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Home My WebLink About10757-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z10565 No .................. Date ............. Ju.].y. 9 ............. 1981 · THIS CERTIFIES that the buildmg ................................................ Location of Property ... 25.1.5. Sp.t~.nqly~..e.}/. Ay.e. ri[19.,..P..9~P.n.~9,..l~.q~...~.q~ ............ House No. Street Hamlet County Tax Map No. 1000 Section . .05 .1 ....... Block ...(} ~ .......... Lot ., .0,9.8 ........... Subdivismn ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 26 19..8.~ursuant to which Building Permit No..Z..07.5.7..Z 0 dated ... ~.u.n.e., .2.7 ................. 19 .8.., 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 ......... ........... e.r.~y,a.~, e.. 9.n.c.. g.a.m.~..~¥..~.,, e..z.Z).n..g ....................... .. ............. The certificate is issued to ....... T. horn.e · Meg. hood .................................... (owner ~?j~ ~rxt~t~ X of tl~e aforesaid building. Suffolk County Departm,nt of Health Approval ...N/R .................................... UNDERWRITERS CERTIFICATE NO ...... ~I 5.1.9029 .................................... Building Inspector Rev. 1/81 FOI~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFI~CE SOUTHOLD, No Y. BUILDING PER~RIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTJL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10757 Z Permission is hereby granted to: '"7-"~t".~...~...J~.c~. ........ ~,../.~.~....J.... ....................... ....... ~.~.~..../.7.¢.. .............. ~..~ ..... ....... ~(~~.:..~..~..: ~o ...Ea.~r~.~....o.~.. ~.~......~z~/~.q.....~ ............. ........ ........ at premises located ~, ........ ~.....~:...~/~..~...~ ............................... .................................................................................................................... ~~'t ~ '~' ...... pursuont to epplicetion deted ............................ ~ ., end epproved by the Building Inspector. ~uilding Inspector 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 buddings (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 .......................... New Building ............. Old or Pre-existing Building ...../f~..'. .... Vacant Land ............. Location of Property ~.~..~../. House No. Street Hamlet Owner or Owners of Property ~-'~: ~'/.~? ./(~/r?.,~.~T; .... .~.~. ~..C~./.~?. F~, Z~) ......................... ~ r (-~ / ..... Lot..cT. ¢2..~i ..... County Tax Map No. 1000 Section ~, .Lc~. / ........ Block ........... Subdivision ................................ Filed Map No ........... Lot No .............. Permit No./..~. :/.~,5~-.~. Date of Permit .~., ~.C?-,Applicant . //~:~.~../~..-,~..~T. '~-~-,¢ c-c"'~-c~ Health Dept. Approval ........................ Labor Dept. Approval ........... Underwriters Approval .~.~./..~. ~...~,c.~. .......... Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ...... ~. ........ Fee Submitted $. Construction on above described building and permit meets all applicable codes and regulations. ~)~, Rev, 10-10-78 THE NEW YORK BOARD OF FI,RE UNDERWRITERS BUREAU OF ICLECTRI~IT~ JO.H STREET, THIS CERTIFIES THAT only the electrical equip~en~ as described below and introduced by the applicant ~d M~ ~orr~a ~c~d, So~ Ave~ 2215, eTo~ ~il in ~he follo~ing location; ~ B~seme~t ~ 1st FI. ~.~ ~.,.in~d o. ,~1 30, ,,~98~ FIXTURE FIXTURES OUTLETS SWITCHES 16 28 .Lb 16 [] 2nd Fl. Section Block Lot and found to be in compha{tce with the requtrements of this Board. RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE FUTURE APPLIANCE FEEDERS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E NO OF CC COND PER ~' OTHER APPARATUS. Elee.Rcom l~t:c~.r/s: 1~1.5~ 5'~75, 4-.5 ALL'$ i~Smo~ I~4,5 Y,.w, R 'V I C E AWG 2/0 AWG OF HI-LEG AWG OF NEUTRAL Walter FJ~l~.er, 405 Brid~ L~, Q%tchogl~ N.Y, 11935 musl not be altered m ar return to the office Board lie, t845~E Ii Inspect6~s may be ,dentified by~t~e,r~¢red~ntials. BUILDING THIS IN ANY MANNER. FIELD INSPECTION COMMENTS FOUNDATION 2. ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: r FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 ., 19~?. Permit No././.J.75.7 ~ Disapproved a/c ............ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This ~pplication must be completely filled in by typewriter or i~ ink and subm,it~ted.in triplicate to the Building Ihspector, with 3 sets of plans, accurater 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 through6ut 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. (Signa~ture of a~i~a~ or name, if a corporation) State whether applicant is owner,~.C,/tlessee' agen~,/~)/~ar;~ect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Builder's License No .......................... Plumber's License No. - )':..~. ~i .h~l !~. ~. ~... Electrician's License No. ~-~.. L~ t~.. Other Trade's License No ...................... Location of land on which proposed workwill be done.....~/~.~.....~..O.d.~.~....~./...~....~.: ....... I~;Ose' '~lumTM ;;~r ........................ ~ir;;; ....................... ~I~le"~ '~' ................... County Tax Map No. 1000 Section .... ~/. ......... Block .... ~);/. .... ~ ..... Lot...1~..~..?. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... -... : .... .~.~.~..~.~.o..D.t[..,p./ .... b. lntended use and occupancy ""I .... /" ............ "/~''"'~"( ¢ ~"'~'~"'~ ....................... 3. Nature of work (check which applicable): New Building ..... Addition .......... Alteration ......... phi ' liti Other Work ............... Re r .............. RemOval .............. Demo on .. ............. , , -.4(-. ~ ..~ oc~ (Description) 4. Estimated Cost .... .....................O<gcP .......... Fee ..................................... (to be paid on filing this application) 5. If dwelling, number 9f dwelhng Units ............... Number of dwelling units on each floor ................ If garage, number of cars ..... l ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7 ..... ~ ' Front Rear Depth · Dlmens~ons of ex~stlng structures if any ............................................. Height ............... Number of Stones ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... :.. Height ...................... Num, b.ertof Stories ........ ,+ .~.t. ......... 8. Dimensions of entire new construction: Front . ~.. ~..~t ...... Rear .../'~.."/f/ ......... Depth ~ ............. Height .. 1.7. ......... Number of Stones.. [..~ 27'..~.. ......................... ,,,,.~ .............. 9. Size of lot: Front .../.al~..., ........... Rear .... /..~.~..~. ........... De.~th .4r./.O...~.. ............... 10. Date of Purchase ........... I.,.----:-m-~ .......... Name of Former Owner ............................. 1 1. Zone or use district in which pr~mises are situated.. ~tL"~t ~.~.'1'~ ~(-*. ................................ 12. Does proposed construction vio~te any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ..... ~ .... .2 ........... ..... Will ex_~s.s .fil!.be re.m,o,?d,,f, rom premises: Yes 14. Name of Owner of premises"[/:/~. ~...~. ¢..g~./~.O~)Address ~.r,~/?.~.,.~//~.~. !.~...Phone No ................ Name of Architect.,., .. ..... , ................. Address ......... . .......... Phone No..~... ~ r. · · .., · - ..~ PLOT DIAGRAM Locate 'clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dimensions from and block number or c~qscnptmn a. ccordi~Lg to deed, and show street names and indicate whether property lines. Give street ' ' STATE OF NEW, YO.RIC_ - COUNTYIpg i' .... ~,~.~[~...~.~.~.~ .............. berg duly sworn, deposes ~d says that he is the applicant (Name of individual sig~ing contract) abovenam6d.. ' ~. ~ ~.....~ ..................... ~ ........ He is the ........... , ." .~.~ .................... ,. ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is dtlly authored to perform or have perfomed the said work and to m~e and file this application; that ~I statements contaned ~ this application are true to the best of his knowledge and be~ef; and that the work will be perfo~ed in the m~n'er set forth in the application filed therewith· Sworn to before me this ...... Nota~ Public, · i ~0mmtsslon EAp~res M,rch 30, ,1~ ~ (Signature of applicant) SOLJ,"ID V;E~'¥