The URL can be used to link to this page

Home My WebLink About11368-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...~.1. 1..3.5.5 ......... Date .. D.e.c. 9.m.b.e..~' .1.5. .............. ]98.~.. THIS CERTIFIES that the building ............................................... Location of Property . .~..5.0 ............... .B.J_.u.e...H.a.P.l.J:..n..I).p..J: .v.e ........... House No. Street Hamlet County Tax Map No. I000 Section . .0.5.7 ....... Block . .0. 1. ........... .tot 026 Subdivision,..~O.u.g. hqi~.d..~h. 9r.e.s. .......... Filed Map No..3.8..5 .3...Lot No. 5 conforms substantially to the Application for Building Permit heretofore filed in this office dated / ..... hk~g.u.s.t, ......... , I9.8. 1. pursuant to which Building Permit No.. !'i .3.6.8...Z ............ dated ....S.e.p. }.e.m.b.e.p...1.0. .......... 19.8.1., 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 ......... ......... a..pr.J-y.a.'9.e..qqe, r f.a:m.~..2-y, d.¥9..].]..5, n.g.. ......................... The certificate is issued to Warren G. & Anna Donnelly ..................... b¥,;dr,-~i~'~'d dAi~',4t¢ ..................... of the aforesaid buildiog. Suffolk County Department of Health Approval .1. 1. .- .S.0.-: 8. .6 j . .5. /. .2 .~ /.8. 2. i..R.qb..t;.., ~. :. y.J..~.l..a.. UNDERWRITERS CERTIFICATE NO ......... bi.. $ ~5.8. Q ? ................................ Rev. 1/111 Building Inspector FOEM, NO. ~ BUILDING D~PARYJ~N~*; TOWN 'HALL SOUTHOLD, N~ Y. ERMiT BUILDING P, (THIS PERMIT MUST BE KEpT ON THE PRE/~IsEs UNTIL ~ULL COMPLI~ION OF THE WORK AUTHORIZED) 3 6 8 Z Date ........ /.~.., ~ermission is hereby granted ~q~// ~. ~ ~_. ................ : ........ ~ ................ ,...~ ................ .... ~.~.W.....~..~2..~ ..-.....~...: ,~.. ~ ,~ ..;..~e~.~.~C.....~.~<e....~~ ~: a~a}~~ .............. at premise~ located at ...,~....~..~~....~.~ ......... :. .......................... ......... ; ................... .......................................................... ........................ ~~ ............................... . ............ , ...... ~.a~.....~ ..................... Coun~ TaX Mop No. 1000 Section ~ .; Black ........ ~Lot No....~ pu~s~ont ~o application dated ~T..~.~ ....... :,...(....., 19. , and approv~ by the Building I~spector. Fee ;..~..~. Re~.i6/30~80 inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,¥, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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 disposa~-(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. B. 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 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 premisest or other pertinent informa- tion required to prepare a certificate. / C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 / New Building ............. Old or Pre-existing Building(X)., ......... ~/Vacant Land 'i ............ Owner or Owners of Property ,... ,~../~ZC'-X,).../~. ..~...,~ Z~.J(.L~ ....................... ..... --- ' CountyTax ~a No, ~O00Sect~on .... ~'~:.'?. ...... -' ' .. ). ............... ."..!. ..... PermitNo. //..~.~.~..~'. Date of Permit .~/~./'/..Applicant. .~..."' .~,~.~.. / Health Dept. Approval ........................ Labor Dept. Approval ...................... ,,. Underwriters Approval ' Planning Board Approval Request for Temporary Certificate Final Certificat~ - Fee Submitted $ ............................. Construction on above described building and p~rrrlft~.meets, aJ~ app~ca,b, le_.codes and regulations. ': ": "' ....... :'" ....... "'" .................. ,,,.,o.,o.,, ',',:.?:::'?!., "- - ' ..' · , " I "':":"'" ",' ' :' '" ~ ' ' : : "i~' "" ' 1000771 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1OO3J~ .ate ~prxl i, i~ ~ppllc~tlon ~o. o,~.~ ~5134-~1 · .,s c~.~,~,~s ~.~ N 5 5 5 8 0 7 only the elect~cal equipment ~ ~scrlbedbe~w ~t~d.int~ee~ by t~ applicant ~d on the ~oue aoolicatJon number in th r ' W~t ~ly, ~O S/~ ~,~ ~ ~iVe, ZOO' ~/O ~1~ Drive, ~re~:~ o/ in tke following location; ~ Basement ~ 1st FI. ~ 2nd FI. Section Block Lot ~ ~x~.,~,~d o~~'~ Z9, 19~2 and found to be in co~npliance with the requirements of this Board. FIXTURE FIXTURES OUTLETS RECEPTACLES SWITCHES MERCURY INCANDESCENT FLUORESCENT VA~OR R. , 5g 35 27 ~/Y S FURNACE MOTORS FUTURE APPLIANCE FEEDERS SERVICE DISCONNECT ND. OF ! S METER 1 150 6~ x 1-G.F.C.L, 1-Smoke ])elector 1~4.5kw H.W.H. RANGES 1 11.8 SPECIAL REC'PT R COOKING DECKS · OVENS DISH WASHER! V I C E A' W' O' [ NO'OF HI-LEG OF CC COND, AW.G. OF HI-LEG EXHAUST DIMMERS 1/0 P.O. ~oc 143, lv~A::i~uck, N.Y. COPY FOR THIS COPY OF FIELD INSPEC~TION~ COMMENTS FOUNDATION (1st) FOUNDATION__ 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL AD~ONAL cOMMENTS: 1 ~ Op~nlng Prot~etiv~s Opening Protectives: Wood Doors Doors illustrated on ~ page, when used with frames and hardware shown in illustration en- titled, "Frames and Hardware for Wood Doors," part 4, page 15, are acceptable £or use in one- and two-family dwellings. Solid-core, l~-inch fl~ick wood doors are acceptable for use as a,~- hour opening protectives in 1-hour fire separa- tions which are not required to bo of noncom- bustible construction. ' solid wood core crossbandlng veneer SOLID WOOD CORE FLUSH DOORS IS/e" min.. 5-1nch min. width battens and brace 2-1nch nominal T & G or splined stock not over 6 inches wide I ~/2" min.' Lj-' ~X/~',~'"~'l~x'J/'Jfx/~,~-~~ / two layers of I-in. ch nominal T & e · ~ stocE not.over 6 inches wide, with one · I layer verhcelsnd theofherhorizontal, and one Isyer of asbestos paper between BATrENED DOOKS 1~" min. - wood panel sheet iron, copper not less than 28 U. S. gage, fastened on each side to stiles, rails and edges with nails or screws 13~" mln. wood panel I/e-ineh asbestos millbeerd or ~-inch gypsum wallboard sheet iron, copper not less than 28 U. S. gage, fastened to side on which protection is desired, to stiles, rails and edges with nails or screws PROTECTED PANEL DOORS CODE MANUAL Opening Proteetlves 4 15 Frames and Hardware for Wood Doors flre-referdanf /a. nd nailed fo ~Crame on not mere treated wo.~ Ffire-retardanf treated wood stop, cjlued ~13/4 ~n 6'inch cenfer~ ~~ :~1'/2'' ~ I ~-;nch m;nimum ~: ~ ~ acf~ual dimension TREATED UNTREATED METAL PRESSED OR WOOD COVERED ROLLED STEEL FRAMES m;n. 41/2", ~ spring hinge or door closer -on doors less than 1~/2 inches in thickness, cover latch dile with minimum 28-gage metal m;nimum throw of latch ~" doors more thee 5 ft high: m;nimum 3 buffs not less than 4" by 4" Frames--Frames shall be of fire- retardant treated wood, of un- treated wood with fire-retardant treated stops of dimensions fl]us- trated, of metal-covered wood, or of pressed or roiled steel. Hardware.--Butts ~hall be not less than 4 inches by 4 inches, or equivalent, with not less than one butt for each 24oot 6-inch height of door. Self-dosing devices shall auto- matieally dose and latch the door. Rectangular latch eases shall not exceed 8.~ inch in thickness; tubu- lar latch eases shall not exceed ! inch in diameter; throw of latch shall be not less than ~ inch. Where door stile eontainlng latch is less than 1~ inches in thlekness, the stile shall be covered at the latch with minimum 28*gage sheet iron or copper. HARDWARE CODE MANUAL FOaM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~OUTHOLD, N. Y. proved ............ , ..... Disapproved a/c ......................... ...' ......................................................... ~. ..................................................... T~...~F~z..~ ........................ ................. ~~;;T ............................... Application No../../.~..~.~...?... ............. INSTRUCTIONS a. This application must be completely filled in by typewriter o~..in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee accordtng 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 ofproperty must be drawn on the diagram which is part of this application. 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, end regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of al~plicant, or name, if a corpq~tion} (Address of applicant) State whether appl~nt is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. /.3/ ' ................................. ~./.'/~.~.. ................................................................................................................................................. Name of owner of premises .Z.~...~.../Z..~..(o. . .f~../}~..~.../..,?//.. . If applican~ ~orporate, si~mure of~ly authorized O~tcer. ....................... ................ (Nome and title of co~orate officer) Builder's Lic~se No .................. ~ ........ ~ .................... ~ Other Trade's License No ............................................... ~l ~ / ~ ~/ .~ ~. ~o~,tio. o¢ ~..d o, ~hi~h ,ropo~4 ~or~ wi, ~e~o.,. M~p No.: .~¢~.~o~ No....:~ .................. s~re~, ,nd N,~er ~......U~¢.~..~d~.....~.~ .................................................. ¢~.~E48.2 ............ Municipali~ 2. State existing use ~nd occupancy of premises and intended use and occupancy o¢ proposed construction: a. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy ~.....~...'.~... ,..~.....~.''/~,-~-.~ Ap?ii(orion Received Type of Development Proposed: Addition and/or Alteration[] Other (specify) .- ~ , Disapproval ~u~ ,, Pe~uit ,t ~ 19 ! 7o APPLICATION FOR DEVELOPMENT PERMIT In the Town of Southold New Structure (including storage ta.nks~ Flood~Proof Below Base Flood Elevatzon~ 2. Elevation Data in relation to above mean sea level of: (a) Lowest floor elevation, including basement ~//~ feet -~. inches (b) In a V Zone, bottom of lowest structural member feet inches 4. Owner of Premises ~/~_.~/~ Location of Property: County Tax Map No., District, 1000, Section~y__ Block ~__ ~'~ Lot( Subdivision ~C~~ ~~__ Filed Map ~ 6. ~rmlsslon ~o be g~nted. L_~er as abovej iNew Owner J jUnder Contract] J LesseeJ~Contractor .. ..... 7. Approval from other(s) before Pe~it is issued: DEC ~/~' ~--~ WmLANDS (Town Board) BUILDING PERMIT PLANNING BOARD ~/~ 8. I, , the applican%, ~ %he Ownem~, Co- O~er[~W-0'wJe~~SY'~nBrac%}~, Lessee~ ~, Agent~--~," Con- Bracto['~, and agree ~o comply with all applicables?(%ions of the Code of the To~m of Soughold; Connty, and StaBs ~d %o a~B authorized in- spectors %o premises aughorized to pemform om have pemfopmed the said work ~d Bo make and file this application, %hat all s~atemenBs contain- ed in this application are true %o %he best of my knowledge and belief and ghat the work will be performed in %he mannerseB forth in the application filed %h~rewigh.~~~~~ COUNTY OF~__ SS SWORN T0 THZS /~% DAY Applicant's mailing address and phone # if not given above: l,/8n