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Home My WebLink About10944-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y., Certificate Of Occupancy Date ....... JeRuarY. Ag, ............ ,19.~? TItIS CERTIFIES that the building ................................................ Location of Property 700 King Street, Orient, h3ds'o hid ................................................... Street County Tax Map No. 1000 Section 26 .Block 2 .Lot Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .0c.~gber 21, 80 .1.09./4.4..Z. .................. , 19 ... pursuant to which Building Permit No ............. ~e~d' . . .O. QtO~.O.~...2./t-., ............. 19 · . 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 ......... ................ One Farqlly ~.o.]~$.~g .(.~%.-I;.h..~ta. 9.hed .addJ:.~.~.o.n.}: .......... The certificate is issued to Curtis and Nancy Norklun of the aforesaid building. Suffolk County Department of Health Approval ...... ~/R. UNDERWRITERS CERTIFICATE NO ..... .P.e.n..d.i.n.g..(.I.~.~.l~. ?.~.t.l:O..n..oked 1/19/81 Building Inspector Rev 4/79 (THIS PERMIT MUST BE KEPT ON THE PRE/~IS£S UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) 10944 Z Dote ........... : ........ , ....... W ........... , ............. ~.. Permission is hereby gronted t9: ~ Building Ihspector, ' .. ....... ,~,.~.¢~..~?..,~* ? ;--:- · i i~ Build!rig nspectoi- Rev. 6/30/80 FO~ NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY I~structio~s A. This application must be filled in typewriter OR init, 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, 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, /v~ultiple Residences and similar buildings and installations, a certificate of Code compfiance 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 property showing all property lines, streets, buildings and 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 formation required to prepare a certificate. C. Fees: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $§.00 3. Copy of certificate of occupancy $1.00 Date ......... .//. Js~/.~/. ......................... New B~ilding ................ Addition .....~...~ ....... Old or Pre-existing Building ................ Vacant Land .............. Locotion Of Property ....~..~..~.......~..~//~.....;~'?..)......~..Z:.~'.C--~...zz..,...~./...~....../.J..~.~.~ .......................................... Qwner Or Ownersi Of Property .....~.'..h'.~J..~:~...J.?...:..,....~.,....'~'.....4:Z/.....~....~.,:...../.~'.R.~.A~.//~.,~ ................................. Subdivision ~ ................................................................ Lot No. ,~.,/.. ..... block ~'~o....--=.. ....... r~ouse r~o ............. Permit No../~.~.~.~..~. ..... Date Of Permit--~'" 7--'/'~'~*~"//~O'"'Applicant .~.~..~s .,~.., ~ .~..~ ~ ~/o,'J//~ ,,~ Health Dept. Approval ......... ..'~'./...~.'. ......................... Labor Dept. Approval ...........-'~ ~-~ ............................... Underwriters Approval .............................................. Planning Board Approval .................................... Request For Temporary Certificete ........................................ Fin~ Certificate .....~... .................................. Fee Submitted $ .~..'....~..*. ....................... ................ day of ............................................ Notary Public .................................... County Construction on above described building and permit meets all applicable codes and regulations. Applicant ... ~f~....~.~.....~...~...~..... ~.~o..Z. :-~;~.. 2/.~..~... Sworn to before me this (stomp or seal)~I 1~ (~! e ~ t~e ~q ..q FIELD INSPECTION COMMENTS FOUNDATION FOUNDATION 2. ROUGH FRAME& PLUMBING (2nd) INSULATION PER N.Y. STATE ENERGY CODE FINAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 o.~e J~ 22, 19~Z ~ppUcatlo,,,¥o.o./ife i06440 - 81 N 507036 THIS CERTIFIES THAT only the efectrlcal equipment as described below and introduced by the applicant named on the aboi~e application number in the prendses of Curtis Norklun, s/$ #8 King St., Orient, N.Y. in the foilowing location; [] B,se,nent ~ 1st FI. [] £nd FI. Section Block Lot Mas exa,nlned on J~u~ry 19, 1981 and found to be in compliance with the rdqulre,tents of this Board. FIXTURE FIXTURES OUTLETS SWITCHES FLUORESCENT 6 21 I1 6 RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E OTHER APPARATUS: Elec.Room Heater/~: 2-1.SKw, 4-1.0g~ 1-.Sgs~ Pa~lboard/$: 1~1~ cir. 200 am~so i~.F.I. 1-Smoke De~ector 1-4.5F~ Hot Water P~ater I C A.W,G, NO OF HI-LEG A W,G. NO, OF NEUTRALS A W,O, OF CC COHO, OF HI-LEG OF NEUTRAL 2/0 I 2/0 Edward T. Patrick St. Maryz Dc, Soufa Janes Port, N.Y. 11970 lic.848-~ Pen 1 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspecto~-s may be identified COPY THIS OF , IN ANY MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ..... Approved ..... ~((~,e.f.. ?~.f. ,, 1 .~.4Permit No ............ Application No. /Oq ~ ¥ g// Disapproved a/c ..... f-:-~-~ ........ ~..... .................. · (Building Inspector) 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 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. (Mailing address of applicant) tod ~~ State whether applicant ssee, agent, architect, engineer, K_ eral contract, electrician,,c____~ r ...~_~ (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 ..... ~d ~. ............... Plumber's LicenseNo ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. .................................. ....... House Nmnber Street Hamlet County Tax Map No. 1000 Section ~ Block ~ Lot ~ f7 .... pN Subdivision ..................................... Filed Ma o .............~; ........ Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .~'.~'! .d..o~..fi.' .~.. ........ . ........... 2.22 ............................. b. Intended use and occupancy .~...~...~:~ !' (f.e?,.: .~.' .~.....t~.....~...~.~ ........................... 3. Nature of work (check which applicable): New Building .......... Addition ...4,~.. .... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) .j : 4. Estimated Cost ....... :'~. ~ .grippe... ...................... Fee .... ~.'./~.'..O'9. .......................... ~ (to be paid on filing this application) ' ...t0'~... 5. If dweliing, number of dwelling Cnits ............. 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 structureh, if any: Front... ~./ ......... Rear . .~./ .......... Depth Height .. c~."~ ......... Numlber of Stories ....0'2... .................................................. Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... :.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ Size of lot: Front ........... ! ........... Rear ...................... e-D. epth, .../h., ...... (-~'h. · ./ Date of Purchase .. j~."].~ .... ' ............... Name of Fr~rm~ Owner ,~.~,o.,.d~ .,.~r'o~..~..c-d.ed... ~..~-..~-.'.~ Zone or use district in which pr~mises are situated:..~.,rB.~.'c[. ~..~. .................................... Does proposed construction viol,hte any zoning law, ordinance or regulation: .'")~<t~ ........................ Will lot be regraded .... ~... ................... Will excess fill be removed from premises: Yes quo Name of Owner of premisesQ~*...q'.O....°~.../[}.t?~..t~ress .'2...o~...~..~...~.~ fl.q'..e~.. Phone No. Name of Architect ' Address Phone No Name of Contractor ' Address Phone No. 10. 11. 12. 13. 14. 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 NE~L~RK,~ / .~ o ,~ COUNTY OF ..%--~-~<-~f~. ia'a ......... ~.~:~.,.:..~'~.~ beingdul, sworn, deposesand says that he is the applicant ~ame of individual signing c~tract) 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 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 , ......... .~C;~ .B4 .... dayoi ....... ~.., 19~.&). - County '---'-- x-I ,," A,,· .............................. ~ ~IOTARY pUBLIC, State of New Yor~ (Signature of applicant) Bo. 52:.8125850, Su[folk Cou~t3'___