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Home My WebLink About11285-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z. 1.4..2.3.2. .......... Date ...F..e..b F.u.a.~..Y..1.8. ................. 19 .8.6. THIS CERTIFIES that the building ., ~ 99.1 .......................................... Location of Property ..... 399.0..S. 9.ur~.d,¥ .5.eY..4¥.e .................... ~..a.~.~.~.t. ,u.c.k ....... House No. Street Ham/et County Tax Map No. 1000 Section ...0.9. q ...... Block .. 9.2 ........... Lot . 9.0.3 ............. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..J..u.~.e..2.2. .......... , 199.!. pursuant to which Building Permit No..1.1.2..8.5.g .............. dated ...J.u. ,~ y..1.5. ................ 199. 1.,, 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 ......... .... ~:~g~.QU~.c[ .poo.:L .~.tlx .~e~.c.q ............................................... The certificate is issued to ..... q 5 b.~.c.~.a. 59..~...~.~?.~. b. b.u.q .&~.z.a.. ! .~.~.~.~.~5..~.~.7..~.~.~.) ....... (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval ...... IxJ../g ................................. UNDERWRITERS CERTIFICATE NO. ~) N 5 2 7 3 0 9 Rev. 1/81 BUILDING PERMiT~ (THIS PERMIT MUST BE KEPT ON THE PP, E~I~[ES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) · .... ~o. ~2ss z ~o,e ~.!! ~...~. ....................... Permission is hereby gronted to: ~.~.~.......Y.~..~.....:~, at premises located at ...~Q..~...~.. ..... ' / / ............................................................................................... :....~. ............ ~~.~.~... ~un~ Tax Mo~ No 1000 Secton B~k ~ . Lot No pursuont to opphcohon d~ted ............... F".", 1 ., ~nd opproved by the Building Inspector. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~- I~m~e~m 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. Commercia~ buildings, ~ndustrial 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 ex~st~ng buildings (prior to Apri{ 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of prOperty 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. Fees: 1. Certificate of occupancy $5,00 2. Certificate of occupancy on pre-existing dwelling 3, Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 New Building.....,..,,...V'/ Old or Pre-existing Building $15.00 Date .... /./. ?, .~./f..~. ....... ............ Vacant Land ............. Location of Property . ,~, ¢-.~'~2 ..... ,,$ ,o..~. ,~. ?. ~,,~1~,. 46].&z~ ...............,/~ ;9~F.~7. ~ .~. t/f4 .~,.. Houee No, Street Ham/et Owner or Owners of Property ....~..;.~ .d .d~ ~ ~,- J~O.../9,7~. ~ J .~, P. P~ ..... 8..O.~..,~ ?..~..~. ...... County Tax Map No. 1000 Section ?~ - ~)- - ~ Block Lot... Subdivision ................................ Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .... ~,: .~.O. ................... Construction on above described building and permit meets all applicable codes and regulations. Applicant Rev, 10-10-78 FO~:~M NO. 6 TOWN OF SOUTHOLD BuildJn§ Department Town Hell Soutbold, N.Y. 11971 APPL!CATION FOR CERTIFICATE OF OCCUPAF~CY Instructions A. This application must be filled m typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following, for new buildings or new use: 1, Final s~Jrve¥ of prope~tv w~th accurate location of all buildings, prooerty lines, streets, and unusual natural or topographic features. 2, Final approval of Health Dept of water supply and sewerage d sposa -(S-g form or equal). 3 Approval of electrical installation from Board of Fire Undet~vriters. 4 Commercial buddings, Industrial buddings, Multiple Residences and similar buildings and installa- tions, a certificate of Cocle cornphance from the Architect or Engineer responsible for tho building. 5. Submit PJanmn.(j I~oa~(J approval of completed site plan [equ~rements where applicable. For exlstln[j bulidl¢].qs (prior to Al)rd 1957), Non-conformine uses, or buddings end "pre-existing" land uses: ~ 1. Accurate surw, y of peopert¥ showing all property lines, streets, buildings and unusual natural or topooruph~c features. 2. Sworn statement of owner or plevlous owner as to use, occupancy and condition of buildings. 3. Date of any I~ou~m.g code or safety inspection of buildings or premises, or other pertinent informa- l~on requued to prepare a certificate C. Fees. 1 Ceruflcate of occupancy $5.00 2. ?rt~flcate of occupancy on pre existing dwelling or land use New L~uddmg~ ....... Old or Pre-ex~sting ~udding ............ V~cant Land ............. ~ounty Tax Map No. 1000 Sect,on ............. ~lock ............... Lot ................ Subd~wston Permit .......... Permit .......... Applicant . ,~ ........... No Unde~riters Approval .Planning Board Approval ...................... ,onstrect~on on above descubed budding and per~, ~c~es~ulations. Applicant ..... THE NEW YORK BOARD OF FIRE UNDERWRITERS ; -i BUREAU OF ELECTRICITY ~> 85 JOHN STREET, NEW YORK, NEW YORK 10038 Date '~kl]',x] j ]}:~ ],; gL Jppllcat~on No. on file ~ ' 2 THIS CERTIFIES THAT ~'/ %` f ' J g only the electrlcal equipment ~s described below and introduced by the applicant ~lamcd on ~he able appllc~on number in the premises of in thefollotvlng Iocation~ ~ Basement ~ 1st FI. ~ 2nd Fl. Section BIoch Lot was examined on 'J[a~ Y~ ~ ~ ~ ~ ~' and found to be in compliance with the requirements of this Board. FIXTURE OUTLETS IECEPTACLES 1 SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS MERCURY ~NCANDESCENT FLUORESCENT VAnOR DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R OTHER APPARATUS. I C E A W G NO OF HI-LEG A W G OF CC COND OF HI LEG AWG OF NEUTRAL !,tc~ 1227 This certificate must not be altered ~n any manner, return to the office of the Board ~f Inspectors may be identifle, COPY FOR BUILDING DEPARTMENT. THIS COPY OF NOT BE~ ALTERED IN ANY MANNER, FIELD INS?ECTION~ FOUNDATION (%~st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL COMMENTS ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.; 765-1803 Examined ~ .~/.../*..~...., 19.~./. Disapproved a/c- .......... o. ...................... ...~...~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Ap plication N o..~./d~...~. ...... INSTRUCTIONS a. This application must 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, relationship to adjoining premises or public stre~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap!: 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 Yorkr~m,d other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for/~embval or dem~ition~,as herein describ~ The applicant agrees to comply with all applicable laws, ordinances, buildt~f?~h~ousing/o/~e, a~ regulations, and admit authorized inspectors on premises and iu buildings for necessary inspe?ti~.~ ~ ~/// ~/ ......... .... ?....:..,.. (Signature of applicant, or name, i~ a corporauon) .... .... ...... (Mailing address of applicant) State whether applicant is owner, lessee, a~ge~, architect, engineer, general contractor, electrician, plumber or bull& ................... . ..... Name of ox~ ncr/~emlses . ~//~e4~..'wtx.~r~,~-~,~ ..... (as on the~''~''~: ' '~' ';a'x roi' "'~ ~; i~t;;t' (];;d")' ..... //' ............. If apphcant, fls.~l~oratioV)gn~ure//of duly authorized officer. (Name and title of corporate officery Builder's License No .......................... Plumber's License No ......................... Electricians' License No../2~. ..../~:.~. .'~ ......... 1. Location of land on which proposed work will be done ................ ...................................... House Number Street Hamlet County Tax Map No. 1000 Section ..... .~..~.J ......... Block ...e'e~ ............ Lot .... .~. .......... Subdivision ..................................... Filed Map No ............... Lot .............. (Name) State existing use ailS occupancy of,l~remises ~nd intended use and occupancy of proposed construction: 02 . a. Existing use and occupancy ... ~~' ............................................ b. Intended use and occupancy .... (].~...~......&.....~....~/L~...C..~. ........ 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