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Home My WebLink About11387-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificnte Of Occupnncy THIS CERTIFIES that the building ................................................ Location of Property . .q3.0 .~l~qtlk .L~aqea .(;qt.c~h.o. gqe .................................... House No. Street Ham/et County Tax Map No. ]000 Section . .0.9.7. ....... Block .0.3. ............ Lot..qo.q ............ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore Filed in this office dated ·..~ellt;eahet .1.6 ....... 19 8~.. pursuant to which Building Permit No .... .1~8..7.g ............ dated .Segt:emb,~: .23 ............... 19 .SJ.., 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~g. I, el~a.t~t~ ............................................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~l& ..................................... UNDERWRITERS CERTIFICATE NO... N§§t~9 [9 ........................................ Building Inspector Re~. 1/81 ~ TOWN TOWN iHA£L , SOUTHOLD, N~ Y.. r ~ BUILDIHG pE~iT:~, ~ (THIS PERMIT :MUST BE KEPT ON THE PREMISES COMPLETION OF THE woRK AUTHORIZED) ~ ~1387 Z · Date;,-- t uNTIL ~ULL Per~nission is hereby granted to: · ...... ..c...~<9.. .... .~ .... ......~.~..~~..,,,...~...~%......~/., at prem s~s located at .~ ...... . ~ p, Urs~ant to application dated ~ 'k ..;.v.4...{t ...... ] .., and approv~ by the :B~ fling ~spector FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 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 disposal-(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 Amhitect 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 premises, or other pertinent informa- tion required to prepare a certificate. Fees: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 New Building .... .~ ....... Old or Pre-existing Building .... Z ..... Vacant Land ..... --. ....... Location of Property ....~....~. ~.O. .............. S.,~ ~. ~. ~,.. ~.~..~...~. ..... .~.~.-~..~..NI.Q .~ .L{ ~ House No. Street Hamlet Owner or Owners of Property .... k .~. ,{'~ m./~. ~ ~..I. ..~. .~..f~..i.~ .... ~ A,i.~.., ~..~'... ........... county Tax Map No. 1000 Section .... O..~..~. .... Block ..... ~.3 ...... Lot..~..O..~. ........ Subdivision ......... ~..~) ~..~ ................ Filed Map No .... ~ ..... Lot No ..... ~ ....... Permit NoJ/~..~..~. ..Z. Date of Permit ~J '~'~"l ~?' .Applicant...~.~J~.l.(~...~..~. ~/~./r~./~..~. ..... Health Dept. Approval .......... ~../~.~...'. .... Labor Dept. Approval ....... .-'7 ............... Underwriters Approval ..~.. 5 .~..~..~t. ~..~ ........ Planning Board Approval ...... '~. ............... R st f Temporary C rtificate -- Fi I C rtifi ,.~. eque or e ..................... na e cate .................... Fee Submitted $..~-. ,.~).0...Z .............. Constructi,on on above described building and permit mee~ al~Pa~plicable c(~des and regulations. ~-~ ,, ~, ~ /~ppucant .~..~..; .......... _. .................... 1000121 THE NEW YORK BOARD OF FIRE UNDERWRITERS T~ BUREAU OF ELECTRICITY V 85 JOHN STREET, NEW YORK, NEW YORK 10038 Bate Mard% 24, 1982 ~p. lic.,ion No. onfi,~ 145111 ' 81 N 5 5 4 9 ! 9 THIS CERTIFIES THAT only the electrical equipment as described belo~v and introduced by the applicant named on the ab°ve application number in the premises of in the following location; ~ Basement [] 1st FI, ~ 2nd II. Section Block Lot -,a$ ~,~a,,~,,ed on March. 22, 1982 and found to be in ,'ompliance witb the requirements of tkis Board. FIXTURE OUTLETS DRYERS FIXTURES RANGES OVENS DISH WASHERS EXHAUST SYSTEMS OTHER APPARATUS: 2-Blanks Panelboard/s : 1-16cir. 100amPS. 2-G.F.I. 1-Smoke Detector R R OF CC. COND, 3 C OF HI-LEO NO, O~NEUTRALS AWG. OF NEUTRAL 5 J~ This certificate must not be altered in any manner; return to the office of the Board if incorrect, inspectors COP~ FOR BUILDING DEPARTMENT. THIS COPY OF ~Jkii~ICATE MUST~NOT BE A~LTERED IN AN MANN R .... ~ Y E. FIE~D ~SPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY GODE FINAL COMMENTS ADDITIONAL COMMENTS: FO~h'3 NO, 1 TOWN OF SOUTHOLD BUILOING DEPARTMENT TOWN HALL TEL,: / D,,.vp, ovid ,/~ ...... :~..~.~.. ..... -~ : ...... fl ......... I ~.~. / (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No ................ INSTRUCTIONS a. This application must be completely filled iu 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. schedp, le. b. Plot plan showing location of lot and of buildh~gs on premises, relatlonsh[p to adjoining premises or public stre~ or a~e.,.s, and giving a detailed descziption of layout of property nmst be drawn on the diagram which is part of this apg cation. c. The work covered by this application may not be commenced before issuance of Building Penuit. d. Upon apprc.'al of this application, the Building Inspector will issue a Building Permit to the applicant. Such peril shall be kept on the .memises available for inspection throughout tile work. e. No buildhlg shall be occupied or used iu whole or in part for any purpose whatever nntil a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION 1S I IEREBY MADE to the Building Department for the issuance ora BuiIdingPennit 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 ]'be applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectoTs oll premises and in buildings for necessary inspection[,~ ~ · ~.o.~.. !¢..6..-.~..~v~..~...k~.,.,?.~.-~.e.~.~ ¢.,. ~...,/:. (Mailing address of applicant) t1~- State whether applicant is o~ner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build. ......... 0 .u0 fl..( P, ............................................................................ N,,,nc or o,,,ne~ or prc,,~ses .... ~..~ ~ ~ fa..fl..o..~ P_..~ 0..~.../3 tu. o...¢.E.. ............................. (as on the tax roll or latest deed) Il' applicant is a corporation, signature of duIy authorized officer. (Name and title of corporate officer) Builder's License No..TO..b.(.. t>~T.(.~. Pit .t¢.~. P. Plumbers L,cens. No ....... -~..~.7.-. IO. EL'ctr'c'a~sLicenseNo. eQ ~'~ ' ~ Other Trade's Liccnse No ...................... }3-(.,)0/. ~/'4UE,q ,_%_~'c~,qf>CL/..C ~og~ Location of land on wl~icb proposed work will be done... ~. 7 .h ~.~ ~ ~.. ~.' .... ~. ~ ~ b.~ ¢~.'[0...~.lP~ ~.~ · - .~6x . .[~ ~ ................. .~.~.~ .... ~8.~.~ ............. ~.~T.~ ~.e~ 9.~ ................ House Number Street ttamlet County Tax Map No. 1000 Sectiou ........ ~.~ ....... Block ........ ~ ........ Lot ....... ~ ......... Subdivisi'on .................................... Filed Map No ....... % ....... Lot - (Name) State existing use and occupancy of premises and intended usc and occupancy of proposed construction: = a. Existing use and occupancy ~gS D~D~ ................... b. Intended use and occupancy ................. ~.~ ~. ~ ~. N:~,ulc of','.',~,ii: (c!:~Ck ..... ',,~: !N llk') " · ........ .... '' ' ........ Repair ............. ?, :m~,.'al .............. Delta:lit]on .............. f)~,hc~ 'Y~rk .'...: ......... oo.oo (to lc paM on ~llng ~his application) ;. If dwclling, number of dwelling units ...... [ ........ Number of dwelling u:~its on each floor .... ~ .......... Ifa'ar;hle, number of cars .... ~ ........................................................ : ......... ' fb~siness co 1 Icrc: or::l xedoccu'~a cv s~ec~y~otureandcxtcntofcachtypeofuse .... ~ ........ .-.-;... ..... . ; Dmwnsionsofcx~stmg~m~cm~ss,~fany. Front ..... [~ ........ R~ar ..[ ........... Depth ............... Height ...~.~..~ ...... NumbcrolStores ~ ~ .................................... }.-¢, ....... Dimcnsionsefsamestmcturcwid~.drerationsoradd~ti~ns: F~ont ...~B.~.~ ........ Rear ...~g...~ ........ Depth ~ ~ ( llci~t ~ .... Number of Stones ..... ~. ~ ............. i. Dimeusions of entire nvw construction: Front ..... ~ ........ Rear ............... Dcpth ............... Ilcmht ............... Nt.mLcr of Stones ............................................... , ......... Ciz~*~flot' Front 100 Oo / Rear 100,oo.' ..... Depth 'xI ~'QP ...... x .... ). Date 0f Purchase ~g~...tl, .I.q k~ ........... Name of Former Owner g¢[~T..g~A~ma~P.,.6~.. N..'.. I. Zone or use district in which premises are situated .... ~.~1 ¢.eMrlq.~.. ~ ........... .................. ~. Does proposed construction violate any zoning law, ordinance or regulation: .... 1. Will lot be rcgraded .... ~.O ..................... Will excess fill be removed from premises: Yes X No I. Name of Owner of prc:mses~gfl.~¢..¢¢~aO~. ~.U~ Address ~m~. ¢~.,~hone No.. 9.ag.-P.~ gY .... Name of Architect ........................... Address ...... '... i ......... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly ,all buildings, ~vhether exisfil:g or proposed, and. indicate all set-back d:.m~'nsions fxom ~operty lines. Give street and block number or description according to deed, and show sheet names and indicate whether tcfio; or corner lot. r,\lE OF NEW ~RK ou,,,rl.¥ OF ..... ...... ~ U _&~.__ .~:J.~.../.-?. 14 m ~ ~ being duly sworn, deposes and says that he is the applic2nt (Name of indMdual signing coutract) ..... .... ................................................................ (Contractor, agent, corporate officer, etc.) said owner or owne~, m~d is duly authorized to perform or have performed the said xvork ~d to m~e and file ~xis >plication; that all statements contained in this application are truc to ~t~e best of his knowledge and belief; and that the ork w~l be performed in the m~ner set forth h~ the application filed E'ercwith. ~om to before me this .............. iA .... ........ t a~~ I~. '~'. ',;,. ~Co u n t y " ' ~ T~ B~I~ M~ a0, 1~ ' ' .... ~ .... USE IS U~L~V~FUL ~Yfll{~'i' CERTIFICATE OF OCCUf~ANCY NOTI~,TTi,?%',~g PEPART~ENT AT ~ATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. I 1:I k :~ 8-7 -[: ': ..... /~ODItqOt4~ .J..~ 5 ,%, 1 I -ri,,,- L~ tl