HomeMy WebLinkAbout11404-zFOB~I NO, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-19841
Date APRIL 8~ 1991
THIS CERTIFIES that the building
Location of Property 2000 KENNYS ROAD
House No.
County Tax Map No. 1000 Section 59
Subdivision
ADDITION
SOUTHOLD~ N.Y.
Street Hamlet
Block 3 Lot 15
Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 24, 1981 pursuant to which
Building Permit No. 11404-Z dated SEPTEMBER 30~ 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 BEDROOM & GARAGE ADDITION TO EXISTING ONE FAMILY DWELLING
The certificate is issued to
(owner)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
JAMES R. WHEELER
PENDING - APRIL 8~ 1991
U~. Buildi~ ctor
~ '~"~ -- e'
Rev. 1/81
(THIS PERMIT MUST BE KEPT ON THE P'P, EMISES UNTIL ~ULL
COMPLETION OF THE WORK AUTHORIZED) i'
Permissiod is hereby granted to:~ , ~ ~
Coun~ Tax Mop No. 1000 Sect,o~ ............ ? Bilk ~,..,~ ............. ~ t N .? · ...................
fo doted ~...; L...Z...., 1~ ~nd 9pprov~ by the
TO~N OF ~OUTUOLD
~UILDING DEPARTMENT
TO~N HALL
~O~THOLD~ NEN YORK
765 - 1802
11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDiNG.~...VACANT LAND ........
Location of Property .... f~Q.~...~.~Q~ ........ ~Q~Q~ .............
HOUSE NO. STREET IIAMLET
Owner or Owners of Property ............ ~q~q.~.~ .....................
County Tax Map No. 1000 Section q~q~ Block ..~ Lot ...~.~~0
Subdivision ....................... Filed Map ........ Lot ..........
Permit No ........... Bate of Permit .......... Applicant ...................
Health Dept. Approval .................. Underwriters Approval ..............
Planning Board Approval ................
Request for Temporary Certificate .......
Final Certificate
XX
APPLICANT ....
A~ent for James R. Wheeler
rev. 10/I./,/88
THE NEW YORK BOARD OF FIRE UNDERWRITERS :!
~(}?'J~5? BUREAU OF ELECTRICITY
~- eS JOHN STREET, NEW YORK, NEW YORK 10038
THIS CERTIFIES THAT
only the electrical equipment ~ ~scrib~ be~w and introduced by t~ appllca~t ~m~ on the a~e application number in the premises of
in the following h,ca~ion; ~ Basement ~ Ist Fl. ~ 2nd ~. (~/ OUT Section Bilk Lot
wes exarnlued on ~P~ f ~.~ O] . '[ ~)9 ] and found to be in compliance ~'ith the requirements ~f this Board.
FIXTURE FIXTURES RANGES %OOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS SWITCHES
FLUORESCENT OTHER
DRYERS FURNACE MOTORS
FUTURE APPLIANCE FEEDERI
TIME CLOCKS [JNIT HEATERS MULTI.OUTLET DIMMERS
SYSTEMS
NO. OF FEET
SERVICE DISCONNECT S E R V I C
OTHER APPARATUS:
el~etri,'a} ecD~iplaenl 5,a the
.o. %,%¢o.o.
CUS"CHOGU$,;, NY, ~
AW, O
OF CC COND
A, W.G. NO OF NEUTRAl
OF HI-LEG
GENERAL MANAGER
This certificate must not be altered in any manner; return to the office of the Board ifjncgrrect. Inspectors may be identified by their credentials.
ALTERED IN ANY IviANNER.
FIELD INS~EC~ON COMMENTS
FOUNDATION (1st)
FOUNDATION~ (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
C,ODE
FINAL
ADDITIONAL COMMENTS:
[~ ~0 -~'q- D ~.-/5-BUILDING DEPT.
INSPECTION
[ ] FO/U~ATION 2:ND [ ] INSULATION
[ ]F~MING~- ~AL
REMARKS:
DATE ~'./.~/'~ /
Examined .~ ~.~?. , 1 ..~.../...
Approved . 1 ~.../...
Disapproved a/c ..............~:-;~ .........
FORI~ NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
Sou~rHOLO, N. Y.
Permit N~ .............
Application No././.....~...~..~... ............
APPLICATfON FOR BUILDING PERMIT
........... · .................... ,
Date 1 c~
INSTRUCTIONS
o. 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 shdwi~g location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and giving a detailed descr pt on 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 '~ 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, and regulations, and to
admit authorized inspectors on premises, and in. buildings for necessary inspections.
(S'gnaturei of app~cant, eft'name, if a corporation)
........ ................... ...........
State whether applicant is owner, lessee, ag~ ar.chTct, engineer, general contractor, electrician, plumber or builder.
.....................................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ......................... ~....... ..................
Plumber's License No .... ~. ..........................................
Electrician's License No. ~ ..........................................
Other Trade's License No ...............................................
1. Location of land on which proposed wo~:kw be done M~n No' ~..~
Street and Number ~ t~l ~'d,~' Cr~ ~..'7-'/~/~?-~ ..... ~'""' ..............................................
,,~ '71'" '"r --,~>'v'...~, .............. '~.: ·..;~ ....... 2'" .............................................................
~ -~c~ o c~ (/ / Municipality
State existing use and occupancy of premises and intended use and occupancy~of proposed construction:
o. Exisiting use and occupancy ..... /....~.~..~.
~' ~-' .......... ;"O ...............................................
b. 'ntendeduseondoccupancy~....~.~... ~/~..x.~/_~ ~7Z_~~ ' ..
3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................
Repair .................. Removal .................. Demolition .................... Other Work ................................................ .....
..~...~ (Description)
4. Estimated Cost ..... ~,..1~/-~.~ ................................... 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. Dimensions of existing structures, if any: Front ...... .~..~. .............. Rear ...... ~.~ ................... Depth -~..~..~...~..~. ......
/~-
Height .....~ .......... Number of Stories ........... ~-.....~...-~. .......................................................................................
Dimensions of same structure with alterations or additions: Front ..... ~.~...? ........................ Rear ..~...~... ....................
Depth ..:~.~-.~.. ...................... Height ........ ~ .~... ............. Number of Stories ....... ~...~. ...............
8. Dimensions of entire new construction: Front ......... /..~..- .................. Rear .......... ~. ................ Depth ....~.. .................
Height ....~....G. ......... Number of Stories ....-./'.........~.....~-. ..............................................................................................
9. Size of lot: Front .,~.~ ............................................ Rear ...... .~....~.~....: ..................... Depth ..~....~...~.....'~. ...............
10. Date of Purchase ..: ..................................................... Name of Former Owner ........................................................
! 1. Zone or use district in which premises are situated ......................................................... ~../.../~...~..-~....~ .....
12. Does proposed construction violate any zoning law, ordinance or regulation: ............................... '-7_ ...................
13. Will lot be regraded ............ ...~...~ ....... Will excess fill be removed from premises: ( ) Yes (~') No
14. Name of Owner of premises .J.~...~......~..~..~.... .......... Address ~........~..:...~P~h~oneT-~o. ......................
Name of Architect ............................................................ Address ................................ Phone No .......................
Name of Contractor '.~././~.~....~.. ~ ~...~.' Address '7' ....... ~'=~'~_~..~
.............................................. ~. ~.~,7~'~'~- ' Phone No.
PLOT DIAGRAM
Locate clearly and distinctly all 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
whether interior or corner lot. ~.~)(~3 · ~3¢'y ~
ATE OF NEW,'~OI~I~, ~ [ c c
......
.......... ~.~ ................................ being duly sworn, deposes and soys that he is the
(Name of individdal signing contracO
above named.
He is the ............................... ~ ....................................................................................................................
(Contractor, agent, corporate officer, etc.)
of said 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; and
tho~ the work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this ~ ~,)
....... ...~.....~....L ...d,~.. ~ fo: :. ~) .......... , 19 ~l..........~:~,: ~~ ........................
Notary Publi~..~i~~ ...... County .
DATE: "QB.p. :~ ~
765-18~2 9 AM TO 4 PM FOR THE
C~ ~SZ