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Home My WebLink About12092-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z. 3 J .~.7. Z .......... Date .... F.e.b.v. ?.a?.y.. 3 b ............... 19.8.3 THIS CERTIFIES that the building . .a .cl.c1.S. ~..J_ .o.n ...................................... Location of Property 3.6.7.0...&. 25.89 ......... $oundview Avenue reconic House No. ' ....... '~'t/e~i ....................... County Tax Map No. 1000 Section . 9.6.8. ....... Block . 9.4 ............ Lot . .0.1.5. . .&..q ~..6 ..... Subdivision....X. .......................... Filed Map No. ~( ....... Lot No....X .......... conforms substantially to the Application for Building Permit heretofore flied in this office dated December 30 1982 pursuant to which Building Permit No. 12092 Z dated ...d.a. 9.u.a.v.y....4 ............... 198..2., 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.. f~.r.e.e..n.h.qu, s..e..a.d..d.if.i.o..n..t.q..e.x.i.s.t..i.n.~ .d..w.e.l.l.i..n~.. .......................... The certificate is issued to ........ .D.~: . ~AR.R..Y..S.A.V..I.T.S. ............................... (owner, let~oe-o~ of the aforesaid building. Suffolk County Department of Health Approval .. p./.a. .................................... UNDERWRITERS CERTIFICATE NO .......... ~..5. 9. 9.5.1.8, .............................. Building Inspector 1/81 N? TOWN O~ S~OU?H~L~D BUl LDING ,D~PARTM~N'~ TOWN HALL ~ $OUTHOLD, N. ¥. BUILDING. PE~IT:; : (THIS PERMIT MUST BE KEPT ON THE PI~,E~IS~S UNTIL EULL ¢OMPLE'rlON OF THE WORK ^uTHORizED) 12092 Z Permission is hereby granted to: ~ County Tax Map No. 1000 Section, ................... ....[. Block .C..i.,; ........... ~Lct No. .......... /. ............ Building Ihspect0r. Fee :~ ........ ; ............... loolo~1 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 ' - JanuazT 20, 1,983 200 ~2018~ ,,.,e ~,pp,ica.o,. ~o, o. ~i,~ N 590518 THIS CERTIFIES THAT only the electrical equipment as described belo~ and introduced by the applicant named on the able appl~at~on number in the premises of ~. ~vitt, ~dv~ Av~, ~c, N.Y. (~ ~) in the follo~ng Ioc~o,~; ~ ~seme,~t ~ l~t FI. ~ 2nd FI. Section Block Lot was exan~ined on J~H~ ~7 ~ ~ and found to be in compliance with the requlretnents of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 4 3 2 DRYERS DIMMERS SYSTEMS NO. OF FEET OTHER APPARATUS: 1-1.Skw. hot water heate~. E R V I PER ,~' OF CC, COND. NO, OF HI-LEG C OF Hr-LEG AW, G NO. OF NEUTRALS OF NEUTRAL G & S Electrical Box 215 ~o~thold, N.Y, 11971 Llc#578E This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may COPY FO~ BUIL~DING DEPARTMENT. THIS COPY OF CERTIFICATE ~/~JS~ NOT ~N ANY FORM NO. 6 TOWN OF $OUTHOLD Building Depar~rnen~ Town Hall FOR CERTIFICATE OF OCCUPANCY Instructions A. This ~Ppfication must be filled in typewriter OR ink, and subr~itted in duplicate to the Building lnsp~ tar with the following; for new buildings or new use: 1. Final survey of property with accurate location of ali buildings, property lines, streets, and unusL ~.Finala0~rova of Health Dept. of wat~r supply and sewers~e disoosal_{S.g form or equal) . Approval of electrical installation from Board of Fire Und~n, vr 4, Commerclat buiidlngs, Industriai buildings, Multiple Residences and similar buiid~ng~ and instal~ tions, a certificate of Code compliance from the Architect or Engineer resDonsibte for the 5. Submit Planning Board approval of completed site plan requirements where 'applicable. B. Fcr existing buildings (prior to April 1957), Non-conforming uses, or buildines a~d pre-ex~stm~ 1. Accurate ~/ey of peoperty showing all property lines, ~reets, buildings and unusual natural c topographic features. ' 2. Sworn statement of owner or previous owner as to use, occuoanc,/and condition of buildings. 3. Dale of any hous[n¢ code or safety inspectJen of buildincs or premises, or other pertinent inform; tion required to prepare a '" - C. Fe~s: 1. Ce~if[cate of occupancy $5.00 2. C~rtificD~e of occuoancy on pre-ex~s:~ng dwefI[ng or [and usa S5.00 3. CoDy o¢ certificate of occupancy $1.C0 New Buddina Old or Pre-existing Building(:() ~ ' ............ ..- ...... ~ /Vacant Land Location of Property .... .............................................. : ....... -.~-. County Tax Mac No..1000 Sect[on . ~ Bio~k ' ' .... ' ................ Lot Subci,.,ision ................................. Filed Mab'No Lot No .......... ' Health Dept. Approval .... ~ ~ ~ .... Labor Dept. Approval .... ............ Unden,vriters Approval ~ O ............... ' .......... Planning Board Approval ................. Requesc for Temporary Certificate ' .................... F~nal Certificate ........ - ......... Fee Submitted S Construction on above de%r~bed buddi¢~q and Per~'i['meets all aPOl~,cabJ~codes and reculations. ...... ., ....... ... ...... ........... FOUNDATION COMMENTS FOUNDATION (2nd) 24 ROUGH FRAME & PLUMBING INSUL^TION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .x./~..~. ........ , 19 Approved .~..~?../~... ~ .... , 19 .~.. Permit No.. {~..O:~.~.~..7~ Application No .............. Disapproved a/c .......................... .//~. ......../ · (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ~ ~ '~c~ ~ft.- 19 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 inspec_fi.o~ns. __ ,'-.--, (Signature of applicant, or name, if a corporation) - ~,~O.. p.~ '4 ~o , (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................... . .......................................................... Na,ne of owner of premises ...~..~.: .~..0( .~5.E"..~...~.'.~..~..~ .~. ~ ............................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ................ ........................ (Name and title of corporat? officer) Builder's License No ....... .~. ?. t..~'?.°,m. ..~. ..... / Plumber's License No ........... I' ............ Electrician's License No ......... '/' ~ .......... Other Trade's License No ........ .~ ........... i. Location of land on which proposed work will be done....q~.....?.[?.'...r.e.o. ........... .......................................................................... House Number Street Hamlet ! County Tax Map No. 1000 Section ...... .O?..~ ........ Block .... ~.c( .......... Lot..../~.~..~'./.q. ......... Subdivision ~ [~' Filed Map No. Lot (Name) 2. State existing use and ~ccu'~pancy ~f pre~ises and intended use and ~ccupancy ~f pr~p~sed c~nstructi~n: a. Existing use and occupancy ...... ~.':':~.--*~ ,~-A 7-w?'~,~r~ ~e~ ........................... ¢ ............................... ~? ..... 3. Nature of work (check which a~plicable): New Building .......... Addition .... ~. Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... I (Description) 4. Estimated Cost ........... f .......................... Fee ............................. , (to be paid on filing this application) 5. If dwelling, number of dwelling hnits ............... 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. ~..O . .. Rear . ~7-.o.. Depth .~. ~- Height ..... ~.~' .... Number of Stories ........ ~ ~.~ ............................................ DimenSions of same structure with alterations or additions: Front ................. Rear...ti?. ......... Depth ..... .~./C. ............ .. Height ..... .~..~ ........... Number of Stories ....... *. ~.~.... ii ...... 8. Dimensions of entire new construction: Front ..... /~//~ Rear Depth Height ............... Number of Stories ........................................................ 9. Size oflot: Front ...........'...........' Rear ....................... Depth .................. . ... 10. [}ate of Purchase .... ge-r- iqp't ............ Name of Former Owner ..... ~.o..,q.Q.t~..o...~.C;./~.~. .... 11. Zone or use district in which premises are situated ........... (4.. /g-ca' Ir~ ~' 12. Does propo~*d construction vioiate any zoning law, ordinance or regulation: ........ ~g. .................... 13. Will lot be regraded ....... .¥.! .o. .............. . ....Will excess fl!l~)e removed from premises: . Yes 14. Na ofOwne ofpe lses~ .............. Address .~ ........ ,..t ....... PhoneNo[~ .......... 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 fines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. : STATE OF NEW YO,R~K~, ,, ,~ COUNTY OF ~). oW~o k ~" -F... 'b.~ ......... ~-...~.'.T~ Y~.*~.~.t~ ......... being duly sworn, deposes ~d says that he is the applicant (Name of individual ' s~gmng con~act) above named. : He is the .. .......................... ~F~ ......................................... '~r~r~ ~t, corporate officer, etc.) of s~d owner or owners, ~d is dul / autho~~rm or have perfo~ed the said work ~d to m~e and file this apphcat~on; that all statements cont~ ~ned m th~s apphcat~on are true to the best ofh~s knowledge and behef; and that the work will be perfomed in the m~n( r set forth ~ the application filed therewith. Sworn to before me this ..... .~r~ ............. day of~..~..~ .... ,19..~ Nota~ Public ..... .... ~..~ ~6~/~.. County Te~m Expires March au, , ~/ (Signature of applicant)