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HomeMy WebLinkAbout11272-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector -I'own Hall Southold, N,Y, : edificateTOf ;:Occupancy No. 7. 101Ll.3 ............ ~ate ....... ~ec. embe~'.. 1 ~IE~ ~ui~ ' ~ca~~y ~Z6~ ................... ~a_~n~ ............. ~a~uck ..... ~:~ous~o. ~t H~let .~unW~~t'ion .. 1 O~ ....... ,~tock ...0~ .......... lot, .~O ? ..1.6 ........ Subdivision . X. " .Filed Map No. X'.: · .Lot No. X. conforms substantially to the Application for Building Pemfit heretofore filed 'in ~s office dated .. ~.u ~..].fi .......... ,19.81 pursuant to which Building Permit No. 1 1 ~ 7~ .Z ............. dated ... ~.aly..~3 ................ 19 al, was issued, and conforms to all of the requirements of the applicable provisions of the law. ~e occupancy for which this certificate is issued is ......... ~e certificate is issued to .... RO.~t~t. ~,. H~lt~ ~..~.~ .~O~,. laq · ........... of the aforesaid building. Suffolk County Department of Health Approval .~.~.~$0~.6.~ Building Inspector Rev. 1/81 l~O~g NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N©. 11272 Z Permission is hereby granted to: . ....... ~.~.~.~.. ./.Z~..../~...c.. .......... ....... .~...~...z.~7. .............................................. ....... Z~..~7~_4 ..-... ~.. ~ ...... ,o ................ ~. .~. . z~.~.~. . . . . .. . ~. ~. ~. ....... ~-~. ,,~ ~, . . . . ~u,~_ /t~ ~. . . . .~.~ ~. .~ ..... ..................................................... ........... /...... ........................ at premises located o, ..... ~.7 .~.~.... ......... ,~.'..~.../.~.~. ~.....~..~....~.~,~g,~ ................................... ................. : ................ ~ ................................... ~, ................................. ,:g'.,~.~.z.-.~....~, Z,' /, ---. ~ ~'~..~....-~ I ~..,/.~ ........ ..n.~..../..~.,....~.~./......~ ................. z~.~.., ..... CountyV Tax Map No. 1000 Section .... /..~..Z ...... Block ..(-,~... ........... Lot No....~...-...-...-..~..7.-.,/,~ pursuant to application dated ...... ~ ......... /...~.. .................... , I , and approved by the Building Inspector. Fee $...~.(. ........ ;'~.... Building Inspector Rev. 6~30/80 1000579 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY l~ 85 JOHN STREET, NEW YORK. NEW YORK 10038 THIS CERTIFIES THAT only the electrical equlpment as described below and introduced by th~ applicant ~all3e~ o~ ~~ a~bove appl~c, atio.n, num.ber in, the ~.re.rt.~izes of in the foltowlng location; [] Basement ~ Ist FI. [] 2nd FI. Sertion Block Lot was examlned on j~__t_*~ 7, ~.~]. and found to be in compliance with the reqflirements of thls Board. FIXTURE FIXTURES OUTLETS ~ECEPTACLES SWITCHES FLUORESCENT VAPOR 16 30 19 DRYERS FURNACE MOTORS RANGES OVENS DISH WASHERS EXHAUST FANS TIME CLOCKS UNIT HEATERS MULTi-OUTLET DIMMERS SYSTEMS NO. OF FEET OTHER APPARATUS: S E R V I C A.W.G+ ND. OF HI-LEG PER ~ Of CC. COND OF HI-LEG OF NEUTRAL 1 -.~,~.e Detector Hocors: 1-F 1-G.F.C.I. uu~eph U. 2.~7 ~Nerly Ave., MmvaZora, N.Y. 11763 11 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. 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 19§7), 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 3. Copy of certificate of occupancy $1.00 $5.00 Date ...D.e..c.e.m.b.e.~. 0, 19.8.1 X New Building ...... · ....... Old or Pre-existing Building ............ Vacant Land ............. Location of Property Lot #13b; El:i.~a_h's Ia. ne J~st&tes~ Sec. 1~ H&ttituck~ N. Yo House No. 5'treet Ham/et Owner or Owners of Property . .l.n..1.&.n.d...H.o.m.e.s.t..l.n.c... ..................................... County Tax Map No. 1000 Section ...... lOB, ..... Block . .4 ............ Lot.. 7...3,~ ......... Subdivision ................................. Filed Map No....6.O.~.5....Lot No .............. Permit No 11272 Z .7./. ]: 3. ./ .~ ........... Date of Permit ... pi/cant ~nland Homes, Inc. Health Dept. Approval . .1.2../7./.8.1. .............. Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ 5.00 Construction on above described building a . Applicant ... R'd-'~'t' 7'E;'.7 Hi:lt'~?' ' ~D'~,~ES',' 'INC'. ....... fdic. FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~ODE FINAL ADI COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 APPLICATION FOR BUILDING PERMIT Application No...~t/dT.~. ........ Date .J.u..1.y..1. O..~ ........ , 19 .8.1. 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, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) Box 117, Mattituck, N.Y. 11952 (Mailing address of applicant) State whether applicant is owner, lessee, agent, ~chitect, engineer, general contractor, electrician, plumber or builder. C-eneral Contractor Name of owner of premises ..... .R. qb. 9.r.1:..$,. ~i. % J;g ................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ............ ................ (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ..... .5.17.-?. .............. Electrician's License No .... .2.1.4.8. 7.E ............ Other Trade's License No. - 1. Location of land on which proposed work will be done .... E..1.i.j..al? .s...L~..n?j..~.a..~.~.~t.u..e.k.,...N,.Y. ............. ..... uS;? .............................................................................. House Street Hamlet County Tax Map No. 1000 Section ...19.8. ............ Block ..... .4 ........... Lot ~ .............. Subdivision....E.l.i.4a..h.s...I~..n?.s..1~..~.t.o.S.~.c....1 ....... Filed Map No .... .6.0.05 ...... Lot . ~ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy V&cant b. Intended use and occupancy ...1...f.a.m.J:.l..y..d.w.e..1.1.J:n.~. ............................................. :-, com~m trGce ~5 c;~d,'or nil'rotes. ~/"4//~' r~quired. -DATA FOR AI~PR0'V/~-..' TO CONSTRUC T SURVEY FOR INLAND HOkfES, /NC. LOT NO. /,:7, "EL/JAN'S LANE EST,,~TE$, AT MATT/TUCK OAT[: TOWN OF SOUTHOL~ SCAL£: SUFFOLK COUNTY, NEW YORK NEW YOI~K STAT[ J~I~JCATION LAW JUNE 3, 19~1 I "=40' ,91 - 295 ~ wat~ ~upp~y may contoin trace ~ amounts of pesticides ond/or ni~ates. ~ ~ ~R WH~ THE SU~EY Is PREPARED H[~ DEPARTMENT-OATA F~ A~R~ ~ C~STRUCT WILL ~FORM ~ T~ ~AN~ OF THE S~K C~TY DEP~TM T TO EXISTING STRUC~RES ~E F~ A I~CIFIC ~ICES, /~ , ~/ ' P~P~E AMO ARE NOT TO ~ USED ~ ESTABLISH OF H~LT~ ~RTY U~S OR FOR THE ~ECTtON ~ FENCES NO~: I ~ ~ ALDEN W.~NG, PROFESSI~AL ENGINEER S~O/Vl~ ~ F/~D W ~g O~ICE Of~ ~RK ~ AND LAND SURVEYOR N.Y.$. UCENSE NO. 12845 ~ ~ ~. ~,/~ A~WO. ~0~ HOWARD W. YOUNG~ LAND SURVEYOR *~L~T~L(W),~ICTAHK(ST)aCE~S(~)WH~E~ . N.Y.S. LICENSE N0.45893 ~E ~ FIELD ~TI~S ~ OR DATA O~T~O s~s ~ __~_ ::, :, :'?. ? It'$~'~ /NL~ND ~ES, INC. N~U~IZED ALT~TI~O~DIT~ m mis SUWlY m A V~A~ ~ ~CTIOi ~ ~ TNE H[~ ~RTM~NT-~TA ~ ~ ~ ~STRUC T ~. (~ ~ ~ .~~RA~ YOUNG~ YOUNG ~,~ ~&~O ~.YOU~G, ~ S~EYOR ~ L~ m ~LM),~C ~m~l ~ ~ M~S. LI~SE ~.4~9~ ~ ~ ~ ~T~S ~ ~V~ F~ OTHERS sheet, ~o. /or, /," :: I)CCI~?ANC¥ OR USE B, UNLAWFUL Vfl'fl-;~T CERTIFICATE OF OCCUPANCY LWl~J~ APP.,RQVED AS NOTED ..~ NOTI~ BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ]. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C, O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. -r . PX~ 0 ktID AT O ii ;F