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Home My WebLink About11398-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z. 3 .q J/~.7. ......... Date .... ~. W~.u.~ L...q ~[ ................... 19 .'?. THIS CERTIFIES that the building ................................................ ~'32r . .......................... Location of Property . ;~.. ,:. ............ .~p.c.~y.. ?p.~.n. t Road East i'~ Pti:Q0.. House No. Street Hamlet County Tax Map No. 1000 Section . 02.1 ........ Block . ...0.1 .......... Lot .. 0.0.7 ............ Subdivision..S.~?.~.~.~.9?.~.~,,.~?.a.~.gF ......... Filed Map No. 3723 ..LetHe. 2 conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..~ ~ £).~.e.m.l?..e ?..1.8. .... ,19~ ]. pursuant to which Building Permit No...1.1.3. 9. {~..7,. ........... dated .... 4e. p .t~.~k~b..e .p..~9. .......... 19.8. '!, 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±vate one-t'a~:~ily d~ellin?;. The certificate is issued to . .. ~jrCqn..u ?.1..~. y.s,,,~ ~ .~.l.~.a.. lflp.qq .i .~:~q ....................... (owner,-~'es~e'or'ten~n't) of the aforesaid building. Suffolk County Department of Health Approval . 1 ] .- .g.q -. 9,5 .~.. 7. ./.2.2./.8. ~ ,..R. q .b .g.... ~. ,. )(~. k..~ ix.,. P.E. UNDERWRITERS CERTIFICATE NO. ~I 5 5 7 5 2 5 Building mspector Rev. 1/81 BUILDING DEP~RT~i TOWN HALL SOUTH'OLD, N~Y. BUILDING P,E~!7 COMPL~ION OF THE WORK AUTHORIZED) UNT L ~ULL Permissior~ is hereby granted to: ~, _.. ............ ~ ........... .~......,~,....,.,~...~.,..~ ~o i(-~./~.~'.~...~..~,. .......... ~.~..i ..~./~./,~../.~.~ ~,-~ ~,/././.~ ., ...... ~ ................................ ~"~"~*'"'":"*"~"*~'*:"*'/~"'"~'";:~"?'"*;'~ ........ 7'; ..... at pi'emise~ located at Map. No. ]000 Section ...~...~.../.........~._Block ......~.Z ....... iLar No. C;unbtyp rs antT~ appi,cation dated .: .~...../.....~...~ ......: :..;....i.....~ l~., and approved ......... by the Bui lng Irhspector ~; i ~e~· ...~.~'~'~' ~, Rev. 6/301 80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southotd, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 disposat-(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. 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 inspectio,,n of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. 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 Date .. ,,/ New Building .... ~'.-.P.~ .,... Old or Pre-existing Building(:~) ......... = fVacant Land -i ........... ,ocat,on of ..... .... .... ..... Hou~ No. Street Hamlet Owner or Owners of Property ........ ~' ~ ..... - -d ~ .... ~ .............. County Tax Map No, 1000 Section ........... Block ............ Lot.. ,~.~ ....... ,, Permit No.~.).~.~.~ .... Date of Permit .' ..~, plicant . ~e/~.~p. ~(.,...~/~ ........... ~C(~.).7~.~ Health Dept. Approval ...,. ';...: .'. ~- ............ Lauor uept. Approval ...................... ,.. Unde~riters Approval ..................... Planning Board Approval .................. ~ .. ~ Request for Temporary Certificate ..................... Final Certificate ................. Fee Submitted $..~...~i ....................... Construction on above described building anc~'~,~mit'meets ~1 app~,,~cable_,codes ,a/,~d regulations. Applicant .; .~~, . .. ,~'~.~ .................... 'r ,,'[ 'f,, ......... T ..... T T FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ........................ : ....... To ~./;.~'.,q'.~.~.e.~.-.~'.~.....~..O../'C.?.-~. ( .7~./. ~ .... . ,.~..~ ........ ~ ......... ~.. ..... PLEASE TAKE NOTICE that your application aat~a..~.., z..~ ........ ~9~ff.. for pemit to constrnct .... ~3~/~. ~ ......... :.'~ .......................... at County Tax Map No. 1000 Section ...0~ ...... Block ~ [ .... Lot ~ Subdivisio~;~{~. ~ Filed Map No ..... ~.T~.~. .... Lot No. ~ is returned herewith ann disapproved on the following ground~/~7.. ~7 ~C~7~,J~ -- / ................................... ......... ...,z. ~ Bhilding Inspector RV 1/80 FORM NO. 1 TOWN OF SOUTFIOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. ~1D71 FEL,,: INSTRUCTIONS Application No..//,,,~./~ff. ...... a. This application must be completely filled in 'by typewriter or in ink and s~bmitted" m' triplicate to the BuiJdi in'q>edor, with 3 sets of plans, accurate plot plan to scale. Fee according tc schedule. b. Plot p~an *howing location of lot and of buildings on ~ ~t.m scs, relationship to adjoining prem sea or public stre~ ¢.,r 9teas, andg~,'v'm=,, a detailed dcsczipl;oll of layollt Of properly must be drawn on the diagram which is part of this ap~' c. The work coYered by this app cation may not be commenced before issuance of Buikling Permit. d. Upon approval of tiffs application, tao Building Inspector will issue a Building Permit to the applicant. Such pern droll be kept on/l~e prc;uiscs available for ;nspection throughout the work. e. No building shall be occupied or used in v.,hok¢ or in part for any purpose whatever until a Ccrtificate of Occupan ::.~li have been grantcd by the Building Inspector. APPLICATION iS IIEREBY MADE to the Building Dcpnrtment for rite issuance ofa ]3tfildingPerm t pursuant to t Buit~ ~ Zoo Ordinance of thc Town of Soutbold, Sulfolk Cot : 5, New York, and other applicable I.aws, Ordinances Regulations, for thc coast~uction oF buildings, additions or :dterations, or tbr removM o] demolition, as hereht describe Fhe applicant agrees to comply with all applicable laws, ordiil:lllces building code, housing code, a id rogt lB[ions ~d ~dmit authorized inspectors on premises and in buildings for necessary inspects, a a (Signaturc of a~antflor name, if a corporation) (Mailing addres~ of'applicant) ~ State whether applicant is owner lessee, agenl, architect, ongincer, penmal contractor, electrician, plumber or build. ........... (as on the tax roll or latest deed) !f' applicant is a corporation, siDmtu~e of duly authorized officer. Builder's License No~ ......................... Phunber's Licensu No .... ~). ~Q.' !.~.q'v.~, .~..: ....... Electrician's License No.'. ~ 5(.~ [ ........ Other Trad='s Liccnse No...~.~.' ....... l. Locati:m of land on which proposed work will bo done .... ~'9~.W.' .................................. ..... ...... .............. House Number Street llamlet Cou,,ty Tax Map No. 1000 Section ..... .0. g. I ...... Block .... [ ............. Lot .... ~7 ......... Subdivision. ~Xa~.~A~.. ,C~ ZO, T~<., ........ Filed Mat, No. ,~. 7 t 7, ..... Lot.,~ .......... (Name) ~. State existing use and occupancy of premises and intended usc and occup~cy~ propo~d construction: b. Intended Use and occupan%, Nature,of work (chcck which applicable Repair Removal ;. If dwelling, number ofdwellingunits .. If ~arage, number of cars .... i,' If bufiness, connnercial or mixed occop~ /. Dimensions of existing structures, if any fS lleight ............... N ~ hero Dimensions of same structure with alten q'cw Building ....... Addition .......... Alteration ...... ...... Demolition .............. Other Work ........... ~ (Dcscriptio, .............. Fee .................... .r ........ (to be paid on filing this application) ;;:::; ................... x ent of ea¥:ypeoi ie... ....,..... .......... Front .. ~/.,~ ~..~...~ .....Rear .............. Depth ............ iories ..................................................... tions or additions: Front ....~.0...~j~.. ....... Rear ............... Depth ............... Itc g ~t ..... Nnmber of Stories ......... I.' Dimensions el entire new constroction: rent .. ?.~, .......... Rear ,, ~'.,~ .... kd.a,.' ' Del)th . .~.~. ........ Height ....... *.... :... l'~umber of S tones ... ~.P..~l ."~ :.;.k~..~t,,-r.. ~..,~-r. ,.,-,.,,..t}.. :,.a' '/ .......... L Size of lot: Front ...~O00/.. i .............. Rear ...."~ ~../. ...... · ....... Depth ./*M~.. ~...'t .......... ). Date 6fPurchase .... I. Zone or ns~ district in which pr~mises ~ ~situated...il~-p.~t~.~l~ .......... i:' · ...... D..o, es proposed constructkm violate any V~ ill lot be regraded ..... ./!/¢.: ....... Name of Own:2r of premises ,, Name of Architect Name of Contractor ...Og,t'~ tw.~.... :oning laxv, ordimmce or regular, ion: .... I~..°. j .................... ...... , ....... Will excess fill be removed from premise~: Yes ~' :,.r~.. ^0d~e~s .. ..... : ........... rhone Nkk.,.°,). ~?.¢>~q6 . .1~., Address . ~T. t2o7.''~ OOP. ~o ~ .... Phone No... .......... - Address Phone No PLOT DIAG RAM l.ocate clearly and distinctly all build ~vhether existing or proposed, and, indicate all set-back dimensions fi ropcrty lines. Give street and block nnmbe: or descrip'tion according to deed, and show street names and indicate whet tcrk)r or corner lot. I'ATE OF NEW ~OI[K, OUNTY OF...J.'". ~:Y.~. ~3.%:.. S.S (Name of indMdual s gn ng )or,2 nanled, ............ being duly sworn, deposes and says that be is the appli~ :ract) e is the ...... C ~ .~.~ .¢. ~...c/~...a_.... .................... Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly auth to perform or have performed the saki work and to make anti fi~e )plication; that all statements co~t,~ ~ed il this application are true to the best of his knowledge and belief; and that 'ork wdl be performed m the manner set fdbth in the application filed fixerewith. worn to before me this ~ N~VI~E PUBUC~ ~te.of New Y~ . ' . SUFFOLK CO. HEALTH D~PT. APPROVAL ~ STATEMENT OF INTENT ~E~ ~. D~ THE WATER SU~LY AND SEWAGE ~ ,~'/~ ~ SYSTEMS FOR THiS RES,DENCE W,LL D. ~. ~~ . CONFORM TO THE STA~ARDS OF THE disposal ~ ~ater s,~ply SUFFOLK COUNTY D~T. OF HEALTH // - il H. S. REF. NO.~ A~ROVED: ~ -- - ,{. . "...'. . . " , ,, ...... ~'' " SUFFOLK CO HEALTH Arr~OVAL ' H.S. NO. ~-~ .:~ -4¢:5~ / . ' ' , ' -. '. ' ' , ~ [ ~[' ' : ' THE WATER SUppLy AND ~WA~-D~AL : ~ ' . // '' SYSTE~ 'FoR THiS R ~OE~-E WILL , . ' . ' , r,.~"LE ~ //It CONFORM TO THE STANDARDS oF THE ~.. : ..~' , .' . ' -' .. : '~~: Lu- - // StRV,cES:FO. a~..'OV'~L :.. .:: ::... --. .:.:: :':- ~ ..,.:~ :: . . . . .:-' :... : :.:.:.- ::. :::i, .. ~.~ .~;-:,:¢:::.:::?...} -: , . ~ .. ~ . . ~ .: ~.:~ .-, . ,,. .,.=. ,. , . . ~ - ...:: . ~ . _ , :. . .. ...... .-. ..... ~.. ~-. . ~ , . . ., :~ ~ .~. . . . . ............ '~ ].oo:[o71 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY J 85 JOHN STREET, NEW YORK, NEW Y~)RK 1OO38,' ,,,,,e 29, 982 ,ppiic,,,io,,No.o,,f.e .S33 S - 82 567525 THIS CERTIFIES THAT only the electrical equlpo~ent as described below and introdu~e~ by the, aBP~ica~ ~arned on the_ above_ ap. plipa, tion_ number in the premises of F~m-m~l Moraitis, Roqky Point ~., w/stoa almost Co w/Brick Front, Ease Maki~p N.Y. was examined on Jl.~ie,&~ ~ .k 9'~ Section Block Lot and found to be in compliance with ~he reflulrements of this Board. FIXTURE OUTLETS 33 RECEPTACLE~ 47 SWITCHES 33 33 FIXTURES RANGES OVENS EXHAUST FANS FLUORESCENT DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATEg MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: Pan~lboard/s: 1-10cir. 125a~p$. 1-~.F.I. 2-Smoke Detectors S E R V I C OF CC COND. PER ,~ AW.G. OF CC. COND 2 NO, O~ HI-LEG AWG. OF HI-LEG NO. OF NEUTRALS A. WG OF NEUTRAL 2 G & S Elec, Box 215 $outhold, N.Y. 11971 COPY FOR BUlL THIS COPY OF ANY MANNER. FIELD INSPECTS'ON ~ FOUNDATION ( 1 st) FOUNDATION (~nd) 2. COMMENTS ~ .__~ .... ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,.ODE FINAL ADDITIONAL COMMENTS: ¸7', 12. THE ALADDIN COMPANY: ~PECIAL NOTICE I, O#E~ WITH IIItllNG IN~EOTOR TO SEE IF WINBQW SIZES MEET LOOAL ~ 2. FIBERILASS RI)IX: ~ NOW BEII~ FURNISHED IN PLKE OF ASPHALT SHINGI,~. 1 765-1802 9 AM TO 4 PM FOR THE FOLLOWING lb~STECTIONS: 1, FOUNDATION - ~O REQUIRED FOR POUR~D CONCRETE 3. INSULAT?N 4. FINal _ C~NSTRUCTION MUST ~ATE CONSTRUCTION & ENERGY CODES· NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERROR~. BAY o ~='~.o,4-r ClTY,, MICH'IG .,.. ,*4 I ,'% ,I _ 31 x~,~, xx i