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HomeMy WebLinkAbout10479-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No .... Z. 99.0.8 ....... Date .... .1~..~lP.~.h. a7.,.. 19JSQ ........... i 9... THIS CERTIFIES that the building ................................................ Location of Property ...... '[800..Q~dl!t~..~0~11'~. DlrLt,~.'e. ~88~¢ ....... 8.Otl~Cho~,ct,. N.,.¥.. House No. Street Hamlet County Tax Map No. 1000 Section .... 9~ ..... Block ...'J ........... Lot ...... ~. ......... Subdivision...Celt~lT..Be&~h. P~l?.k ......... Filed Map No .... 90...Lot No... Bg. &. 5t0.. conforms substantially to the Application for Buildmg Permit heretofore filed in this office dated ·.. l~l.o~re~l.lg.e~'. ? ......19 .~.9 pursuant to which Building Permit No....10./-tT. gZ ............ dated .... ~!'~..~o¥.ellfl~e~..[9 ........ 19 751, 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 ......... ........................ ~. rC[~.~e..one, l~.~J,~-¥. J~e~,;1J;ng ........................ The certificate is issued to ........./¥ .e .o . . ,. n. .d . ~grS.lL.n.~...~.%~0 .~.~.1. ..................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . UNDERWRITERS CERTIFICATE NO ........ p.e~:J, lQ~ ................................. Rev 4/79 FORM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTt-IORIZED) N? 10479 Z Permission is hereby granted to' to ..... ~ ~. ~../..~c~.~.. .~. . . . ...~. ... . . . . D.'Z'.~ ~. ~..,~. .?~. . . . . .o.x¥,~ ....~..',4~'~..,~ ~ . ..,~.,~//. zx~ . ~t premises Iocoted ot ........ Z~ ........ ~Z ......................... ................................................. ~ ................................. ~ ~x~:~: ~, ....... . b<xdz.~....~z Z2x~,--- ~ ~G ..... ~.~,.......~.~.....~. ............ ~4:~ ~'~ 19Z.~., approved by the pursuant to application dated ............................... ~- ......... , and Building Inspector. Fee $..~2)..,~....g..~ .... Buildik'g Inspector 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 featu res. 2. Final approval of Health Dept. of water supply and sewerage disposai-(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, Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 ............ New Building .... /~ ....... Old or Pre-exist~ng Building ............ Vacant Land ............. Location of Property ...... /.~..4~..O ........... .~.~'.~.~./~.../.5~..~./.x.~.7-,, . .z~..'~./.u'..~., .,~.,~.~?T.,..~.o.o.~'~ House No. Street Hamlet Owner or Owners of Property . O..~,., .~'.~. ~./..~,/..~<~... ~.~. ~Z[:S/ .......................... County Tax Map No. 1000 Section ..... ?..~. ...... Block ..... /. ......... Lot .... .~. .......... Subdivision ~"~-~O~,. ~7.4~'~.~../~...,~77~. ~. ........... Filed Map No.. ~..~ ...... Lot No...~..°07'. ~. ?.~.. Permit No./.O. ,~..~.~. .~, Date of Permit . ././~/J~/~¢..Applicant .~.~.~..~. Health Dept. Ap proval .'~/E?~/.*.~. ..... .~.~'.O..~..~.... Labor Dept. App royal ..... ,~./.~ .............. Underwriters Approval ........................ Planning Board Approval .... ,~. ,/.~ ............. Request for Temporary Certificate ..................... Final Certificate ..... X ............... Fee Submitted $.. ~ ,O.O~ ..................... THE NEW YORK BOARD OF FIRE UNDERWRITERS ~[~' BUREAU OF ELECTRICITY' Date ~l)pl~catio~ No. on,file N THIS CERTIFIES THAT only t~ electr&al ~qulome~t_az &scri~ed~el~.~d ~t~yt~ appli~~{~v~app~a~n ri.tuber &t the premises of was examined on and found to be in compliance with the requirements of this Board. FIXTURE OUTLETS ~ECEPTACLES SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS NCANDESCENT FLUORESCENT DRYERS SYSTEMS NO, OF FEET E SERVICE DISCONNECT E R V I C ~JO OF CC COND PER ~' 1 , AWG OF CC COND 2/o AWG NO OF HI LEG OF HI LEG qo OF NEUTRALS 1 OTHER APPARATUS: ~1~¢. Roota lleat~rs:g~2.bKW1-2.0KW,l-l. SKW,5"L.0KW,5~.75~,2~SKW MoLo~/s;I~F 1-G.F.C~ l~Smok~ Degector i-4.5~ ~ot Water t~ater AWG OF NEUTRAL Paul Burns Tow~ }{arbor Lan~ Southold~ N~Y. 1,1971 Th~s certrficate must not be altered in any manner, return to the office of the Board if ~hco~ect Inspecto~ copy ~o. ~u,,o,~o o~.A~mr, m,s coP7~ o~ be ~dentified by )~ IN ANY FIELD INSPBC~ION COMMENTS FOUNDATION (~st~) FOUNDATION 2. ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: /! LAWRENP-E M. TUTHILL No,ember 4,1979 Residence Mr. Leo Alessi Design temperature Inside 70° F Design degree days 6,000 Insulation "U" Floor R-11 .07 Stairs 2" insulation F 38 rigid Walls R-11 ~oof & Ceiling ~-19 .05 ~indows Dbl glass .69 (thermal~ Doors oer code .40 Infiltration )volume) .018 P Outside lO° F Area Loss SF 26 990 2,596 12,400 1,075 3,220 283 11,700 49 1,180 15,470 16,70__.0 50,690 per cent glass 10 Thermostat as per code Heati~ and Service water lines Do be insulatadaas per code Weather sbripoing al windows and doors Caulking as per code l~urnace bo be 75% Minimum efficient Hot water heater as oar code FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined . .,~...~.. f.~.. ..... , 19~. ~. Approved r~f.Q..~../. ~. ..... , 19 ~. Permit No...ir.~. .%f...~.~..'-~' Disapproved a/c ~.=~'~-. · . ~~~ (Buffdin'g Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No. ~.d~).~. ~.7 ....... a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 buildings for necessary inspections. ·. .... (Signature(~f applicant, or name, if a corporation) .s~.~...~ .~.~ .~..o../.~..&/..~,.. ~! ~.-?.t. ..... (Mailing address of'qtp~ant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... .................................................................... Name of owner of premises .. .~..O..h~.. [ .t.T.).[ ¢C.9 .... I.~.~'~.l ........................................ (as on the tax roll or latest deed) If apphcant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... 1 ~. ] ................ Plumber's License No../~t~.y..~ .~/'F) l . .~... .... Electrician's License No...R.~.b~.l....~. tA_.rDJ'. Other Trade's License No ...................... 1. Location of land on which proposed work will be done ..... ]J0~.CI.I.~..~. .............................. · ./. ~.¢~. ..... ~.x:..~.,,?.~.. ...... ~,~.. ~ .~..,.w- ............. -- .&..~.~..o.~.~ ............... House Number Street Hamlet County Tax Map No. 1000 Section ....O~ ..~. ........ Block ....... [ ........... Lot .... 3 ............ Subdivision.~-.Q0%~..r~.~..~:~..~ Filed Map No. . .~.Q ......... Lot.ff.c~:r.?..~ ...... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................. b. Intended use and occupancy [ [~..(~._.fI.) I 3. Nature ofwork (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost I (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 business, commercial or mixdd occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure ~)ith alterations or additions: Front ................. Rear .................. Depth ................... ~... Height ...................... Number of Stories ...................... 8. Dimensions of e,n, tire new construction: Front... ~.~ .~,~ ..... Rear .... ,h.~,~. ....... Depth .. ~.O ......... Height ...... ~..Z. ! .... Number of Stories 9. Size of lot: Front ...... c~.~.. ........... 10. Date of Purchase .......... : ................... Name of Former Owner ............................. I 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction vi01ate any zoning law, ordinance or regulation: ..... t3.'O ....................... 13. Will lot be regraded ...... ...,..t~ ~ . .:.. . Will excess filI be removed from premises: Yes No 14, Name of Owner of premises ~.tP.~. .0.ffq'~ O~ 99.. ~.{.t.~. IAddress ~ COa~.~o~q-: .Lg~q.~d.. Phone No. ,~01 .".~ ~.~. q.~c~ .~ Name of Architect . ~ ...... i ....., ....... ., .....Address .Q~¢..Q-~3~..~. q_~.C[q..~hone No ......... =....... Name of ContractorQ~'O~.~qC .~A~. '.x.. {~¢-.t\.~..e4-.. Address 3.3.6C~..~.. Q.r~..h~...~. [ .d~.. Phone No..r~0.~7.1.3..,x{?~... PLOT DIAGRAM Locate clearly and distinctly ali 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 NEWtS~)RK~ · ~ ~, i ,, o COUNTY OF~ ' ~'~ (Name of individual sighing contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is d~ly autho~zed to perform or have perfomed the said work and to m~e ~d file this application; that all statements contained ~ this application are true to the best of his knowledge and belief; ~d that the work will be perfomed in the m~n?r set forth ~ the application filed therewith. Sworn to before me this .day ~f ~~ 19 , No. 52.8125850, ~uffolk ~ (Slgfiatdre'of app~c~t) J ',,, ~ , , // AEEA, L27A, .-__-_,_._ :===. - .'__. f-', , '- F ~,, ¢; F D LAN D SL~P. VL"FO~S ~ISi.: N '~ ET, N. ~ iA ALE,SS OCCU ANC¥OR. r'~ ' USE IS ,UNLAWFUL :~i~ll]~T' CERTI[:ICATE I)F OCCUPANCY ALL CONS,TRJC~-ION SHALL MEET THE REQUIDEMENTS OF TH,E N,Y, STATE CONSTRUCTION &ENERGY '' ' . 'NOT [~ESPON~!BL,F- , CODES ' ION ERRORS ' ' · DESIGN OR CONSTRUCT ' ,, 765-1802 9 AM TO ;¢ PM FOR, TH FOLLOWING INSPECT'IONS: ,1. FOUNDATION -TWO REQUIRED' FOR p©URED CONCRETE 4. FINAL - CONSTRUCTION MgST . BE CO.gL ET~ FOR, C. ~,, L : i""' ...... *'- *'