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HomeMy WebLinkAbout12505-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z). ! .s?F .......... rate ..... ~.~..k~..2.~. .................... 19~..~. THIS CERTIFIES that the building ................................................ Location of Property 70 Seawood Drive Southold /4~&~'~ ~io: ....................... 's'ti~;i ....................... h~,~iol County Tax Map No. 1000 Sectiot~ .. 9.8.8 ....... Block ... 9.2 .......... Lot ....0.0.9...: ..... Subdivision ..... .~.e.a. Vp.o.d' . .~.c.v.o.s. .......... Filed Map No. 2.5. .7.5 ....Lot No. 4 conforms substantially to the Application for Building Permit heretofore filed in this office dated · . .g.u.n..e..2.7. .......... , 19.8..3pursuant to which Building Permit No...~ .2.5.0.5...Z ............ dated .... ~u..1 .y..2.3. ................ 19.8.3., was issued, and conforms to all of the requirements of the applicable provisions o£ the law. The occupancy for which this certificate is issued is ......... ....... .a..~. V.i.m.m.~..n~..p.o. ?.l.. ...................................................... The certificate is issued to WILLIAM J. & PAMELA McGONEGAL {owner,-le~o'or-tet~atl' of the aforesaid building. Suffolk County Department of Health Approval .. N/R UNDERWRITERS CERTIFICATE NO ............ ?.e.n..d .i.n.M ............................. ....... ~. ~ ..... -. ~.. Building Inspector Rev. 1/81 FO~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALt. SOUTHOLD, No Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12505 Z Permission is hereby granted to:__ ,-, - ........................................ ~¢...: ........... ././~7/ ,o..~ ...... &...~.~..~.....~.....~.d...~.~ ........................... at premises located at ........................ Z ......................................................................................... .....~....~......~..~., ......... .~.....~.=~......?......s...z..~......~..~...~. ................. ~Y~ ~ ~o o .ca County Tax Map No. 1000 Section ........................ Block ...................... t N · ..../~ ............... pursuant to application dated .................................. ..~., 1~ Building Inspector. Fee $....f.. ................. and approved by the Building Inspector Rev. 6/30/80 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 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 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 occupancy on pre-existing dwelling land use ¢¢1 $5.00 3. Copy of certificate of occupancy $1.00 Date ..... 2 ~. ¢?¢?.~. .~..~;.~ ........ Ne~Lgu[!d!ng .~..O .(~.. .... Old or Pre-existing Building ....~.. ...... Vacant Land ............. Location of Property ,'.~.~.....~.~.~ .'~. '..~. ~ '~...~..~...~..;~...~.~...'~.~... · .~. · · .~. ~-/.~ ?--~. ' ...... Owner or Owners of Property ~', .......................... .~.¢. · · .~? · ................. County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision. .c~ . ,,.,.~.-... ;-. ......... Filed Map No..c~. ~.7..~...Lot No...'~... ........ Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ..................... Request for Temporary Certificate ..................... Final Certificate ...................... Fee Submitted $ ............................. Construction on above described building and permit meets all applicabl~e_qodes and r/e~lations. Applicant. ' ................ 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: I, 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 requ ired to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 J use '~'//$5.00 2. Certificate of occupancy on pre-existing dwelling ¢ land 3. Copy of certificate of occupancy $1.00 Date ....... -~.:..~..~. :..~,~ ...... New Building ............. Old or Pre-existing Building ...~. ...... Vacant Land ............. Location of Property'S..~...~..~.~..~..O.~.¢.. , .~.~.~...~...~..~.~?.~...~,. ~.¢../.~.; .~.~. t~. ~..~.,~/., House No. Street Ham/et Owner or Owners of Property .~.,[~.1}'.~..~.., ..~../../) .... ~.~,,.. ,.~.~.-.~.. .......... County Tax Map No. 1000 Section .~. ......... Block ............... Lot ................ Subdivision ....~.. ~...~... ~.C..~.~...~. ......... Filed Map No. c~.7~.'~...Lot No...~. ......... Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit meets all applica~z[~ codes and r~gulations. Applicant¢~.~. 2~.~ ~~ ................... Rev. 10-10-78 1000344 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 .JOHN STREET, NEW YORK, NEW YORK 10038 ~,.e July 26, 1983 .~..,,c.,,o. No.o.~,. 2247.~-83N 610875 THIS CERTIFIES THAT o~[y t~ efeetrlca[ ~uip~t ~ ~c~ ~ a~ int~ by t~ ~t ~ off t~ a~ ~at~ ~um~r in t~ p~m~s inthe~oll~ingi~atlon; ~ B~ement ~ IstFI. ~ 2nd Fl. ~S~ ~ Bl~k/ ~t fiXTURE OUTLETS RECEPTACLE~ SWITCHES 1 1 2 1 FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C F40. OF CC, COND.A.W.G. NO, OF HI-LEG A,W.G. NO.O~NEUTRALS A.W.G. PER ~' OF CC, COND. O~ HI-LEG OF NEUTRAL OTHER APPARATUS: 1-G.F.C.I. (b--'~tr, mtng P~ol) This certificate covers ~mapliance aC Cb~ da~e of irmFecciom ~ec~;m_e of unusual e~/~u,~e~a it is advisable t~ have frequent teac amd/or r~de by a qual/~Eed f~.rson. Phil Gordon 12 Dean Port Jefferson Station, N.Y., 11776 LIC. t1101 This certlficote must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. UILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Examined · · · Approved 19 ~/~Permit FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c . . ~- 7} .~.......~ ....... ................................ i .~(Building Inspector) APPLICATION FOR BUILDING PERMIT Application No ..... ff.~....D--.?..~..'~... June 27 85 Date ................... 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 la~vs, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ,~ ' (Signature of applf~ffit, m/name, if a corporation) 70 Seawood Drive, Southold (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................. Owner ........................................................................ Name of owner of premises . . Win.---. ~I¢onegal ........ -.,-. ..... · ........................................ (as on the tax roll or latest deed) If applicant is a corporation, s,~nature of duly authorized officer. ...................... (Name~nd t~tle of corporate officer) Builder's License No. 61 Plumber's License No .... .n./.a. ................. Electrician's License No. ll01-E Other Trade's License No .... n/a .............. OF 1. Location of land on which proposed work will be doixe ................................................ :. .... ...................................... S. o. ................... ,,.//.. House Number Street Hamlet / County Tax Map No. 1000 Section ..:~. ~''~ ....... Block ...... 2 .......... Lot .... JlL.~? .... W../ Subdivision..Seawo'ad' Ac'~ce~4'a~) ................ Filed Map No. · .2.~.~.~ ....... Lot . . .& ......... './. 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: l} a. Existing use and occupancy' · ' re~±d~-nee ................... ,,' ..................... '~' .a'/[~'-'.XI/..~v~/ b. Intended use and occupancy .. ?.e.a..i.d.e.n.c. ?...%/./..:... ['......:... 2. ?.'?.'.. ,],. .............. )"\' ?/" ' '~l 3 Nature of work (check which applicable): New Building Addition , : .. :... Alteration .......... Repair .............. RemOval .............. Demolition .............. Other Work .%~. ×..3~.~I i (D ipti ) 4. EshmatedCost ........ $.~., , ...... ............. ... ee . .' ( , (to be paid on filing this application) 5 If dwelling number of dwellingiunits -- 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 D' ' of ' ' tm t 6s ifa y F t Rea Depth Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ..... .-7 .......... Rear .. 7. .............. Depth' ........... : ....... i · ' Height .......... -, ........... Number of Stories.. --' 8. Dimensions of entire new construction: Front .... .16: ....... Rear ...3~: ......... Depth . .3. =-..(~ ~. ...... Height ............... Number of Stories ........................................................ Size of lot: Front .. ZO0!... i ........... Rear ....1OD.' ............... Depth ...150.' ............. Date of Purchase ............................. Name of Former Owner ............................. Zone or use district in whichprgm~ses' ' are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: .. No Will lot be regraded ........ i · no ................ Will excess fill be removed from premises: Yes No Name of Owner of premises ~ra ~ · NI~Gone~ai .... Address 7©' ~oawooc[. t)p.o. · · Phone No..76~-.1.5t~ ..... Name of Architect ' ......... i ................. Address ................... Phone No ................ Name of Contractor . .Swim..K±n~..1?.oo1~ ...... Address .. R~au~e. 25A ...... Phone No...?g&--.8't O0 .... 10. 11. 12. 13. 14. PLOT DIAGRAM Locate clearly and distinctly alli 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. __ t O STATE OF NEW YCOI~,Kr~ COUNTY OF .... ?.o .%¢.q [~. .... iS.S ........ .~.e, oc~.~e,...~..q~e~-~ 'cxq .................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ..... ~.q o.+. ............................................................................. (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 applic~,tion; 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 ............. ~?..'~5....... .dayof:.. ,'TJ..9.D..~,~. .,....... ., 19 Notary Public,....~...~.'. ~. · . .,.~a~. County C/uahhec~ m :,,?,,," (Signature of applicant) Corem,ss