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Home My WebLink About11461-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Zq4967 Date October 6 19 83 THIS CERTIFIES that the building . ALT~P~g~IOi~ ................................... Location of Pro ert 3ILO Breakwater Rd. Ha~tituck lie. use No. Street ........ ~l~/e~ County Tax Map No. 1000 Section . .q J .~ ....... Block ..... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · .. ~oYembe:~..7 ...... , 19.8.'1. pursuant to which Building Permit No. 'V)~.~.q.~ ' dated l~ov. ember 48 ...... 19 84 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 ......... For alterati.ons & renovations ~;o dwelling The certificate is issued to ROBERT T. BAYLEY (owner, le.~ee or tenant) of the aforesaid building· Suffolk County Department of Health Approval 4 UNDERWRITERS CERTIFICATE NO..~..5~. 5.¢.'1.5 ........................................ Building Inspector Rev. 1~81 ~ TOWNOF$O~ ~I~D~ TOWN'HALL , SOUTHO~D, N~. Y" ' :' BUILDING, R~V. 6/30~80 (THIS PERMIT MUST BE KEPT ON TH,E PRE/~!S'~S UNT L~ULL COMPLETION OF THE WORK AUTHORIZED) ' Z Dote .~' '('</~.f~..~ .......... ,19.~ Permissioh is aranted .... - to . ~x~ere~''_ ' . ...... ~~....~, ~ ........ ~~ ........... ...... ~.~..=....~.,....:...~..~, ................ ....... at p,remise:s located at ~ ~~;.; ....... ~ ~ ?: ~ : · .............. ~'--~ ~' ~, ~' ~~-'':~.~,.. ~z. ~ ................................. ~uh~ ,a~ ~p uo. ~0o0 ~,o~ ....Z~&.:...,..,~. ~ ~.~;.-: ....... ~cotNo.:..~...a~.7 .... pUrSuant ~0 applicotion dot*d.~~...~...Z.7.~,...~?...., 1~.~.., ond ~pprovod by tho 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. 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 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 April 1957), Non-conforming uses, or buildings and "pre-existing"- land uses: 1. Accurate survey of peoperty showing ali 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. C. Fees: 1. Certificate of occupancy $5.00 ~ 2. Certificate of occupancy on pre*existing dwelling land use $/ 5.00 3. Copy of certificate of occupancy $1.00 Date.....~.'~..~L:..[. ~ .I.~..~..~. ...... New Building ............. Old or Pre-existing Building ........... Vacant Land ............. Location of Property . . ~...~(~.. C ~'. I I-Iou~e No, Street /-/am/et Owner or Owners of Property ...~V~.~.~....~.' ......................................... County Tax Map No. 1000 Section ... [l- .~. ........ Block ~ Lot. ~ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. I. [.~'~ ~.. 1..'~. Date of Permit [.[l~ .~.1.~. ~..Applicant. ~)J°.~. k~....-[,...~...~..~. I.~..~ ......... Health Dept. Approval ~.~.'.l.~.~.~2.~, ~h~.. J?-.:$~:~..0Labor Dept. Approval ...~l..~.~: ................ Underwriters Approval. ~1°.~...~.~..~. [.5 .......... Planning Board Approval . ~., Ar: ................ Request for Temporary Certificate ..................... Final Certificate ~ ................ Fee Submitted $ .... ~;..(~... .................. Construction on above described building and p~ets all applicable codes~/~ regulations. Applicant .... ~...~..~.4 "' R~. ~o-~0-7~ _~FIEL~ ~k$~ECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: 1000378 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW yORK 1OO3~ aa,e November 17, 1982 pp. a,lo,. ~o. o-S.e 134983-81 N 5 8 3 G 13 THIS CERTIFIES THAT only the elec trical equipment as described below and introduced by the appllcartt na~ned on the abo~e application autrzber irt the premises of Robert Bailey, Brea_~ater Rd., C/O Breakwat~ & Mill Rd., Mattituck, N.Y. ~n tt~e/ollowing location; ~ Basement [] lst Fl. ~ 2nd FI. C~O Section Block Lot ~a, exaa~,,ed on November 11, 1982 and found to be in compliance with the re~ quirements of this Board. FIXTURE OUTLETS 5O DRYERS FIXTURES RANGES OVENS RECEPTACLES SWITCHES FLUORESCENT VAPOR 45 4O 5O FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS DISH WASHERS EXHAUST FANS MULTI-OUT/E1 DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: Electric Room ~ater~13-.65 K.W. Novembel-3/4 H.P. Z-G.F.C.I, 2-b~oke Detectors 1-4.5 K.W. tbt Water Heater 1-14.4 K.W. Heat Pump S E R V I C E NO. OF CC COND. PER 1 A, W g NO, OF HI-LEG OF CC COND, 4/0 A. WG OF HI-LEG NO. OF NEUTRALS A W G, OF NEUTRAL ~/o Charles M. Hall Elect. 760 Long Creek DR. Southold, N-.Y. , 11971 Lic,~657-E This certificate must not be altered in any manner; return to the office of the ~ if THIS COPY OF~ FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOt. D, H,Y. 1i.971 TEL.: 76'.5-1802 ~,~,,,~ned ~..<~..<~ ..... , i~ A1;F'roved ~, .Z ~ ...... 1~. Permit No. ff~ ~ D~sapproved a/c ....... ' .............................. [~u~!ding Inspector) APPLICATION FOR BUILDING PERMIT Application No. (/.¢'..67/ ......... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to tke BuiMJ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee accordiug to schedule. b. Pict plan ' ' . ,. s,~owm~, location nf lot and of buildings on premises, relationship to adjoining promises or pub:lc stre{ or areas, antl giving a detailed description of layout of property must be drawn on the diagram which is part of this calion. c. The wmk covered by this applicat o ~ may not be commenced before issuance of Building Permit. d. Upon apprc.'al of this application, the Building Inspector will issue a Building Pmmit to the applicant. Such pern shall be kep on the premises available for inspection throughout tile work. e. No buildJag shall be occupied or used in whole erin pa~ for any purpose whatever until a Certificate of Occupan q:all have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Btdhtiug Department for the issuance ora Building Permit pursuant to t Building Zone Ordinance of thc Town ~f Southold, Suffolk Connty, New York, and other applicable Laws, Ordinances 'AcguL~tions, for the coustruchon of buddings, additions or atteratmn~ removal or demolihon, as herein describe Fhe applicant agrees to comply with all applicabl~ laws, ordinan~uildi~ code, bousi ~g code ~d regulations ~t admit authorized inspectors on premises and in buildings for nec~sa~y b~ctions, ~ ~ (MMling address of applicant) State whether applican[ fs owner, lesse~, agent, archi[eot, engineer, general contractor, electricfan, plumber or bufld (as on thz tax roll or latest deed) ~f' applicant is a corporation, signa[ure ofdul7 authorized officer. (Name and title of corporate officer) Other Tradc's License No ...................... I. Locatio..~and on wldch proposed work wilt be done. ~, .~.~.~..k .f~.~.~.~...t-. l d,. ..... House Nmnber Street ...................... /f2,;,'l;/ ...................... t0oo ~ ~5'- ~ '- PT, o~ ~ Couuty Tax Map No. I000 Section .................. Block .................. Lot ................. Subdivision ..................................... Filed Map No ............... Lot .............. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~' ~d .~ll * b. Intended use and occupa c 41~ -~Ut[ . , ...... ........... .............. , ..................... Repair Removal De, moiition . . .' .....Other ! (Description) 17~ga:ared Cost ......................... F,,, . ~ .................. .~ (to be paid on filing this application) If dwelling, number of dwelling units . .O...~.~ ........ Number of dwdling units oil each floor .~.."77 ......... If garage, number of cars . O~.~, .................................... : ............................. ,, if business,' commerc~a!' or nnxed' occupancy' specify nature' and extent of each ~},'pc' of use ~ ..... ~,i ........ , D,nensm~ o~f, cx}?no stnlctures, If any. Front . . . .qr.& ........ Rear . . ,~.~. ........ Depth .:~n/p... :.l ......... , l leight -.;(M,~.'ZO~. . ~ .... Nurnber of Stories .. ~ ......................................... t.-- ; .......... Dimensions structure with alterations or additions: Front .1/~0. ~,14,0,,1S~.~ Rear aa .c.14g.~;t.¢ ..... t. Dhnensions of ~ntire new construction: Front .. lBO..q~.~l~.l~ Rear .1~0. ¢-~16¢~.~-..'. Depth lan Height FIO .~..Idr,,k~,i~. Nt nberofStories ~O ~B, 6kPl,~¢, ). Slze oflot: Front ...... I.~O. .... ' ......... Rear .... .'~.1.~'. ............. ,. Depth ..~.~,0 ................. ). narco'f Purchase .b~.O,~..0.°].~[ ................ Name of Former Owner ?.6~4tr; .ffld,.r.l,lit'l .......... I. Zone or use district in which premises are situated .I .... .... !. Does proposed construction violate any zoning law, ordinance or regulation: . .!~O ................ ........ L ~,\ ill lot be regraded .... PlO.,l: .' .................. Will ex~ess fill be rem,qved from premises: Yes l. Name of Owner of premises .~"~Obet.~ l~,.l~,~je'~ Address ~)0. ~,t2~, .'.'.'.'.'.'.'.'.'.~.'~q¥[~0i~.. Phone No ~,6..; N ofArcl itect ~04~le,- Ad 1 Pho N 7 Name of Contractor ]~VlV~.r. ffg W~. ~L'~.. ~.O-. "21'7 .... Address ~.14 .al-ktl, l~..~.e.c~ ./~. Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex/sting or proposed, andl'i~dicate ail set-back dimensions from roperty lines. Give street and block number or description according to deed. and slmw street names and indicate whether terior or corner lot. fATE OF NEW/YORK,,~ Z OUNTY O~ .'... S.S (Narrie of indMdual signing contract) )eve nan'ted. being duly sworn, dkposes and says that he is the applicant is the ......................................................................................... (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed ttic said work and to make and file this ~plication; that all statements contained in this application are true to the best o~ bis knowledge and belief; and that the ork will be performed in tl~e manner set forth h~ the application filed fi~crewith. ~vom to before me this .................. ..day of...~, . ~ ]U~TH T, TERRY . ~o~ Public, State of ~ew Yor~~ /ff f~ ~ / ~ ~ /~ I+ vt.,' / / I HALL i Il I + ~.--r~-~,*~ 51bk4 IL'Z" ~ATTITb~--.K AT Iv~TT~TUE~ 7%000 ~ ce, ~'; ® 5~t oo0 ± ~, fT. MAF~VI ~,,1 ' --