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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