The URL can be used to link to this page

Home My WebLink About12554-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..g..1.2.8.1.5. ......... Date Sept. 27 19 84 THIS CERTIFIES that the building . .AQ.c.e.~ s. 9.tX .B..1.d.q: ............................ Location of Property .5.0... RockL/ Pt. Rd. East Marion ~.louse NO~ ...................... 'S'ttJe~i ....................... County Tax Map No. I000 Section ...0.3.], ...... Block . ...0.2. ......... Lot .... 0.2.6. .......... Subdivision... X .......................... Filed Map Ho ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .J.u.n.e....2.7. ....... ,19 .8 .3. pursuant to which Building Permit No...1.2. 5. .5.4.g. ............ dated ....... AqcJ, .... 2. 7 .......... 198..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 ......... ...Two..Stor. y..[{0;1 .~ab~%. ~.q~.s.s.o.r.y..B.u.i..1.d.i.n.g ............................. The certificate is issued to ......PQ.R.F.! .R.I.S.,.JOHN ..... ?oYn'.;, ...................... of the aforesaid building. Suffolk County Department of Health Approval .1..3 r~q. Qr .1.5.3. ............ UNDERWRITERS CERTIFICATE NO ............. hl ~ f~.0.6. 7 ~ ............................. Building Inspector Rev. 1/81 I~O~IM NO. ~1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 12554 Z Do,e [~...~...~. ...... ~3 .............. , I~.~...~ Permission is hereby gronted o: ....~. ~...~..[. ......... ~ ...... ~,. ............. ~ ....... ,~....:.-.... ................................................................................................. County Tox Mop No. 1000 Section .-~...',-'~..I ......... Block ........ .~,, ....... Lot No......~.....~.. ........... pursuant to application dated ......... ~.2~1¥>,~.......~....~ ................. , 19~..~, and opproved by the Building Inspector. ,b ............... .... Rev. 6/30/80 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, and submitted-=ia=~af~iee~*eto 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 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 dwel ng / land 3. Copy of certificate of occupancy $1.00 use--?re-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Rev. 10-10-78 existing Building ....... Vacant Land .. . LocationofProperty~.r~..~..~,~..~. 5'd ~-~p_~$t~.~t?.~ ~ .~ ~.~ Hou~ No. Ham/et Owner or Owners of Prope~..~..~ '~. .................. CounwTaxMapNo. 1000Section . '~ ........ Lot .... Subdivision ................................. Filed Map No ........... Lot No ........... Permit No..~.~.~ Date of Permit~.~.Applicant ..~.~.~... HeathDept A rova ~ .~ Unde~ itersApp Oval ~'.~ r r ........ Plan i g Boa d App oval Request for Tempora~ Certificate ..................... Final Certificate . .~. ~ ........... ee ~ ' -~ F buomitted $..~ .................. Construction on above de~ribed building and permit meets all applicable codes and regulations. ~ j~- Applicant .... . ................ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY I~J~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 .~,..,,~.,,o. ~o. o.~,,e ~..~.~/~ N 6 6 0 6 7 5 THIS CERTIFIES THAT ~OZaA Porfiri~, ~ ~ PoL~ Avowa, '~b~ ~"lOtx, ~.¥. in the following location; ~ Basement ~ 1st FI. FIXTURE OUTLETS RECEPTACLEt SWITCHES [~ 2nd FI. Section Block Lot and.found to be in compliance with the requirements of this Board. FIXTURES FUTURE APPUANCE F~EOERS RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE TIME CLOCKS UNIT HEATERS MULTI-OUTLeT SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E R V NO Of CC, CONg. A.W.G. PER ~/ OF CC. COND 1 WO OTHER APPARATUS: ~lectrlc room ~__~ers; 1-2.'J~m~. ,~-~.Ot~w. ,~-i. OW~., l-~.F.~.l. ~ ~tet~CT. or~ C NO. OF HI-LEG A- W.G. NO, OF NEUTRAt$ A. W, G. OF HI.LEG OF NEUTRAL 1 2/0 ~ ~-1o O0~AT~ola, ~.Y. llvT1 L~Lc#bT~ ~ MANAGER Per- This certificote must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FrELD'~INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING COMMENTS INSULATION PER N. Y. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ~.'~9..~'..~...~.., 19~..~. Disapproved (Building Inspector) APPLICATION FOB BUILDING pERM.IT Application. : No ......... Date (~.~. ,~. Y .... , 19~..3. INSTRUCTIONS a. This application must be .~omplete!y ~l~d in by typ~vriter or i~n ~ .~!~d ~bm, ~t,t, ed in: .m.'iLlis~.te :t,9 ,~.,e .B. ui~ding Inspector, with 3 sets of plans, accurate plot plan to scale. Fe~ according to .~ehed~le. b. Plot plan showing location of lot and of buildings on premises, relationship lo adjoi!~lg premises or public streets or areas, and giving a detailed description of layout o.f propell'y must be drawn on ~he ~diagram w. Mch is l~t of. ,t~i.'s 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 issue a Building permit to the applkan~. 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 wha. t, ever3mlfl a:Certific!te of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building .Department for ~the issuance of a Buflding~Permit pursuant.to the Building Zone Ordinance of'the Town.of Southold Suffolk County New.York,.and other applicable,L~, ws .Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal 0r.den!oliiipia,,as herein described. The applicant agrees to comply with all applicable laws, ordinances, :building code, housing ,co.de, and r. egulati0ns, and to admit authorized inspectors on premises and in buildings for necessary inspections. .(Signature,o(applicant,~0r name, if a ~orporation) ...... ............ (Mailii~ address of, app,i ,an ) State whether applicant :is owner, lessee, agent, architect, engineer, general contractor .electrician ;plumber. or builder. .... ........................................ Name of owner of premises (J (as on t e ta roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No....~...6..~ ............... Plumber's License No. $" 3 Q ~ O~er Trade's License No ...................... ~ 1. Location of ,anO~n which proposeS work.will be done.. ~..~ ¢ ~ ~ {~2 ....... House Number Street : Hamlet Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occup~cy of proposed construction: a. Existing use and occupancy .................. 2 ................... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration _.. a ..... Repair .............. Removal .............. Demolition .............. Other Work [(.~_~o_~.~ , ~ 4Ii c~ ~ ,.~ 0(Descripti°n) 4. Estimated Cost . .~&~ o-w-o ................... Fee ...................... : ............... (to be paid on filing this application) $. If dwelling, number of dwelling units ...... -z. ........ 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 ..... [.6 ....... Rear ... f. 6 ........ Depth .. ~..t ......... Height ~.,. ~ ~..t .... Number of Stories..,2, ................... 2 ................................ Dimensiox{s'of same structure with alterations or additions: Front ..../.6 ............ Rear ...'b:. ~.. ............ Depth . . t~ ~.. ~.G ............. Height ..... .~..~.t ............. Number of Stories ...~ .-.(T. te.~) .......... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories .......................................... ; ............. 9. Size of lot: Front ...... ~.~.'. ........... Rear ........ 9./. .~. 7. ! ...... Depth . 2~ .6 .~ .... i ....... ii' 10. Date of Purehase .~,.,..~.-.J.~.~.~. ........... Name of Former Owner .......................... 11. Zone or use district in which premises are situated. ~~. t-,..~l~· .~. ......................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .. h~...- ......................... 13. Will lot be regraded .~[,A~.,- ...................... Will excess fill be remo,ved from premises: Yes 5( No. 14. Name of Owner of prenttises .~.~{~-. V.~.. Address ...f-~r~....% ~ .~:)~Phone No ............... Name of Architect ................. · .......... Address ............... . ....Phone No ................ Name of Contractor ~-~..~ .......... Address C~. ~?.-.~ .h. ~.,.. Phone No. 7.4 .~.~ 6 ~..~ .... PLOT DIAGRAM Locate clearly and distinctly all 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. STATE OF NEW YORK, COUNTY OF...~Xc/..~..ff-~9..z-../K.. S.S .... ~.~/.~.,~.. ~.~. ..... .~. ¢ ~.D. 4x2~. ~d.' .............. 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 duly authorized to perform or have performed the said work and to make and f'fle this application; that all statements contained in this application are true to the best of his knowledge and belief; and that th~ · work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ...... ~..ff...'~. .......... day of ........ ~ .~.~-~ ....... ,19. ~ d Notary Public,~ '' ~. ~. LINDA F. KOWALSK! f/OTARY PUBLIC, State of New Yo~ ' ' ' ........... No. §2-4§24171 (Signature of applicant) Qualified in Suffolk Counly Commission Expires March 30, 198,. /'/ . 'TO~VLI oF GOUTL-IOLD. 'TOWLI oF GOUTI4OLD. Id.¥. for water distributing system; piping shall be : of types K or L only APPROVED AS ~,IC)TED DAT~: ~'~)~, ..B.P. ~ ~, ~('~'~i z FEE: ~.L/~ .BY: /~' NOTI"Y BUILDING DEPARTM"NT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING IN~CTIONS: 1. FOUNOATION - ~O REqUI~ED FOR POURED CONCEETE 2. ROUGH - F~MING & ~LUMBING 3. IN~ULATION 4. FI~'~L - CO~TRUCTION MUST BE ~b~PlZTE FOR C.O. ALL C~STRUCTION SHALL MEET THE REOI~JR~MENTS OF ~ N.Y. STAT~ CONSTRUCTION & ENERGY CODES. ~T RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. lC.