The URL can be used to link to this page

Home My WebLink About10922-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z10567 THIS CERTIFIES that the building ............................................... Location of Property .... 2.?.5..B.o. ?.n.d.v.~..e.w..A.v..e.n.u.e...g.x.~.: ~. ...... .S.o.u.t.~old, New York House No. Street Hamlet County Tax Map No. ]000 Section . 9.5.q ....... Block ...0.2. .......... Lot ...0.0.5. ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated ..... .O.c.~. o..b.e.v..6. ..... , 19..8.0pursuant to which Buildhig Permit No. 1.0.9.2..2.Z ............... dated .... O..c.t.o.b.e..v..1.6. ............19..89, 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 ......... Addition to Dwelling Sanford F. and Sue H. Hanauer The certificate is issued to ..................... [d~,de'r,~j6x'~ir~d~:dx'x' ................... of the aforesaid building. Suffolk County Department of Health Approval N / R UNDERWRITERS CERTIFICATE NO. N5 19034 Building Inspector Rev. 1/81 ', FO~M ~0., ~ SU~L~ TOwN HALL SOuTH'OLD, t~,; BUILDING~ P, EP. JvilT (THIS PERMIT MUST BE, KEPT ON ~H,E PR~klS~S UNTIL F~ULL COMPLETIO~q OF THE WORK AUTHORIZED) ' i· N? ~o922 ',z ~o .,~ ~/~:~......~ ....... , ~,.. Permission is hereby gro~ed to: ~ ,_~ ....... ~..~&~ :....~r...~. ....... ....~.~r~....,.7~...~...~_..zz..~.~ .......................... Z~,(~..~ .......... . . .~.;~ ~ < ~ ~ · .~. : ",/" . ~.,.- .......... ~.~.~..z,...,....~,~..~.~:....~~~r ........ at premises located at ; ................................................. ~....~.~a~~..~..5¢.. . ~ ~ ~ -..~ ........ pursuant to apphcat,on ~dated ,~ .... ~..~..,..,t.., I , and approved by the Bu,ildlng Inspector. Fee $.Z. .................. i~pector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD 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 suppty 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 ex~sting 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 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 3, Copy of certificate of occupancy $1.00 $5.00 Date .... .~Z.~. ~.,.. 1. cJ.8.1 ........ New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property 275 Soundvlew Avenue Ext. Southold~ N.Y. House No. Street Ham/et Sanford F. and Sue H. Hanauer Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section 050 Block 02 Lot 0.05 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ,10922-Z.. Date of Permit 2~.Q/Z6/.8,0Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ......... Underwriters Approval .... ~[5 J 9D.3.4 ............ Planning Board Approval .................. Request for Temporary Certificate ..................... Final Certificate . z ................. Fee Submitted $ ....... ,5...0..0 ................. Construction on above described building and p~r/~t meets all applicable codes and regulations. Rev. 10-10-78 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This apphcat~on 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 featu res. 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), Nomconforming 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-ex~sting dwelling or land use $5,00 3. Copy of certificate of occupancy $1.00 Date . .-~/-];,~ ......... /..~/..~..? .... New Building ............. Old or Pre-existing Building ..`. ,V~'.. ..... Vacant Land ............. Location of Property . . ,~. House No. Street Hamlet Owner or Owners of Property ¥_~(!.~,,,r¢¥~ .4).. ?...~.~A. ('.J~...z~. ~4~.~L~,, ..................... County Tax Map No. 1000 Section ..... .5~.O. ....... Block ... ~ .......... Lot .... ~.' .-~ ......... Subdivision ................................ Filed Map No ........... Lot No .............. Permit No../.~..~. Z.. Date of Permit /.~.//.~./~z2..Applicant . .-J~/('~.. {5~-/E.~¢~.. ~.~.~.-~.~, .~.~..~.. Health Dept. Approval .... ~.'~.~ ................. Labor Dept, Approval ..... .'~'~.~, ............... Underwriters Approval .~. 7~./.~.~,~/.~ ............ Planning Board Approval .../¢/~.~. ................ Request for Temporary Certificate ..................... Final Certificate ....~.~.. ................ Fee Submitted $ .... -;-~..~. ~ .................... Construction on above described building and permit meets all applicable codes and regulations. Applicant. ~..,~...~ ......................... Rev, 10-I0-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.3~ BUREAU OF ELECTRICITY, THIS CERTIFIES THAT on y the electrical equipment as described below a~ int~duc~ by the ~plicant named o~ ~he able appl~ation number i~t the pre~nlses of in the following location; ~ Basetnef~t ~ 1st FI. FIXTURE FIXTURES OUTLETS SWITCHES FtU~$CEN? 13 ,~,Z !Z 13 ~ 2nd FI. Section Block Lot and found to be in compliqnee with the requirements of th~s Board. RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS DIMMERS SERVICE DISCONNECT $ R R V I C NO OF CC COND pER ~' NO OF HI LEG AWG OF HI LEG NO OF NEUTRALS AWG O~ NEUTRAL Th~s certificate must not be altered in manner, return to the office of the Boo~d ,f~,incorrect. may be ,denhfle BUILDING D~ARTMENT. THIS COPy A~?[~ED IN ANY MANNER. FI~D I~SPECTI0~ FOUNDATI0~ (frs2) FOUNDATION (2nd) 2. COIVff~ENTS ROUGH FRAME& PLUMBING INSI~ATZON PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1803 Examined ..... , Disapproved a/c ............ ~? .........~/ ......,. ~PPklC~TIO~ FOB B~ILDIffiG Application No./~.fd.~/ ........ Date ..... (!~¢,i .7~... (to..., 19~3c~ 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 wilt 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. . .V.~...~. :..~..~.~. '~..~, ~.~o_. z~w~: ...... (Signature of applicant, or name, if a corporation) · S.c../...~..qz~.. c ..... ,,~.~.~F~Z:~ ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... ,g.~.,..~.~.. ............................................................................... Name of owner of premises ...~..~..~. '.~-. ~ .~ .. ~.~.~./. ~:~'~ . ./7~,...~../~../-4./.'.~.~,t~. ........................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized ofhcer. .... .............. (Name and title of corporate officer) Builder's License No .... /~./ ......... _~ ...... Plumber s License No. ·,]·4... [~. Electrician's License No. ~ Other Trade's License No ..................... Location of land on which proposed work will be done .................................................. .... ?. f.~. .................. .~.~.o.~.~..~.. ~./. e .~....~.~ ./~ ~n~ ~ .... ~. ~. ~.~. ~ ........ House Nmnber Street Hamlet County Tax Map No. 1000 Section ..... .~.?. ......... Block ..... .~. ........... Lot .... .~.~.. ........... Subdivision ................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ~.AdZ~.. '.~.~,¢MTdl/. ~)~.. ¥~..'~,~. ................................ b. Intended use and occupancy ............................... ..................................... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .,~ ....... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost ....,~.O/02F6) i 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. I ~ business, commercial or mixed occupancy, specify nature and ex. tent of each type of use ..................... 7. Dimensions of existing structur{s, if any: Front ' . Rear .............. Depth ................ Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... '.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... 9. Size of lot: Front . . . /.~.~. .... '. ........ Rear .................... Depth 10. Da~/e of Purchase ........... ~ .................. Name of Former Owner ............................. I 1. Zone or use district in which pr~mises are situated ..................................................... 12. Does p~opose~l construction viglate any zoning law, ordina.n, ce or regulation: .... .~?.o. ........................ 13. Will lot be regraded ...... .X;{.O ................... Will excess fill be removed from premises: Yes ,x~ No 14. Name of Owner of premises /2,/.~fA/~.. 5', A/6~Address ................... Phone No ................ Name of Architect ' Address Phone No Name of Contractor.7 Pb~.~m, mT'~x~t, a!l'~lz~,~-~... Address ~.~/. t'~ 3 ~.~ .~ ..... Phone No. ;Tg~.,~/~ff2~.~.... PLOT DIAGRAM Locate Clearly and distinctly alll 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 c~orner lot. STATE OF NEW YORK. cOUNTY OF .... ~ ¢.~.~.o..U.~... ........ ~.o.A/xA .~?~W..r ...... ' .................... being duly sworn, deposes and says that he is the applicant (Name of individual signling contract) above named. (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 contoined in this application are true to the best of his knowledge and belief; and that the work will be performed in the mannoY set forth in the application filed therewith. Sworn to before me this .... ~ EIJZABE~ ANN NEVILLE ' ' z,,, · ................. , I NOTARY PUBLiC,State of New York (Signature of applicant) No, 52-8125850, Suffolk Couply Term Exp,,'es March 3§, 19~