HomeMy WebLinkAbout11369-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the BuildJn8 Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No.%1303.0 .......... Date ...... .J. tlly. 9 .................... 1~..
THIS CERTIFIES that the building ................................................
carl nofPronertv .400. Betts Street. Cutcho~u. 9..'
Lo o - - ~o~-;,~vo[ ....................... ~'b~i ......................H~m~
County Tax Map No. lO00 Section 1 .1.0 ......... Block . 0 {~ ............ Lot . ~)Q.q .............
Subdivision... X. .......................... Filed Map No. g ....... Lot No. 3. ...........
conforms substantially to the Application for Building Permit heretofore fried in this office dated
· .,1 ~ 1 y..~ ~ ........... ,19,3 3. pursuant to which Building Permit No...t l 3 § 9..~ ...........
dated .. ,~ ~ p ~.e~ b e r..11 ........... 19/~ ]., 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 .........
The certificate is issued to .. [/.a.r.r.y..P.... F ~/,,~r~ ,..J.r., ,..&..~ g.e. ~. ~4/a.r.~e ................ (owner, im~.~r4~nt)
of the aforesaid building.
Suffolk County Department of Health Approval .... .n./.a. ..................................
UNDERWRITERS CERTIFICATE NO ........... ,q ~6~2~0 ................................. ...
1181
Building Inspector
FOEI~ NO. ~
TOWN O~ S~OU~ O~D
TOWN .HALL
SOUTHOLD, N~. Y.
euILDING I),E~M!T
, ·
N? i1369 Z
COMPLETION OF THE WORK AUTHORIZED)
Permissiod is hereby granted to:
......... ~...~..~ ...... ~..!...,.]...i ............... ·
~ , ,~,..,.......~~...,......,~.~ .......... ff....~,,
,o ..... ~~.,.~..~......~..~..~.~,~...,-~.-,.~..c.,../~..~:... ~./.~,~<..v ....
· .. ~. ................... ~/~.....i~...-..~.~.~..~....~...~.~...i ........... ~. ....
: ;::::
................. ,, ............................................................................. ~.....f ................ ~! ........................................
County Tdx Map No 1000 Secton ./. ,/.~,.. Bock '~,~ .......... .iLot No...~..~..~.. ........
pursuant to application a ............... .~/....7- ........ ,.'.: ............ ~ ...., - ~", PP Y
BUilding I~spector. ·
t=ee !$ ....... ~. ..............
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLE!~'S OFFICE
SOUT ~I~ hD, N.Y.
//./. ,> / r
NOTICE OF DISAPPROVAL
File No ..... .~ ........................
. . . ?/.o. . . ?.t!. ..... . .
~, ~ (~Tt~u~~
Date ............... 4.~.t V...~.,~9. ~.. !
PLEASE TAKE NOTICE that your application dated ............. .~?..Z.~/.....~..,~9 .~./.
for permit to construct... ~. ~.~).t.."~..Z.../~. ~. ........................... a~
~oo .~~ ..... S~f~.7....
Location of Property ...................... ''' '~ff
House NO. / / 0 Stroot
County Tax Map No. 1000 Section .............. Block ..... .~. ...... Lot
Subdivision ................. Filed Map No ................. Lot No ..................
is returned herewith and disapproved on the follow~g grounds... [ ~ ~. tE~-d. ~.~.t~ 7 .........
~ Y~Pb. A~7 ~"-. .... ~0.:.~1.
Building Inspector
100077! THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
85 JOHN STREET, NEW YORK, HEW YORK 10038
Oate June 14, 1982 /lpplicationNo. on/i~e 152832-82 N 5 6 5 2 9 0
THIS CERTIFIES THAT
only the electrical equipment as described below and introduc~ by t~ applicant named on tim able application number in the premlses of
~ Fa~ J~., ~/~ ~t~s ~., 300' ~/0 ~ ~., ~, ~.y.
was examined on and found to be ~n compliaace with the requirente~ts of this Board.
FIXTURE FIXTURES RANGES
OUTLETS SWITCHES INCANDESCENT FLUORESCENT
DRYERS
DISH WASHERS EXHAUST FANS
SYSTEMS
E
E R V
~,% A.W.G
C
AW, G
OF HI-LEG
NO. OF NEUTRALS
AWG.
OF NEUTRAL
Ruland Elec. Co.,
P.O. Box 143,
~t~;i~uck~ N.Y. 11952
Id~c~ 24ZE
)lNG THIS COPY OF IN ANY MANNER.
FIELD i~SPECTION COMMENTS
FOUNDATION (1st)
FOUNDATION (2nd)
2.
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
G,ODE
FINAL
ADDITIONAL COMMENTS
APP~OYED AS NOTED
FEE:~/~~ BY:
HOTI~ ~'.YL~)NG DEPARTMENT
7~5-1802 ~ AM ~Q 4 PM FOR THE
FOLLC~ ":~ '~:?ECT)ONS:
1. FeU~ - T~/O R~QUI~ED
FO? ~ CONCRETE
2. RCU~~ ~ ERAM~NG & PLUMBING
4. ?N~L - .~NfTRUCTION MUST
ALL COf<~E2: 'C~e~4 SHALL MEET
THE RE~U~EE?,E~TS OE THE
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
t
FOR~ NO. !
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN GLERK'$ OFFIGE
SOUTHOLD, N. Y,
E em,ned ........ ............ , App,cot,on ..............
Approved .~ ....... ~ .............. , 19~.. Permit No, ...~..~ ......... ~., ...............
~,,~pp,o~ ~/~ .'~ ,~...~:.,~.. = ~ ..........
.... ...... ......................................
.................... ....
~to ........ ~u~z..~2~...5~5 .............. , m ............
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 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 o Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of o 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.
(Signature of applicant, or name, if a corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Bu~.Zde~ .....................................................................................................................................................................................
Nome of owner of premises .....'fl~:.~..~...'~agan.,..~.r .........h ...... .~... ......................................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No .................. .4..7. ...............................
Plumber's License No ........................ .~...,,~ ...........
Electricians License No .... ~..(.......,/....~..~..~--~.[-~-~.~.~',~
Other Trade's License No ............................................... /
Location of land on which proposed work will be done. Map No.: ........................................ Lot No .........................
Street and NuZ~b~er° ,,~,e.~,,~,,~,,,,S,.~,~,e.,e,~,,,.C,~b,,o,~,u.~.,~..~g~ ..............................................................................
/ Oa~ ~ /~ o ~ ~ ~ ~ Municipality
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy ........... d.~f~.]L£p.~ .....................................................................................................
b. Intended use and occupancy ........... ~.~..e..1.~.~.~
'? Nature of work (check which applicable): New Bui!ding . ................. Addition ........... .~ ..... AIt'eratio~ .............
Repair .................. Removal .................. Demolitior'. ................... Other Work ..................................................
/' (Description)
4. EstimatedCost....... °.................................... 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. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...........................
7. Dime,~sions of existing structures, if any: Front ...~.~...~..7.'.'. ......... Rear ..~..8.:...~..7.]'. .............. Depth ..3..8..'....~...~.'....
Height ...~.{~.~ ................. Number of Stories ~
Dimensions of same structure with alterations or additions: Front .....3..8......~...7. .................. Rear ...,3.8..'....]f..]~ .........
Depth ..... .4.~.:....~...§.'.'. ........... Height ........... .~.~.: ............ Number of Stories ........... ~.½ .................
16' × 0" ,~ i6' 8'
8 Dimensions of entire new construction: Front .................................... ~ear ............................ Depth ........................
Height tO' Number of Stories 1
9. Size of lot: Front ......... 1..0..0..'. ........................................ Rear ...........~.0..0..'. ........................ Depth ....... k.0..0.; ..................
~. Date of Purchase ......... 7.~/.[..7.~/..7.~. ................................. Name of Former Owner A~f.l:.~.~.~[,...~f~,l;;i.~ .....................
11. Zone or use district in which premises are situated ..... Sn~.t;;h.q~-.c]..:~.o~'~ .....................................................................
12 Does proposed construction violate any zoning law, ordinance or regulation: .......... ~..e..s. .......................................
13. Will lot be regraded ........ z.e..s. .............. Will excess fill be removed from premises: ( ) Yes (×) No
52 Lincoln Ave.
]4. Name of Owner of premises ..]~aZ~'~..~'.,..,~,,...5.= ............. Address V~]~i.~p..St~[j~M.;,.N.PC?ne, -- No....Z3.~.Sf)f}~...
Name of Architect .............................................................. Address ................................Phone No .......................
h~or3!9 of Contractor ........ ~.o..~.fl..H.;...~,..a~t.~..u...s ........................ Address .C..u..t..c..h..°.fLu..e.z..~.'.X:... Phone No..7..3..4.7..6..8..6..6. .....
PLOT DIAGRAM
Locate clearly and distinctly ail 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
~h~ther inter;or or corner lot.
................................................................... being duly sworn, deposes and s~ys that he is the app[iccr, i
(Name of individual signing contract)
above named.
................... ..............................................................................................................
(Contrac~agent,~ corporate officer, etc.)
of sold 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;
that the work will be performed in the manner set fo~h in the application filed therewith.
Sworn to be~ me this
....... o, ...... , ...... ,1
~ota~ Public, State of ~ ~ork
~o. 52-03~63 Su~olk ~un~
~mmission Expire~ March $0, ~