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Home My WebLink About10920-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. 7~1.048.5 ......... Date ...... May..8 ..................... 1981. THIS CERTIFIES that the building ................................................ Location of Property ... ~.8.0.. ~.~r~o~Ke.t..a..R.q~ .d ,..qu..l;9.h.q~.ug.,..~ .e.~..Y.o..r.k ........... House tvo. Street Hamlet County Tax Map No. 1000 Section . .11 .~ ....... Block ...07 .......... Lot ..... 0.1.6 ........ Subdivision Nassau..P. t~,..Blub..P, vop.,. ..... Filed Map No..806 .... Lot No.. 3.8'~ ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. $.epl;emhee. 3. ..... 19 H0 pursuant to which Building Permit No ...... 1.0. 9.~.0..Z. ........ dated ... 0.c.~obo~.. 15 ............. 19.8.0, 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 ......... ......... ~.civ~.h~. On.~ .l~.m.i, ly. D.~ll.i.n.g ...................................... The certificate is issued to .... 9',i.tio. C~,tialari. o ....................................... (ownerd~e,O~jelia~3ZJ. of the aforesaid building. Suffolk County Department of Health Approval , . .§ t~8./.~ 1. J.0.-.g..0.-.4.5...Rp.b.q .~.t;' .g:.: , .I/.:t..l:.~ .a.. UNDERWRITERS CERTIFICATE NO ..... 1!15 fl.6.?. 06 ..................................... Rev. 1/81 ........... '~'Building In ..... 1O920 (THIS PER~IT BE KEPT OIq 'I~HE PR~IS~S UNTIL ~ULL COMPL~IO~ OF THE WORK AU~R~IZED) ~t~ ...~..~E~.r~z~.../.~ ....... , 19...~ Permission is hereby gra~ed to: at premises located at pursuant to opplication~doted ..... i.-~ 19 , and approved by the Buildlng Inspector. Fee $..[..~:..:i .......... : Bui~dlng ~ln~ecto Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-ex~sting dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 New Building . .~.x~. ?.x. ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .2.4.8,0...W.~.n.~.e..~.e.t.a., .R.o.a:.d. ~ . .C.qt.c..h.o.c,l~e' ¢..~.~¥.. ....................... House No. Street Hamlet Owner or Owners of Property ....... ' ..................................... County Tax Map No. 1000 Section ....1.1.~. ........ Block ..... .07 ........ Lot .... .0;t.6. ........ Subdivisior~..~.&s.s.&.~.. ?.t.: . .C.l.~.b...P.~.o. pe..~.l;.~.e..SFded Map No .... 8(}0 .... Lot No... -387 ....... Permit No. 1.O. 9..2,O~<. ,. Date of Permit . .~0../.l.5./.8.~pplicant . .:[~.~.~.~.4. ~.o.~e.$ ~ ~:.qc. ~ ............ Health Dept. Approval ........................ Labor Dept. Approval ..... ~../.a ................ Underwriters Approval .N.5.1.6.7..O.6 .... .~./.Z.5../..8.1 .... Planning Board Approval .... y.e.s. .............. no Request for Temporary Certificate ..................... Final Certificate ..... y.e.s. ............. or,bed building and~__~Bzt~ a%oab~_~de~nd regulations. Applicant...~//~ ................ R~v.~04e-zs Robert E. Hiltz - I~1~ Inc. T~i; ~UREAU OF ELECTRICITY ~;, ~ ~ ? ' '~ ~,'.u, APl~iL ]5, ].981 ,~.~u~.,~,,~o,o.~ 110770 -' 8L' , ~ g ,~; ~ VU'o (,atalana, W~me~ata Rd., V~mton Rd. ,.-C~gton, .Out. ct~ogua, Richat-d Relyea - 'Yotmg's PoinL Mattitv~k, P.O. l~x 372~ !i l~lura.l, N.Y. 11948 lic, 48,-E ¢~:,~ at 1~ ,, 1 L ~ ,~ , ~:j T[,~ ce tificate rau~t not he cdtomd in m~y nannet; return to the office of the Board if m.orrect, Insp~ctors may be Identified by FOUNDATION ( ~ s~ ) ~0U~-D~TI0~ (2n~) 2. ROUGH FRAME & PLUMBING CO~R~ENTS INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-18013 Disapproved a/c .......... ' .-...~... i ........ ~ ,/. ..... ,~ / .................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .S.~.]~..o.~.~.o.~...~.. i.., 19 .@.0 INSTRUCTIONS a. This application must be completely filled in by typewriter 9r 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. (Signature of applicant, or name, if a corporation) .......... '.. :.. 7. f... i~ 7. J. /7?. .'. .'. .~:q .i:: .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .. ¥ ? .~?.. r.~'¢.~c.c;J. q~).o. ........................................................ (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. 5~ 7- :' Electrician's License No.. ,.-.~ ~.~: ':.7. ............. Other Trade's License No ...................... 1. Location of land on which proposed work will be done... ..... . ..... Z.Z.,z. x. : .............. . ................. ;, -. . . . House Number Street Hamlet / County Tax Map No. 1000 Section . 7! .~ ~g~.;.qA~l. ~'5..C}t~l-tock ................ Lot.. Subdivision ................ (}q'a~;) ............... Filed Map No ..... ,¢]Q0 ....... Lot ...~. '~'7 ....... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 1_ 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. RemoVal .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost g.O.~Q99.,.QO.............................~ Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling Units ...............l Number of dwelling units on each floor ................ ff garage, number of cars ..... . ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... ...... . ........ pth 7. Drnenmons of ex~st~ng structures, ff any. Front ............... Rear ...... De ............... Height ............... Number of Stories ........................................................ Dimenmons of same structure w~th alterations or addmons ront ................. Rear .................. ' Numbe of Stori Depth ' Height ...................... r es ...................... 8. Dimensions of entire new construction: Front .. ?(? .......... Rear .. ¢.6 .......... Depth .2.q ......... Height . .2.6. ........... Number of Stories ..... ¢ ................... i ........ 9. Size of lot: Front .1.OO Rear .... %0.0. Depth .. 322 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... x.~9 ......................... 13. Will loi be regraded ...... ~q.s ................... Will exge_ss fill_be removed fr_2om premises: . Yes ~'c No · VJto Catalano ~' / ,¢,0 ¢~',~r-'t.~.4q-mneNo .............. 14. Name of Owner of premmes ...; ................. Address .~.~. .... ~. ...... Name of Architect .......................... . Address . .'~?. q?~.a.~.~..,E. ,.c{... Phone No ................ 13,7 tqat~J-t~ck 298-~ 96 Name of Contractor SN1,AND l}Ol~J~,o~ IIqCo .Ad~°es:~ ......... honeNo ..... ~ .. PLOT DIAGRAM Locate clearly and distinctly allI buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate interior or corner lot. & q_c/ above: He is t of said applica ~ork Swo~ Notary Public, . 5.uff.°.3. 1.~ ...... , OF NEW YORK, S.S OF $~f. folk .......... ...... .t~.~., .LI ~- .l .t'~ ...... i ..................... being duly sworn, deposes and says that he is the applicant (Name of individual sigping contract) amed. ................. ............................................................ (Contractor, agent, corporate officer, etc.) wner or owners, and is d~ly authorized to perform or have performed the said work and to make and file this [on;that all statements contained in this application are tru~ to the best of his knowledge and belief; and that the II be performed in the man'er set forth in the applicatipn .filed.therewith. , before me thts .... .~.~.s. ......... day Of..8.ep.~.e..m.b.e~ ......... ,19 ~ ..... ~ .....x ...... County ]]Zb~er t'. .... "V,, ......... ~D~Tt.-.-.~'. ~' '~ ........ ~ ............. ~e'~al~ Inland Ilomes~ I~c,. 0