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Home My WebLink About10314-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. Z9737 Date October 31 19 79 THIS CERTIFIES that the building ................................................ Location of Property 'l Q.B.5. ................... ~-~or.t;on.~ s..Lane ..... S.o. uthold,. NX... /Youse No. Street Hamlet County Tax Map No. 1000 Section . . 0. ~.4 ....... Block ....0 7 .......... Lot ?./Q. p.ql. ........ Subdivision ..... 7.- ........................ Filed Map No...':.- .... Lot No... ::-: ........ conforms substantially to the Application for Building Permit heretofore f'fled in this office dated · J..u~.y...1.3/ ........... , 19.7. 9. pursuant to which Building Permit No. ~. ~.) .3 .1.4.g. .............. dated .. '.J.u.l.y...1.6., ................. 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 issued is ......... one-family dwelling. The certificate is issued to Jose~>h J. arid Catherine K. Hawkins .......... ?~n'e'r, 'l~ieYr't~t~e'n't) .................. of the aforesaid building. Suffolk County Department of Health Approval . .O?.~o..b.e?...1.6/.. Jr..9.7.9..~: .~....V..i.i.l.a. ........ UNDERWRITERS CERTIFICATE NO... ~%.4 -~ 3 p.8. O ..................................... Building Inspector Rev 4/?9 FORM 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) No. 10314 Z Permission is hereby granted to: ...... ~, ..... do.~J.~F~a.c~.....~..~_~:~.~z~....~.....~..~.~. ........ ~~.~.~ ..................................................................................................................... .................... ~.Z~.~....~ ........................................................................................................... pursuant to application dated ................ ,,~',, ............................... ,~,;~'"' 1~"~'"~7 Building Inspector. Fee ,../.~..~:.~ Building 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 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 build~ngs, 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 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 Date ..... :~..o. :-..;t,~...~.~'..~. ? .... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property House No, Street Ham/er ........... ............................ Owner or Owners of Property~.~ ,~ ~.' .~. ~..~', .~--. County Tax Map No. 1000 Section ~ ,-~...~'. ......... Block . ~. ............ Lot ~./~ . .~;', .~. .... Subdivision ................................. Fded Map No ........... Lot No .............. Permit No./. ~/.~./. ~... Date of Permit ,~.~.~./). ~.Applicant .~..~//./~¢.. ~.,~',~. ..... ~ ......... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. THE NEW YORK BOARD OF FIRE UNDERWRITERS P~ BUREAU OF ELECTRICITY ~-- 85 JOHN STREET, NEW YORK. NEW YORK 10038 octob,,. No.o./,,. 035 62 N 4539 0 THIS CEEIFIES THAT only t~ ~t~M ~u~t~ ~ ~ ~ i~t~ b~ t~ ~ ~ on t~ a~ ~ ~m~r i~ t~ ~m~ o~ in the/ollowinR Ioc=tlon; ~ Bm~ment [] 1st FL tcasexamlnedo. October. 19, 1979 ~2nd Fl. Section Block and found to be in compliance with the requirements of this Board. Lot RXTURE OUTLETS DRYtql$ RXTURES RANGES COOKING DECKS OVENS DISH WASHERS SWITCHES FLUC~ESCENT ~2 30 31 FUTURE APPUANCE FEED~ES OTHER APPARATUS: ~otor/s~l-P Z-0.P,I. l-Smoke DetectoP S E R V I C E Robert O'Brien 21 North Ocean Ave. Center Moriches, N.t. 1193~ Lic.2338 E I1 ~is ce~ifica~ mu~ not be alte~d in a~ manner; return to ~e office of the ~ard if incorr~. Inspectors may be i~nt~ied ~ their COPY FOR BUILDING DEPARTMENT. THIS CERTIFICATE MU~ NOT BE ALTERED IN ANY MANNER, At) DtTIOk/AL I FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Application No. ,/(dt.T ./..~. ........ INSTRUCTIONS a. This application must be completely filled in by typewriter or m ~nk 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 tayout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this apphcation 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 mspection throughout the work. e. No building shall be occupied or used ~n 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, 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 apphcable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary~inspections. ,-, . (Signature of applicant, or name, if a corpo~ration) ........... ih' iliA ;ia;e;i a} applicant--" -- C' 0t ...... ~ State whether applicant is owner, lessee, agent, architeTt, engineer, general contractor, electrician, plumber or builder. .... ................................................. Name of owner of premises~.~...~.? ..~ .&T./C.~.% .~.-~-:?.~.~..'~...~. ........................... (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 L~cense No.../..~ .~..~¥../?..' .'~.. ....... Plumber's License No. ~ o~ 7 ffC~ , Electrician s License No ............ Other Trade s License No ...................... Location of land on which ro osed work will be done '' ~.. 1. p p .,,5~... _~. ........................................ . .................................... House Number ~F_) ~'N~ Street Hamlet County Tax Map No. 1000 Sect, ion .... .d?..~.~.~.¢ ...... Block . 7.. .............. Lot..~'..F~....~...'7~.../~. ..... Subdivision...~.~/f. ..................... Filed Map No .............. Lot ............... (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 .. ~. ...................................... 3. Nature of work (check which applicable): New Building .... Addition .......... Alteration ......... Repair .............. RemOval .............. Demolition .............. Other Work .............. .~.(.~..: (Description) 4 Estimated Cost ~..~. ~ Fee ~ f..g~ ...................... (to be paid on filing this application) 5. If dwelling, number of dwellingiunits. ~. ............ Number of dwelling ~rnits on each floor ............... If garage, number of ears .... ~-~ ...~. ........................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each.type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Iteight ............... Number of Stories ........................................................ Dimansions of same structure with alterations or additions: Front ................. Rear .................. Depth ............... ~ .. Height ....... ~.j ~,.t., .......... Numbe_r, of Stories ...................... 8. Dimensions of entire new construction: Front ....~...~'.'~. ...... ,Rear . ~..~..,.' ......... Depth . ~..~'.~ ...... Height .. ~ .~. ......... Number of Stories .... o~.:. ~ .... :. ~ ...................................... 9. Size oflot: Front ... ~r.~ .~..~'. ~. ....... Rear...~..~../.].77 .......... ,~D~.epth. 2~...7~: ~),~.~ ........ 10. Date of Purchase ........ '. ~ ................... Name of Former Owner c_.x~-,-'x~,~,,.. ~ex, w~-..,~. ........ 11. Zone-or.use district in which premises are situated ...................... 7 ............................. 12. Does proposed construction violat~e any zoning law, ordinance or regulation: ~ ~ ......... . .................. 13. Will lot be regraded ..... ~ ................. Will excess, f'fll~bb~j,emov~d~rogt,l)rqr~is, e~.' 14. Name of Owner of premises'~/I . .~,~ . Addres~,~ .... ,> ............ ... ., ,, l~ame of Arcm~ect ~Yl~Y-u~n~....~ .....~ ......... ~.z.'"/rcttlress ,~'... ~ ............. rnone l~o ............ . .... Name of Contract;r.(] ~~ · Address, .a Phone No. · 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 NEW YORK, ~ S.S COUNTY OF ................. ............................ I ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sigi~ing contract) above named. He is the (Contractor, agent, corporate officer, e'tc.) 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 contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworu to before me this ........................ day of ..................... ,19... Notary Public ' ~ County (Signature, of applicant) SUFFOLK CO. HEALTH DEPT. APPROVAL STATEMENT OF INTENT SYSTEMS FOR THIS REStDENCE WILL m SERVICES FOR APPROVAL OF '~-" DATE' ~) TEST HOLE~ STAMP VAN TUYL, ~ll ¼ ~LL~ APPROVED AS NOTED FEB, I0~-.~~ .¥: ¢7¢~ NOTIFY BUILDING DEPARTMENT AT 765-2660 9AM to 4PM FOR REQUIR. ED INSPECTIONS: 1. BEFORE BACKFILLING FOUNDA- TION OR START FRAMING 2. FRAMIHG INSPECTION 3. BEFORE COVERING P~P~S OF ANY KIND 4, FINAL W~IEN lOB COMPLETED NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 5, ALL CONSTRUCTION MUST MEET REQUIREMENTS OF N.Y. STATE CODE AND TOWN HOUSING CODE & ZONING r,:SA LCO t4"( CdT CAt,iT, ] t LEFT mI- 7_SL~ HAWK~M s Il'- L Ivlkld ~ ~"-, o I-~ (Id, -+ 15t4'' 2"~ J' RAFTE (t2) ':!"* IcY' ¢o.R, 14" (~O FT) ~Z~' ~2 i wD 2 6Z'~, ' .%, CLOSET MASZEF-, ,LL / ,Il FULL'( ~X,._A ,/ --q ~I/Z"THK (~,I!jI~JSL/L, itel FL?o~-ALL 1 F ,/-FILL-" %J ~ ~j //~, 4 Tf!.!CAL ,E×TER[OR. WALL: wALL ~TwLI H~.S*T~ a~¢E A~EM,EHT · . ' . ~.00 OVER ~&¢Hgsrgb ~ ".~, ;.~ -,,~ ~5~--=d.=:~-= ' ~u A~ ~,~ , ~ ,,., ~,. ~"~ FLOOR OV-R GAf,A,._,~. C2-AWL;.-PALc~' ~" :' DATE: