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Home My WebLink About12566-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ...... ZI2536 Date... June II .......................................... 1984 THIS CERTIFIES that the building ..... add ...~o. se.cor~cl..fl, OO~:, .Of..d.W.~ .1.1.i.n.g .... Location of Property $t3t~sb ~o.'6 E ' · Street Hamlet County Tax Map No. 1000 Section ..... 3.5 .....Block ...... 7. ........ Lot ...... 5. .......... Subdivision ......... .x. .................... Filed Map No. × .Lot No. x conforms substantially to the Application for Building Permit heretofore filed in this office dated August 25 19.8.3. pursuant to which Building Permit No. .1.2. 5.6,6.g. dated............................September 4 198.9.,wasissued, and conforms to all ofthe requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ..0~.~i~$.o.~ to second floor of an exis%ing one-family dwelling. The certificate is issued to LOIS PARADISE LATIMER ..................... [o¥,'d..'F ...................... of the aforesaid building. Suffolk County Department of Health Approval ............ N/A Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12566 Z Permission is hereby gronted to;~ . ~ , O · . .C~....~ ...... L.~~.....C~~ L.~5.?...~....!..~.~ .................................................. ,o...~.~. ...... ~~...~....~......~~ ....... ~ ......... ..................... , .............. at pmm,.s ,~at~ at ...... ~.~ ...... ~.....~ ........ ~.~...~~ ........ County Tax Map No. 1000 Section ....... ..0....~....! ....... Block .......... ..~.. ........ Lot No ...... ..~Z ............. pursuant to application dated ..... ~..~..~........~...~.. .......... , 19.~..~, and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD 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: 1, Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural 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/ land 3. Copy of certificate of occupancy $1.00 use--Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date.., ,--~. ,'T .~,~('..~, .......... New Building ............. Old or Pre-existing Building ..... ~ .... Vacant Land ............. Location of Property ..... ~.~..~;C~ .... ~,~..~R4 .. ...... E~i~, .~,'~-,,, ~ JO~ ~.~, ..... House No. Street Ham/et Owner or Owners of Property . ...~..~. ,~. ................................................... / 5"- County Tax Map No. 1000 Section .... .w'.~ ..... Block .... .'7 ......... Lot ................ Subdivision .... ~...~_, ...................... Filed Map No ........... Lot No .............. Permit No. /~ate of Permit ~'..~..App licant ~"~.' · Health Dept, Approval ........................ Labor Dept. Approval .. 'II~'~ r"~',,~'~'r~ nn ,~._~__;;': ' ' .... "' ' ~ ' Underwriters Approval ........................ Planning Board'Approval Request for Temporary Certificate ..................... Final Certificate .. Fee Submitted $/-~,-, ........ ~ ............... . Construction on above described building and permit meets all applicable codes, ~d regu a ~ ._ ....... FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: FEE: -~'-., ~ ~y: ~/, ~'. NOTIFY BUILQING -7~5-'1807 9 AM TO 9/ PM FOR 1 ~F'~DLLO\~'tNG II~,S.~EC T I O N S':' '", 1~. FOUNdATiON:- TWO ' REQUIRED ~. ~ ~ F~ P~/JR~ CONCRETE 0~l ~} ROUGU j~I~PLUM~ING ~* ~' ~"~F FOR C, ~, OF ~: N. Y, FOR ERRORS. 7GS-~802 BUILDING DEPT. INSPECTION FOUNDATION 'IST FOUNDATION 2ND FRAMING ROUGH PL.BG. NSULATION [ ] FINAL 1000773 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~ 8E JOHN STREET, NEW YORK, NEW YORK 10038 m, te March 12, 198,~ App,~,,,,on;Vo. on/i,e 238228-83 N 636549 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the appllca~t named on tlw above application ~urnber i~ the prem~es Carlton Latimer, Main Rd, Old Orchard La. & Bay Ave., East Marion,N.Y. in the following location; ~ Basement [] 1st FI. ~ 2nd Fl. Section Block Lot wo~ exami.~d on March 8 , 1984 and found to be in compliance with the requirements of this Board. fiXTURE RXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS 5 10 4 5 DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTlET DIMMERS SYSTEMS SERVICE DISCONNECT S E R V I C OTHER APPARATUS: Panelboards: 1-12cir. 1-G.F.I. 1-Smoke Detector 100amps. O~ A.W. G, NO. Of HI-LEG OF HI-LEG NO. OF NEUTRALS A.W. G, Arthur Ruroede Main Rd. Orient, N.Y., 11957 LIt.f2334 11 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Examined...~.~ ~,~... .... , 19 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved Disapproved a/c ..................................... Received .......... ,19... (Building Inspector) APPLICATION FOB BUILDING PERMIT INSTRUCTIONS Date. ~.c/.? 2~ 19~ 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 regtflations, and to admit authorized inspectors on premises and in building for necessary inspe,ctio, v4. ............ (Signature of applicant, or name, if a corporation) · (Mailing address of applicant) / 5tate~whether applicant is(6~, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner ofpre~nises . . ~./.$ .... ~ .... /')Y~& ....................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... ~(/.~ ........... Plumber's License No ......................... Electrician's License No..~.O..~..c~.. .............,~'~... Other Trade's License No ...................... ' ,Ed, Location of land on which proposed work will be done..//~ t~z'./fk) ............... ~. ...... ~. .... ltouse Number Street Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of pre~3jses and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .~. ~. & ~ .'.O(..&-..X~.~.-~. .... ~.~..,....~.~..~../~. ((.~...' .................... b. Intended use and occupancy .... A~.~.s./~ .~..~..,~..~.. ~... , ?~//.~. ~ ........ 3. Nature of work (check which aEplicable): New Building .......... Addition .......... Alteration Repair .............. Rem6val .............. Demolition .............. Other Work ............... _---- (Description) 4. Estimated Cost ............ 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 bustness, commercml or mixed occupancy, spec'_ffy nature and extent of each type of use ..................... 7. Dimensions of existing structure's, if any: Front..~.~.'; .5-..t~.(O.~.. Rear .............. Depth .............. Height.. ....... · ....... Nun~ber of Stories ........................................................ Dimensions of same structure w!th alterations or additions: Front ................. Rear .................. pth i H 'ght Nu fSt De ...................... el ...................... tuber o odes ...................... tm ti pth ' 8. Dimensions of entire new cons c on: Front ....... , .... Rear .............. De ................ Height Number of Stories 9. Size oflot: Front...............,......~ . Rear ...................... D.~pth ................... 10. Date of Purchase r/. ~-.li~;~, ... ~.. ~ ....,.-' ................ Name of Former Owner ,/.~.o.t~.d~.~9.. 11. Zone or use district in which premises are situated ..................................................... · 12,'Does propbsed construction ,violate any zoning law, ordinance or regulation' . 13. Will lot be regraded ..... fi)"~) 'L ................... Will excess fill be removed,from premises: Yes No 14. Name of Owner of premises .LO/.? tO~/se.,~jnt¢/Address ~.Z~f~','q~./'.'.~4'~.~. Phone No. ~7.P.,,a 2 ~,--.%... Name of Architect ' Address Phone No Name of Contractor ......... : ................. Address ................... Phone No ................ i , 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 gumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW Y~RK, ~ ,, ,, above named. being duly sworn, deposes and say~he~ . . is'the, applicant /~eis the ' . '../. ~' i (Contractor agent corporate officer etc ) ' of said owner or owners, and is duly authorized to perform or have performed the said work and to ma~O ~nd file.this application; that all statements contained in this application are true to the best o~_0_wledge and belief ahd that the, work will be performed in the m anne~ set forth in the application filed therewith. -:' Sworn to before me this .............. ,~k-~. ~vday ofi ..... ~. Co!mty . ,~ ,,' '..?:?,~, ~ (Signature of applicant)