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Home My WebLink About11371-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. ~ERTIFICATE OF OCCUPANCY NO Z-22971 Date APRIL 28, 1994 THIS CERTIFIES that the building ADDITION Location of Propert~ 1085 BAY SHORE ROAD OREENPORT, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 53 Block 3 Lot 13 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 3, 1981 ~ursuant to which Building Permit No. 11371-Z dated SEPTEMBER 14, 1981 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 ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ROEERT & BARBARA HOLLE¥ N/A H-040081 -MARCH 29, 1994 N/A Rev. 1/81 l~zng Inspector N? TO~N iHALL SOUTH'OLD, I",l, Yo BUll. DING p,ERMiT (THIS PERMIT MUST BE KEPT ON '-~HE PREMISES UNTIL· IULL COMPLETION OF THE WORK AUTHOR ZEb); . ~-- ' -- 13 71 Z Date .....~'~..~..a; ~...~,.. .......... , 1~ ...... Permissio~ is hereby granted to: .............................. ~.~...~. .............. ~...~....~... ......... ,..,. , at premise' Io,ated at. Z~X Z ~ ~: ~. '~ '¢~~/ ~ ......~ .... ; ............................................................. ~ ,..~ .......... ....~ ................ ~. ........... ~ · ......................... ...... .......... ........ z co.,~ ,~ ~o~ ~o: ~0~o s~:,o, .~:&...,.,. ,~o~k ,.~......,....,.~ ;. ................... pursuant to~ apphcat~on' ' dated ~ ' ,'~'".'"'~m'",: ~1~., and opprov~ by the Building I~spector. : Form No. 6 TOWN OF'SOUTI~LD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). · ~.3. Approval of electrical installation from Board of Fire Underwriters. ~. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6.Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and Vpre-existing" land uses: ~1. Accurate survey of property showing all p~operty lines, streets, building and unusual natural or topographic features. ~2. A properly completed application and a consent to inspaot signed by the applicant. If a C~rtificate of Occupancy is denied, the Building Inapector shall state the reasons therefor in writing to the applicant. C. ~ertificate of Occupancy - New dwellinB $25.00, Additions to dwelling Alterations to dwel~ing $25.00, Swimming pool $25.00, Accessory buildin~ $25.00, Additions to accessbry building $25.O0. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 · O10rPreexist~ Da~/ ~...~_~.~r ......... ~ev Construction .......... 01~ - ing B~i~diog .... .~. ........... ,ocation of Property..../.~..~.. Z~Z~.?~....~... ~.'.~ ............ '.. ~.z~.z~.. ....... House No. Street Hamlet wer or O ners of ..................... :ounty Tax ,ap No 1000, Sectio,...~2d.'' ...... Bioc~.... .....'-'m ........ ~ot .... .Z-~. .............. ubdivision .................................... Filed Map ............ Lot ...................... ealth Dept. Approval .................... n er~r ers rova ................. iaontng Board Approval ........................ equest for: Temporary Certificate ........... Final Certicate..~.. ...... ~ Su~mitted: $..4..~.. Z ................ ~ c. ~ ~--).~ ~// THE NEW YORK BOARD OF FIRE UNDERWRITERS 8046774 BURl[AU OF: ELECTRICITY [~ '~ lBS JOHN STREET, NEW YORK, NEW YORK 10038 Oate HARCE 29,1994 App:ic. tlon No. on file 05690594/94 H 040081 THIS CERTIFIES THAT only the electrical equipment as c~scribed below and introduced by the applicont named on the abOve applicotion nu tuber in the premises of BAP&3ARA HOLLEY, 1085 BAY SHORE ROAD, GREENPORT, N.Y, %~>:~ in thefollowlng location; [] Basement [] Ist FI. [] 2nd FL 0~ Section Block ,-~ Lot ~s examined on ~L~CH ~ '7 ~ ].99g and found to be in compliance ~ith the National Electrical Code. (.~ FIXTURE OUTLETS OTHER DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS AMT. K,W, alI. H.p. GAS H P AMT, NO, A,W.G SERVICE DISCONNECT t NO. OF I S j~ ANJ, AMP. TYPE.METER~ '~ W 4W NO'OFCCCO~ $~rve~ ha~ bee~ m~de~ ~e e~po~e~ unsattsfacto~ condition was found. RANGES ~ R TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET SYSTEMS ~T ,~PS. TRANS. ' ' NO. OF FEET V I C E EXHAUST FA~t$ DIMMERS 300 E~ST gOTH STREE'~ NEW YORK, NY, 1~6 GENERAL MANAGER This certificate must not be altered in any mann~e; return to the office of the Board if incorrect. Inspectgrs may be identified by their credentials. COPY FOl~ BUILD NG DEPARTNIE~F','~I $ COPY OF CEJ:JT!FIcATE M~BT NOT BE~LTERED iN ANY MANNER. NO OF NEUTRALS I A W.G. OF NEUTRAL 765-Z802 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: [/J~INAL "-jr T ,/ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL,: 765-1803 Examined .~..~ ../ .... ~..., 190~./. Approved .../. ~..., 19~.~.. Permit No..~.~e~.. 7./.. ''~. Disapproved a/c ....... : ~ w;-.-:-7 ..... ~.. .....~ ......... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ........... Application No././. .~W. ~. ~ ........ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi 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 px:emises or public stre~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apF. cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon apprcval of this application, the Building Inspector will issne a Building Permit to the applicant. Such peru shall be kept on the premises available for inspection throughout the work. e. No buildiug sbalt be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan 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 t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized iuspectors on premises and in buildings for necessary inspections. (Signature of applicant, or nd'me, if a corporation) ...... ........... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, .. /. . . . ...... /.7.c. ........................................................ Na~ne of owner of premises .... fie..~.e.~..t( . . . ~.'~a/,~.~./~ ............................................... ~ (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 No.....'~../.?.~. ............... Plumber's License No .... .,:~...'.. e~,zcd.d co....~..O?./o Electrician's License No.. '/'~' fiT.?..,~. ........... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ .... /. .o. 47 .... .y. . . . .... .xd. , ....... .-. , . . . ..... ,. . .)7: . ..... House Number Street O~'~' Hamlet ~.~~ County Tax Map No. 1000 Section~.ec.a.q.&..g3..~),,..4~,/e~... Block ....O.?. ........ ... Lot..t'~.; /.?. ...... Subdivision ~ Filed Map No. ./../..~.~. ...... Lot .~-.cd4.../.. ....... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy / .,.,.,~.qm.,~ b Intended use and occupancy ...... 1. Nature of work (check which applicable): New Building .......... Addition ...~. ...... Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... /f / <o- ~ (Description) Estimated Cost .... ~q..~ ~ .......................... Fee .......................... -~ ........... -' (to be paid on filing this application) ;. If dwelling, nmnber of dwelling units ..... ./ ......... Number of dwelling units on each floor ................ If garage, number of cars ...... .-7. ................................................................ L If business, commercial or mixed occupancy, specify hature and extent of each type of use ......... ~..., ........ 7. Dimensions of existing structures, if any: Front .... .'4..-~..' ...... Rear ....o~'..~.: ...... Depth ..... t7 ......... Height ..... /. ,.~.: ......Num her of Stories ....... /. ................................................ Dimensions of same structure with alterations or additions: Front ..... .'(.'?.: ....... Rear .... .~.(..' ......... Depth ..... ~.a..: ............ Height ..... ~d'..: ............ Number of Stories ...... ./ ............... 5. Dimensions of entir%new construction: Front ... ,alT-(.: ...... Rear .... ~.Z-6'.: ..... Depth ... ~. ';'.: ....... Height ...... .,(.d. ......Number of Stories .... /. ................................................... L Size of lot: Front .... d~.~.: .............. Rear .... ./.d..-5~.: .7.~.... ....... Depth ../.d.d... .............. ). Date 6f Purchase ............................. Name of Former Owner .... .~.,...IC.o .b. J g.t~ z.q .r' ........ 1. Zone or use district in which premises are situated ................................... : .................. 1. Does proposed construction violate any zoning law, ordinance or regulation: ..... ,e'ff~.~ ....................... ~. Will lot be regraded ...d~.*4' ...................... Will excess fill be removed from premises: JYe~f No L Name of Owner of premises . , o · .700 ,6- 19 r,, ,2/a -~ · .gi~...fl.,./,4., '.~ ..... Address .......... ~ ........ Phone No ...... 7....v.a. Name of Architect ..... ~.... ~.0'.q ~ ............ Address . ~'~-~,././r ~ ./~..g.~. ~ 6.~: Phone No....7~- .X~y..~.$.-.-$7..,~. Name of Contractor .... .g4d. :. ~.¢.r-.;.4-./ ........... Address .. ~/.,g P...Qe~,:-.. ~27;. Phone No.. 7.. g.~.''. 7./.~.~. ?.. ;-: PLOT DIAGRAM :' Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from roperty hnes. Give street and block number or description according to deed, and show street names and indicate whether terior or corner lot. TATE OF NEW YgeRI¢,x OUNTY OiN~.~n iii c on.t ~dc.t 3~ being d~t ly )ore named. sworn, deposes and says that he is the applic?.nt e is the ......... .~.a.~../r..a.,/a..,~. ................................................................... (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this >plication; that all statemcmts contained in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner set forth in the application filed ti~erewith. worn to before me this ........... . .~...&7-.41 .... day of...~., 19..~./ °tary eublic'~¥~'~' '~' ' '~' '~C°unty- ~ ;~J~rrl4 T. TE~RY ~ ~ ..~... ~.... ~.., N,o,~_ ry Public, State of New,York~ 1~52-034~cj63.~ so~b~t~ '~-~t~t~/~ ........................... Co~'~-tl~t~, &~.~,ll~'- (Signature of applicant) OCCUP~IC¥ OR US~ [~ UHLAV~FUL CERII[:ICATE Iff O~CU?AN,CY '" I )':9" :% kj r