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Home My WebLink About11414-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No...gl 1.15.2 ........ Date ........ ,q..tl&k~ a.t,..2z* .............. 198.2.. THIS CERTIFIES that the building a~,d:tt:l.~n ...................................... Location of Property .. ~ .~5.O ............. Ca~.l~,:tla..K~.~I~..I~l~..v.e. .......... ~a. ~.~$.~.u.$l~ House No. Street Hamlet County Tax Map No. 1000 Section .. 106 ....... Block ·. ·02 .......... Lot.. ,0.46 ........... Subdivision...Cap.t,,. K:Ld.d. B~.faat;o~ ....... Filed Map No. fi. 6. 7.2...Lot No...1.5.0. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. ~ept~ezaber. 2.9 .... 19.81 pursuant to which Building Permit No... J.1.4.] .4..Z. .......... dated ....(lct, ob~.r.. 5 .............. 19 .SA, 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 ......... ..... an..add~,.f,.Lon..g.a .ex't=,gSr~g .~r~$.l,J, gg.0 .................................... The certificate is issued to ......... Cl~r. J,$..& .~101t~qO..P~.p. p .a.~ ......................... (owner, la~,~e, ar,4~eea,t~. of the aforesaid building. Suffolk County Department of Health Approval .... la~.a .................................. UNDERWRITERS CERTIFICATE NO ............ .}I..5. ~ ~}.0.6.~ ............................ Rev. 1/81 Building Inspector TOWN~O~ii BUILDIN~ TOWN H~LL ~ SOUTH'OL~Di N~. Y~ BUILDING eERM!~ ;: Permissiot~ is hereby granted to: ...... ~.~.~...~.. .... (THIS PERMIT MUST BE KEPT ON THE PP, E/~IS~S UNTIL ~ULE COMPLETION OF THE WORK AUTHORiZ~D) Dote ..~, ..~..~..~,.~..~..~.~...~,..~. ....... , 19.~..../ at premise~ located at ..~.. ............. .~.,...,.~.. , ...~.~ ........ ~ : :;:; · ....... .... C~ m~ Mop No. 1000 S~tion ;..,~.~ ..... . I k pg[s~ont ~o application doted ....... ~ Bui ~in~ I~pe~tor. ~ ~.Z.~ ,;~ ..... · t No.~. ........ ' :ii....,, 19~..?, and ~pp dby rove the FORM NO. 6 TOWN OF SOUTHOLD 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. Fina~ approva~ of Health Dept. of water supply and sewerage disposal--iS-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 instaila- tlons, 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. B, For existing buildings (prior to Aprit 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: 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 .~ ~:&, .~,,. 1,¢~i'.2. .. or re-ex,st,ng ............ Location of Property ,4/CZar ............ ~Zr. ~¢~.. ¢~/¢¢~ ......... Hou~ No. Street Hamlet Owner or Owners of Property . .~5. ~ ~/~¢~-.~ ................................ County Tax Map No. 1000 Section . ./~ ~ ........ Block .. ~ .~ ........ Lot.. ~. ........ Subdivision.. ,~/~. .~. ~.~...Filed Map No./~ .?~ .... Lot No. ~'~-~ ........ Unde~riters Approval. ~. ~.~ ~.~ ~... :..Planning 8oard Approval..~ Request for Temporary Certificate ..................... Final Certificat~ ..... ~.- ......... Fee Submitted $ .... · ......................... Construction on above described building and permi~meets ell appl4,cabie~codes and regulations. ~L n Applicant ., ,. ". .............. ~oooo62 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY SE .JOHN STREET, NEW YORK, NEW YORK 1005~ Date January 26, 1982 JpplicationNo. onfile 145109 - 81 CER , ,ES N549044 only the el~trical equipment ~ described bel~ and introduced by t~ applicant ~m~d on the above application number in the premises of ~ie P~p~, ~t~ ~d ~., ~ & ~t ~., ~[tit~, H.Y. in the following location; ~ Basement ~ 1st FI. ~ 2nd FI. Section Block Lot ~.~$.m~,,~do. J~ 21, 1~2 FIXTURE OUTLETS 6 RECEPTACLES SWITCHES 6 FIXTURES FLUORESCENT and /ound to be in compliance With the requirements of this Board. RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R NO OF CC, COND A, W. G. PER ~ OF CC. COND, 1/0 OTHER APPARATUS: Elco. Room Heater/s: 1-2.0, 2-1.5, 1-1.25, 1-;5 K.W. 1-G.F.C.I. 1-b~ke Detector NO OF HI-LEG AWG OF HI-LEG 1 OF NEUTRAL 1/o 227 E. i~ealG,mCe~ Rd. · Per . ~TY, i,"F~e~iJ,YW~,g'/~mTTe~m~,F;y~,l,Ty,~[~ This certificate must not be aJtered [n any manner; return to the office of the Board if into?reef, inspectors may be identified .' ~r [OPY FOR BUILDING DEPARTMENT, THIS COPY OF CER~IelCaTE A. iie.~...~ .~ ~....~ .~. -... COMMENTS FIELD INSPECTION 1. FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL ?S: FORM NO. 3 TOWN OFSOUTHOLD BUILDING DEPARTblENT TOWN CLERK'SOFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL ../~.a x...d.~?... PLEASE TAKE NOTICE that your application dated... ~~..~, 19~.. for pemit to construct.. ~Z~A~..~...~/Z~.:...~---- -- ............... at ~ . Location of Property ,.. ~ouse No. county Tax Ma~ No..~O00 Section ..... Z~.~. ....~oc~ . .~'. ...... ~ot~ ~.¢~ ...... , Subdivisio~ ~. ~:. Filed Map No .... ~. ..... LotNo .......... is returned herewith and disapproved on the following grounds ~..~ [.~ ..... RV 1/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 .... , 1~..~. Permit No. Disapproved a/c ....... ~, .............................. -J ................. / (Building-Inspector) APPLICATION FOR BUILDING PERMIT Date .................. ,19. 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 plau to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre~ or areas, and givil~g 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 approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such pern sbalI be kept on the premises avai/able for inspection throughout the work. e. No buihtiug shall 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 1S 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 inspectors on premises and in buildings for necessary inspe~ctions. . (Signature of applicant, or name, ff a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build. ............ ................................................................ Name of ofpr mises__ , / ,- (as o'n';t;e'[a'x';o'li ;; iit;;t'ci e'd') ....................... owner If applicant is a corporation, signature of duly anthorized officer. (Name and title of corporate officer) Builder's License No. ~/. ~./. ................ Plmnber's License No ......................... Electrician's License No.'~.~.,~".,O~.. ~.z.~2;'~'...... Other Trade's Liceuse No ...................... 1. Location of land on which proposed work will be done...~'9~..,~."..dZT/~2z~...~.~...7'-.~57..~5: ............... · 4/.77.a. .... ............... House Number Street Hamlet County Tax Map No. ! 000 Section ...Zd..d~.'. ........ Block .. (~r.....~. ........... Lot ~...,~....5~Td~. Subdivision .~../--~.'. ,<~Z~...~.....~.-¢~"~.x~.'-~. '. ..... Filed Map No. ~.~...,~2 ....... Lot...,~.,~5.-~.. ...... / (Name) 2. State existing use and occupancy of premises and intended use and occ~ipancy of proposed construction: a. Existing use and occupancy . . . .t~..d~,/..~Z/~.Z~:~-~ .... ./;~.T..,<'/'Z:> ..~P~..~/~. ............................. b. Intended use and occupancy ...O'. ~.~ Z-.-.-.-.-.-.-.-.-.~/.~<.;C.~..../.~.. ~e(,7.,~L/..~>./~.,~..~.~...~..~. t~. ~../..---'~..O.~ 3. Nature of work (check which applicable): New Building .......... Addition . ./.'x .... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... .~..~..~. ..~.~ (Description) Estimated Cost ........................... Fee ..................... , ........... (to be paid on filing this application) ;. If dwelling, nuxnber of dwelling units ...~../~/.~'. ....... Nutnber of dwelling units on each floor...'¢'../'.'.~.,~- ........ If garage, number of cars ........................................................................ i. If bus ness, commercial or m xed occupancy specify ~ature and extent of each type of use .................... t. Dtmensmns 9f exdstmg structures, if any: Front .. ~. ~..-.q ...... Rear . ~ .q/.-.~.'. ..... Depth . ~...~.... Height ~.7 ........... Number of Stories ...,~.0'5~. ............................................... D~mens ons of same structure w~th alterations or additions' Front xe(.,4('. Rear 'e~. Depth ~:~..~. ................. Height .../'.'~.... ~.. ............. Number of Stories ... ~,6(.,~7 ............. L Dmlensmns of enhre new constructmn: Front ..../.~. ......... Rear ... ~.~ ......... Depth . ~...q .......... Height /.~..-. ~. ........ Number of Stories .... ,~../<,/~. ......................... .~ ................ Size of lot: Front . .. ~.~,~.-. ~. ?' Rear ~.~. ~Y %~ ;"' ' ' Depth ././~- ~' Data 6f Purchase ............................. Name of Former Owner ............................. Zone or use district in which premises are situated..zq.~$.,'2~. ~..~..~AT. ~ ............... : .................. Does proposed construction violate any zoning law, ordinance or regulation: .............................. Will lot be regraded .... ~/5~..O... .................. Will excess fill be removed from premises: ~ No Name of Owner of premises~"?4/.~f. ~'. .../v~ .,ff,,°./7~' .... Address /./,)'-~.. ?.,q.~.Z:../¢:,Oq. ~ Phone No. r-2. ~.-. f,'~,~'~.. Name of Architect ......................... '.. Address ................... Phone No ................ Name of Contractor . ~,~.../ff./.~.... ,(/~.~'e?4q: .,-(./~. Address .~.X/.~. 4',g.6a. .'(?/:/~.~'~e.~'. Phone No. ~.. PLOT DIAGRAJvl Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether ~terior or corner lot. rATE OF NEW YORK_ .. ou rY .'... s.s .~'~ · ."'5.~ :v'""--:-7'vl~,~.' ...................... being duly sworn, deposes and says that he is the applicant (Name of indMd'ual signing contract) ~ove named. e is the ....~?/.~..7.(e.~.~. 7-.~.. ~.~- .................................................................... (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 statements 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 li~ the application filed therewith. worn to before me this ......... ....... ......... · ,NOTARY PUBLIC, State of New York . "0.,52-4524771 ..... ./4~..J~-~,..'¢'~'r~ .'.~.., ~.. ,,/~-~., ,~'~_~ ~/. ......... (~Ua ted n Su roi(County ~o~gnarure or appncanr) llolamiesl~n Expires .March 30~ l$&~ . ~:OLI oWING' INS, ,' INSUlAtiON'" : ' ' , , ~ ~. CODE~." NOT RESPONSIBLE FOR .3 ~,×.~2v :3 [ n -_i