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HomeMy WebLinkAbout10137-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z10440 THIS CERTIFIES that the building ................................................ Location of Property ..... '! J !~.5.. I~ 9~.q~79 p.d..D. ? ~y.e. ~ ..... l~. 9 ~.t.~' ~ .u.c.l~ t. ?.'.Y.: ........... House No, Street Hamlet County Tax Map No. ] 000 Section ...... 1 .13..Block ..... 02 ........ Lot ..... G 0.4 ......... Subdivision...~p.~.e.,~. p.o.6.. ~.~.~.a.L..e.~ .......... Filed Map No.5 ~.~+.0. .... Lot No... 1. .9 ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated · Mar. ch. 2.0.. 19.79pursuant to which Building Permit No. ~ 013 ? Z dated ...M.a..~.c.h.. ¢ ,.2 ................ 197. .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 ......... Private One-Fancily Dwellin~ The certificate is issued to Mro & Mrs, Bruno Sabat {owner,/e~c.e'or' te~rnO- - of the aforesaid building. Suffolk County Department of Health Approval ............ 9.-.s.q-..29..3./..2.4./.8. ~...n.qb. e..v.e..a.: V±l la UNDERWRITERS CERTIFICATE NO ......... !,l..4.4. 9.6.0.Q ............................... / ,,; /;, / Building Inspector Rev. 1/81 ~FOI~Y~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLEgK'S OFFICE SOUTHOLD, FI.. Y. BUILDING PERMIT (THIS PEEMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK A, UTHORIZED) N°. 10137 Z Permission ~-~-~-' ,/ ,~,,~ ~ / / ~' ...~./~....,?.--,.;:~.~.... ~~...~ ....... .~.....~L...~~...~ ......................................... ~../~... ,~ ~ ~ ..................................................................... ~ .................... ~;?-...~.;; .................................. ...~ ....... ~?..: ............................ ~...~~ ................. ~....~....~ ............. ~ ....... ~ ........ ,~, ........................................................... pursuant to application dated ........................................................ , 19 ........ , and approved by the F~ ,.:~'~C..~.-.. Building Inspector 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. For existing buildings (prior to April 1957}, Non-conforming uses, or buildings and "pre-existing" land uses: 1, Accurate survey of peopertv 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 requ ired to prepare a certificate. Fees: 1. Certificate of occupancy $.6.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1 .DO $5.00 New Building . .~. .......... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .115~..~Q$~.qc~. ~.~.~,V~. ..... ~.~.~, ~,u.q~..,. ~e,w....~.o.~.~. ............... House No, Street Ham/et Mr. ~ Mrs. Bruno Sabat Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section //~ Block O Z- Lot..9.°. ~ ......... Subdivision.~Osewood Estates .Map No. ~,~,~.~ Lot No. 19 10~? ~/22/7,0- Andrew Muller Contracting Corp. Permit No. ~.. 7.t'. .... Date of Permit . .~..'. '..~.Applicant .................................. Health Dept. Approval .~./~.~./~./...~.'Y~..~-~...Labor Dept. Approva, .. ..~/././~. ............... Underwriters Approval .,~...~..~/.~.~'~'~. ~. ......... Planning Board Approval. ~.~./.~. · .............. .\~,~ Request for Temporary Certificate ..................... Final Certificate ........ .~ .............. ~ Fee Submitted $ .?: .0.©. ....................... ,~, ~['~)~ Construction on above described building and permi~m~p~c,~e c~nd r~lations. ~ ~.~ :~' Applicant.. ~~[~.. .... ~.~ /~ Rev. 10-10-78 ~"u~e 25A l¥j ~ ~,~/ Miller Place~ New York ~ \ ~ ~Y THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NETM YORK, NEW ~/'ORK 1003~ THiS CERTIFIES 'THAT only the electrical equipment as described below and introduced by the applicant ~na~ed on the above application na tuber in the premises of was examined on ~.!~) ~'~.~{f:~ ~!~ ~ 7 , ~ ~) ~ ~) and found to be in compllance with the require,nents of this Board. FIXTURE RECEPTACLES FIXTURES RANGES OVENS EXHAUST OUTLETS SWITCHES hiCA~DE$CENT ~LUORESC~N? DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: S E R V. I NO. OF CC COND A W G NO OF HI-LEG PER ~ OF AWG OF HI-LEG NO, OF NEUTRALS GENERAL MAI~/~GER~ This certificate must not be altered in any manner return to the off ce of the Board if inc,~rrect Ins~ectc~r ..... ~.~ :.~-..~. ~ c ~[ . ~ .... ;~oP~ , ~l emLOINa OEPAR~MENT. THiS COP~ OF ~t~,FiCATE;:~M~T[NOT~:IE~A/TERED IN ANY MANNER. ' -~Ou CS H i ~-I ~ c~ L~.T I 0 KI 4-d. v'. ~-c/~ T~ .~, 0 IZ) i'l-~ c_~r,J /-x L l~O~ NO. ! TOWN O~ $OUTNOL~ BUILDING DEPARTMEHT TOWN CLERK'S OFFICE ~OUTHOLD, N. Y. ~" (Building LFnspector) APPLICATION FOR BUILDING pERMIT Date .......... ................... , INSTRUCTIONS o. 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 az areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application· c. The work covered by this application may not be commenced beforeissuance 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 port for any purpose whatever until a Certificate of Occupancy shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance ora 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 a applicable laws, ordinances, bu Id ~ig code, housing code, and regulations, and to admit authorized inspectors on premises and ir~ buildings for necessary inspections. (Signature of applicant, or name, if a corporation) ..... ............. (Address of applicant) //,~ ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... ................................................. Name of owner of premises ......~...~..~.J~..~./.~.~.....~.....~....~'.../..~...~.......~.~.~.../...~... ............................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......... .~..'~:-.~...~..~...' ................... Plumber's License No. ~-~o~ Electrician's License No .... ..'~...~-~..~.. ........................... Other Zrode's License No ............................................... 1. Location of land on which,~roposed work will be done, Mop No.:~'..~....°..~.~.....~Lot No.....~..C.~.. ............. Street and Number .~./~.. ~~....~../.~.-.~.....~...(.~'...~2..Z~. -,~~.... ...................................................... / .,~//~.(- / Municipality 2. State existing use and occupancy of premises~d intended useza occupancy of proposed construction: · · · a. Ex,stung use and occupancy ........................... ..C~.~. ................................. ; ....................................................... b. Intended use and occupancy 3. ~Nature'of work (check which applicable): New Building ~ Addition Alteration Repair .................. Removal .................. Demolitior ..................... Other Work ................................................ .... /7 ~ ~ ~ .--- (Description) 4. Estimated Co~.....~....J...~...ig...~....~.~. ...... Fee ~.... ~'~ ~ ga, (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. 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 .. .................. Neight .............. ~ ......... Number of Stones ..... ~.~ .............. ; ............ ~ ........... : .................................................. Dimensions of same structure with ~lter~tions or odditions: Front ........ ~: ........... ::,: .......... ~ar ..,.~ ...................... Depth - ~ Height ................... :........~mber of Stories ................................ S. Dimensions of entire new construction: Front .,,...~,J. ............... . ....... Rear .............. Depth ,~,~..,.~ ....... H~ight~.t.~.m ..... Numbe~ of Stories ....... ~,.,~t~ .............. ~ .............................................................. bt: ........... .................................. .......... ZI.D ....................... Depth ...~..~ ................... ]0. Date of Pur~ose ............... I,~Z~. ........................... N~me of Former Owner~..~,~,~..~ ................ ] 1, Zone or use district in which premises are situated ..................................................................................................... ]2. Does proposed construction violate any zoning law, ordinance or regulation: /~ 13. Will lot be regraded ~..~.~... Will excess fill be removed from premises: ( ) Yes ( ~o 14. Name of Owner of premises .~(~..~...~ ........ Addres one No.~J...; ........... Name of Architect ~~. ............................ Address~~f.~ne No ....................... Name of Contractor~~ ............................. Address .~.(~.~hone No.~..~f.J~Z PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from prope~y 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, ~ ¢ c COUNTY OF .~.~.~4~L, ........ ~'""~ .................. ~.~/.~...~'..,~....J~.......~...p_~..~...C~..~ .............................. being duly sworn, deposes and says that he is the applicam (Name of individual signing contracf) abovE; named. He is the .......................... ~,~.~..../~..~...~.,. ............................................................................................................... (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 ail 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 ........... /..~....F./..t.. day of ...Z~/~ .~c....~...~.. ..................... , 19 .~'...~.. Notary Pu'~lic,~~~. .......... ~ --..~- . ....County (Signature of applicant) ~ .: · Ali W~II 8~ CesspOol Information Obtni~(~-" From Phvsc~.. ~:,,:A~,-o..~,..__ or Dire:orion o~ Owner or Rc~cJ~hf. Location of Same Guaranteed only :W~en Visable, TH[ ~tFSETS (OR OtI~ENSIONS} ~dOWN h'Ei~FON FROM THE LINES ARE FO~ A SPEC1FI~ ~GSE AND USE AND AffE NOT IN'~ENDED 10 ~HE'ERECTJON OF FENCES, TAINING WALLS, POOLS, ~m~TING AREAS, ADDilION MAP OF' PROPI~IiTY J RICHARD WIL [M AND AS$OCIATI~S LICeNSeD LAND T~!. 87~20 ~1. 273~t63 Shown Thus jO0 EXCAVATION INSPECTION REQUIRED MAP OF PROPERTY "~'/z~} ~"77 ~d/c'/~' ~~ ..... ~NDRE~V MULLEI~ ,~'~-~ '' '' ~ ,,~,.,: ..... v.~t~'e be considered to be .D J. TAXI, L.S. ~ SUCCESSOR TO RICHARD WILHELM LICENSED LAND Cen~r Moriches~ N. Y, 11934 Bre Tel, ,20 PER All Well & Cesspool Information Obtained From Phys~cM Evidence or Direction Ov.,nor or Resident. Loc~tlon of G-nrante~d only Wh~.n ~ o,~- ~LK COUNTY HEALTH DEPART~iN! .... to be so.t~factcrv. ~' f. . f , f: .-. ~AP OF PROPERTY ~ u:",~:~:, L. S. OUARANTEEO TO: Tel. 878-J3~20 T.~L 273-8163 FEE~ 7654 ED ,, 3. BE !, AT 9AM to 4PM ~OR BACKFILLJ~IG COVERING pm~s WHEN JOD COMPLETED RESPONSIOLE FOR DESIG~ N.Y, STAT~ C~