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HomeMy WebLinkAbout11346-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Occupancy NO. Z. J .4.9.5. ! .......... Date ........................ Oct ob.er. 6! ...... 19 .8.6. Addition to existing dwelling THIS CERTIFIES that the building ............................................ .. . . House No. Street Hamlet County Tax Map No. 1000 Section 1 1 1 .Block 14. ...... Lot 018 Subdivision .~l/.q .l~g~.s. ai~..P.qi.n..t ........... Filed Map No. ........ 156 Lot No .......... 235 & .~. 9f 235 conforms substantially to the Application for Building Permit heretofore ~ed in this office dated A.u. gV ~.t..], 8, ........... 19 t~.1. pursuant to which Building Permit No..1 1.3. 4 .6 Z dated . .A.u..g.u.s.t...1.8., ............... 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 ......... Addition to 'existing one family dwelling The certificate is issued to E r n s t L. M i d g e t t e (owner, ~Jiii;W t~XJ~ of the aforesaid building. N/A Suffolk County Department of Health Approval ................................... .. . . ... N547711 UNDERWRITERS CERTIFICATE NO ......................................... .... . .... Rev. 1/81 FOE~I NO. TOWN OF $OU~l~Oi D BUILDING DEPAR~M! TOWN HAL~ SOUTHOLD, N~ Y. BUILDING IXERJ (THIS PERMIT MUST BE KEPT ON THE P~E~ISES UN~IL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 11346 Z Permission is hereby granted ....... ..... 71..~.z'~....: ................. ..~..=...~.. ....... Z..Ifx.,~..~:.~ z~(~,...~i ................ .~ ........................................ County l~x ~op ~o. 1000 Section ,..Z~.~,.,,~,..:... .... Bl~ck~....;. ..~ ...~ kot ~o....;~. ........ pursuant to opplicotion d~tod . ~...,.ff.~{ ................, I~. Ond opprovod by tho Buildln~ In~poctor. 5 / Rev. 6~30/80 ;: FORM NO. 6 TOWN OF SOUTHOLD Buildlng Department Town Hall Southold, N,Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Ao This application must be filled in typewriter OR ink, and submitted 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, propertv 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. For existing buildings (prior to April 1957), Non-conforming uses. or buildings and "pre-existing" land uses: 1. Accurate mJrvev of p~operty 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 $15.00 3. Copy of certificate of occupancy $1.00 .. 4.Vacant Land C.O. $5.00 9/1.6../86. 5. Updated C.O. $15.00 Date ...................... New C on a t r u c t i on Old or Pre-existing Building Vacant Land 12.2,0 Little Feconlc Ba.y Ro. ad. C.?.t.c.b;.o..~?e.. N .~ Location of Property ............ , ............................. : .' ..... Hou,~e No, Street Hamlet Owner or Owners of Property Ernst L. Hidgette County Tax Map No. 1000 Section 11,1 ....... Block 1,4 ,018. Subdivision .~./.o...N.a.s.s..a.u..~o. $.n.~ .............. Filed Map No.. 1, .5,6 ...... Lot No. 2.3.6...&..~......°f 235 Permit No.....113.4.6.Z. .. Date of Permit .8./.2.7../..8.1..Applicant .................................. Health Dept. Approval ..... i~.../A ................ Labor Dept. Approval ........................ Underwriters Approval...~5.4.7.. 7..1.1 ........... ... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....x ................... Fee Submitted $ ..... 5., .Op..C..k ... ?. ! 7.2.~ ........ Construction on above described building and permit meets all applicable codes and regulations. Applicant .......... ~;~'p~s.%, $, ,~$ d, g,e,t.~ e. ...................... Rev, 10-10-78 3o f3 ? ,~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 10003 ~3 BUREAU OF ELECTRICITY 8E JOHN STREET, NEW YORK, NEW YORK 100138 THIS CERTIFIES THAT only tbe elec trlcal equipment ~ described belo~ attd intmdaced by t~ applicant fla~d on the above application ~umber in the pre~tlses of in the following locatlm~; ~ Base.~,~t ~ 1st FI. ~ 2nd FL Section Block Lot ~.~ ~.,,~i.~a o,, ~C~' 24, 1901 .,,d/o..a to ~ i,, ¢o.,~tm,,¢~ ~ith th~ ~.,~,.~.,t~ o/thi,~ ao~d, FIXTURE OUTLETS ~ECEPTACLES SWITCHES FIXTURES RANGES OVENS EXHAUST FANS DRYERS FEEDERS SYSTEMS NO OF FEET ~THER APPARATUS E R AWG OF CC COND C NO OF HI LEG E A W G [NO OF NEUTRALS~- A W O OF HI LEG [ i OF NEUTRAL L~c ~ 783~ GRNEI~AL MANAGER Pe~ ~l 'h,s certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspecto~rs may be identified by their credenhals TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 August 18~ 1986 TEL. 765-1 $02 Mr. & Mrs. ~L~ Mzdgette 1220 Little Peconic Bay Road Cutchogus, New York ~1935 Dear Mr. & Mrs. Mldoette: While reviewing our files I find that your expired building permit # 11346Z has never been finalized. Kindly return the enclosed application with a check for $5.00 so that we may issue a Certificate of Occupancy and complete this outstanding file. Yours truly, Southold Town Building Dept. TOWN OF $OUTHOLD OFFICE OF BUILDING II~SPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 August 18, 1986 TEL. 765-1802 Mr. & Mrs. Edward Midgette 1220 Little Peconic Bay Road Cutchogue; New York 11935 Dear Mr. & Mrs. Midoette: While reviewing our files I find that your expired building permit # 11~46Z has never been finalized. Kzndly return the enclosed application with a check for $5.00 so that we may issue a Certificate of Occupancy ~- and complete this outstanding file. Yours truly, Southold Town Building Dept. FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1B92~ Examined '~' (';'2'' ~: .7. ..... 19~. Application No.././. 5'?(.~T'. ...... Approved//~.O¢.. ~ 7...,19~?. Permit No.././..~.~?. Disapproved a/c ....... : ....... '~ ........ c'7/ ........... ................. : .7'.-T 72 .......... ~ ...... ~..' (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .................. , . INSTRUCTIONS a. This application must be completely filled iii 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 bnildings 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 commem, ed before issuance of Building Permit. d. Upon appm.al of this appbcation, the Btnlding 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 m part for any purpose whatever until a Certificate of Occupan s!iall have been granted by the Building Inspector. APPLICATION IS IIEREBY MADE to the Building Department for the issuance o£a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, 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 r~mI~ions, and admit authorized inspectors on premises and in buildings for necessary inspections. , / / (Sigl~*ffre of applicant, or name, if a c~/porat, ion) '(Mailing address of applicant) /? State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build, ............. ............................................ ~ne of owner o~prem~ses ..... /~.~..'r./~.~.S:..~4'-.'~/YX./.~.~e..~.<.: ............. , ............. (as on the tax r611 or latest deed) If applicant is a corporation, signature of duly attthonzed officer. (Name and title of corporate officer) Builder's License No ....... Plmnber's License No. . .~ .............. Electncmn s License No .................. Other Trade's License No ...................... 1. Location of land on wtxich proposed work will be done. ,al.qr...&..~.g. ;r..-~7.oJ". j..."rS..'~..'f.". .................. .............. .,/../,?.'. & ....... ......... House Nmnber Street Hamlet · Z(/. ......... Block ..../.~ ........... Lot...c~. (.( ......... County Tax Map So/00..J,0 Section~.__...;,7z , -- ~/'., ,Z_ Z Subdivision .... .'~f4~. ,5.~.'~..r~. f. Y::~ ................. Filed Map No .... ./..'.~..'.~ ...... Lot .~5..?."?... (Name) 2. State existing use and occupancy of premises and intended use,~nd occupancy of proposed construction: a. Existing use and occupancy b Intended use and occupancy ~-~..''wI7 .~. , Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. RemoVal .............. Demolition .............. Other Work ............... Estimated Cost ............ ' ............... ee .................. ~ .......... ' (to be paid on filing this apl~ication) / / If dwelling, mnnber of dwelling units ............... Number of dwelling nnits on each floor .... / ............ If garage, number of cars ......... */~.(~ ................................................ If business, commercial or mixed occupancy, specify fiature and extent of each type of use . .4~.~..~'~ ............ Dimensions of existing structure~, if any: Front ............... Rear .............. Depth ............... Height ............... Numlber of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... I. · Heigkt ...................... Number of Stories ...................... Dimensions of entire new construction: Front ....-~. t..~.*.~. .... Rear ............... Depth ............... Height ............... Numlber of Stories ......................................... .~, ............. Sizeoflot: Front ........ z-.- ~:~ ......... Rear ....... ¥.~ .......... D ep t h,./~. ~57~M ~.'~. .......... Date of Purchase ........... /.~. r~.~.~ ........... Naive of ~Forr)ler Owner .../~.//./.. ................... Zone or use district in which pr?rises are situated ...... % .~ .7F'-,4~/.o.~. ~ ~_~....~ ........ ' .................. Does proposed construction viol;ate any zoning law, ordi.nance or regnla~ion: ../.~..~..~t( .'~. ................. .*... Will lot be regraded ....... ~t54..~:~ ..~..~.. ~ ~: ...... Will excqss fill be re~mo~e~ from premises: Yes '~ No Name of Owner of premises .~. ~ ./-~../.,,r.//..,~r.~..~./...~. .... Address . ."~'.~..~..~L~..~. .t?./...~.'~.... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor . .~TT., .h:q. ~. c..~&CC/ ....... Address .... ~..q<-~.~..~.~,/.~.... Phone No.. j~.O ~ .'~a~/.?.. ). [. PLOT DIAGRAM Locate clearly ,and distinctly all,; buildings, whether existing or proposed, an&indicate all set-back dimensions from roperty lines. Give street and block number or description according to deed, and show street names and indicate whether terior or corner lot. TATE OF NEW YD'tlK r~ ~ S .......... ~..x .,f~...../.././; --O...'~(7'../'7 .,~. ...............being duly s,vorn, deposes and says that he is the applicant (Name of individual signing contract) e is the ..................... ~ ........ ( ...................................... ' (Contractor, agent, corporate officer, etc.) f said owner or owne~, and is dMy authodzed to perform or have performed the said work and to m~e and file Ods ~plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the 'ork will be performed in the mann{r set forth in the application filed therewith. worn to before me this , ' ~ Term rb,r~s ~arch 30 19.~ ~ ~ , (S~gnature ofappheant) i , ~o. s2.a~2s850, Suffolk Count_ ~' ~ ~Signature of, ..... , .... ~ .... ~ ....... ~' .- '-~.~-~'~.~,,~'----,,~"~ . ~-'"~'"'~~~ ,'-T'q~! -! I , ~.,._ . _ ........ ,4 o. ~ . · 1~-4~~~t'-l~ _... ....... ...... ' ' . ..'... ';.. ~:~.-:':z.,..':"" · ~ ' '-' · ~ · ' ' ' '?'- ;.~2 .... - .... ~ - ~.,,*/ / -Ir> ~./ i /i ~' / _~ _ ~..~ ....> ..... ~,, ~.~ . ....... ~a~" ~ ..... O~ /~' ' '' ~OLLOWI¢~G~(.i~ p(3[]REDINSPECTIOb4S" I, ~OUNOA'rlON TWO R~QUIRED " ~ ,. -)-~j '-[ , coNCP,~TG : .... /' / ~? i ........ ,~.._ ~,, RtA[J¢~ "FRAMING · ,~, IN~ULATIC3N .. ~ "~' ' ' _ ~_][ --- ~j ' BE Cr)Mpl--I~TE FoR'C. O." - .- , , ,, .. ....... ALL CONSTRUCTION SHALL ME~T gTATE'CONSTRUCTION & ENERGY~RO~ I cONSTRuCTION ...... ' ~ " ' ¢.' ,,~ s¢7~,".,r [~¢,~D~7~. ............. " t~l~ ~ ~ "' ....... " ~ -~.-- ::q r" I ' ,,.: ~- . ....... t/ ~ ('"-"' ~" '"'-~ ~ ' ' I'. ~ .... ~ : '..-;.%.-.. - :._ ~..~.. .......... ~ ,. .... "' ..-- ""-" ~.~ .~.'~....-' ........., ... '-:.' ,~"~" ~ r ~-Z; -N ....... '-1'