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Home My WebLink About10548-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. ~.1373.8. ........ Date August q2 ., 19.8.5. THIS CERTIFIES that the building .. alteration. 70 ~'~,$h's'd~' ~': ............................... Location of Property .. 37.8~. .......... .~.5.~..~.k.e..i}1. 99.k' .R..d: ............ 9.u.~gh..o.g.~.? ..... House NO. Street Hamlet County Tax Map Ho. 1000 Section ...q..0~ ...... Block .... ~10 .Lot Subdivision .............. X ............... Filed Map No .... x. ....Lot No. x conforms substantially to the Application for Building Permit heretofore filed in this office dated January ~ 7 80 ~05~8Z ..................... ,19... pursuant to which Building Permit No ...................... dated January fl 8 19 80, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy ~r which this certificate is issued is ......... Alteration o£ existing ~arage to bedroom with full bath. The certificate is issued to ... tkF21BlSR2. $3glI).F~$. g..t?.A~.I.G ~.A. ~ .]~..9.R~.. ............ (owne~ of the aforesaid building. Suffolk County Departznent of Health Approval ................ ~I./~, ...................... UNDERWRITERS CERTIFICATE NO N576722 Building Inspector Rev. 1/81 FOR~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EM1SES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10548 Z Permission is hereby granted to: ....... ~,~.~b....J~z~ ................. ....... ~. .,~,~..~:.~.,~.~rz.~ ~/. ~.? . to.... ~. ~.~ ~~....~.~....~.~/'~.~;'"'~~"~'a'~ ........ ........ -::~,.~.~ ....... ~,......~.'-. ~'~ .............. at premises located a .Z~:.. Z ............................................. ............................... ~...7o......:z~:~.~....~..., ........ ~.~:~:~:.:..~ pursuant to application dated ~~~-....[.~ .............. 19 .., and approved by the Building Inspector. FORM NO, 6 TOWN OF SOUTHOLD ~ui/ding Dapar~men~ Town Hsll Southold, N.Y. 1197'i A?PLICAT~O,*,J FOR CERTIFICATE OF OCCUPANCY Instructions A. TR,; ;32Pc3uon must be filled in ~'/pewrher OR ~nk, and . ' "*-= tot wire :23 following; for new buildings or new use: suum~a in duplicate to the Building Inspec- l. F:ncl $ur.'ey o~ property with accurate location of all buildings, property lines, streets, and unu~al 2. F~na~ ;,:arovel o, Hea tn Oeo~. of water suDotv and sesverace dispossl--(S.9 form or equal). o. *tL2:C'.'31 of e~ectrical ms~sllst~on from 8oard'of F~re Uaden,~riters. 4. Commarc,sl ?ildin~s, Industrial buddings, Multiple Residences and slmflar bul'~: ...... ,.~,,~ t~ons, a car[~cate or Code comp ance from th= Arch ~' ~ ~;~=~ -= - . ,/,? ~nu In~,,=- g. For exlst~n~ bui]din~s (prior to April 1~/), Non-conformino uses, or build~ncs a~d ..... pr ...... t,n9 1. A *',r '~ ~un/ey c.. a,_ of peoperty showing all property lines, %rests, buildings ~nd unusual natural or 2. Sworn s~at:ment of owner or previous owner as to use, occuoancy end condition of buildings. 3 Da~e of :ny housing code or safety ~nspect~on of bu;~dines or premises, or other pertinent mforma- 1. C~u',cata of occupancy $5.00 2. Car:'f,ca:a of occupc, ncy on pra-e×mtmg dwellinQ or land use 3. Cc2',' of certff:cate of occuoancv 81.C0 ~ $5.00 New ~.ut!d~r': ............. Old orPre-exis;lng Bulicing(Z) .... ~(~ --= /Vacant Land - c" ........ ............. Block ............... Lot ................ ........................... F~led Map No~ .......... Lot No ............. Heahh DcpL Approval ........................ Labor Dept. Approval .............. . ........ ,.. Undep,vr..:ars Approval ........................ Planning Board Approval Reques[ ~or Temporary CertJ~cate ..................... Final Certificate Cu ...... F,:.on on above de.~nb~d budding and ~t ~eet~l ~;~.,~ ~ ~,~'~ / ~ '~'~ .... ~-.'-¢~ouasancregulatlons. Apphcan~ .~ / .............................. TOWN OF q,quT-~-r~rr~ OFFICE OF BUILDING INSPE~OR ' P.O. ~ ' ~OX 728 TOWN HALL TEL. 765,4 802 Applicant · ,-o l~ uo aQ%'lse you %hat t. ' ~ . Permit No. ~&-~ .......... ~e 2o.b u,,~er Buzld~n~ - ' * ...... ~ ,a~ ..o% /~ oeen done. in Otter to complete this file, mt is necessary that a Cerrzf!case of ~ .... y be .... ~ P! -ss .... ease ~-11 out enclosed form(s), re~urn same to ~ above o~ ° wish a check fo~ $5.00 payaDle to %he Town oF Southold. Please znezcate to whom the Certzficate of~0ccupancy is to be mailed, an~ arman~ with thzs offlce for an ~n~D=C~ion daoe. Thank you for your prompt a%tension. VL:ec EnClosures Very truly yours, Victor Lessard Acmin~s ~r~ tor T0V,~N OF Souir~OLD OFFICE OF BUILDING INSPECTOR ' P.O, BOX 728 TOWN HALL SOUTHOLD, N.Y, 11971 TEL. 765-1802 .... o 1_ ~o aavmse You .... ~ .zo .... ~ na~ no~ been done. nd in ozceu Lo com9!ete thzs fiie~ it ~s necessapy that a Cen~lf~ca%e of 0 ..... ,.~y be -ss .... Please fill ou% ~ne check Fop $5.00 payable to %he Town of Southo!d. Plemse lne~Cate to whom the 6ePEiflcate or Occuoancy is to be nailed Thank you fop your prompt a%tention. VL:ec Enclosures Very truly yours, Vactor Lessard Admanis ~r~ tot ~ooo?71 ,THE NEW YORK BOARD OF FIRE UNDERWRITERS , BUREAU OF ELECTRICITY '~ "~ 85 JOHN STREET, NEW yORK, NEW YORK 10038 Date N 576722 FIXTURE FIXTURES RANGES OVENS EXHAUST FANS OUTLETS SWITCHES FLUOreSCENt 9 9 DRYERS FURNACE MOTORS NO OF HI LEG AWG OF NEUTRAL P.O. Box 143 Matt~tuck, N.Y. 11952 47o 75 lic. BY TO THE ORDEB YORK~OARD ( CASH ThIS IS YOUR BILL FOR &~RVICE RENDERED AND IS NOT A CERTIFICATE OF COMPLIANCE THIS BItL PAYABLE AT THE NEW YORK OFFICE, 85 JOHN STREET, NEW YORK, N Y 10038 COMMENTS F IELD~ IN~ECTION , FOUNDATIO~ (~st) FOUNDATION (2nd) ROUGH FRAME& PLUMBING INSULATION PR 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 Approved F., .... , me it Disapproved a/c .. :...........~ "~. ..................... ........... -.,.,'", APPLICATION FOR BUILDING PERMIT Application No. ~('~.~.~..~. · ...... Date (Jd:+.~ .".q ~y... /' 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 tot and of buildings on premises, relationship to adjoining premises or public streets or areas, and pgving 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 applicabon 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. ....... :,,.' .......... ¢,..~'1~-,. .~. ?. .~-~ ................. (Signature of ap~ant, or name, if a corporation) .... .m. .~-?. ~ ~,o. .~:J. .h./. +?/'... 7: ::~./.'~ , . ~/(~f. .~. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~,7~ . ~,- , ,. ~. v d . ~ b-.~w. . .s~ lb?./?.~: ,~. ..................... Name of owner of premises ~. ......... .~..? (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 NoF~:,~. 9! ~.'7. . / f[. .!~/~ ........ Plumber s License No .... ~,.~.~ .~. J .~.~..~J.~J~ .': · Electrician's License No Other Trade's License No ...................... C~,*'~/-L 771~ ~/~/~ 2~fi, ,¢ ~7~r~/,~,~,,' 1. Location of la~M ~ich propo~O w~k will be done ........ .................... 7.: ....... ;: ....... ~.. ·. .... +~' .... -'" .............................. h;;'~g ............ House Number Street County Tax Map No. 1000 Section /O~ Block O / O Lot Subdiwsion ..................................... 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 ~7ev~- t~ ,'T~ ~'~.~[ c Intended use and occupancy ~5~ ~'?,J. ~i~.~ ,v~'r~.~ ~¢~.. ~ +~. ~.rg4q'~ ~ ~: b. 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .../-r'~.. ..... Repair .............. Removal .............. Demolition .............. Other Work ............... ~t (Description) 4. Estimated Cost .//.~.~:~..q .............................. Fee ...................................... (to be paid on filing this application) number of dwelling finits ./ Number of dwelling units on each floor /. ' 5. If dwelling, ..~. ......................... If garage, number of cars Qr,JV¢~,-.~..~.' .'Pt..'~... ~....~. e.~..~.o.~. ~ .eJ~ &t'A ............................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structure~? if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure wi!h alterations or additions: Front ................. Rear .................. Depth .................... [.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stones ........................................................ 9. Size of lot: Front ...........i ........... Rear ...................... Depth ...................... 10. Date of Purchase ........... I ............... Name of Former Owner ....................... 1 I. Zone or use district in which premises are situated., tl~s i r]~,~.~-.~ ...................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .. A/O ........................ 13. Will lot be regraded ........ ~/.o ........ ' ......... Will excess fill be removed from premises: Yes ~ 14. Name of Owner of premises ... i.. ,~-~%g..o,Z~.~... Address ~.,,./c.~...<,~ ~ ....... Phone No.7.3.~.: .~...8~.6. .... Name of Architect ., ..... .o/rg.. !..~-A~.. ............. Address . .~.~.~' .~ ~ ~ ~ ....... Phone No ................ Name of Contractor .£.~.n, az:r: i.u./., .:r'o.n/a6 ....... Address .~s,;mT'f'. ~. TS. ~r~ ......Phone No. 2,..~.~.-. ~.6. 6. .3 .... 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, S'rA'r OF NeW Ymr, COUN'r¥ is's ............... (Name of individual signling contract) above named. : being duly sworn, deposes and says that he is the applicant He is the .................... (,~. ~ .................................................... ~ (Contractor, agent, corporate officer, ere.)' 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 i ......... //~...~'/~ ........ day of .... .~..~.l.,.t,a...~.r.~..., 19~'.~. cg,, ;" , ...... ;.,,, .... .,. ,. EL~ZABEDt ANN NL3/I ·, · (O ,.;{ ; 4.~x,~.~. ~, ( ~o. 52-8125850, Su [olk ~o~ Term Exo~res March 30, 19~~ ,/ DEsiGN OR COi,,ISff!XU I I ! / / / /