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Home My WebLink About10518-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Date April 13, 1987 THIS CERTIFIES that the budding .... .A.c.q e..s.s.qr.y..O.a.r..ag? ......................... Location of Property ,... 75.0.0.. Grand Avenue Mattituck, New York County Tax Map No. 1000 Section 107 .Block 2 ...... Lot 16 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated December 7, 1979 10518 Z ...................... pursuant to which Building Permit No ...................... dated ....D.c.c..e .m.b.e.r...I .4. ,.. J .9.7.9. .... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ACCESSORY GARAGE ROBERT & J'OAN CHRISTIANSON The certificate is issued to ..................... [o~Jn'o'r,'le~g~¢~rTt~'[/x ..................... of the aforesaid building. Suffolk County Department of Health Approval iq / A UNDERWRITERS CERTIFICATE NO. 1,1800796 N/A PLUMBERS CERIIFICATION DATED: Rev. 1/81 FOP,~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTI-IORIZED) N? 10518 Z Permission is hereby granted to: ..... .../A.~.~ ........................................................................................................................................ at premises Iocoted at pursuant to application dated ,,~,~C.~.~'...L~./,~-~.~(--....7- ......... , 19.7..~.., and approved by the Building Inspector. Fee $..../..(~..~ ..... Building Inspector FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m aammmmm 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 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" ~and uses: I. Accurate ~urvey of property 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 New Dwelling $25.00, Accessory ,$t0.00 Business $50.00 2. Certificate of-occupancy on pre-existing dwelling $ 50.00 3, Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 /~b~t /..~2~/~ 5.Updated C.O. $ 50.00 Date ...... '~' ~ NewCons truc tion ...... Old or Pre-existing Building ............ Vacant Land ............. of Property ~, .~.~.~. ............. .~,/~/1~..~...~../:'~_ ............ J~.~.d./:~./a' '~/tJ Location House No, Street Hamlet Owner or Owners of Property . , ~ .. .Z~/ ..... ~../.~. /..~?..///~,~..~ .............. County Tax Map No. 100OSection .... /.~..~. ....... Block .. ~ ,~ ......... Lot.../.~ .......... Subdiwsion ................................. Filed Map No ........... Lot No .............. Permit No. ~..~../.~.~'7. Date of Permit .... ?. .Applicant.. ). ~. i.oq. }... ...... Healtl~ Dept. Approval ........................ Labor Dept. Approval ................... Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above descmbed building and permit meets all applicable codes and regulations. Applicant ../~9D.~).2/C...~.. J.O. ?~t/~.....C,..~..~./.tss..~/: .~ ~ ~5.0./:{ .... Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1003'8 THIS CERTIFIES THAT only the electrical equipment as described below a~l introduced by the applicant named on the above application nomber ~n the premises of in the following Ioca£ion; ~ Bo. se~ent ~4arch ~8~ 1957 FIXTURE OUTLETS FIXTURES [~ 2nd FI. ~1~¢~ Section Block Lot and fottnd to be in complia~tce with the requirements of this Board. RANGES DISH WASHERS EXHAUST FANS SYSTEMS NO OF FEET OTHER APPARATUS' E I C NO OF CC CONO PER ~' R V NO OF HI LEG E A W G NO OF NEUTRALS A W G OF HI LEG OF NEUTRAL This certificate must not be altered ~n manner; return to the office CO~Y FOR BUILDING DEPARTMENT, TI'tiS ~OPY GENERAL M~NAGER ' be identified by ~heir'~redentials. ANY MANNER. FIELD .INSPECTION COMMEN~S FOUNDATZON FOUNDATION 2. ROUGHFRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY COpE FINAL ADDITIONAL COMMENTS: Atlantic Homes of suffolk' InC. Z -J <~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved ........ (Y. ...... 19 Permit No. /OD~'~t' °~ / Disapproveda/c ... i~' '~' ............ >'""'"'// (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No. ?..~- .~7./. .? ....... Date,/~....~. .~..7 ........ 19Z7 INSTRUCTIONS a Th~s 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 ~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 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 necess~Tns.~..~____~...~' "(Signattir'e'~f'~p;licant, ~c~;~;;a~io'n') .... (Mailing address of applicant) State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ... t~....~'. ..................... m................... (as on the tax roll (r)- If applicant is a corporation, signature of duly authorized officer. FEE: ............. BY: NOTIFY BUILF)JNG DEPARTP4FNT AT (Name and title of corporate officer) 765480? 0 AM TO 4 PM · r,~P, THE .~.. FOkt OWING ~F-ISPECTiON'S. Builder's License No .... J. FOUNUATION . TWO R£OU1RED ............. FOR POI./RE,% CONCRETE Plumber's License No ......................... 2. ROUGFt ~ gRAMING & PLUM~iNG '3. INSUt.AT!ON Electrician's License No ....................... 4, FINAL COb STR - -- , N M, UST BE COMPLETE FOR C O Other Trade's License No ...................... ALL CONSTRUCTION SHALL ,~AEET ~.UDI:5. NOT RESPONSIBLE FOR DESIGN OR CONSTR, IJCTION ERROR. S: House Number Street Hamlet County Tax Map No. t000 Section .. ~..0.. 7. ~ ........ Block .... g. ............ Lot .... ./.~.' ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy .. ~/.a..r~..5]?-..)./?.O..O..C.C.a..p.a..O.e. ~ ..................................... ~c . ,..V/. 3. Nature!of work (check which apphcable) New Building ..... ~.... Addition ......... Alteration .......... Repair ..............Removal .............. Demolition .............Other Work ............... ./o (Description) 4 ~stimated Cost ........... Fee ....................... (to be paid on filing this application) 5. If dwelling, number of dwelling,Units ............... Number of dwelling units on each floe If garage, number of cars .... ./. ~.6t. r ........................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of uso ..................... 7. Dimensions of existing structurels, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories .. ] ..................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ' Height Number of Stories 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of:lot: Front . . . l..B.c~:O.~.,i ........... Rear ,../.~..c~. ............... __~ .__. ~_ ~.~_ ..~ _Denth .-~/.~,: .~,/. ............. 10. Date of Purchase ........... ' .................. Name of Former Owner 11. Zone or use district in which pr~mlses are situated ..................................................... 12. Does proposed construction vie!ate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... ~,. .................. Will excess fill be remove,d from premises: Yes No 14. Name of Owner of premises D~/TJ'. ~'~/ttQff!... Address ~t2/~/~.Y~., .~Z2~'!~tg(~Phone No.<,O~.<~.~,~r/~.~ .... Name of Architect .......... . ................. Address ................... Phone No Name of Contractor .~ Address Phone No PLOT DIAGRAM Locate clearly and distinctly alli 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 ..... ;s.s 'DI4//OJq ~ ~d~l~Ql'~ being duly sworn, deposes and says that he is the applicant , (Name of individual sigr~mg contract) above named. (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 file this application;that all statements conthined in this application are true to the best of his knowledge and belief; and that the work will be performed in the mann6r set forth in the application filed therewith. Sworn to before me this NOTARY PIIBI.IC, State of New, York No 52-4524771 Quallile~ In Sultolk C0unt~ Comrmssma Expires March 30, i1980 ..... , 19 .f Count. y