The URL can be used to link to this page

Home My WebLink About10564-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. Certificate Of Occupancy No..Z.1.3.3.8..5 .......... Date ... Pq?.~..~..1.9. .................... 198.5. THIS CERTIFIES that the budding ........... G. g.~.a.ge...A.d.d.i..g.5.qn. ................... Location of Property ..... .6.0.0 .- ~2.0,. S p?.t.b. P? ............................ ~.a,~. ~, $ .~,u,q k,, House No. Street Hamlet County Tax Map No. 1000 Section ... 1. 9.6 ...... Block ..... 9.6 ........ Lot . .0.2. 6. 7.0.2.7. ....... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... ~. ,e .b./.. 1. 9 ....... 19 .g.0. pursuant to which Building Permit No. 1. 0..5.6.~.Z. .............. dated ....F.e.b.:..2.1 ................. 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 ......... Garage addition to accessory cottage. The certificate is issued to ........ L. 0..~.S..~.... b.a.s. ~ .~.r.o.~. s..r.~ ............................. (owner, I~ ~ffu'Ya~ X of the aforesaid building. Suffolk County Department of Health Approval ... N / A UNDERWRITERS CERTIFICATE NO ................... .N.4.7.3. ! .7.1 ....................... Rev. 1/81 Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERICS OFFICE SOUTH"OLD, N. Y. N°. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ( ~056~ Z Dote .. ~ .~.. · ./..~..../~.......~..~./.. ........ , Permission ~s hereby granted to: ....... ~.%~ ........ ........ ~(,'D...,..../. '-,~.. ~ ..... ~.~;~ ................. ...... /~.~.~.7..;~.c../.~.~.. ~.. -..~:.... ........... ,o.....('.~ .~:~...cr.;<.c,..c .r.......~cz~.c~.a: ...~ ~.~?.'../..~.~. ,:~...z~.....~ ~ .:~z,~? ......... . at premises located ot ....~..~...~....-.....~..~.~. ....... ~.~...,~....~..../~......~..~..~c~.., .......... ....~....~.../.~...~..~...C.Z~,,......~..~/~. pursuant to application dated ...~..../.~'/'~.~.~...~ ...... -/-.~. ........ , 1~., and approved by the Building Inspector. FORM NO. 6 TOWN O? SO'LITHOLD Buiiding DeparTment Town Hall SouthoM, N.Y. 11@71 APP,_IC,-,T,ON FOR CERTIFICATE OF OCCUPANCY Instructions A. Th,s apohcatlon must be filled m typewriter OR ink, and submitted in duplicate to the Building Inspec- tor w~tn the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual naturrd or tooograohic features 2. Final ~oproval of Health Dept. of water supp ,v and sewerage disposal--{S-9 form or equal). 3. Aporoval 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 buiiding, 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For ex~sting buildings (prior to April 1957), Non-conforming uses, or buildmas and "pre-existing" land uses: ~ 1. Accurate sur'~ey of peoperty showing alt property lines, streets, buildings and unusual natural or topo,~raphic features. 2. Sworn statement of owner or previous owner es to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent reforma- tion required to prepare a certificate. / C, Fees: 1. Certificate of occupancy $5.00 2. Cartd~cate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 New Budding . . ~ ......... Cid or Pre-ex~sting Building(X) ,. ....... = /Vacant Land -. .......... Loca,,on o; ,operty .... ... Hou~ zVo. Street Hamlet Owner or Owners of., .................................. County Tax Map No. 1000 Section )O.~ -z ~%~.~. Block ............... Lot .... ~ ......... Subd~ws~on ................................. Filed Map No ........... Lot No .............. P~rmit N°.' ~.~ Health Dept. Approval ........................ Labor Dept. Approval ...................... ,.. Undenvriters Approval ........................ Planning Board Approval .................. Fee Subm tt~d Construction on above described building ,an~er~it'mee[s all apP~aM~odes and r/gu lotions. I ~% Applicant . .~ .. ~.. , . ............. FIELD INSPECTION COMMEN~S FOUNDATION FOUNDATION 2. ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY CO~E FINAL ._ T · ADDITIONAL COMMEN D. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~-- ~)D~t BUREAU OF ELECTRICITY: 85 JOHN STREET NEW YORK, NE~VV %;~ORK 10038 THIS CERTIFIES THAT only the el~trlcal equip~nent as descrlb~d belo~ and introduced by t~ applicant ~med on the above application number in the rem 'sea P/ Le~nikowski, North Dr~ (~00' n/o Ba~iew Ave.~ on Private ~.~ ay in thefollowing locatton; ~ Basement ~ 1st FI. ~ 2nd FI. garage s,~tlo, ato~ rot was exa,nined o,~a~C[~ 2 ~ ~ 19 ~0 and found to be in compliance with the requiren~ents of thts Board. FIXTURE OUTLETS DRYERS IECRPTACLES SWITCHES FIXTURES NCANDESCENT FLUORESCENT 2 2 2 OTHER APPARATUS: S E AWG OF CC COND C NO OF HI LEG AWG OF HI LEG NO OF NEUTRALS AWG ~ Gustav Bartra j~ 227 ~a~t Breakwater Rd. I~ Matt/tuck, N.Y. 11952 L~c.1529 E j] Th~s certificate must not be a tered n any manner; return to the off ce of the Board if mco?ect Inspector[ may be identified by their credentials COPY ;OE B~I~IN~ ~EPA ~ENt. THiS CO~? O~~ ~ ~ IN AN~ ~ANN~R. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .~2~'...~.] ...... , 19 4~.(? Approved ~.~..~.....~. ., 19~. r-P. Permit No..<~. ~.~.~.~. ~ Disapproved a/c . . . .--iT...~. ........ "i ................... / (BuildiiSg Inspector) APPLICATION FOR BUILDING PERMIT /1/ Date .... 7¢' /'~" INSTRUCTIONS Application No../.(~9. 4J.. ~ ....... 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 apphcation 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 inspfi%tions, t / .... ......... (SignaBt're of applicantraSr nargr~, if a corporation) (Mailing address of applicant) State whether appli~ant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... ....................... , .................................................. Name of owner ofpremises...~.~../~. .... /G..~:*./.e-z./.~a.../~.~'.~.'../'Aa. ?. '~.~.(4~.5;.../... (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 License No....~Z. ~ ................... Plumber's License No...~..(~....~...~. ........... Electrician's License No .... ~. : . .~...../~.~-~* Other Trade's License No ...................... 1. Location of land on which proposed work will be done. e~ ~' ~-- ~ ,,~f" .3' House Number Street Hamlet County Tax Map No 1000 Section ..../.~..~ ......... Block ........... Lot .... 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.. (~)j¢/~-~ .~.(~ ../& ,/~ZT~. ~,~'~.. ~.~(..(...~... ~/'~5' ' ' b. Intended use and occupancy ...... 3. Nature of work (check which apphcable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost ....... . .~.-~. · ..................... Fee . i~'. ......................... , (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. If business, commercial or mixed occupancy, specify_ nature and extent of each type of use .....-:w-. ............... 7. Dimensions of existing structures, if any: Front... ~..O. ........ Rear . 3.(2. ........ Depth... ~...(-. ....... Height ............... Number of Stories .... / ................................................... Dimensions of same structure with alterations or additions' Front '- Rear [) epth....~. ~. ............. i:.. Heaght' ...................... Number of Stones' ..... /..: ............ 8. Dimensions of entire new construction: Front .... Afl. ....... Rear .... ,)..~. ....... Depth ... ,2r..~;~ ........ Height ............... Number of Stories .... /. ........................................ .~ ........ 9. Sizeoflot: Front . ~.F..c/:~ ......... Rear ..... Z~.~.'..~. ..... Depth ...~.~.~,.]~ .......... 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: ................................ 13. Will lot be regraded ......... ................ ~,. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ~.,..fi~,. ~ .~Q~. P~..).ff..O.O:?.{/Address . .,f~..~.[]./q~..6.(~... Phone No. ~-.¢. ~'.: iF~...,~'.~... Name of Architect ........... , ................. Address ................... Phone No ................ Name of Contractor ...... I . Address 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 ~aumber or description according to deed, and show street names and indicate whether interior or corner lot. ..... being duly sworn, deposes and says that he is the applicant STATE OF ........ ..... (Narrle of individual signing contffict) 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 applichtion; 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 . Not P.u,b!ic, ............... i..~.1~~. ]/~'. County S.88ol3'$ O"E 123.06 74.45' Areo Lot N 2.760 ~A'~res _ _ Lot L :. :-' YOUNG & YOUNG ...... '400 OSTRANDER AVENUE, RIVERHEAD, NEW YO:' SURVEY FOR LOIS PAT RIClA ,LESNIKOW/S~.. ?~.~{o, LOTS' M & N SUFF. CO., N.Y.