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Home My WebLink About10496-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No .... .Z .1.0.. 1. 9. ~ ....... Date October 10 198..0. THIS CERTIFIES that the buddmg ................................................ Location of Property .. .700 Robinson Lane, ?e¢onic County Tax Map No. 1000 Section ....9.g. ...... Block .../4 ........... Lot .~../4 .............. Subdivision .Pec~n~.c. ~Ba.y. Oak~ ........... Filed Map No, 3 .~.~....Lot No ..... ~3 ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated · .No.v. ellltael~. .27~ ..... , 19 . .7.~ursuant to which Building Permit No..'1.0/.~9.6. .7. ............ dated ... ~O.v.~nat).e.w..P..g~ ......... 19.7.9, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is msued is ......... ........ .~. ~r. xv.~.~... 0v.q-.F.o!n..~.l.y..~.w.e.l..1.t.n.g: .................................... The certificate is issued to ..... O~e.sJ.g. ~r.... ~la~ .P. ~la~y..~..nTl..V.o..13.b.~.l?g.e.n ................ of the aforesaid building. Suffolk County Department of Health Approval ....... 9.-..~.0.-.~. ? .0 .......................... UNDERWRITERS CERTIFICATE NO ...... N.../49.~.~..0./+ ................................... Building Inspector Rev 4/79 FO~V~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10196 Z Permission is hereby granted to.~ ? .gr~.....d %'.~ ......................... to .........(.~ .~ .......................... r.. ~.~.~ ~A~.....b,-..~:~....~.~ L ~ ............... ff. ................. at premises located at~ ......... , .......... pursuant to application dated ' ~...~.~....(-~ .......... 19l , and approved by the Buildtng Inspector. Fee Building Inspector 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 buildings, 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. 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 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 or land use $5.00 3. Copyofcertificateofoccupancy $1.00 _7, ,~0/' / ~/// Date New Building ............. Old or Pre-existing Building ............ Vacant Land ............. 700 £'£ co ' Location of Property &/~ 8 &/ /- ~ . / House No. Street Hamlet OwnerorOwnersofProperty (~, N:;I~ L~J , ",F ~ hzNY k~'J~,J County Tax Map No. 1000 Section ...... ~.~. ...... Block ....... .~/. ...... Lot .... ~.;¢.*~;; ......... Subdivision ........ - ............... Filed Map No. ~4/°~z~ .Eot No. .. ~ .......... f Permit klo. /::¢~':~ . Date of Permit .' ~ .~,:-.~ ...... - .... Apphcant .¢. ;/ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .................. Fee Submitted Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY, 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT 1~96Z only the electrical equipn~ent as described below and i~trod~ed by the applicant rmmed on the above application number in the pr~mises of in tbe followin~ location; ~ Basement ~ 1st FI. w.~e.,,.,i,,~do,, ,%pt~r 11, 1.980 FIXTURE FIXTURES OUTLETS ~ECEPTACLES SWITCHES ~NC~OE$CENT FtUORE~NT 26 30 ~! 26 ~[2nd FI. Section Block Lot andJound to be in compliance with the requirements of this Board. RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS S E R NO O CO%q~ O~ CC COND 2t0 Rocky Point EI~. Const. ~ Fooncain Rd. Rocky Point,iq~Y~ 11.778 This certificate must not be altered ~n any manner; return to the office of the Board if COPY.; ~Oa BUILDING D£PAR~MENT. THIS COPY;..~ OF [Ac. 333 Inspector GENERAL , may be tdentffied by the~ IN ANY MANNER. Memorandum from.... BUILDING INSPECTORS OFFICE TOWN OF SOIJTHOLD Sov~r:~oLr~, N. Y. 11971 765-1802 FIELD INSPECTION o COMMENTS~__~_~__ ._~ FOUNDATION ( 1 s 2 ) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY COpE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUT,O .D, N. V. E×am ned ........... , Approved ............ , I¢7g.. Pem,f ...... .................. Z..7.~......~....'. ........................... .../ ....................... Disapproved o/c ~ ~uilding Inspector) Application No...~...~...~...~.~....~?. ........... APPLICATION FOR BUILDING PERMIT Date /h/cJV6;-/~4,~,,~ ~-~ 19...~... INSTRUCTIONS a. This application must be completely filled m by typewriter or ~n mk and submitted m triplicate to the Budding Inspector, with 3 sets of plans, accurate plot plan to scale. Fee accordmg to schedule. b. Pict plan showing Iocatmn of lot and of buildings on premises, relationship to adjoimng premises or pubhc streets or areas, and g~wng a detailed description of layout of property must be drawn on d~agram whmh ~s part of th~s apphcation. c. The work covered by this application may not be commenced before issuance of Building Permit d. Upon approval of th~s application, the Building Inspector wdl issue a Budding Permit to the apphcant. Such permit.shall be kept on the premises avadable for ~nspect~on 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 Budding Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffotk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as hereto described. The applicant agrees to comply with all applicable laws. ordinances, building code, housing code, and regulations, and to admit authorized inspect~ors on p~remises and in bui~ necessary inspections. , .................. ~tgnatu~ of appli~nt, or flame, if a corporation) ........... ....... (Address of applicant) State whether applicant is owner, ler~, arehi~, e~-general contractor, el=ctricL"n,~pluc~be~-or bui!deL Name of owner of premises .............................................y ........................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......... ,.~....~...~./.......~......~...~..'~....~...¢...'~/z~'¢/O¢5~-(~O Plumber's License No. ~.~.~.~.-~.,'~..~...~..~.,./.,/~"~ ...~~'3''~:~ Electrician's License No..~¢.~Z~~.....~¢~ Other Trade's License No ....................................................... Locat n ' ' n ~o ~/~/~ ~ ~ 1. o of land on which proposed work wdl be do e. Map No......~ .................. ~ ............. Lot No ......................... Street and Nu er ~~ ~ ~/~O/~ ~ ~/~ ~)~OZ~ ~, . Municipality 2.aStateExistineXistinguseUSeandandoccu°CCupanCYanc of premed. ~ ~ ~ ""intended~use and occupancy of proposed construction: · g P Y ...................................................................................................................... b. Intended use and occupancy .......... ~...~.(~.....~.~.~.~~ ....................................................... 3. Nature of work (check which applicable): New Building ......... ~... Addition ..................... Alteration ............... Repair ......................... RemoVal ......................... Demolition ........................ Other Work .................................... (Description) . ~ . ~ (to be paid on filing this application) 5. If dwelling, number of dwelhng umts ................. Number of dwelling units on each floor .~.~.~..~~ If garage, number of cars ...... ~,.~ ............................................................................................................ 6, If business, commercial or m~xed occupancy, specify nature and extent of each type of use .......... ~....,,~ ................ 7. Dimensions of emst~ng structures, if any: Front ............ ~ear ........................... ~epth .......; ........................... He ..................................... ;......; .............. Number of Stories ............................................................................. Dimensions of same structure ~ith alterations or additions: Front ........ ;... .............. Rear ......................................... Depth ...................................... , ....... Height ......................................... Number of Stories ................. ;. ..................... ]0. Date of Put ..................... ~ ............a,,,e of Owner ................................................ /.~,~.; ............... 11. Zono pr uso district in which pmm~ses am situatod ................ ~ ................................................................................. ]2. Does ~roposed ~onstm~tion viOlato an~ zonin~ law, ordinance or m~ulation: .......... ~ ............................................. (Address) ~ (Phone No,) Name of Contractor ....~ ~~..~.~.~ .) PLOT DIAGRAM Locate clearly and distinctly[all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and blockl number or description according to deed, and show street names and indicate wheth- er interior or corner lot. STATE OF NEW YORK, COUNTY OF .~..C2 ~...~., ..~-... .~.....~../~-~/'~2- ~...Jff.~./~, .~..~(:::~/~ be n- dui sworn, de oses and sa s that he is the a""hcant ~bove named ......................................................... ~ ............................ ~ ~ P Y ~v . (Name of individual si~m~ contract) He s the ~o~ owner or owners, and Is duly authorized to ~rform or have performed the said work and to make and file this application; that all ~stateme~ts contained in th~s apphcation are ~true to the best of h~s knowledge~and belief; and that the work wdl be p~rform~d in the manner 'rSet forth in the application filed therewith. z~o ...... ~,~5ul *uttom ~o,mty W ' (St~ature of applicant} ' , ~// ' COr4FOR~ T~ THE S~NDARDS OF THE ; SUFFOLK COUNTY DEPT. Or HEALTH DATE' , [ ~FOLK CO. ,TAX M~ . ,, ...... , TEST HOLE , ,, STAMP NEW YORK / \ ;, ~JI~(Y~ OOUNT~ H~T~ DEPART~ JUN 03 1980 ~.~.~,.#~e . e The sewage disposal and water supply facilities for %his location have been inspeoted by this department and f~und Ohi~f of ~ensral EnEine~rin~ ~ODE~,IC,~zVAN TUy_I., P.C. LICENSED LAIRD SURVEYORS GREENPORT NEW YORK SUFFOLK CO HEALTH OEPT APp'~OvAL H S NO 9- 50-- STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO. THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. ' (S) APPLICANT SUFFOLK COUNTY DEPT OF HEALTH SERVICES - FOR APPROVAL OF CONSTRUCTION ONLY DATE: H. S. REF. NO.: 9:- ~OT lilOll I A~PROVED. i SUFFOLK CO. TAX MAP DES:iGNATION: DIST. SECT~~ - -St OLeK - P'C'L "OWNERs ADDRESS: DEED. L. P. '" TEST H(~'LE STAMP .: SEAL OCCU?ANCY OR · , ,APP O,V£D AS NOTE .USE iS UNLAWFUL. , T CERTIFICATE . _ FOLLOWING INSPECTIONS: 0F OCCUPANCY ~,... ..~ , ~ .......... _-:::-~ ................................................... : ......... . .......... ~: ............. , , -.,__, , C~T,O,S SPEC F [NSTR ,' ' ' ' ..... - , m' · '~' ," , ~,~ ~ V~ ~b 4 5{~AT~ ARE NOT TO BE USED IN ANY OTHER pROJECT _EXCEPT ..... ~'~ ,. WRI~EN AUTHORI~TIO~ OF THE ARCHIT~CT~: 1. - TWO RE( POURED CONCRETE 2. - FRAMING & PLU, 3. ON 4, INAL - CONSTRUCTION COMPLETE FOR C, O. SHALL TH[ REQUIREMENTS OF THE CONSTRUCTION & COqES. NOT RESPONSIBLE DESIGN OR CONSTRUCTION HNG v~UST MEET N.Y. ~OR$. l) ki ~X~AVAT ~r~, L .,] -I t '1