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HomeMy WebLinkAbout10917-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ....2.d.d.~..5-9.n. ................................... ~CPro.ert,, q260 Jackson St. New Su££olk Location ,~ t~ y ........................................................ House No. Street County Tax Map No. 1000 Section ....'l.q.~. ..... Block ....1.0. ......... Lot ....O. Q9 .......... Subdiwsion ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Budding Permit heretofore filed in this office dated November ? 1 9~.0.. pursuant to which Building Permit No. qogq.?.~. dated .... .~z..~obe.~...'1./47. ......... 19.8.0., was issued, and conforms to all of the requirements of the apphcable prowsions of the law. The occupancy for which this certificate is issued is ......... ........ y.o.~...a..d9 .~.m.e.a?.' .a.d.d.5.~. ip.n..$9..~., g.~?.~.g~ ................................ The cemficate is issued to . . . .A.~.~.e. I3.e..lVI8.~. V~32 ........................................ (owner, lessee or tenant) of the aforesaid buildtng. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO ......... 31/g. ....... 1j~.G.~.O59 ...................... Building Inspector Rev, 1/Sl FOI~M Tow. 01, BUILDING ~pAR~I TOWN HAL SOUTHOLD, N~Y. BUILDING~ PERMIT, (THIS PER~IT MUST BE KEPT ON, ~H,E P~,~IS~S UNTIL GULL COMPLETION OF THE WORK AUTHORIZED)i N©. ~09~7 ,Date ..... ~.~..~..~..~.~.r-~.:.....J,..~.~.. ........... 19. Permission is horoby or~tod to: ~ ~ .......... ~:_~__.._.~_..~.~~ .............. ~o. . ......~r z~r~ .~'~. . ., - :..~....~;.~z%..~ :...~....,~. ~, ~,~,~, ~o~od ~, ...~Z~.~..O ............ ~C~5~....m~.~...~ .............................. ........................... ~ ......................................... ~ ........ :.:.~.~m...&m*~ ......... ....................................... t ............ ~, ' ~ ~ ~ , p~fsuant ia application ~ dated . .&~...,..~ ........ ~ ...... 1 ., an~ approved by the BUilding Inspector. / ~ ~ R~v. 6/30/80 - ' , FCR,',I NO. $ TOWH OF $OUTHOLD Town H~II $outhold, ' ........ ~ns~ucztons A. Tn,; c2nhs3t~cn must be filled ~n typewriter OR ink, and submf~;ed ~n duphc¢~e ~o ~he Budd~na Ins=~c ]. F~n;t ~d~.'3'/ of properw w~;h accurate location of ~il bu~dmgs, proper~y lines, s~re~ts, ~nd unu~a: e r~c~i ~ns, ,Ldon from So~a or Rite Undem~rlters. 4. Ccmmerc~zl buildings, Industrial buHdmcs, Multiple Resldencss and simHsr ' '~ ' ..... . . -- - ouhdmgs and 5. %. ..... ~-~- ~ o -.9° c-~oh, once tram tne,A, cmt~c~ or ~ngmeer resoon*bi~ For e~ls:~nq buz[dm9s (pr;or to Aprd 1~3/), Non-conforming us~s, or hundreds and p o~r / lines, %rears, buildines and unusual natural or 2. S,,.,c:n sta:ement of owner or Drevlods owner as to usa, Oc~uoanc,/ and condition of ~u[idings. ~. Da~a o; cny housing coqe or safety Inspection of bu,[d(ncs or pr8mlsas, or o~ner pertinent Informa- l. C~:,cata of occuoancy .,ca,a -, t P ~-~x,s,,,,gdwethn~or land usa $/~ 5 CO 3 Cop,,. at c2~:~f[ca~= of occuo~n~ Data .f' /'~% N¢'v Sudc,,"': Old or ?re-ex!sting SuHding{:¢) ....... /Vac~n~ L~nd ..... ...... ~./ .................. :.. ~ C~,~:',T~:.~,~ No. ~ooos~:~o~ ... 272 .~ ] ~ L~, ................................. FHed Map No ........... Lot No ...... ......... U ,~c ...... , ~ o/~l ...... ..P~anmn9 Board Approval ............. .~ ..... r T~m,orar¢ C~rd.,ca,e . · , ...... Final Certificate Ccn:[ruc:.on on above described bu~dmg a c ~,¢mh m~=~s ail ~ooh~*ble cod .... ,¢ , ' FIET. D I~SPECTI~N COMMENTS~~ ; ~ FOUNDATZ0N (~ s~: ) FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL FORM NO. 5 ~, ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date .......... ~ ......................................... (owner or authorized agent of owner) o (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance Other Applicable Laws, Ordinances'or Regulations ............................................ (state character of violation) ...... .................................................................................... (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions ebove mentioned forthwith on or before the .................... L. ............................................... day of ......... The premises to which this ORDER TO REMEDY VIOLATION refers ore s~tuated at ~,..~.~t~ .~" ....... ~--'~.C ~c..,~. ~/.~j,~ ......... -~-~,,.../(.~.~.:~-cC-~..~,C~ o u n t y-','' ~ of Suffolk, New York. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law imprisonment or both. Building Inspector FO~ NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION TO (owner or a~Lborized agent of owner) ...... ...... ... . (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance Other Applicable Laws, Ordinances'or Regulahons ............................................ (State section or paragraph of applicable law, ordinance or reguJation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with, the law and to remedy the conditions above mentioned forthwith on or before the ........ ~..,,/....~. ............................................. The premises to which this ORDER TO REMEDY VIOLATION refers are situated at ~,/./.~.~......~.7~C~.~...,~....~..-.~/...x(-~:..~f(...~.....~.,4'~A,~ounty of Suffolk, New York. Failure to remedy the conditions aforesaid and to comply with the opplicable provisions of low may constitute an offense punishable by fine or imprisonment or both. ector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved . . . . ., Application No. t~.~.7 / ..~. ...... APPLICATION FOR BUILDING PERMIT . .~..~_: 19~'~ 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 atreets 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 th~s 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 isstlance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinancea 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 apphcable laws, ordinancea, buildings,, code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inhmSctions. ..... '/:'"' ih'~ili;,i 'a>,ilZis; 'o'~';p'pii'c'.;,;) ..... ':: '"' State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .;L: Z; ZZ ii ............................... t~ (as on the tax roll or latest deed) If applicant is a corporation, s~gnature of duly authorized officer. (Name and title of corporate officer) Builder's L~cense No .... [¥.t ?.~... r.~.-fl..¢/~ . .t ?rio.: Plumber's License No ........ ./fi/. f(~..~ .......... Electrician's License No ....... ./~..o.~. ?/. ........ Other Trade's License No ...................... l, Location of land on which proposed work will be done ................................................. ... !.:.b. 9 ............ ~.:~_.s~:~., ~.~..--. .......... ~.,~ .. ~.~:~ ~ .< ............ House Number Street Hamlet County Tax Map No. 1000 Section ...... [.[.7(~J~. .... Block .... /.? ............ Lot...&.'.~!t~. ........... /~?c4~k6 Subdivision ................................. Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Emst~ng use and occupancy ......... : ......~. .............................................. ....................... ~"~' .......................................................... 2__'Z' ...... 3. Nature of work (check which ' ' ' .......... applicable): New Building Addition .......... Alteration Repair .............. Removal ............ ~. Demolition .............. Other Work ............... Estimated Cos .~.~..~.~.':./5..~..O.0 ~/c~--°~ (Description, 4 * Fee (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ................ If garage, number of cars ..... [ ................................................................... 6. If' business, commercial or mixed occupancy, speedy r~atu_,re~and extent of eal:h type of use ....... ; ....r ........ 7. Dimension. s of e~xisting structure~, if any: Front .... ~_. ...... Rear .'~.~.: ........ Depth..~'~.~. .......... Height . .'.~..~. ......... Number of gtories ..... ~..~.~Z~'. ...................................... Dimensions of same structure with alterations or a~ditions: Front ....~ .~..*..v.>~. ...... Rear . ~,-.l,V'~ :.~. ....... Depth ~ ..~,~i~_..?..~.. ...........'.. Height . .~'.~...~..t~. 't ........... Numbm; of Stories...~.. ....... ~ ......... 8. Dimensio~fif entire new construction: Front ....~r..~.. ....... Rear . ~Z..Z.~. ......... Depth .~-~ :' ......... Height ~ ~ ...... Number of Stories .................................. 9. Size of lot: Front ........... i ........... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Fctrmer Owner ............................. 11. Zone or use district ~n whmh premises are situated ............ /.~.' ...................................... 12. Does proposed construction violhte any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........... i ................. Address Phone No ............... Name of Contractor te.'~.~.~'.~:. .~>.../~ th,~-~..~-?~.~-Address i .'~.~"~,~-~i~.' i .~.' i i i i i 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 humber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YOR~K, /q r/~k ~t,t ¢- /'D ,q~ ¢ ~ ~/ ' being duly sworn, deposes and says that~e is the applicant (Name of individual signing contract) above named. .~He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) ~Jf so~l owilei 6i oct-ii~i:s, and is dulk authorized to perform or have performed the said work and to make and file this application ;. that all statements contgined in this application am 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 (Signature of applicant) , ate of ~lew ¥0r~ THE NEW YORK BOARD OF Fi RE UNDERWRITERS BUREAU OF ELECTRIC~ITY~ ~ 85 JOHN STREET, NEW YORK, NEW Y~ORK 10038 THIS CERTIFIES THAT only the elec trical equipment as described below and introduced by the applicant nampd on t~ above application number in the premises of was exa,nined on ~?~'] ~h~ ~ ~ ~ ~ ~,c3 ~ ~ and found to be in compliaace wtth the requirements of thls Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS FLUORESCENT VAPOR DRYERS FURNACE MOl'ORS FUTURE APPLIANCE FEEDERS TiME~.LOCKS UNIT HEATERS MULTI-OUTLET DIMN~ERS SYSTEMS NO DE FEET S E NO OF HI LEG V I C E OTHER APPARATUS OF HI-LEG OF NEUTRAL Thru cerhflcate must not be altered m any~ manner, return to the office of the Board Lic~ 252 !i ,rs may be ~dentifled by credenfl, CO~Y, FOR 8U!LOING IN ANY MANNER.