The URL can be used to link to this page

Home My WebLink About11024-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ..... g.1/~52 ~ ...... Date ....... .~.u.n.e...8., ................. ,19 ..8.1 THIS CERTIFIES that the building ................................................ Location of Property ... ~.0.q..Bp.u.n.d...B.e.~.c. 1~..~qg.dj ......... ~g.~.~..t;.u.c.k. j. ~.e.K' .~97.k.... House No. Street Hamlet County Tax Map No. ]000 Sectiou . .099 ....... Block .... 0.1 ......... L~t .Q06.-.0.Q7 .-0.0.8.. , Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....... .F.o.b.~.u..a?.7..2...,19 81pursuant to which Building Permit No' 11024 7. dated ...F.e.b.~. u..a.~.7.. 2. .............. 19..8. 1, was issued, and conforms to all of the requirements of the a~0plicable provisions of the law. The occupancy for which this certificate is issued is ......... ...... ~..d.d.~.~ $9r~..q.f..O.e~.,g.e..a..n.d..B.~..e.e.~.e.~,y..~q. p.~.e. 1..l.:[.n.g ..................... The certificate is issued to .... G~.b.~. $eJ...~0~1..P. eltf~J,c~pe. Kc~lll~.o.u,~.q~ ................... (owner~/e.~ ~r. tar~o~J.._. of the aforesaid building. Suffolk County Department of Health Approval .......... }I [.It. ............................ UNDERWRITERS CERTIFICATE NO ................ 1~ ~.3.0.~5 .......................... Rev, 1/81 tsuilding respecter ~ FOl~[ ~0~ BUILDING D~p~RT~IY TOWN HALL SOUTH'OLD, N~ Y. BUILDING P,E~IT ~ (THIS PERMIT MUST BE KEPT oN THE PREglS~S UNilL <~ULL CQMPL~ION OF THE WORK AUTHORIZED) No. 11024 Z Permission is hereby granted to: ...-..~.z. at p~emises located at ..~..~...Q......: ' ............................................ ~ ~. County Tag Map No. 1000 Sechon ..~.~ .......... Bloc · ,,/......~ ..... ilar No. C2.~...'.....~....~..7 pG~'sgont (o application doted .. ~? ....... {.,.,:,,,..,., 19 ~ and approved by the B~!l~llng Ir~spector. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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. 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 .......................... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property House No, ~ -- Street Hamlet uwner or uwners o pe ty .............. { ...... ~.. ................... ( ............... County Tax MapNo, 1000 Section ,.~...~..~. Block.. ............. . [ot..~.~.~. .~ ....CorSe..~.~*Z.....~erm,t~o' .~[~atoof~ormit Subdivision .................... ~Y.:.~.r'ZFiledMapNo. ~, Health Dept. Approval ........................ Labor Dept. Approval ........ Hnde~nters Approval ............ Planmn~ ~oard ~ro~al ........... .7. ....... Bequest for Temporarg Gert~fmate ..................... Final CeCil[cate ......... ~ ......... ~j.. Fee Submitted $. ~f~.~,¥ ..................... ~. ,~ . .~,..~. ,~ :egu lations. Construction on above described building andop~h'r~it,,mee,ts all ap~licab~ codes and Applicant . . ." ................... Rev. 10-10-78 FOUNDATION COMMENTS FOUNDATION 2. ROUGH FRAME& PLUMBING INSULATION PER N.Y. STATE ENERGY cope FINAL ADDITIONAL COMMENTS: :L000579 THE NEW YORK BOARD OF FIRE UNDERWRITERS G. I~o~'os, n/~ 900 So'~d in the following location; ~ a.s.m~.t ~ t~t vt. ~ ~,~a Ft. ~r~e Section Block Lot was examined on ,JOl,~e 4, 1~8 2[ and found to be in compliance witk the requirements of this Board. FIXTURE I FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT VAPOR " 2 3 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO OF CC, COND pER ~ A W G, NO OF HI-LEG A W, G, NO OF NEUTRALS A, W. G. OF CC COND, OF HI-LEO OF NEUTRAL OTHER APPARATUS: Joseph D. 227 Wavez'ly Ave. M~.:di:ord, N.Y, 11763 lic, 482-E GENEI~AL MA~IAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectdrs may be identified by their credentials. ~¢,O~Y, FO~E BUILDING DEPART~EPiTo THIS COPY.~, ,,OF BE ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE UND[ RWRITERS ][3~f~ BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT C~b~:'i~l ~-ou~o~os~ 900 ~ound inthefollowlng location; ~ Basement ~? Ist FL ~ ~,,d F~. o~tside Section Block Lot ~,~¢~..~i,,.d,,. February 7,1980 and found to be in compliance with the requirements of this Board. FIXTURE RECEPTACLES FIXTURES RANGES OVENS DISH WASHERS EXHAUST DRYERS SYSTEMS NO. OF EEET OTHER APPARATUS: S E R :~ NO OF CC,COND. A, w G, PER ,g~.~ OF CC COND. 2 I : C NO OF HI-LEG AWG OF HI-LEG NO' OF NEi~TRAL$ ~ A'WG Lic. 1529 OF ~ qEE. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .-~. ~.~. ~...~ ...... , 19c;O/. Approved~d.~. 7.. -~~. ..... , 19~.~. Permit No. /.d..C)..~.?-..~. Disapproved a/c ........................... /~ ...... ~. (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No.././.0...~.~...~.- .... Date .................. , 19... INSTRUCTIONS a. 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 showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- 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 permit shall be kept on the premises available for inspection throughout the work. e. N,o building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall ha~e 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 bml&ngs for necessary ~ns~e~[ign~: ..... '..'./.: ............... (Signature of applica~f, or ha~he, if a corporation) ~ ' ~ ~-~9., ,--(Msilin~-address o~ppli.c~_ant) State whether applicant is_owner,lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.! .... .... .... ................................................................. Nameofownerofpremises ..................~'~ 0~5'(5',..~' ~ ~ ~.'.l.~..~.P. .t.~. J. . .......... t~pv',-~.l .~. .>~. y)?.~ /. ~. ~. ;C ................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......... ~.' ........ Plumber s License No ......................... Electrician's License No.../.',f.o..,%,.: .'.~< ........... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. 5o., a er ck ......................... fi~;;e'/q~;r ........................ Sir~;i ..... Hamlet -'A ¢/d -- County Tax Map No. 1000 Section .. ~7../.7. Z... Block..~ ......... Lot..~.Z)..~..~. ...... Subdivision ..................................... Filed Map No ..................... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... / .4'..3~.~.../g. 71../~.~.~. ~.'.~...~... J.~..q.g.{-~2 .............................. b. Intended use and occupancy 3. Nature of work (check which applicable): N, ew Building .......... Addition ......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 1 ~J(~, ,,,.~_. (Description) ,~ ~'~L] OOO ! Fee .7~ .................................. 4. Estimated cost. ;tj .................................. (to be paid on filing this application) 5. If dwelling, number of dwelli~g Units ............... Number of dwelling units on each floor ................ If garage, number of cars .. t. 'i ................ ' ' 6. If business, commercial or mixed occupancy, specify nature and extent of each type.of use ..................... 7. Dimensions of existing structurek, if any.: Front .~..~.. fi. ...... Rear . .~..o.., ....... Depth . .fl.?. ......... Height ./.t~. '. .......... Number of Stories. ~ i .................................................... Dimensions of same structure wlth alterations or additions: Front .... ~ .'~. ........ Rear .. ~.~. ............. Depth .... ~..),~..'. ........... .. Height ../.c/. ................ Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height l ............... Number of Stories .................................... ; · · ......- ........... 9. Size of lot: Front ...I..~l._~...i ........... Rear .... {'..~:'..~,~-. ........... Depth . .'.~7.0.'.~. .~.i .......... 10. Date of Purchase ........... i ...... .].~.~..¢-: ..... Name o f Former Owner ~. ~....~...~.' J;..~./~. T'~ ........ 11. 2~one or use district in which promises are situated .......... , .......................................... 12. Does proposed construction viol3te any zoning law, ordinanceorregulation:..fi:E,tp. .......................... 13. Will lot be regraded ......... . .............. . .....Will excess fill be removed from premises: Yes No 14. Name of Ow.,n..e.,r of premises . ,.~, Address .................. Phone No. '~..~. :'. Name of ~ 0 .u/.~..~. ~(.).~'../.d/_ .~.o.r.o.°'.g.~.tZ. CAddress . .ff¢:/.,y..r>../.~..eq~. 0g: Phone No ................ ...~..TkL~,~,~,'. ddress ~-o,,~_ / Name of Contractor ~//t[~{.. d d ~ ' P~')~'! ...... ,Phone No. .'-2:.....~ ..... 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 cornerlot. ~d~ A~g~/)~.~ ( STATE OF NEW YORK, ~ ~ ~ covey O'F ..: .~O/~A~.~..~.. ~Cfl~ :~ .................. being duly sworn, d~poses ~d says that h~ is th~ applicant n~o~(Nam~m of individual sign .rig contract) abow Heisthe ............................ .... ..,.. . ......................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is dul~ authorized to perform or have perfo~ed the said work and to m~e ~d file this application;~ that all slatements contained ~ this application are true to the best of hi~ ~owledge and belief; and that the work will be perfomed in' ~e m~ne~ set forth in the application filed therewith. Sworn to before me this , ........................ ..... , Not~ Public, ~ ...... ~un*y ~ ~ .... .... r.: ....... , ~ . .- o~:;; ,, ~ ,///(Signature of applicant) ~ommissi0n Expirc~ II,ret} ~01 M A"P o~-, LOT 4~, ~t'L00..K ~ A'PT A I N E~'"r'A,T E ~ H ATTITU ~K INLET T0~,/N -'~0LrTHOL~ ~0.0 C~ O. ~ N .'K