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Home My WebLink About11052-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ....... .Z.1.0. tf ?.5 .... Date 8ay 4 198.! THIS CERTIFIES that the building ................................................ 2045 Lake Drive Southold~ N.Y. Location of Property ............................................................... House No. Street Hamlet County Tax Map No. 1000 Section ....0.5.9. ..... Block 0§ ... ~Lot 004 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated 80 11052Z March 10 19 .. pursuant to which Building Permit No. dated March 13, 81 ............................ 19 .... 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 ......... Second Floor ~ddi%lon ~o One Family Private Dwelling, The certificate is issued to Joseph Zimmer (owner, Io~e' tYr'tOtt'dltttF - of the aforesaid building. Suffolk County Department of Health Approval ...... N / R ................................. UNDERWRITERS CERTIFICATE NO .... 11518 D.0.I~ ..................................... Building Inspector Rev. 1/81 S OUTHOLp BUILDING TOWN HALL SOUTHOLD, BUILDING PERMIT: (THIS PERMIT MUST BE KEPT ON TH.E PP, E/~IS~S UNTIL EULL COMPLETION OF THE WORK AUTHORIZED) , Permission is hereby granted to: pursO~nt to ~pplicoHon d~ted ...~~ ...... ~.~ ......... , 19 .., Ond Opprovod by the BUilding m~spector. Fee ....... 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 p~an 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 all property lines, streets, buildings and unusual natural or topographic featu res. 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 $§.00 3. Copy of certificate of occupancy $1,00 ~Date.. ~a~n.~L~.~..'~...~..'...: New Building ............. Old or Pre-ey~isting Building ........................ Location of Property ~o.~o...~..~. ..... ~.~.~... Owner or Owners of Property ............................................ County Tax Map No. 1000 Section .... ~'.%~..~.' .....Block .... ~.~ ,~. ...... Lot .... · '.~..~. ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. 1.1.(~..~'.~.,, Date of Permit ~. ~'.'.~.T.~/.Applicant,., .~,~.'~.,....~, '/~ff~./~ . . . Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval Request for Temporary Certificate .Final Certificate Fee Submitted $.. ~'~....~. ..................... Construction on above described building and po[mit meets al~plicab, le codes and regulations. Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 May 8, 1981 TEL. 765-1802 Randazzo Building Co. 127 Swan Lake Drive, Patchogue, New York Re: Joseph Zimmer, B?#1~052Z-Addition Dear V±to: Please advise to whom the Certificate be mailed to? You paid $5.00 fee office and wanted us to give her you. We~ are holding same in and Mrs. the Certificate. this office until we of Occupancy should Zimmer came into the hear from Yours truly, George H. Fisher Sr. Building Inspector GHF:jd THE NEW YORK BOARD OF FI, RE UNDERWRITERS '[~ BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1~,~O38 113905 - , ~ate April 27, 1981 .~pp,,.a.o., ~o. o.~'i,e N 51,9004 THIS CERTIFIES THAT only the alee trlcal eq~ipr~ent as ~scribed below and introdaced by the applicant ~med on the above application number in the premises of Joseph Z~r~ Z045 ~., .~.~..d o. ~C[ g3, 1981 and found to be in compliance with the requirements of this Board. FIXTURE OUTLETE DRYERS {ECEPTACLES SWITCHES 13 3 FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FLUORESCENT SYSTEMS E E R V I C OTHER APPARATUS: glecJic~:~m Reai:~/s: 1-2.0 Kw, 3-1,5 Kw 1-~ke Detector 2/0 AW, G OF NEUTRAI. 2/0 6 ,oplar Ave. ~ Modford, N.Y. 11763 li~.2677-~ GENEI~AL MANAGER 4 Per This certificate must not be altered in any manne¢; return to the office of the Board if incorrect. Inspectolrs may be identified by their credentials. rVK~UUILDING DEPARTMENT. THIS COPY OF CE TIFICATE~M '~St NOT, B [ A/TERE~ IN ANY MANNER. ~J~ FI__~t) .I~_?PECTION FOUNDATION COMMENTS ~FOUNDATION (2nd) ROUGH FRAME& PLUMBING INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 Examined..~)//Y..ff(,~.../.~.., 19 ~ "~ "% Approved /~//./3..,~.( .~.../..~.., 19~../. Permit No. t/./.~.~.'.'~. Disapproved a/c ................. ~---~----~........~~ (Buil;g Inspector) APPLICATION FOR BUILDING PERMIT Application No..//((~)..~-...~.. ...... 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. No building shall be occupied or used in whole or in part for any purpose whatever until a 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~ousing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary i~e~ons./~,J~ ~,~t:a,~.,q ' ' ' i~i~natur'X~4A~e';~ ~71 ~'~n'e~ ii ~ 'c~>~a'tio'n') .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer,/~g~neral co~ctrician, plumber or builder. Name of owner of premises . [~.tV.. ....... .~t}~L~tx~(7~... .............................................. (as on the tax roll or latest deed) If applic~l~is ad6~rpora!ion, signature of duly authorized officer. ...... ....... (Name and titl~[ of corporate officer) Builder's License No. ~../.~'0. .................. Plumber's License No..-.. A~7/.,:q.~. £././?.r'-'5 ./%-. ........ Electrician's License No. Crv., (9.. ~Fz,~.~V~..P4..ct:..-. .... Other Trade s License No ...................... Location of land on which proposed work will be done .................................................. · .... ................................ ' .... .............. House Number Street Hamlet County Tax Map No. 1000 Section .... . .CY..~..~. ...... Block ..... .C)..~.~7 ....... Lot....~..~9...~. ......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....I..~.W-~....~..~ ....__ /? __ .~. ~.L~. ~.. ~..q~T2.~/~... ................................... b. Intended use and occupancy ..... $ & .v:t~...~.. ?.~..~..~..~..f..~'...~.,....~/.~.,ff .~..t~..a..v-~. '....~.~.~...,~...A~.~'.,C.~ .... 3. Nature of work (check which applicable): New Building .......... Addition...~...... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 4. Estimated Cost~. ~ ~.~ ~O.O.. Fee .~../.~---~-~ (Description) (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 ..... i ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimension~of existing structureh, if any: Front ............... Rear .............. Depth .............. Height . I ~ ............ Number of Stories..I ............................................. i ........ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ....................... Height ...................... Number of Stories ...................... 8. Dim~ensions of entire new constr,uction: Front .. ~ .......... Rear ............... Depth Height . .~. ~ ........... Number of Stories ........................................................ 9. Size of lot: Front ........... ........... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction viol~te any zoning law, ordinance or regulation: ..~.O ........................... 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ...i ................. Address ................... Phone No ................ Name of Architect ......... ~.;.. Address ............. ^ ..... Phone No. Name 0fContractor [P,,/~-f~.~..20.. g.~. i~.' i i i i'Address I .g'.~..~O2/~/'[../x./e. ~.t/:. 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. STATE OF 'NEW YORK, 'S.S COUNT~ OF ....... £.1 ........ ~ ...... · ~..~..~ ........................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the : ( (Contract~, agent, corporate officer, etc.) of said owner or owners, and is duly auth~perform or have performed the said work and to make and file this application l that all statements conthined in this application are true tothe best of his knowledge and belief; and that the work will be performed in the manndr set forth in the application filed therewith. Sworn to before me this ! ( ~C", ~'~e"o~'~W YOrk y -(Signature o~appficant) ~ No. 52-8125850, Suffolk Coup,.I ~ Term Expires Msrch SO, 19.~-''~