The URL can be used to link to this page

Home My WebLink About10319-zTOWN 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. 10319 Z Permission is hereby grcmted to: _ ................. _ ...... ~-//z~ ............................. Z ...................................................................................... : ......... ,/~,~ ~ ~,~.~7 .c~.. ............. ~. ,.,...-7 .... z .................. pursuant to application dated ............. ~..-77.../..,~... ........................ , 19...7..~.., and approved by the Building Inspector. Fee $ ~..Z,..,"~,,...-~ ~':". .... 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 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" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topograph i c 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5,00 3. Copy of certificate of occupancy $1.00 . Date .... /. .....~ ...... New Building .... 7\ ....... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...................... House No. Street Hamlet Owner or Owners of Property . .~}.O. ~.~/.~... ,f~...~/..~ .... .~. ??.~../~../~......~.~'.. County Tax Map No. 1000 Section . P.~.~ .......... Block ...... ql. ....... Lot ...... 0..0~ ....... Subdivision ..... g~t~.v.~,~F..~.~.k ............. Filed Map No~6.2. 1. ....... Lot No...6. .......... Permit No/ .0...j. ?.... Date of?er.mi~,,,/. ] .8J.7.9....Applicant.. J,O.~..~-~./.~'.,,../~..~, .~..~/~../~/..~.~.4~ 714 . IJ3~J~'j~ SO O~ 'aborDe A rev Health Dept. Approva ................ .-...;..~ pt. pp al ........................ Underwriters Approval .... ~.~.8~2 6.1 ~5 ............Planning Board Approval ...................... Request for Temporary Certificate ................... Final Certificate ...~..,. ..... Fee Submitted $ ............................. Construction on above described building and/~~~5~l~, c°des ~d~Jlati°ns'-i, Applicant....~. '~~'~ ............ ~ ,.v.,o.,o.,a 0'? THE NEW YORK BOARD OF FIRE UNDERWRITERS ~- f ]. BUREAU OF ELECTRIC+IT~ JL~e [7 s ~[~0 85 JOHN STREET, NEW YORK, NEWo~3~YORK 10038 THIS CERTIFIES THAT Joseph N. V~nde~oCh~ So~he~ ~lvd~ ~/a Rock~ P~Rd.& Cedar' '0~. was examined on g ~ ~e ~ ~ ~ ],980 a.d fo.nd to be i. compliance with Lhe requ~reznents of this Board, FIXTURE OUTLETS 26 DRYERS ~ECEPTACLES SWITCHES 33 26 FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OF ~EET E R I C E 11.75, 2/0 NO OF HI LEG OF HI LEG NO OF NEUTRAL$~ A w 0 OF NEUTRAL 1/ 2/0 Joseph Vander~oth Box 216 Bay Ave. flast Msrion,M.Yo 11931 Th~s cerhficate must not be altered in any manner, return to the of{ice THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY [, 85 JOHN STREET, NEW YORK, NEW 'YORK 1003/3 THIS CERTIFIES THAT only the electrical equiprnent os described below and introduced by the applicant ~m~d on the abo~e application number in the premises of Joseph Vand~r~o~h~n/~ ~outhern B~vd. ,1500fo. e/o Rocky' Point in thefollowing location; ~ Basement ~ 1st FI. ~ 2nd FI. Section Block Lot FIXTURE OUTLRTS RECEPTACLES SWITCHES DRYERS FIXTURES and found to be in con~pliance with the re~luirements of this Board. RANGES EXHAUST FANS FLUORESCENT OTHER APPARATUS 1-4.5kw E R V I C NO OF CC COND PER ,~ AWG OF CC COND NO OF HI LEG AWG OF HI-LEG INO OFNE~TRA/$ A W G OF NEUTRAL Thermal hl.i,c. Oom~or~ Znc. ~~f~~ ZbA Cariough ~ohemJ. a, N.Y. 11716 Per_ ~ Th s certificate must not be ~hered m eny monner; return to the off ce of the Boord f ncor~ect Insoectors m~ be idenfifl /~~~L~2~ ' ~ ............ - , t~ .... ~ ~ y 'ed by ,he,r credentials COPY ~O~ BUILDIN~ D~PA~T~NT. THIJ COPy OF Cg~l~"~ ~i,i.~ ~ ..... I t'--! 5C~ L.~.T' 1 ~3 ICl FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1~03 APPLICATION FOR BUILDING PERMIT ' 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 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 applicatton, 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 tn 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 of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~. _ _~l%meofownerofnremises~.~7;~.,..,.'. O ........................... (as on the tax roil or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ........................ Plumber's License No. Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................. ...~.7.~ ................ ¢.~.~¥.¢,~¢..~... %.o ¢a.-.g ~ g .~.c3, .... .... ~g~.~.. ~-.L¢. ¢~\a.~ .... House Number Street Hamlet County Tax Map No. 1000 Section .~.~_.C~ .~J~4 ...... Block ...~ .N ............ Lot .... q .0.~. .......... Subdivision...~ .~.x~¢.Q.\?~.~ . .~.(~.~./.~ ...... Filed Map No..~Tb.~\ ..... Lot .... b ......... (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~ .............. Remdval .............. Demolition .............. Other Work ............... ' . .~.,~../ ~ t~ -~"' (Description) 4. Estimated Cost ..O..C[?. ..--[. .................... Fee ..c~..~.~ .......................... (to be paid on filing this application) 5. If dwelling, number of dwelling hnits ...... ~..~.~ .... Number of dwelling units on each floor ................ If garage, number of cars .... ~.~ ................................................................. 6. If business, commercial or mixed, occupancy,.specffy nature and extent of each type of use ..................... 7. 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 ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front F.I.~..~.M..IFO~.(~, Re, ar .V.\.ff.. ~...~O.t,l .~. Depth .T..v,l..Ly.~..~. He~ghtq~.t/O F~...~.~ ..... Num,b, er of Ston.es ....'~ .x~5. 0 ............................................... 9. Size of lot: Front .).%~,~ .... ~¢.k).~..~.. Rear ...................... Depth ...................... 10. Date of Purchase ..... ~-l..~ .................. Name of Former Owner .~.~.. ~)?~. 11. Zone or use district in which premises are situated... ~ ................................................. 12. Does proposed construction violhte any zoning law, ordinance or regulation: ...1~.O. ........ . ................ 13. Will lot be regrad'ed ...... .~. ................. Will excess fill be removed fr~om. ,premises: Yes 14. Name df Owner of premises~i~3.~.%...x3 ~.9~g.~.iff~ddress~..0..t~?t.~!~..?:;q~g?.~[~.[q.~lhttone No..%q~:..9,.2. !~..-~ Name of Architect Yx~,,..\5 h ?.~ [5.ff~-g.Cx ......... Address ................... Phone No ................ Name of Contractor .~. '..'~j~,S....k).h .~.~. ~-~..~.~Address ~,~,. [5DX ~\to .~.q..t~hone No. J4-.~'~. ·; .%.~.~.. · · PLOT DIAGRAM Locate clearly and distinctly alll 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 v_rt)RK, COUNTY OF .'~,-~-~/~... ' ......... '~..~.~ 5~'~... Vt~./~ .FJ')~ .... being duly sworn, deposes and says these is the applicant · (Name of individual sig~ing contract) above named. . He is the ............ t-, O .................................................................. (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 contained in this application are trt!e~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. Sworn to before me this ............... ]..~.~..day o,i ......... .q~...~/g/ ..... 19~..l Notary;,Pub!iCl ........... i .,,~..¢/:.._._._._._._._._~.~.. County . ...... . ~ ~ 0~T0,.S ~. ,~a~i0?~:t ,~ ~.~ (Signature o f applicant)