constrnction violate any zoning law, ordinance or regulation: ...P'.( .o .......................... 13. Will lot be ~cgraded . .,/~ .C?. .............. Will excess t~l be remoyed from, prem~ses Yes 14. Name et Owner ofp~em~se,, [~..~. ~... {1~.~..~.~..~ldress .1 ......... vq2/.(,]..~.~.~one No. ?./.7.7. 7/.3.:~.'~J.., Name of Architect ......... .................. 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 fron property lines. Give street and block number or description according to deed, and show street names and indicate whethe interior or corner lot. STATE OF NEW Yg, I~K, COUNTY OF. ,,5..ct. .6,~. 2¢~'( I(~ ......S.S .. ~.(?.~. ~.U-~ ...... [g).d; ~).~) ........ .................... being duly sworn, deposes and says that he is the applican (Name of individual signing contract) above nanled. t{c is the ........... , .................................................................. (Contractor,, agent, corporate officer, etc.) of said owner or owners, and is du!y authorized to perform or have performed the said work and to make and file thi* application; that all statements contained in this application are true to the best of his lmowledge and belief; and that tht work will be performed in the manner set forth in the application filed therewith. Sworn to before me this . ' ~ da of. ~'~ 1 ~ ....................... ~ y ...... : ............. 9~ . Notary Publi~~..~:... S... ~... County /~J ~, ~ . / ~ JUDITH T. ~ERRY ~x ./~ ~~/ / ~// _ ~O. ~2-034A9~3 Suffolk ~un~ ' ' '~ ............. ~ ..... ~.. . ' '. ., ".: ~F~n Expires March 30, 1~ talgnature OI appncant)