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HomeMy WebLinkAbout11060-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall $outhold, N.Y. Certificate Of Occupancy No. Zq 36q0 Date July 9 85 THIS CERTIFIES that the building . one-£amily dwelling. ~00 Prai~y Lane Cutchogue Location of Property [-I(~;s'e 'l~ol ....................... 'S't/e~i ....................... ~/~/'e~ County Tax Map No. 1000 Section '109 .Block 5 .Lot Subdivision .......... :c .Filed Map No. x .Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 9 .~ .'lp q~060Z ...................... 19. ursuant to which Building Permit No ...................... dated ..... .M.~F. qh,..'1.9. ............. 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 ......... .N. ew 9ne-.f.a.m. il.y dwelling. The certificate is issued to ... i~EGGY S. I~FEIL (owner,~ of the aforesaid building. Suffolk County Department of Health Approval . q ~] 7S0-26 UNDERWRITERS CERTIFICATE NO ................................................. -Bm-l-ding Inspector ..... Rev, 1181 l~OEl~ NO. ~ TOWN OF $~UTHOL BUILDING D~ARTMENT~ TOWN HALL SOUTH'OLD, N~ Y. BUILDING P,ER~IT ITHI$ PERMIT MUST BE KEPT ON THE PREMISES UNTIL. FULL COMPLETION OF TH£ WORK AUTHORIZED) Permission is hereby granted to: ......... .~.~.~.~.~..~...~:,.~'~ ................ ........... ~'.'~'~z~ ~' ~.~..~.~ ............ ............................................................. ? ............... ~ ~o.....~...~.~.~.~.cz.....~.~......~.~.~.,~....~z./.,~;.....~..~. ....................... ................................................... ~..~...~5:.....~.~ ........ ~ ........................................ County Tax Map No. 1000 Section ..... ./...~...? ....... Block ...~',.~,. ......... ~Lot No.....C~.~,~..~.. ...... pursuant tO application dated .~./~-~..C~/~.......~.'. ........................ , Building Inspector. Pea ,.../.~C...~.. and approved by the Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD 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 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 survey of pZt~perty 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. 85.00 $15.00 Date ........ Z..u~.e.. :]:. 7,'.1.9. 8..5 .... New Building × Old or Pre-existing Building Vacant Land Location of Property 1400 Pra~ty La~e Cu'cchogue House No. Street Ham/et Owner or Owners of Property .~,e.~rc~. S. Pfeil County Tax Map No. 1000 Section 109 Block 05 Lot 025 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. 11060Z Date of Permit 3./..8.1 Applicant Health Dept Approval 11-SO-26 Labor Dept Approval Underwriters Approval . . .~. 5. &. .0 ,7 ,4. 6. ............. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .. × Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and regulations. . . ~ ~ppllcan~ .................... /. ............................... ~'~' ~Z~ call when ready 73~S200 ,.. ,o.,,.,, ~oo~o~3 THE NEW YORK BOARD OF FIRE UNDERWRITERS Q~ BUREAU OF ELECTRICITY ES Jo.. STREET, .E"' ¥OR , - THIS CERTIFIES THAT only the electrical equipment as ~scr~bed below and introduced by ghe applicant named on the able application ~mber i~ the premises of was ext.nb~ed on OL~O~L* ~0 ~ ~)~fi~ and found to be in cotnpl[ance with the requiretnents of thts Board. FIXTURE OUTLETS ~ECEPTACLE$ SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE /~OTORS FEEDERS TIME'LOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO OF FEET SERVICE DISCONNECT OTHER APPARATUS S E R V I C E 1 210 .~ 2/0 G~gy Do~oaki iic.294i-E GRNEI~AL MANAGER Thts certtflcme must not be ahered in ony manner; return to the office of the Board if ~ncorrect Inspecto~rs may be idenhfled by their credentials. FTEr~ Ii~PECTION COMMENTS FOUNDATION (~st) FOUNDATION 2. ROUGH FRAME& PLUMBING (2nd) INSULATION PER N.Y. STATE ENERGY C0~)E ' FINAL ADDITIONAL COMMENTS,: FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved 7' ', Permit (Building Inspector) Application No../.~..~. P~. ?. ........ APPLICATION FOR BUILDING PERMIT 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 heroin 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 inrs~0ections. .... .~. '..¢~..v ..~:.~....~-..~..~ ............. (Signature of a~plicant, or name, if a corporation) ...q_~..~s4. ~ !...v>.q ¢ v~.*-. ..... CP.. !., ............ (Mailing address ~f applicant) . State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or build~r~ ............. ............... ..................................................... 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) Builder's License No ....... ~ .~/ .............. Plumber's License No .... ~'. ~3..t~a:...~. ........ Electrician's License No. ~-2~ ~ t~. c¢x ~' Other Trade's License No ...................... 1. Location of land on which proposed work will be done.. ~ . .cq ~.t.L~. .... ~o~ ~ ~ .. ~.1:.. ~ :~. House Number Street J/0 ~ Hamlet co,~ ~a~ U,~ ~. ~0~ S~io~ ..... ~. ¢~ .... mo~k .................. ~..: 5¢: ........... ......... ...... (Name') 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ~. :~..T~n& .......................................... Existing use and occupancy ....... use '~1 b. Intended and occupancy ........ ~ ..................................................... 3. Nature ofworlc(check which applicable): New Building .... .~.... Addition .......... Alteration .......... I Repair .............. Removal .............. Demolition .............. Other Work ............... 4[ Lstlmated Cost ....... .O./.0. fl. b Fee .................................. (to be paid on filing this application) 5. If dwelling, number of dwelling !units .... .'~... ...... Number of dwelling units on each floor ................ If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... tteight ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. R6ar .................. Depth ...................... Height ...................... Number of Stories ............... , ....... 8. Dimensions of entilce,,~eav construction: Front .... ~',~: ./,~./.... Rear ...c~. ~..t.~. { .... Depth .. ~ ~. ( ....... tteight ........ J ...... Number of Stories ....... ~ ......................... , .................... 10. !)ate of Purchase .......... ]. ~ .'7.~'. ........... N~ame of F;rmer Owner .. p~..~a ~ .co~] .-~. ............ 11.. Zone or use district in which premises are situated ..... ~..eS J d ~Yt~.Ck.], ............................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .../~.~ ........................ 13. Will lot be regraded ........ /~ O ................ Will excess fill be.removed~from premises:~,,es Yes~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW ¥ORI~,// .~ /2 ,,, o COUNTY O,F .~~. ~'~ ..... ~ .~'~ .................. being duly sworn, deposes and / (NameqSf individual signing contract) above named. says that he is the applicant He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworu to before.me, this . .......... ~ .......... day o£ .... . ./~. · ~ ..... , 19~../. (/ '_._// Notary rul~t~~...'~.~.:., .~. ~:~... County JUDITH T. 'TERRY Notary Public, State of New York Ho. 52-0344953 Suffolk Count~/,,~ Commission Expires Mar~h $0, ~,9,,~ (Signature of applicant) the possibilitY, suppJy m~y,,~ ~. ~ f~ The sew~ di~]. ~d water ~n~ected by this de~rtment ~fo~d  ~:~ Services ~"~'<" '~ ~ ' , , ' ~LL ', 0 6o~ H. UHL oJ / ~PPRO~:D AS NOTED 765-]802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ~1. FOUNDATION - TWO REQUIR~::D FOR POURED CONCRETE 2. ROUGN - FRAMING & PLUMBTNG 3. INSULATION 4. FINAL - CnFICTRUC?ION MUS~ BE COMP[ ~Tc FOR C. O. ALL CONSTR~,CT~ON SHALL MEET ~HE REOU~EMENTS OF THE N, Y. STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTiO~ ERRORS, ,. % ! ! '¸4 *I; 1 ; I } .. I I I t I ~l l-l.-- I I I .Il .................... Il- l II iI I r ...... r-~l I ,I ?