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Home My WebLink About12186-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z12105 Date ......... DECEMBER 1 8..3 THIS CERTIFIES that the building ADDITION · 695 KERWlN BLVD GREENPORT 'Hem/et Location of Property .................... : ................................... ~louse No. " County Tax Map No. 1000 Section 053 .Block 03 .Lot 017.3 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 16 19 8.3. pursuant to which Building Permit No. 121865 dated M.A..R.C.H.. 1..4 ................... 19 .8.3. , 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 ......... ..... ~.o.r..~n.. ~.d.4i. t. ip.n.. ~9..a,n,, ,e~.~.s.t..X.n,g, .d,w.e.~. Z..i.ng. ............................ The certificate is issued to .3.QI;t]~. ~,. ~Ab]TgC~Q¢?oYn.o),¥,s~e¥o.r.t~t~e.n.O_ of the aforesaid building. Suffolk County Department of Health Approval ...I~/A. ..... ; ............................. UNDERWRITERS CERTIFICATE NO .... N6212L~4 ...................................... Rev. 1/81 Building Inspector sOuTHO~D, N~' 12186 (THIS PER~IT' MUST BE'KEPT oNe, HE COMPLETION OF ~'H~wOI~ Z Permission is hereby granted at:p~emiseS located at ...... .~.: '-~:;"i' ......... : ............................. : ............. '~,~"'!'":'"'Ti''~ COUnty Tax Map No 1000 :Secti¢ rBloc~ pU~uant to application dated BoIl~lng I~spector. · , ReV.,6/OZSO , . 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 bqildings, 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-existin~;'7- 1and 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 3, Copy of certificate of occupancy $1.00' --Pre-Existing C,O. $15.00 Vacant land C.O. $ 5.00 New Building '~l~ Old or Pre-existing Building Vacant Land .. Location of Property .~.~.~..~...~J~. ~, .~3.~.~%. · .'¢~. \~, .~[~'.. ~ ~t~.~/~.~;...~,.~ .................. Hou~,e No. Hamlet Own er or Owners o f Pro p e rty ...--..~C~,\~'~. ...~.~.. ~,~,~.' ;%.~ ~ ~ .............................. County Tax Map No. 1000 Section ... ~. ~-.. ........ Block .......... Lot. Subdivision....~..~,t~ ....................... Filed Map No ........... Lot No ............. Permit No. ~.~, .~..~z.. Date of Permit ~.. ".~.~..~..Applican~.~x~'~G~..t~ .~ ....... 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 applicable codes and regulations. Rev. 10-10.78 FIELD INSPF~CTIO~ COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: 78s.1,8e2 BUILDING DEPT. INSPECTION FOUNDATION 1ST ~ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION ] FRAMING [ ] FINAL REMARKS: ~/~//~ - INSPECTOR 7GS-~.802 BUILDING DEPT. INSPECTION [ ] FOUNDATION tST [ ] ROUGH PLBG. FOUNDATION ZND [ ] INSULATION [~ FRAMING [ ] FINAL REMARKS: DATE/~///~/ 7GS-1802 BUILDING:DEPT. INSPECTIONi FOUNDATION 1ST [ ] ROUGH~. pL~BG. [. ~/~OUNDATION 2ND [~] INSU ~LATIO~ FRAMING [ ] FINAL THE NEW YORK BOARD OF UNDERWRITERS 1~)010~ BUREAU OF ELECTRICJT¥~ ~ 8E JOHN STREET, NEW YORK, NEw YpRK 1003~ THIS CERTIFIES THAT only the el~trtcal equipment as ~scribed below and int~uved by ghe applicant ~m~d on t~ ab~ application number ~ the premises of in the followirtg locatior~; ~ Basement ~ 1st FI. ~ 2nd FI. ~ Section Block Lot and found to be ~rt cotnptiar~e with the requirements of this Board. FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FIXTURE SWITCHES ~ 7 ~ ~ DRYERS FURNACE MOTORE UNIT HEATERS MUlTI-OUTLET SYSTEMS NO, OF FEET DIMMERS SERVICE~ DISCONNECT S E NO OF CC, COND PER ~' OTHER APPARATUSz OF CC COND. NO. OF HI-LEG A W. G, NO. OF HEUTRAtS OF HI-LEG OF NEUTRAL Ga~y 4~ Mon~ell C~l;chogL~e F N.Y. This certificate must not be altered in any manner; return to the of the Board if !nspecto may be by MANNER. credentials. MAY ~p, 1974 the aewege disposal and water supply £~e!).itlea For this location have been ~u~ee%ed by ~his de~rtmen~ ~d fe~d %o be satisfac~o Chie~ o~ GeneraI EnEia~r~ THE [OC,~T~ON OF WEL[~ .AJCD CES~PO0[.~ SHOWN NEREIN ARE FROM FIRr, D OBSE~''~A~Oj'IS ,~NDIO~ FROH DATA O~TAINED FRO~,I 0~'''~ ' ~EV~S~O~S AP~ 25, 1974 _( YOUNG & YOUNG 400 OSTRANDER AVENUE, RtVERHEAD, NEW YORK HOWARD W. YOUNG SURVEY FOR: LOU~S HODOR ' F-- su~o~ co., ~.Y. ~~~ _. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMEN!, TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved. ee it APPLICATION FOR BUILDING PERMIT 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 b~ 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 issded '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 thee issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, N~w York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, lot for removal or demolition, as herein desctibed. 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 necess ~!3spect~. s. y (Signature of applicant or name, if a corporat'on) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... O~.~.~V. ............................................................................ Name of owner of premises .... .~.. ~. c> .~.~ .~._.. k..'~ ~: ?..q~d~t~-?.~._~,~ ed~. .................................... (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 .... ~..~.. ~-.~Z~-..: ........ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. . . . ....... .,. . .......................... House Number Street x xh Hamlet County Tax Map No. 1000 Section ... ~.~ ......... Block . .'. ~. ~ ........... Lot..~?~ ~ ............ Subdivision .... ~.~-~,- ......................... Filed Map N0 ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy. ~L~C~ . .~.. ~~.~ .................................... b. Intended use and occupancy.· :~.<32.~..~%.,~,.. ~,~ ..... .~..~... ~ ~.~ Nature of work (check which a~plicable): New Building .......... Addition .)('~ ....... Alteration .......... Repair .............. Removal .............. Demolition .............. ~ Other Work ............... 4. Estimated Cost . .1. t.~.~.%.,..I ....................... Fee ............................ I (to be paid on filing this application) 5.If dwelling, number of dwelling ~nits ...... [. ....... Number of dwelling units on each floor....t ............ If garage, number of cars ..... ~....~.~. ............................................................. 6. I business, commercml or m~xed occupancy, specifyfiature and extent of each type of use ..~ Height ............... Num. ber of Stories ............. ~ .......... ~ ' ' ' TI ............... Dimensions of same structure with alterations or additions: Front ....tW-. :~. ~ . .t:~. ...... Rear i i i~'. i'.~7.~. ..... 8. Bimensions of entire new construction Front..w..~. ........ Rear....~..~i~. ........ D~th ii i~iiii, i. i J Height.. ............. ~. Nu_mb~er of Stories ............ ~ .......................................... 10. ~ate of Purchase ....... ~.k. ~.~ .Of7 ............. .~ame o.f Fornler Owner .~iu~l~ ::::: %.~.%'%. ......... 11. Zone or use district in which'premises are situated...~..~.~-~ .~t. ~gv~:x.~:~ ........................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ...... ~ · .i .... ~. .............. Will eltcess fill be removed from premises: Yes No 14. Name o f Owner of premises~..~.~.~Mv;~.~g ..... Address~. ~.~ .~9 a..~l~Phone No. t,.¥~[ .-[: .I.t~ .~ .... - Name of Architect .......... i ................. Address ................... Phone No ................ Name of Contractor ......... i ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all~ buildings, whether existing or proposed, an& indicate all set-back dimensions from property lines. Giye street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE)~/YO. RK, '~ S cou Y ...... i .... C.~ .d~'. · .~'Y~'. · · · .°':'~.. · .'~. · .i .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ 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 manne~ set forth in the application filed therewith. Sworn to before me this T .! ' .,, , " ;" NOTI~ BUILDIN~ DEPARTMENT AT , 765- 802 9 AM TO 4 P~ FQR THE FOLLOW NG INSPECTIONS: . ' 1', FouNDATION - TWO REQglRED , : , , FOE ,p. OURED~CO~CRETE' - 2 ROUGH - FRAMING & PLUMBING : ' 3, INSOLATION ,' ;4 FJNAL-:.'CONSTRUCI'ION MUST ' ' ' ' : "~ ' , ':, 'A~L ~bNS~[~C~[ON. SHALL MEET ' ' ' , ', , :~HE BEQUIREMENTS OF :THE N,Y, , , - ..... .. , ~TATE: CONSTROCTIO,N & -ENERGY ' : , ~ ' ,,," .... . , - ~,'. , ~ CODE~ ' ~No~: RE~PONSIBLE~,FOR. - ~ - , , ,, ,., ' ' 4: DES G~ OR:CQ~4ST~UC~ION-ER~OR~ ,, ~,, .... , , , , ., ,, ,