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HomeMy WebLinkAbout11294-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y, Certificate Of Occupancy ho. 7M. 108B, ......... Date ...... Jul;y..14 ................... 1982. THIS CERTIFIES that the building ................................................ 2?25 Oaklawn Avenue Location of Property .39 g.~; ............... W~i is. A~enu.~ ............ S ou.t;tlO1 ~ ...... House tvo, Street Hamlet County Tax Map No. 100D Section . . 0 ? D ....... Block . .0./f ........... Lot . .0. 0 .1 ............ Subdivision .... 1( .......................... Filed Map No..1( ...... Lot No...X ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... · 1u1¥..20 ....... , 19,8 ] pursuant to which Building Permit No...1 .I .~. 9. 4.. . .Z ............ dated .. Jll.l~r. 2.1 .................. 19.8.1[, 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 ......... ..... a. d.e.ck, a.{td~1;;t.o.~..t;.o..a.n..e.x,~,s. ,t:,X,n,~. 9.n.e.-.C..a.~.t.l:~r..d~e.~..1.J..n.g.: .............. The certificate is issued to ...... l~ql~e~'.~ . .H ,..l~q .t; .h.ra.~.n...&. ?.~ .f.e ......................... {owner, of the aforesaid building. Suffolk County Department of Health Approval ........ :1 { ~ ............................... UNDERWRITERS CERTIFICATE NO ................ ~[ ~ ............................... Building Inspector Rev. 1/81 N©. 11294 z TOWN, OF ~O~TH~D BUILDING D£PARTM~N' TOWN HALL~ ~ SOUTHOLD, N,. Y. i BUILDING P, ERMI~ (THIS PERMIT MUST BE KEPT ON THE PP, E/?~ES UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) ~L~ ...;~ ..... Date ...... ~ 'T ...... T ...................... ' Per~nission is hereby granted to: , ~ ~.?.... ..... : ........... ~. i~ . ..:: .......... ~ ........ ~ ......... ~ ~ ~ ~ . ........ ~.~....~..~.:.:~. ............. . ...... ~ ............ ~. ....~ ~ .... .~ .. . ~ ~ ~ ~ ~ ~ ~ ~ .. ~.. ~.<~....~L~ ......................... ?...~...~: ............................. ~ ......... ........................................................................................... .............. COun~ Tax Mop No. 1000 Section .... .~ ......... BJ~k . .: ............. Lot No. ~ .................... pursuant to application dated ~L~ .~ ~ .............................. ~ ...... 19 , ond opprovod by tho BUil~lno In~poctor. .................... . 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 apphcation 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 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. 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 New~ng .//~J~..~ ..... Old or Pre-existing Bui].d.~,ng(X) = 'Vacant Land -' ~_"~ 2_~ O~ I~., ~ .' ........ ' ....... Location of Property . .,~ 9,~,¢. .......... ~(~'.. ~ ............................ Hou~ No. S~reet Ham/et Owner or Owners of Property .... , .... k-,. Coup,,,o. 000 .... 02.0 ...... ..... P.tf7 ..... Peg .4 ........ Subdiwslon .... ~ .......................... Filed Map No ........... Lot No .............. Health Dept. Approval ........................ Labor Dept. Approval ...................... ,.. Unde~r~ters Approval ........................ Planning Board Approva} .................. , .. ~ Request for Temporaw Certificate ..................... Final Certificate . . ~ ........... - Fee Submitted $ .... S~. ... 0.~.~) .................. Construction on above described build~ng and perm~meets all appL~cable~codes and regulations. Applicant .; "'4'-' .... '-' ........ ;" ......................... . ..... FIELD INSPEC'PION COMMENTS FOUNDATION (2nd) 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.: 7135-180:3 Disapproved a/c .............................. I~ ........ ,] (Bnilding Inspector) APPLICATION FOR BUILDING PERMIT Application No./'/~' ~/ Date ................. ]9 INSTRUCTIONS a. This application nmst be completely filled iu by typewriter or in ink and submitted in triplicate to the Buildi Inspector, w~th 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan <hewing location of lot and of buildings on premises, relationsMp to adjoining premises or public stre.~ or areas, and Stying a detailed descrlptmn of layout of property must be drawn ou the diagam which is part of this ap[ carton. c. The work covered by this ~pplication may not be commenced before issuance of Build~ng Permit. d. Upon apprc, al of thru apphcatmn, the Bull&ns Inspector will issue a Building Permit to the applicant. Such porn shall be kept on the premises available for inspectton thronghout the work. e. No bmldiag shall be occulned or used m whole or in part for any pnrpose whatever until a Certificate of Occupan shall ]lave been granted by the Building Inspector. APPLICATION IS tfEREBY MA DE to the Building Department for the issuance of a Building Permit pursuant to t Bmldmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordnrances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicaut agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, ~md admit authorized inspectors on prenuscs and in buildings for necessary inspections. ...zff.;.~e...~... zZ...~.. ~ .... ~'.<, ............. (Signature of applicant, or name, if a corporation) ......... ........ ....... (Mailing address orapplicant) },lt:~t~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, ·..~...~..~.~. ~ ~ ........................................................................ ,~ame of owner ofp~'e,n,s0s ..m. ¢.:...~..~..~.X .... ..~_.....W~..'...m.~ ........................ (as on tile tax roil or latest deed) If applicant is a c_ozporat mn, s[gn~ure of duly authorized officer. (Name and title of corporate officer) Bmlder's License No....'.~..~..~.. ................ Plumber's License No ......................... Electrician's License No ....................... ,/ Other Trade's License No ..................... 1. Locahon of land on which proposed work will be done..~.9.~'. ?:)..~..~: ...... U~..~.~..~...~..~ ./~. ?..~..O~..~..~J · ........ ................................................ ltouse Number Hamlet CountyTaxMapNo. 1000Section ..:~..~? ........... Block .... .~.. .......... Lot .... /. ............ Subdiv~smn ..................................... Filed blap No ............... Lot .............. (Name) State existing use and occupancy of premises and/intended use and occupancy of t2roposed construction: /, ,~b. Intended use and occupancy . .~.~7.~ .~.... ~.,~..(~.. ~-- /~ ........................... I. Nature of work (cheek which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Renioval .............. Demolition .............. Other ",¥ork .t~e~J .~-~ ...... ~ZtDO ' / _~?:,~,. (Description) E timat'd Cos' F (to be paid on filing this application) ;. If dwelling, number of dwelling units ............... Nulnber of dwelling units on each floor ................ If garage, number of cars .... ' .................................................................... ;. If business, commercial or mixed occupancy, specify fiature and extent of each type of use ..................... I. Dimensions of existing stmctuies, if any: Front ..... .' ......... Rear .............. Depth ............... Heigb't ............ ~... Number of Stories ............... ' ......................................... Dimensions of same structure With alterations or additions: Front ................. Rear .................. Depth .................. '... Iteight ............... ~...... Number of Stories .............. ~, ....... ~. Dimensions of entire new cons!ruction: Front .../.'"~.. ....... Rear ../.'~.rr.'~ ....... Depth . ,,~-,O ......... Height ............... Nuinber of Stories ......................... ~ .............................. 1. Size eliot: Front ...................... Rear ...................... Depth ....................... ). Date of Purchase .......... i ................... Name of Former Owner ............................. I. Zone or use district in which premises are situated ..................................................... !. D,oes proposed constrnction violate any zoning law, ordinance or regulation: ............................ .~ ~. ~,t, ill lot be regraded ........................... ~ Will excess fill be removed from premises: Yes .1.Name of Owner of premises .................... Address ................... Phone No ................ Name of Arclutect ......... ' .................. Address ...... '...; ......... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ PLOT DIAGRAM Locate. clearly and distinctly all et 'ld ngs, whether existing or proposed, and. indicate all set-back dimensions from roperty lit~es. Give street and block number or description according to deed, and show street 1lames and indicate whether terior or corner lot. TATE OF' NEW YO2~K, )eve named., sworn, deposes and says that he is tile applicant e is ]the .................................... . ..................................................... : (Contractor, agent, corporate officer, etc.) t' said owner or owners, m~d is drily authorized to perform or have pet~forlned thc said work and to make and file this >plication~; that ~all statements con}ained in this applicatmn are true to the best of his knowledge and belief; and that the ork will be performed in the m~n~r set forth h~ the application filed t'?erewith. worn to before me this ....... ........ o,'r ...... .... JUdiTH T. T~ ~ ] Nota~ Public, S~ate bf New Y~ i ~mmisston Expires M~rch 30~ l~,