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Home My WebLink About10481-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate O[ Occupancy No .... ~999~ ........ Date...g~r~.,~:Q .................... 19.~0 THIS CERTIFIES that the bmlding · . ................ Stree~ t Ham/et County Tax Map No. 1000 Section . ...0.~.~. .... Block 2.'~, :' .... Lot i .... .0./*.0. ........ conforms substantially to the Application for Building Permit heretofore filed in'%his office dated Noveml~r 16 ,19 7~. pursuant to which Building permit No. ' IO/~tlZ dated November 2.0 19 '~. was issued, atilt conforms to all 'of the requirements of the applicable provisions of the law. The occupancy for which this certifidate is isstied is ......... One Family. Dwelling w/reduced ~!de Yar~s* The cemficate is issued to Janet Halvereon ;:, ,, 1 ..................... ?o¥.'o;, ~' ~ ' of the aforesaid building. Suffolk County Department of Health Approval 9.-~.07109 UNDERWRITERS CERTIFICATE NO ...................... Building Inspector Rev 4~9 *Board of Appeals No. 26~1 November ~5, ~979 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUThlORIZED) Permission is hereby granted to: ......... .~../.z-o...../~'~/...t ~.Z.o: ........ ..... /...¢-...7.......,.,;:~.~m....Z.~.,c.,: ............ .... ......... , ,. ,o L/~ z.~.: Z.z..~.c.r..'. :.,.z~z:....m-~.~ /z.c.,...z6~,.~.//¢~.¢, ...... ~/.~-~.~-~,,;;:' ........... ':; .... -"" ./ I , I c,.,,,~,-~,~.~ ~/,'q .................... /.~......V/-,'Z?. ~...¢:./.....,.'../.: .~../---,-/-:.~:.L,~.,.:.O.X~. ....................... /:. ......................... ,¢ ~ .~ at premises located at ...... ~. ............ .~....0..Q.4~./~.¢; .C .......... ,!~/.L-~.'7.....~,.CC¢.T~ 4~. · ¥. .,~ .~.~.. ~.~.:;:/.r.-.,~...~3z .~.,'.:.~......¢... ,/,:¢... ......................... Z.~-...,7....... ~..Z .................... pursuant to application dated .~.¢b'.D:,~Z.'-~'.~/~/..~ ..-/.~. .......... , 197.¢., and approved by the Building Inspector. Fee $.~.~:7.....~....~.. .... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This apphcat~on 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 buddings, property lines, streets, and unusual natural or topographic featu res. 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 featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of anv housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certihcate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 / ] 3. Copy of certifmate of occupancy $1.00 __! / / ............ Owner or Owners of Property ...~, .P~t..~E"..'~, .'.~..~.,. ,~,..~/~ .................................... c~ ~,~ ~,~ ~o. ~o~ s,c,~o, . .q ~ ......... ~oc~ . .~ ........... ~o~ ................ Subdivision ................................. Filed Map No ........... Lot No. ~ .......... Permit No. ~ ~.~,~ . Date of Permit/.[~7.~pplicant ,~ ~,... ~.~'~ ........... Health Dept. Approval., ,~.~.~.. ~ ........... Labor Dept. Approval ........................ u nae~i~r~ ~,,~o~M .V. ~:.y..7( ....... ,~a,,in~ Soa~ ~,,~o~a~ ...................... Request for Temporary Certificate ..................... Final Certificate , ~ ................... Fee Submitted $, ~.~ ...................... Construction on above described building and p~r~n~,_~_meets/~l app(~.cable codes and regulations. Applicant ..... .~"..~. .... ~.~.., .~T~...~. ...................... FIELD INSPECTION COMMENTS i. - a,.-..., . , FOUNDATIOM FOUNDATION (2nd) ROUGH FRAME & PLUMBING ca. INSULATION PER N.Y. STATE ENERGY CODE FINAL /, ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICJTy~ [~r 85 JOHN STREET, NEW YORK, NEW ~ORK 10038 -m,s cE~r,~,ES THAT N 4.7247~ onlytheelectr*cale i~.fnento~s e cribedb otv ~dlntr duced t a i na d nthe bore ' tn the following location; [] Basement [~ 1st Ft. ~rc~ 13, FIXTURE OUTLETS DRYERS IECEPTACLES [] 2nd FI, Section Block at, d found to be in compliance with the requirements of this Board. SWITCHES FIXTURES RANGES OVENS EXHAUST FANS FLUORESCENT Lot. OTHER APPARATUS- E R NO Oi~ECC COND a W G. OF CC COND I c E NO OF HI-LEG A W G OF HI ~EG NO OF;EUTRALS John T. Sapanaro Inc. 102 Oak Ave. snlrtey,N.y. 11~67 must not be altered in any manner; return to the office THIS COPY Board If IN ANY MANNER. FORM NO. 1 TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined . .~..O..~....?-.?..,., 19 ~ .2 Approved ?'..~..br...~..O. .... , 1977. Permit No./..O..~.?/'...~ Disapproved a/c ~ . . .~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date, , . [ [ ."T..[~. ...... Apphcation NO../.O'. ~..~..d ......... \ INSTRUCTIONS 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 g~ving 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 ~ssuance 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 ~n part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Builging 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, NeWYork, 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, ho~g code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspe~t~.~_~ oration (Signature of applicant, or name, if~t ~q~xp~ ) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer~neral cont~ electrician, plumber or builder. Name of owner of premises ............................................ (as on the tax roll or latest deed) If app~__a co/~_ation.~gnature of duly authorized officer. Builder's License No .......................... Plumber's License No.~.,. ]ffiJ~.t.~. ~,~ ,~. -... Electrician s License No. ~[7, j0f~, ~. ~.'0. -~.~.'.. Other Trade's License No ...................... 1. Location of land on/which proposed work will be done. ~,~./~ ....0..~....~. p..bl.~. ~.....~'..-/'7.~.. .............. ................ ..................... t~;~;e ~q~m~;r' ' */~ 7~?:~' Street Itamlet County Tax Map No. 1000Section .~.¢ ........... Block ...~ ............. Lot....~....~ ..... Subdivision.· ~.0. bl.~t~.. 2;....~.~,%m'J'~S .......... Filed Map No. ?~.~. ~. ......... Lot. ~ .7 .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....''--.~/.'..~. {~-~d..~....ZT.,~../'/..O ............................................. b. Intended use and occupancy .. [..~.T'.Q g.~ .... .~.~,-.~1.~ ~.~/x~.t./~/-.,., .... jLfldO~ ................. 3. Nature.of work (check which applicable): New Building .... Addition ........... Alteration .......... Repair .............. Remqval .............. Demolition .............. Other Work ............... I ;l~(~_..~, ~ O. (Description) · t .4($ vero.' 4. Estimated Cos . ~ ......................... Fee...~?./'. ............................. (to be paid on filing this application) If dwelling ' ~ , number of dwelhng Omts ............... Number of dwelhng umts on each floor ................ If garage, number of cars .... (~.~ .......................................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions'. Front ................. Rear .................. Depth .................... !.. Height ............ w ........... Number, of Stories ........... t .......... 8. Dimensions,o~entire new constrUction: Front .. ~.t~. ........ Rear .~...617 .......... Depth .~ Height ...I.~ .......... t Num'ber of Sfories ... ] ...... .~ ....................... t'" ........ 9. Size ofilot: Front ...~/,~. .... "i" .......... Rear...r-/.~. ................. Depth i$.~.'~.' iiiii, ii ........ fp i N fF 0 10 Date o urchase ............. amc o ormer wner ............................ J I, Zone or use district m whmh pr~m~ses are s~tuated .................................................. 12~. Does proposed construction violate any zoning law, ordma,nfe or regulatmn: . ~ 13. Will lot be regraded ....~1~-~ .J ..... ,._~......_ ........Will excess fill be removed from premises: Yes 14. Name of Owner of premises/~t:{~.~7.~...~.~.~l~ Address ................... Phone No .............. ...~. Address ................... Phone No. Name of Architect .......... I ..... ; ....................... Name of Contractor~.~N~'~'X, . ~L] .(~ ......... Address ~0~ ~/,00tt4../d< .0~- .... Phone No. ?~'"~.~ltP. .... I 5. PLOT DIAGRAM Locate clearly and distinctly all i buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block: mmber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW Y~O~,K; ,~ ,t _ a ~ ~S COUNTy ....... 53.... .............. , (Name of individual signing contract) above named. being duly sworn, deposes and says that he is the applicant He is the ...................... l .....'.t~L"~'""~ ............ .'" ' .......... I ~ntracto~ . of s~d owner or owners, ~d is duly authored to perform or hav~ perfo~ed the said work and to m~o and application; that ~II ~tat~m~nts contained ~ t~? application are tree to the host of his knowl~dgo and b~li~f; and that work will h~ p~rfo~ed in th~ m~n~t set forth m the application filod therewith. Sworn to before me this i . ~ ......... , ...... ...... ............. Notaw Public, ...~ ........ i'C6finiy "1. "~" ~~g~ SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. ~U~V~ ~ STATEMENT OF INTENT ,~/~/.._'~j~ THE WATER SUPPLY AND SEWAGE DI~AL SYSTEMS FOR THIS RESIDENCE WILL ~T CONFORM TO THE 5TANDAR~ OF THi ~O~D SUFFOLK CO. DEPT. OF HEALTH SERVICES. APPLICANT SUFFOLK COUNTY DEPT. O~ HEALTH SERVICES - FOR APPROVAL OF CONSTRUCTION ONLY DATE: H. S. REF. NO.: SUFFOLK CO. TAX MAP DESIGNATION: c/e~r ~OD~EIC~ VAN TUyL, P.C. LICENSED LAND SURVEYORS GREEN~RT NEW YORK .~:~T ROD~ERICI( VAN TUYL. P,C. LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT SUFFOLKt~DEF~',}OF~r' HEALTH SERVICES. ~ APPLICANT Ir SUFFOLK COUNTY DEPT. OF HEALTH SERVICES FOR APPROVAL Of CONSTRUCTION ONLY DATE' /J-/6 ~f . ,~o~ 3~~ ~ ~r~ . SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL OWNERS ADDRESS: DEED: L.4Cgi'-;~ P. ~;CLk~ ,~-,;' ' TEST HOLE STAMP SEAL ~9 /O CObE .o~ ?v-~ DP~T& . OCCU? HC¥ OR ,Ii ' , NOTIFY D~NG D~AA~A~ENT AT 1, FOUND~'rlgN - TWO pEOUIRED FOR rm !R':D CONCeETE 2. ROUGH - FP, AMI~% ~ PLUMBING 2, IN%IL/*?~N 4. ~INF! - c~,q ....... lzN MUST ALL C~N?~lCCf~f[ ¢"AI L MEE~ ~TATE CONSTRLrCTImFf & ENERGY OR 60NSTAU6TION EEAO~-- t