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Home My WebLink About10255-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No...z. 9.a.67. ......... Date ....P.e.b?.u..a.r~. 1 ' . .................... 19 8.0 THIS CERTIFIES that the building .... . ............................................ Location o f Property ..... '[ 6.~ .~..Flap~,a. Llano .................... ~oortpap~c ,..lq.¥ ... House No. Street Hamlet County Tax Map No. ] 000 Section ....0.~.~. ..... Block ....~ ........... Lot ...... ~ .......... Subdivision..~...'L.e.a.¥ .e.~...P.o..~ .ri.l:. ............. Filed Map No.. ~57,1...Lot No...42 ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... d'l~r4e. 6 ........ ,197.9. pursuant to which Building Permit No ....... '102,55Z ........ dated ..... ,IulaO..8 ................ 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 ......... ................. P. I'%.v.a.$¢..O. rl~. F.a. mily..Dwelling ............................... The certificate is issued to .R.o .b~.~.~. ~....~lll:~h .... ~ .................. ............ (owner~I~_~, ' ' ' of the aforesaid building. Suffolk County Department of Health Approval . . 9.. -. .~ .0.-. 5. .~ .... ~../.'l .'1/.8.0 .... 1~,. A.o..¥I%~'1,~... UNDERWRITERS CERTIFICATE NO ......... .p. erl.d;i,~lg ................................ Rev 4/79 Building Inspector FORM NO. Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CO~MPLETION OF THE WORK AUTHORIZED) N? 10255 Z Permission is hereby granted to: .......... ...?<..j..o:......~..~.~.~...z....o.. ............. % ... ~-'~ ~ ....~.~.,: r~.~ .......................... ~o .... ~.~.5.~.~ ......... ~z.~.....~.x~ ..... t. ..~.~. /~ ....... ................................................................ ~.~.~.~......kA~ ...................................................... at premises Iocoted ~t-~Z~Z~ ...... ~ ....................................................... ........................................................................................................... ~~~:'L~ ...... ~' ' ' / ~ "~ ~x /~ ' ~.~.~: ........ d.~.~.~....~.~z ........... ~.~...~..~. ............... pursuont to *pplication doted ........... ~......~ ....... ............ 19.~., ond opproved by the Building Inspector. Fee $ ........ (0. ............. THE NEW YORK BOARD oF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 February 4, 1980 ~JpplieationNo. onfile 041316 N 465305 THIS CERTIFIES THAT only the e~ect~cal e~uipment ~crlbed be~ ~ in~u~ by t~li~ ~ o~ t~ a~ ~t~ numar i~m~es of ~zzo 9L~B. ,v/8~pLe ~. ,kuv' n/o ~r~e r~. ,ureanport,a.I. in th*following location; ~ Bo.tement ~] 1st FI. was examined on January 31, 1980 [] 2nd Fl, Section Block and found to be in compliance with the requirements of this Board. Lot FIXTURE FIXTURES RANGES OVENS DISH WASHERS FANS OUTLETS SWITCHES 22 31 20 22 DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS TIME CLOCKS MULTI-OUTLET SYSTEMS biO. OF FEET DIMMERS SERVICE DISCONNECT S E R OTHER APPARATUS: L-GFC[ l-S~oke DeC. Track Lt.~hti.n~l'-O" .o. % cc. COHO, ,~ w. o. OF cc, COND. C OF HI-LEG 5htrley,H.~. 11967 Ltc. 334 Per This certificote must not be oltered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by :redentials. COPY FOR BUILDING DB~ARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. November 20, 1979 To Whom It May Concern: Re: New building Maple Lane Greenport, N.Y. The above referred to structure has been chemically treated for the control of Eastern Subterranean Termites by the HA~DER CO~]PANY in lieu of the installation of a termite shield. Yours very truly, HARDER SERVICES, INC. RO. BOX 75, BELLPORT, N.Y. 11713 · (516) 475-2100 Memorandum from.... BUILDING INSPECTOR'S OFFICE TOWN OF SOUTHOLD TOWN HALL, SOUT~OLD, N. Y. 11971 765-1802 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 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. 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 V Old or Pre-existing Building Vacant Land, New Building Location of PriOritY' ~ [ '~. .~.~.~. '~. . . .~r~. . . .[.~.~. i '~.~.~. i '~. .~. /.~./.~. . ~ ~' ~ ~~ Hou~ No. Street Hamlet Owner or Owners of Propertv. .~0.~...~: ~ (~ ............................... County Tax Map No. 1000 Section . ~ ...... Block . .~ ............ Lot.. ~.~ ........ Subdivision..~~ .... ~.L~.~ ........ Filed 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 $... ,~, ,~ .................. Construction on above described building and pe(~i.t.~_eets allj~, licable codes and regulations. Applicant ...... V.~b ..... ~ ...................... L ,O, / BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ZN'D [ ] INSULATION [ ] FRAMING REMARKS: /, FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved ..... 19 PermitNo.. Disapproved a/c ............. ~. ~- ......(~. .... f / APPLICATION FOR BUILDING PERMIT Date ..............~./.~. , 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 dia,'am which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Peanit. 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 o.~ demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, h96sil~g code, and regulations, and to admit authorized inspectors on promises and in buildings for necessary insets. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber ~uilde~ ....................... Name of owner of premises . (as on the tax roll or latest deed) If appli~a~t.~cor~re of duly authorized officer. ...... v. ......... Builder's License No .......................... Plumber's License No. Yk/ T7 Electrician's License No. ~ ' Other Trade's License No..- .................... House Number Street Hamlet County Tax Map No. 1000 Sectio¢. .... .LO..~..~.~'. ....... Block....~. ............. Lot...r.~,....C). 5. ..... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... 3. Nature of work (check which applicable): New Building .. ~ ..... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Lst~mated Cost . .O. QO J t (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 ....... .~4..~ .......................................................... 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 ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ..... :_~, ............. Numbe~ of Stories .......... :., .......... 8. Dimensionsaffentire new construction: Front . .~5.~. .......... Rear . .~-.~ ........... Depth .~.~ ........... Height /.t/t ...... Number of Stories .... ]. ...... r ........................................... 9. Size of lot: Front . J.O?.' ................. Rear... ].O.O. ............... Depth ./.'~. >.~]'. ............... 10. Date of Purchase .: ........................... Name of Former Owner . .. ........................... 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................ 13. Will lot be regraded . ~..~. ....................... Will excess fill be removed from premises: Yes 14. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No.. Name of Contractor ~(D. ~2~o.....~ff~..~... ~6( .c... Address /~7 -qw~ /~. Lv&Phone No. ]~..~.' ~..~])~/] ] · 'a{/. · · PLOT DIAGRAM Locate clearly and distinctly all 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 YO, R/~,~ /,/o/~, S S .... · ...... d. ..... .................. (Name of individual signing contract) above named. duly sworn, deposes and says that he is the applicant He is the ........................... ./. · .q....'.~ .................................................. ( (Contractor, ~gent, corporate officer, etc.) of said owner or owners, and is duly autlio~zed to~ze, r~orm 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. Sworn to before me this .............. ..... dayo ......... ,10 Notary Public .................................. County TJlitlV PUBLIC, Stttt~ ot N~,v ¥orll (Signatu,~.~, ~,,~,., Commi~mion E~l~iro~ bI~ch SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT OF INTENT WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE sTANDARDS OF-THE ~d~l~L leANT SUFFOLK COUNTY DEPT.. OF ' SER~VICES --, FOR APPROVAL , CONSTRUCTION ONLY.. / . ' APPROVED: · ~ ~ ~ SUFFOLK CO. HEALTH DEPT. APPROVAL /~ ................................. ! H.S. NO. - r C ..... ~g~l, * * t ~ STATEMENTOFINTENT . .." ~ ........................................................ THE WATER S~PLY AND SEWAGE DIS~AL ~ ' ; ~ ~S FOR THIS RESIDENCE WILL ' ~-'-~-~ ~t~t~ coNF~M TO THE STANDARDS OF THE VP -- .-' ' ~ ~ APPLICANT ~':: 'xNN O ~ ,' ~ ~ S~O~K 80L~ ~ ~ ' SUPFOLK COUNTY DEPT. OF HEALTH ~"0~ ' ~4 ~ :~ ' ~ ~ ~,~g~ j~ ~ t E~ . ~, ~-~ ~ i CONSTRUCTION ONLY '~ ~ ~ ~: ....... '/" ~ ~ DATE: ~ - ~, ~ , 6~ ~ ~ ,, ~, . . .V, - , ', i ~IST:' SECT. ~ ~;.. , ., ' ,, / / "] ~ HOLE ' "~" ' - '*' ~ ~ ~'~ roT~ ASSm~E~S~r T~'L~.~ t.sn. . ~ J ~ ~ 7UTiO~ GUARANTEES A~ NOT Dawn ~ ~ ~ ,, sEAL '- "' '~il~e~ Co~. : ,. j L'CE"SED LA.D SUR~O~S ................... ~ GR~E~O~T N~W YORK ~- OT~L "~c:,-T ~ L. 1%5' COb, E .0'~. ,0 .~ 8,71 t-- I I 14- DATE~ ~ -- NOTIFY BUILDING DEPARTMENT AT 765-2660 9AM to 4PM FOP. REQUiR- ED INSPECTIONS: 1. BEFORE BACKHLLING FOUNDA- TION O~ START FRAMING FRA~A]NG INSPECTION 3. 5~FORE COV~G PIPES OF ANY KIND 4, FINAL WHEN JOB COMPLETED ~ NOT RESPO~SrBLE FOR DESIGN : OR CONSTRUCTION ERRORS ~,' ALL CONSTR~T[ON MUST MEET R~UIREMENTS GF ~.Y. STATE COD~ AM~TOWN HOUSING, COD~ & ZONING J . [ BY DATE