The URL can be used to link to this page

Home My WebLink About10267-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No, .7~1., ~. ~5 .......... Date ..... NOV.~¢ r..9.. 198k~. THIS CERTIFIES that the ba-il~14r~g- .... p oo.], ....................................... Location of Property .. ~ JB. 0 ............. ~.4,~.~.e C YJ.~q..~?..l,v..~ .............?p.q ~..h 9.1.d.... House No. Street Ham/et County Tax Map No. 1000 Section .. 0 7 ~ ....... Block ... 0 7 .......... Lot ... 9 ;~.4 ........... Subdivision .... X .......................... Filed Map No .... .Z .... Lot No...~. .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... J.t].np..].~ ......... 19 ff.?pursuant to which Building Permit No...~ 9.9,6.7...g ............ dated ..... 5. u.n. 9. fi.ti. ............... 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 ......... · O..R~..tT.~.~.a.~..lY. J,n. g?P.t,!n..d. :~.q6.. p.~,~. ~. ~.1..l.!r. ,~,b.q?97,~o, ,up,d' ,~, ~w~).g,..q99.~.. ..... The certificate is issued to ......... ~?.u. qo., .~..~.n..n.a..~. a..r,.a.~.qc..c.h.~.a. ..................... (owner, Iosse~ of the aforesaid building. Suffolk County Department of Health Approval .... .n./.a. .................................. UNDERWRITERS CERTIFICATE NO ............ .I,I. fi. 9. ~ ,5.9.4. ............................ Building Inspector Rev, 1/81 FO~M IgO.' 2 TOWN OF $OUTHOLD 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 AUTHORIZED) N? 10267 Z Permission is hereby granted to:~ ........... ~z.~... '~.. ~~.~ ...... ~,.r..:~.....~:.:. ............ ....... ~.~~~/~......~ .......... ~, ~,e~,~e~ loeate~ ~.~-.-7.Z~....-~~~ ...................................... ........................ ~ ............................................................... : ............... ~:.~..~ :::::::::::::::::::::::::::::::::: .......... Building Inspectol. ' .....y~L .................................. FORM NO. 6 TOWN OF SOUTHOLD Buiiding Department Town Hall Southoid, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A, This application must be filled in typewriter OR ink, and subr~itted 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 lJuildings, property lines, streets, and unusual natural or to~ograohic features. 2. Final approval of Health Dept. of ~vater supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercia~ buildlngs, industrial buildings, Multiple Residences and similar building~ and installa- tlons, 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 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 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 $5.00 3, Copy of certificate of occupancy New~i~,,,~ .. ~..........('~ Old or Pre-existingeuild[ng(X) ......... Land ............ Location of Property .t--~,~- ~.(~ " ' ' ' ' t · _ ................ ,F,%t~.b~ .e.~.; ................ -,~-;. ~.~, .%Q.. Hou~ No. ~ ~reer Ham/et Owner or Owners of Property ~ ~ ' , ¢ ' ' County Tax M,p No..1000 Section ... ~ .~ ...... Block ...(j~'.] ........ Lot..(?. ~ .~'. ....... Subdivision ..... ~ ........................... Filed Map'No...:~ ...... Lot No..~ ........... PermitNo. /~ " ~/~', .~ ~Date of Permit / A Hea~h De~t. Approva~ ...................., ~ Labor De~t. Approval .................. ,.. Unde~ritersApproval.....~ ./.:~-'~..~. · .Planning Board Approval ... . Request for Temporary Certificate ..................... Final Certificate ..... - ......... Fee Submitted S ............................. Re¥,le.~0o7e Construction on above described building and perr~iCmeets all apP~cable_,codes and r~gulations. Applicant .: .... ,,~. ' '7:' .. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY~ THIS CERTIFIES THAT only tl~ electrical equipr~Rt ~ describ~eJo~end i~tr~duced ~ t~ applicator ~m~ on the abo~e application number ~n the premises of FIXTURE OUTLETS FIXTURES ~ 2nd FI. 0~$~ Section Block Lot and found to be in comp!la.ce with the requirements of this Board. RANGES ·OVENS DISH WASHERS EXHAUST FANS DRYERS E g C E IN OF NEUTRALS Copy FOR BUILDING COPY . TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 November 12, 1980 Anna Tarabocohia 1730 Waterview Drive Southold, New York 11971 Dear Sir: This is to notify you that Building Permit No. issued___~J e lb. 1979 to construct Dt'l I/G & will expire on ... Dq~ember 1~, 1980 lO267z pt'l A/G ~ool If more time is required to complete the Job and obtain a Certificate of Occupancy, you may apply, ~.y letter, for a six (6) month extension. If the work is not completed and the Certificate of Occupancy not issued after the six (6) month extension period, you are than required to apply for a new building permit. Very truly ~ours, GEORGE H. FISHER Sr. Building Inspector TOWN OF SOUT~OLD OFFICE OF BUILDING INSPECTOR P.O.m..X 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-I 8O2 Applicant Dear Permit No. /o4~/7~ i ...... - ~o u..c~r ~ui!dzn~ ''~' ~ - Cone. o. c~r com~ this fi~= a Certificate of Ozcuoancy be issue~ e"c~osed ~orm{s) nurn ...... s~ fill out ~' ~ o.._ce with a .~c.. for $5.00 payable to ~he Town of Southo!d. lnezcate to whom the Certificate of Occuoancy is to be mailed, and arrange with ~' ~ on~s office for an inspection date. Thank you for your prompt attention. VL:ec Enclcsures Very truly yours, Victor Lessard Adminis ~r~ tot FORM NO. 1 BU LD N D PARTM NT SOUTHOLD, N.Y, 11971 Examined 19 (Building~nspector) APPLICATION FOR BUILDING PERM IT [,, Date~ . . . r..~ .., 19 Z~ a. This application must be cmpletely filled i~ by typewrite~ 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, relalionship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagrm which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Buildi~g Pe~it. d. Upon approval of this application, the Building Inspector will issue a Building Pemit to the applicant. Such pe~it shall be kept on the promises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any pu~ose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. ~PLICATION IS HEREBY MADE to the Building Depa~ment for the issuance of a Building Pemit 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, The applicant agrees to comply with all applicable laws, ordnances, buildi~e, housing code, and regulations, ~d to admit autho~zed inspectors on premises and in buildings for necessa~i~Sp~ctions~) , ... ;~. ·. :.~ ...... : ........... ~; ........ :.....2v (S~gnature of apphcaB~, or z[ame, zLa ;orEoCtzon/ (Mail~g address of applicant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... ~i .'~,~'/.. ~., ,,,.T .-,'...~Pq~..' ................... (as on the tax roll 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 ...... >. ..................... ./. .................... .......... ". House Number Street County Yax Map No. 1000 Section ...~..2..~. ......... Block ..~..Z ........... Lot...~..~..~.. ......... Subdivision ..................................... 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 ......~,,,d.~.r..~q<¢~ /~-,/~,~_../1~.. ¢7/~.,~/.~ ............... b. Intended use and occupancy ..~,~(-~. ................. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .. · ....... Repair .............. Removal .............. Demolition .............. Other Work~-e~-.: ....... ,-, '~ z~ ~ (Description) 4. Estimated Cost ............................ Fee . (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 ........................................................................ 6. ~f business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. D~ensions of~xisting st~ctures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Sto~es ........................................................ D~ensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... HeiSt ...................... Number of Sto~es ...................... 8. Dimensions of entire new const~ction: Front ............... Rear ............... Depth ............... Height ............... ~umber of Stories ............... , ........................................ 9. Size of lot: Front ...I.~.. r.O ............ Rear ..... ~ ~. ~ ............. Depth .. Io0. r~ ............ 10. Date of Purchase ............................. Name of Fomer Owner ............................. 1 1. Zone or use district in which premises are situated ......... ~ ............. 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................ Will lot be regraded ............... 13. Nme of Owner of premise~' ZCW r4. ddress ................... Phone No ............ 14. Name of Architect ........................... ~nAddress ................... Phone No ................ Nme of Contractor .......................... Address ................... Phone No ................ 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 NEV~YORK, S.S COUNTY OF · ./f·////.;.(/ .... /.(/~.~;3/.e~.O.r%?.q.//.-g .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ~He is the .......... 0~7..&77...~4...-~.. .................................................................. (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 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. Swam to before me this -- ............ 4.~:' .Q ...... day of...~..~ .......... 19 .~.~ Notary Public, . ................................ County ~~ __ um,u 1~ ....... ozs~e,~,, - (Signature of applicant) /"' --