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Home My WebLink About11483-zFORM NO. 4 TOWN OF 50UTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..g.l.q~¢~; .......... Date ...... P.e..9.e.~qb.? .p' .1.8. .............. 19 .~,) .1 THIS CERTIFIES that the, building ................................................ Location of Property ..6.37.~..gr.e.?'.qn..Y.qa.~. ............... .cut¢~95ue . . House No. Street Hamlet County Tax Map No. 1000 Section . .0.c),5 ....... Block . .0. 1. ........... Lot . .0.0. z.} ............ Subdivision .... .X .......................... Filed M~ip No. X .Lot No. X . conforms substantially to the Application for Building Permit heretofore filed in this office dated · ...O.c.t:.?b.?.~.. ? ....... , 19 .~. [ pursuant to which Building Permit No....1.1.h.8..~. 7 ........... dated .... .Iq.q ¥ .e .m.b.e.p.. :3.0. .......... 19 .8.1. , was issued, and conforms to all of the requirements of the applicable provisions of the law. ']?he occupancy for which this certificate is issued is ......... ....... ~.c?.q ~ ~.o?.y...b.u.M.d..~!~.r,' .-:..ay.~.. 5.~.~.~! .~.o.. ................................... The certificate is issued to .... .l:lp.b.e..p.t;..~ . .S.hp?.r'. ~r..S.qt.1 .p.e~.b.e..P ......................... (owner, Icss~¢ or'~rratrt) of the aforesaid building. Suffolk County Department of Health Approval ...... .N./.I.~ ................................ UNDERWRITERS CERTIFICATE NO.. iq S/4 4 1 1 2 Building Inspector Rev. 1/81 FO~M NO; 2 TOW~ OI BUILDING TOWN HALl, SOUTH'oLD, N,. Y. BUILDING PERJ~!T, (THIS PERMIT MUST BE KEPT ON THE PRE/~IS~S uNTIL ~ULL COMPLETION OP THE WORK AUTH(~RIZED) No. ~48~ z Permission is hereby granted t~ ~.?~..~~.,...~..-..,.....? ........... ...... ~.~. ~.~.~.~,~....~.~..~..~,,-. _ ~o ..~.~.~....~.~...~.~.~.~ ...... ~.~Z~.x~..-../x~.o.. .~.~......~.~ ........... ......~....:..: ........ ~....t~......, ....... ,~ ....... ? .................. ................ ~ ................................................................ . ,. .......................................... ~....~ ............... ~{. ............ ~ ...... CO~ T x Map No. 1000 Section .. .; ..... BI~ ~. .......... ~Lm No.~.~ ....... pUr~uont io opplic~tion doted .... ....;... ......... ,.- ...., ~I ~, ~nd ~pprov~ by the iJ~ing , pector, Rev. 6/30~80 ~ ~ ~ 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 P~anning Board approva~ of completed site plan reqt~irements 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 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. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date . . /..~.~.. !. ,~..l~¢'. //. ...... New Building ... ,x~ ....... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ........................ · -~.~ · ~. · · · ~~~ County Tax Map No. 1000 Section . .~?..~.~.. ..... Block ...... /. ........ Lot.. ~'...~...~.. ..... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./.~ .~..~. ~Z Date of Permit~//__~.~,~'~.__ .Applicant .... Health Dept. Approval ....... ~ .............. Labor Dept. Approval .... ~ ................ Underwriters Approva /V 1.2- ........ P anning Board Approva . Request for Temp~)~ry Certificate ..................... FinalCertificate..i i:~ii: ::ii Fee Submitted $ .~. ~ ..~..~. ................. Construction on above described building and pe,rcn, Jt meets all applical~le codes and regulations. r'~L FORM NO. 3 TOWN OF SOUTItOLD BUILDING DEPARTMENT ToWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL T oFile~'.N°' ,; ............................ ~.. ~.~./~S~eff~. ~7~/~?./~ ·./.~... ~~. ~.~.- ...... · .~~"~'V" .... ~ PLEASE TAKE NOTICE that your application dated ~{~... :~ ....... , 19fi/.. Location of Property ....(~3 ......... ~O~..~ ....... ~ZC~ ~ ~. 7 ~ouse No. ~ i Street _ ~ . Hamtet ~ Subd~vJsio~... ~..' ......... FJ~ed Map No ...... : .... :'. .... Lot No ............ , ..... is returned herew~ disap~ved on the followi;g grounds ~~. ~~. ...... ~.~:~... ~,.. ~.,.ro ..... ¢ ............ i Buffd~g Inspector FIELD INSPECTION· COMMENTS · FOUNDATION (1st) FOUNDATION 2, (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C~ODE Yt FINAL ADDITIONAL COMMENTS: C ~.oo014 THE NEW YORK BOARD OF FIRE UNDERWRITERS ['l~ BUREAU OF ELECTRICITY [~D~;* ~'.;~ l~l ES JOHN STREET, NEW YORK, NEW YORK 1003~ THIS CERTIFIES THAT :- only the electrical equipment as described belo~ and introduced by the applicant named on ~he abo~e application number in the premises of ~b Sc~ie~, ~eg~ ~., ~1~ ~ ~, N.Y, ~ in the lollo~in~ loc~ion; ~ B.se,nen~ ~ ls~ Ft. ~ 2nd FI. Section Block Lot ~.~ ~,,,i.od o. ~ 23, 1981 a~td found to be in complia.c~ with the requireme~ts of tkis Board. FIXTURE OUTLETS IECEP/ACLES 9 SWITCHES 11 6 FIXTURES RANGES OVENS DISH WASHER EXHAUST FANS FLUORESCENT DRYERS FUTURE APPLIANCE FEEDERS TIME CLOCKS JNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: P~lboard/e: l-6c/r. 100amps. 1~4.5 K,Wo }be Water Hmmter ~' - 0'~ T~:ack li~ging, 2 lites S E R ~c~ AWO. NO O E COND. OF CC COND. V I C Stiltwat~r Ave.. :' Ct~chogue, N. Yo 11935 lic.2670-E GENERAl. MANAGER" Per_ . ' This cer~tJficate must not be altered in any manner; return fo fhe Office o~ the Board i( incorrecf, inspectors may be ~enf { ed ~y their FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT . - TOWN HALL SOUTHOLD, N,Y, 11971 TEL.: Z6 -1802 Examine~ ..... , (B u~g Ins~ctor) ~[~~ APPLICATION FOR BUILDING PERMIT Application No. ~./..~..~.~. ....... INSTRUCTIONS a. This application mnst be completely filled in 'by typewriter or in ink and submitted in triplicate to the Buildi Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to. schedule. b. Plot plan showing location of lot and of buildings on premises, r~lationship to adjoining premises or public stre* or areas, and giving a detailed description of layout of property must be drawn on the dia~am which is part of this ap[ cation. c. The work covered by this application may uot be commenced before issuance of Building Permit. d, Upon apprc'.'al of this application, the Building Inspector will issue a Building Permit to the applicant. Such porn 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 a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION IS I IEREBY MADE to the Building Department for the issuanc, e of a Building Permit pursuant to t Building Zone Ordinance of the Town of Soutbold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for th,e, construction of buildiugs, additions or alterations, or for~4-emoval or demolition, as herein describe The applicant agreus to comply with ~11 applicable laws, ordinances, builili~/dode, hous~g code, and regulations, and admit authorized inspectors on premises and in buildings for necessary~ ~:~ --. ~'~i~yfEt'efi°n~%P'.'//'~ . ' ac.--- ~ ~.- (iS ig n_~a t u re 'o/~. ,~ppli~ff},.,-~ //, -- //..°r n an),p, if a corporation) ' (MailL~, address of applicant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bnild, .................. ...... : ......... . N,'~nc of owner of pre , scs ~.',~.."~.7- ~ ~,,~.,~'..o~.~.~ .... - .~. ,~,/~f?./,'~?, .. . .............. ...... ........................... /(as on the tax roll or la'test deed) ' If applicant is a corporation, signature of duly atKhorized officer. (Name and title of corporate officer) Builder's License No. ~)d; 7L' Plumber's License No.",. ~': ................... Electrician's License No.Z. ~ .~4. C ........ Other Trade's License No. ,. o,, ,,:,,'L; ',Z ;;; :,Z .... .' ........................... House Number Street Hamlet County Tax Map No. 1000 Section .................. Block . 6 Lot Subdivision ~ Filed Map No ~ Lot ~ (Name) 2. State existln8 use and occupenc7 of premises and intended use and occupancy of proposed constrnction: a. Existing use and occupancy d444f~' /~O ~&g¢~ ' ' b Intended use and ' ' : · occupancy 1. Nature of work (check wi~icb applicable): New Building .......... Addition .......... Alteration ...... Repair .............. Removal .............. Demolition .............. Other'Work ... ............. ' (to be paid on filing this application) ;. If dwqlling, number of dwcllin~ units ............... Number of dwelling units on each floor ................ If garage number of cars ;. tf business, commercial or mixqd occupancy, specify ~otnre and extent of each tSpe of use '~.. ?'d~..t,q/.~'..,O... t. Dimensions of existing strtctures, ,f any: Front...'~19. ......... Rear . .=)..O. ......... Depth . .~7%.~. ......... Nnmber of Stories /. '~?.~.~7.$ }leight · Dimensions of same structure with alterations or additions: Front Rear Depth ................... .... Height ........... .~ .......... Number 9f Stories ......... .~./. ....... ~. Dimensions of entire new construction: Front ...'zig. t,9. ........... ....Rear . .?..r)... Depth . ~.:~ ........... Height Nu'nber of Stories ./ ' t. Zone or t se t strict n whi'ch pfc n scs are s tuated ..... i:' . .... 2, Does proposed construction v~olate any zoning law, ordinance or regula:ion: . ~,/0 '. ...... ',. Name of Architect ' Address Phone No Name of Contractor ._z-:---. Address Phone No PLOT DIAG RAM Locate 'clearly and distinctly al.I buildings, whether existing or proposed, and.indicate all set-back dimensions from roperty lines. Give street and block number or descrip'tion according to deed, and show street names and indicate whether terior or corner lot. being chfly sworn, deposes and says that he is tile applicant rATE OF:N~V ~"0RI,5¢ i (Name of int.l/vidtial si ii '" )eve namqd, ~ is the (Contractor, agent, corporate officer, etc.) ~ said owner or owne~, and is dq'ly authorized to perform or have performed the saki work aml to make and file this )plication; that all statements con{ained ~ this application are true to the best of his knowledge and belief; and that the 'ork will be, performed in the manner set forth h~ the application filed fi~er~with. ~orn to before me this t't