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Home My WebLink About10466-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No... ~!qqT.~ ........ Date August 12, 19 80 THIS CERTIFIES that the building ................................................ L .... ~8705 Soundview Avenue, Southold, New York ocatlon oI trope y ............................................................... House No Street Hamlet County Tax Map No. 1000 Section ....0.5.1. ..... Block O1 .Lot 9 & 10 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated October 30, 19 7.gpursuant to which Building Permit No. 10466 Z " 7..9 dated .... .Ngye. m..bg.r' .1. ............ 19. , was issued, and conforms to all of the requirements of the applicable provismns of the law. The occupancy for which this certificate is issued is ......... ........ ~..~.~..~.t. ?. 9~?..~LY. ?.~.~.~.~.g.. y~.n., .~?.~?~.. ...................... John Feldis The certificate is issued to ..................... ?o'~n;,:,'~ ................... of the aforesaid building. Suffolk County Department of Health Approval .... .N./.R. .................................. UNDERWRITERS CERTIFICATE NO. N 473218 Building Inspector Rev 4/79 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N!. Y. BUILDING PERMIT (THIS I~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 10~66 Z Permission is hereby granted to: ......... ..... .......... (.(c~..~..~..c~.~...-....~:..~... .......... ,o ..... ..c.~.~.....~..~.~.."~.~.c~...~..~...~'~.-.~..~~;~'~.c~i~..~ ~ ~ ......... ~.~.../..-,...~..~......~...~.~z~.z.,.~....~.~Y~,~.y...~.././~,,.~ at premises located a'~.....,/...~,.~..~.,.....~..,~..~..~...~../.~..C~...~.~...,~....~.....-.O,. ,~.~.(~..~,...~.-' ~/'~;/ , Building Inspector. ~ee *-./.~ ............ Building Inspector FOI/M NO. G TOWN OF SOUTHOLD , Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be fdled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, end unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposol--(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 installations, 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: ], Accurate survey of property showing all property lines, streets, buildings end 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 in- formation required to prepare o 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 Rte ................ New Building ................ Addition ...... ~ ....... Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ........ .- ....... .~. .~ .................................. Owner Or Owners Of Property ·./~..~...~.~,, ............................................................................ Subdivision .............. ~. ................................................. Lot No ........ ~.... Block No ....... ~.... House No ........... Permit No..I.~..~..~..~'...~'.. Date Of Permit .~....~...//..~...~..Applicant ..~,~:'~.~.: .................... Health Dept. Approval ....~...'.....~..~. ............................. Labor Dept. Approval .........~'~ ...................................... Underwriters Approval .....~........' ............................... Planning Board Approval .....~. Request For Temporary Certificate ........ .~. .............................. FinaJ Certificate ...~ Fee Submitted $ ....~..~..~ ................... Construction on above described building and permit meets all _applicable codes and regulations. Apphcont ......................................................... Sworn to before me this ................ day of ............................................ Notary Public .................................... County THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTR~ICI+Y ~35 JOHN STREET, NEW YORK, NEW'YORK 1OO;38 only the electrical equipment as described below and introduced by the applicant named on the above appllcat~o~ t~mber in the premises of Jo~m J, ~,eldis,'a/~ ~oundview Ave. ,opp, Mt. Bevlah Dr. ,Sou~b. old>N~Y~ wasexami,*edon ~,~trch Z], 3.980 a,~d found to be in co,nph&nce witb the requ~remertts of tbls Board. FIXTURE FIXTURES RANGES OVENS DRYERS SYSTEMS NO. OF FEET E EXHAUST DIMMERS OTHER AFPARATUS 1 ~GFI E R V I C NO OF CC COND 1 1/0 R~land Elco. Co. P.O.Box 143 Ymttit~ck,N.Y. 11952 ~ ~ia. 242 : Per ~ ~t~ Ib~s certificate must not be altered m any manner return to the off ce of the Board f nco~rect nspectors may be dent f ed b the r edent e s COPY FOR BUILDING DEP BE 'ALTERED tN ANY MANNER'/ FIELD~INS {ECTION COMMENTS FOUNDATION FOUNDATION 2. ROUGH FRAME & PLUMBING (2nd) INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FOBM NO, ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .....~....~......~..'....../.. .............. , I~Z~.,. , Application No, ..Z~...~..~ .......... Approved .**~****~,***~***...../* ................ , ]9...~.~.. Permit No.../*(~*...*~**.(..,~*...,.~ ...... Disapproved o/c ............. ;~..,..:~:*..**.~** .................................................... ......... ~" ~'l~ru [1'~ti'~'~' ~ ~pector) ..................... APPLIGATION FOR BUILDING PERMIT °ate ... ....................... , ..... INSTRUCTIONS a. This application must be completely filled in by typewriter o~' in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according ta schedule. b Plot plan show ng ocat on of lot and of buddings on premmes, relahooship to ad oimng premmes or public streets az areas, and giving a detailed description of layout ofproperty must be drawh on the diagram which is part of this application. c. The work covered by this application may not be commenced befbre issuance 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 necessary inspections. (Signature of appllcont, or name, if a corporation) opp,i ' t) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ............. ................................................................................................................................ Name of owner of premises ...,~.......~...Z,.~..~4~..~ .............................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of c~rporate officer) Builder's L,cense No .... ~.?..iZ..~.......~..(./...~....'~'....~..~-~.. .... Plumber's License No..~...g..~...~[....~-..- E,ectric,a.'s L,cen,e Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ...'~.. .................................. Lot No ...... ~.. ................ Street and Number ..~.~-~-~£~.....~.-~.~',~--~-.--~'...n ........................ ~,C/~/..!~'..~.. ....... ;.:. ......... State existing use and occupancy of premises and intended use and occupancy of proposed construction' a Exisiting use and occupancy ._/~4~,~4~....~.~....~. ............................................................................ b. Intended uso and occupancy .....~.~.-...~:v~'~'-' C~'~'q~'' '~': ' 7''1~;~'~' '~' · · ~'m~' ' · ' · 'm' ............................... 3. Nature of work (check which Japplicable). New Building .................. Addition .............. Alteration ............... Repair .................. Removal i .................. Demolition ................... Other Work ................................................... ' (Description) 4. Estimated Cost ..3..~.J.~.i ..................................... Fee ........... ~..~.~ ....................................................................... j (to be paid on filing this application) 5. If dwelling, number of dwelling units .............. -~. ............. Number of dwelling units on each floor ..... , ...................... If garage, number of cars ............................ C ............. , ................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structuies, if any: Front ........L./'..~. ............. Rear ........ .~...~ ................ Depth ~.....'~.. .......... D mensions of same structure, with alterations or additions: Front .................................... Rear ........................... Depth ................................ Height ........................... Number of Stories ................................ 8 D~mensions of entire new construction: Front ........................ Height ....J.J/ ............ Numberiof Stories ........................................................ ~ ........................................................... 9. Size of lot: Front .............. /...i~..' ........................... Rear ............ ..................Depth ................ 10. Datel of Purchase "- I ....... Name,, · ~.-.~ ~°f Former Owner .....-~... ................................................ 11. Zone or use district in which premises are situated ............. /('~ ........................................................ 12 Does~proposed construction vif)lete any zoning law, ordinance or regulation: .... ~..? .......................................... 13. Will lot be regraded ........~...,.~ .......... Will excess fdl be removed from premises: ( ) Yes (X) No Name of Architect ....../q/,/_))_~~~/~.._~. ........................................... Address(J l~h~/~) , ~ --[ ...... Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly al buildings, whether existZng or proposed, and indicate all set-bock dimensions from property lines. Gwe street and block number or description accord ng to deed, and show street names and indicate whether interior or corner lot. SLATE OF NEW ~bP~/,,,~ ~' tSS COUNTY ,Q,E,~ ........... ~'i' ' ~~ .... .. . ......... being duly sworn, d, eposes and says that he is the applicant (Name of md~wdu above nam'ed. He is the ..................... ~]~-~~ ............................................................................................................... ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du!y authorized to perform or have performed the said work and to make and file this application; that all statements contained in this applicohon 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 flied therewith..~, Sworn to before me this i ~ /'~ '"-/' /~ ~ / / No, tg_ry Public, ..............,~ ............ ~ounty "'~ ......... :z': ................. i ~ .................. ~,~,~ ~.~~ ' (Signature of applicant)