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Home My WebLink About11136-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building tnspecfor - Town Hall Southold, N.Y. Certificate 0t' Occupancy THIS CERTIFIES that the building . ~...o.w..d.w..e.3_.3..5:.~. ~ ................................ House mo. ~treet Hamlet County Tax Map No I000 Section ... 9.2.7 ..... Block ....O.'1 .......... Lot ...... 0.?.0 ........ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... gt.l~.r'.5_.3_..q..~ ....... , 19~.q.. pursuant to which Building Permit No....'ltl. ? }.G.g. ........... dated ...lV[.~.~....¢ .................... 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 ......... The certificate is ~ssued to · Jg~.elph. ~ .~cl~/~,rt~. ~/;$~;v. .............................. (owner, levee or tenant) of the aforesaid building. - 50- 55 Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO .... }c).q.FaO/~ ....................................... Building Inspector Rev. 1/81 FO~M NO. BUILDING TOWN HALI~ SOUTHOLD, N~ ¥. · BUILDING ~ PERMIT (THIS PER~IT MUST BE KEPT ON ~H,E PREglS S UNTIL lULL COMPLETION OF THE WORK AUTHORIZED) 11136 Z Permission is hereby granted to: pu~uant to application dated ~.~.,.~ .,. ~9. ond ~pprov~ by the Building Ihspector. ~g ~lnspector FORM NO. 6 TOWN OF $OUTHOLD Buiiding DeparTment Town Hall Southold, N.'/. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be fdled in typewriter OR ink, and subr~itted in duplicate to the Building Inspec- tor w~th 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 topograohic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-g form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buddings, 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 ex~sting buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperw 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, t 1. Ceruficate of occupancy $5.00 2. Certificate of occupancy on pre-existing dweliing or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ..F-~.~ ~5-/ /~g3 .. New Building ...y..~ ..... C~ .. Old or Pre-existing Bullding(X) . _. ._, --~/Vacant Land- Location of Property .., ......................................... Houm No. S[ree; Hamlet Owner or Owners of Property ~ '~ ~ ~ ~ County Tax Map No..1000 Section ..~.~ Block .. O Submws~on ................................. Fded Map No ........... Lot No. ~,~th ~,t. Ap~o~,l .../.T.S. 0... ~.~ ...... b~bo~ ~pt. A~p:o~ ...................... ,.. .,:.? ....... .................. .~- Request for Temporary Certdlc~te ..................... Final Certificate ................ Fee Submitted S ,~, D O Construction on above described building am~d perm~t'mee~;s all appL(cable~codes and ,regulations. tooo31.z~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,,,~ Jam~cy 31, 1983 ~..,i..t,o,. ~o. o.f, le z3~s0-a N 5 916 0 4 THIS CERTIFIES THAT only the electrical equipme,~t as described below and introduced by the applicant named on the above applicatior~ number in the premises of Joe J~er, Pla~c t~1, 1610, Orient, N.Y. in the following location; [~ Basement [] Ist FI. [~ 2nd FI. Section Block Lot was examined on J~'~'~d~ 25 ~ 1~83 and found to be i. complia.ce with the requirements of this Board. FIXTURE FIXTURES DISH WASHERS OUTLETS SWITCHES NCANDESCENT FLUORESCENT DRYERS OTHER APPARATUS Eie~tric Room ~eaters:2-l.5 K.W., Pmtelboards; 1-23cir. 150a~ps o 1-G.F.C. I, I-~oke De~ec ~or 1-4.5 K.W. tto~ Wa~r Heater. S E R V I C A w O NO OF HI-LEO A W O NO OF NEUTRALS A W O OF CC COND OF HI LEG OF NEUTRAL 1/0 B. J. Electric $~illwacer Ave. Cu~chogue, N.Y. ~ 11935 IAc.~2670 ust not be COPY ANY MANNER. F1EbD FOUNDATION FOUNDATION 2. ROUGH FRAME & PLU~ INSULATION STATE EN epee FINAL PER ~-~ OWNER: ~U . ~IO,.~I~AI~"{'t-I t3tI~PT AI~I~OVAL I H. $. ]'~. "'~" *~v,~ . ?,uy ~,1~1~ trace . , am~s ~ ~stm~es a~lor ni~a+~, ~ ~m~ a~lysis(~f~ r~'~'' ~ ' ' :~ ~./7 _ ~' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ~xamined .............. 19 Application No .......... xpproved. ~C~.~..dC~. ..... 19c2¢.~. Permit No..//~/.. ~.~Q.(~..~ /' )isapproved a/c .2 .... ~~ ............... .... (Btfilding Inspector) APPLICATION FOR BUILDING PERMIT Date /:)/~'/d_ /6 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building .nspector, 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 saccts )r areas, and g~vmg a detailed descriptmn of layout of property must be drawn on the diagram which is part of this appli- 'a/ion. 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 th~ applicant. Such pmmit ,hall 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~.,y ,hall have been granted by the Building Inspector. A APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or t~egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Fhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in buildings for necessary insl~ections. ~ ~gnatdre of applicant, or name, if a corporation) (Mailing address of applicant) ~ltate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................... ........................................................... ',Irene of owner of premises (as on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No Plumber's License No. Electrician's License Other Trade's License No ...................... I. Location of land on which proposed work will be done .................................................. }louse Number Street Hamlet County Tax Map No. 1000 Section ...~9.7. ........... Block t/ Lot. ../.~ ..... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~/~£ .~ . ...~...~.~f-~,..~.' b. Intended use and occupancy . . ]2 .~.J/O~d~ ~TAA~ ~.~..~..' .~..~.f ~.. Alt ti · ' lq B Jldi Additi Iqature of work (checkwhlcb app,llcable): ew u ng ....... on .......... era on Repair .............. Removai .............. Demolition .............. Other Work ............... o (Description) Estimated Cost ' Fee ,' (to be paid on filing this application) '~ / Number of dwelling units on each floor If dwelling, number of dwelling Units .............................. If garag~ number of cars ' .~,q .~,%~,~ If.business, commercial or mixed occupancy, specify nature and extent of each t~pe of use ......... ~: ......... D~mensions of e~xisting structure% if any: Front ....... (6. .... ,~. Rear .... ./~.., ....~,. Depth ..... .~ ......... Haight . ..[J.< .... Number of Stories ...... /. ...... (../~. f.'.~v..4./~..~./)... ~. ,O....~../-~7,~....~..~?..fi... Dimensions of same structure with alterations or additions: Front .... .. /.~./. ..... .. Rear .. . .../df. ........ .. Depth ~,~. ' Height 43./ Number of Stories ~.~. ~' Rear . .~'..~ r Depth Dimensions of entire new constr¢ction: Front ................................. &3 ~ Number of Stories Height .. .. ............ Size of lot: Front ..... ./?..~',~..~f..~ ......... Rear ...... ./?.~. ,..~./ ........ De~th .. d .~.~. ~ fi~.?- .......... 7'7 '~ ~_ ~,~ .b'- Date of Purchase . ~.q.~ . ./.q/;../.~. ~.~ ......... Name of Former Owner . . ~.~. ....... . ............... Zone or use district in which premises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: .....,~..o. ........................ Will lot be regraded ....... .~.'.~. ................. Will excess fill be removed from premises: Yes Iqame of Owner of premises .~/.t~/t~ .~.,~.,'.~.~.'~ ..... Address ~..~ K ............... Phone No. 7. ~..~ ?. · ~.... Name of Architect ........................... Address ................... Phone No ................ Name of Contractor ........................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all :buildings, whether existing or proposed, and, indicate all set-back dimensions from 'operty lines. Give street and block pumber or description according to deed, and show street names and indicate whether terior or corner lot. L~?/O 0~: //{~-y~/~ ~tA ~ F) rATE OF NEW ?t~ORI~, ~ ; ~ ~ oove nh~med. , ........ being duly sworn, deposes and says that he is the applicant ,e is the ................... ~;ntract;rl a~;nt corporate office; , , otc,) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplk:ation,; 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 manner set forth in the application filed therewith. worn to before me this .~?~-~.-:.'-- day of .~...~. 19~. lot axg Public, ................... County ...... '-" ..... .................... i (/] ~O~R~'b-~[l'dl State of Pl0w York f/ / " (Signature, of applicant) , j }lO. 52-8125850, Suffolk Cou~n~ _ Term Expires March 30, 1 ~.~E~T~. APPROVED AS NOTE_D '"r'~l/~('~; BY 'h~ .-- . FEEff : '^1 No~NG DEPARTMENT 765-1802 9 AM TO'4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE ~ ROUGH - FRAMING & pLUMBING 3. INSULATION 4. FINAL - coNSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONS-F~UCTION SHALL MEET '~1£ REQUIREMEIXr[$ OF THE N, Y. 5'TA31~ CONSiKUCTION & ENERGY CODI~ NOT RE. SPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS, OCCU2AHI~Y OR I~ IS UNLAWFUL 'V~ii~IIJUT CERTIFICUE OCCUPANCY HATAIER