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Home My WebLink About11282-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z'I~6R8 .......... Date ............. May..~ ........... ,19 8.5 THIS CERTIFIES that the building Accessory . Location of Property ....~.9.0.. F_&ijara .t,azm ................ iVlatt/.tuck .............. Mouse two. Street Hamlet County Tax Map No. ]000 Section ...108 ...... Block ... 0.~ ......... Lot .... O0~.008 · · · ._ Subdivision .Gree~bri~ .Ac~.ea ........... Filed Map No.. 6609 · .Lot No ...... ~ ...... conforms substantially to the Application for Building Permit heretofore f'fled in this office dated ·..~ILme..~[5 ........... 1981. pursuant to which Building Permit No...1~.2@2~ · ........... dated July .15 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 ......... for an above ground pool The certificate is issued to Terronce E. Matthews (owner, le=ee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..... ~/(.A. ................................. UNDERWRITERS CERTIFICATE NO...1~.6..0~..0.~.? ....................................... Building Inspector Rw. 1/81 FORM NO. 2 TOWN oF SOUT.0~D BUILDING DEPARTM~N~ TOWN HALL SOUTHOLD, N. y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMIS~ES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ' 11282 Z Date ....... }...~... ................ Permission is hereby granted to: .....4..: ....... ~..~.~..../,o..~....C."..: ....... . ..... ~: ~7~....~../~.~; , ~o .......... .~.~.2F2~.a.,..r:....~z~.~.....~Z~a~.~ ........ ~.~....:.~ .............................................................. L.. ................ : ......................................... pursuont to opplic*tion dotod ..... ~:~ ........ Z.~ ........... 5"'"' 19.~Z ~nd ~pprov~ bv tho Buildlno In*poctor. ............. ~ ' ~g inmector ' Rev. 6130/80 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 featu res. 2. Fina~ approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical ~nstallation 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 alt 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 New Building . .~-~..~ ........ Old or Pre-existing Building(X) ........ ~ ZVacant Land ............ Location of Property . .,-~ ............... ~ ............ ,'%.~. ,~- .................. House No, Street Ham/et Owner or Owners of Property ...,,~'..c.~..~,~,,~_ .~.'~ .~._._~..~'. ~.~.~,,~./.~.~, .~.~.. ~...~ ,~.~,~..~. ..... County Tax Map No. 1000 Section .. / ~C).~. ...... Block ....~.'~. ........ Lot..~..o.~..~ Subdiv.sion..~.~..~.~.'~.~..~.,: .~ .~... ~ .~.~..~ .......Filed Map No. G~.~ ~ .~.... Lot No .... .ZZ/.. ....... Permit No. Z ./.~..~..'-~-... Date of Permit ?..~ ./~..o~/.Applicant ...~.~.~.U .~.~.~.~. ................. ?.. Health Dept. Approval ........................ Labor Dept. Approval ......................... U nderwriters Approval ........................ Planning Board Approval .................. ~ ,,, Request for Temporary Certificate ..................... Final Certificate ........ ~ ......... * Fee u m tted Oonstruetion on above desanbed building and permit'mee~s all ap~oabl~es an~lations. App cant ,~~_. ,~./~~~ ....... ],aoo37 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.~ BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 B. te ~lt~,y 27, 1~)[:~.~ AppllcationNo. onJTle ~71932-82 N 60~059 THIS CERTIFIES THAT only the electrical equipment as described below and introduc~ by the applicant na~ed on the above application number tn the premises of Te~y ~e~s~ El~jah~s I~z~e~ Rte. 48 & PWe. ~, ~t:ti~k, N.Y. {n tbe/ollowlng location; ~ Basement ~ 1st f'l. ~ 2nd FI. ~tside Section Block Lot ~as exam.ted on ~? ~ ~83 and found to be ,~ ,ompllance wtth ta~ requi~,n~nts of tai~ ~o.~d. FIXTURE OUTLETS SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS FANS DRYERS SPECIALREC'PT. TIMECLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS SERVICE DISCONNECT S E R V I C A w G OF CC COND NO OF HI LEG A w G NO OFNEUIRALS OP HILEG AWG OF NEUTRAL (~larles M, Hall Elect~ 760 I~;:ag Cre~-~fk Dr~ ;,southold, N,%., 11971 #657 Th~s certificate must not be altered tn any m~n~er; return to the ofhce of the Board ~f ~incorrect. Inspectors may be ;~credentials. ~IG ~RTMENT. N ANY MANNER, COMMENTS FIELD~iNJ'~ECTION FOUNDATION (lst) FOUNDATION (2nd) 2o ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 ~ TEL.: 765-1803 Examined..d~/~..Z.~., 19~. ~__ .................. /~l~ng hspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS /~ 198'/ Date~ .......... , a. This application must be completely filled iu 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, relationship to adjoining premises or public stre~ or areas, and giving a detailed description of layout of property must be drown on the diagram which is part of this apE. 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 pern 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 HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulabons, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections. .... ./.~.. ¢.:. T/..'54.'. .... : ...... (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build~ Name of owner of premises ................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer)/' Plumber's License No ......................... Electrician's License No ....................... Other Trade s License No ...................... ? Location of land on which proposed work wilt be done ................................................ .~ ~ ~ ........ ~./. ~ ~..4 :?..~ ~ .~.~.- ................ .../~.. ~ .4. ~.-:~.~ ~ ................. House Number Street Hamlet County Tax Map No. 1000 Section .../.'.o. ?. .......... Block ...¢?..~ ............ Lot..<~.cD~'.*.°. 9.~... Subdivision. '.~77..~.'z, 4.~.".~..rT..../~...c; .~.e-v 5 ............ Filed Map No. ¢.~..c?..9 ....... Lot., ~ .......... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... , .................................................. use ana occupancy .. :.~.~ ~.:. 4~.~.~.....~.: .¢..Z.. ~ .z.~.¥ ~..~..o:~ .~.45../, ?.~./. .......... b. Intended Nature of work (check whict, applicable): New Building .......... Additio .... Alteration .......... Repair .............. Remogal ............ Estimated Cost .............. · Demolition ............ Other Work ............... (Description) ......... Fee. (to be paid on filing this application) If dwelling, number of dwelling ~nits ............. Number of dwelling units on each floor ................ If garage, number of cars ..... [ .................................................................. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ............... Height ............ ~... Numl)er of Stories ...................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ...?.,. ........... Depth ...................... Height ...................... Number of Stories ...... ., ............. Dimensions of entire new constrgction: Front ............... Rear ............... Depth'. ............ Height ........... Number of Stories .. '.. Size of lot: Front ...........i ........... Rear ................. i Depth ..................... Date 6f Purchase ........... ! .................. Name'of Former Owner ............................. Zone or use district in which pretnises are situated ...................................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ............................. Wilt excess fill be removed from premises: Yes No Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect .......... . ................. Address ................... Phone No ................ Nme of Contractor .......................... Address ................... Phone No ................ PLOT DIAGRAM Locate 61early and distinctly all i' buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street and block: mmber or description according to deed, and show street names and indicate whether terior or corner lot. ~" t 5 TATE OF NEW ¥O.~K _ i ,. ,. ~r-.~ .~.,~.,~~.......'"7. ...... being dtdy sworn, deposes and says that he is the applicant (Name of individual signing contract) ~ove named. , e is the ..................... ~.~... ....................................................... (Contnactor, agent, corporate officer, etc.) t' said owner ar owners, and is duiy authorized to perform or have performed the said work and to make and file this ~plication; thatt all statements coniained in this application are true to tlie best of his knowledge and belief; and that the 'ork will be performed in the manner set forth/n the application filed therewith. worn to before me this , ............ /t.5'c~' .... day of ....... ~~"., 19. otal~Pu~ic, ........ ~ ....... .~gt(-~gn~. County /j ~nl~An¥ Ptl~LIC, State of uew ~ .................................. , t.,, I' ~',i-' ~, ~,s~f~a~- 0, su,o ~ c~u~cou c.- ) (Signatu~. of applicant) ] ' Term Expires March ~u, · u~