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Home My WebLink About11143-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z15414 Date March 23, 1987 THIS CERTIFIES th ildi P o o 1 at tile bu ng ................................................ Location of Property 2055 New Suffolk Ave. Mattituck County Tax Map No. 1000 Section ... J .I .4 ...... Block ... 9. ........... Lot 12 Subdiwsion ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated A. ~ .r .i.1.. ! ~.. 1.9. 8..! ......... pursuant to which Building Permit No.. l .I.1.4. 3 Z ............. dated . .M..ay.. 1. ] ~,. I. 9. .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 ......... ....SJ4i~atn.i.r~g. p.o. ql. t.o.c.o.de: The certif~cate is issued to ,MILLARD AND MARYLOU NORTHRIDGE III of the aforesaid building. Suffolk County Department of Health Approval ..... .N./.A. ................................. UNDERWRITERS CERTIFICATE NO .... N 780 .463 PLUMBERS CERTIFICATION DATED: N/A .......... Building Inspector Rev. 1/81 BUILDING (THIS PEI}~AIT MUST BE KEPT ON THE PREMISES, UNT ~ FULL COMPLE-~ION OF THE WORK AUTHORIZED N? 11143 Z Date .(,...~..~.....Z. ...................... , · ..:~ ~. .~...r7.. . ~&~ ...... ?~:~ ....... /~.~.o. ............ ~ .... / ~o ........ ~.~.~.~........].....,...~.~....~......~ ................................................... at premises located at .~6~....~.. ~.;~..,~...' ....................... ~ .................. ...~ ....... ~~.~.....z~....~.. .................................... ~, ~ co~,v r~ ~op ~o.~ moo s,~t~o~ ....~.¢ .......... mo~k ,~.~.~ ....... ~.~ ko~ ~o...~.Z~ ........ pursuant to oppli¢*ti~n dotod ............. ~..../...~. ........ , 19 ,ond opprovod by the Building Inspector. Fee $ ....... ~ ............. ~ ' ~Bu'lJdl ~g i~ector Rev. TOWN of SOUTHOLD OFFICE OF BUILDING INSPECTOR To~vn Hall Receipt NO, 315] ? Southold. New York11971 IL , Date ~./..-~ ~ .~....?.. .................. eceivedof . ~ ~ ~~'~'~' ' ......................... .......................... ¢.-~:. .............. ~--~$.~. .................................................................. . /~f"-'~'~ ..Y7 './../..~. ,.~ ............... /100 Dollars ;"iiiiiiii i;i iiiiii iiil;.il;:.i i: iiiil..il...C ....... .................. Fee for Fee for Fee for r~t,~L~tificate Z] Yard Sale [] [] r~ H.I.C. [] Building Permit ~l~_J of Occupancy [~ Misc. .......... ,~,;;..'~",'~' ................. ' ....... Budd'l';g In;;ector ~ ;ual ~lla- ing. 1. Accurate s~v~y 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1000 5.Updated C,O. $15.00 Date ....... NewConst~uction ...... Old or Pre-existing Building ............ Vacant Land ............. ~,,o~o,~o~ert~..~.~.-~ ..... ~.~.~...~ .... ~~ ~o~~o ~ooo~,o~ ~.l ....... ~,o~ ...~ .......... ~o~ .... ~ ........ Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and .permit meets all a~plicable c~odes and regulatio~,s. Applicant.. o~~ 4~2;~..0~", ~.~~.. ~, ~. ~ ~ ~ ,.~.~o-,o-~ ~ ~/~ ~ /~ ~/~ THE NEW YORK BOARD OF~F!RE UNDERWRITERS J.(jl.,i0~.j~ BUREAU OF ELEGTRICelTY [-~ B5 JOHN STREET, NEW YORK NEW YORK 10038 THiS CERTIFIES THAT ~.~c. ~or~.h~d~, ~/~ ~u~olk Ave~ 2055, ~tt~cuck~ N~ in the followlng location; ~ lle~ement ~ Ist FI. 0c{;ober 30~ FIXTURE OUTLETS DRYERS SWITCHES FIXTURES ~ 2nd FI. OU~;J~ Section Blm'k Lot .nd found to be in compliance u'ith the reqtzire.~ents of this Boar~l. RANGES DISH WASHERS EXHAUST FANS FURNACE MOTORS FUTURE I~ f~EDERS CLOCKS MU/TI-OUTLET DIMMERS SYSTEMS NO OF FEET C~ENRRAL MANAGER Th~s certificate must not be a)tered m any ~onner; return to the ofhce of the Board if incorrect )nspecto[s may be ~denfified by their credentials. C°~L? BU'~)'"° ~)~P~!~"!, T"'S C°~'Y ?~ FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C ODE FINAL ADDITIONAL COMMENTS: 76~-~8~2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: ....... FINAL FORM NO. 1 TOWN OF SOUTHOLD . BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1B02 :~,a~in~./~¢..%//. .... 19 & Application ~o. Z//~ ....... )~approved a/c .~~~ (Building Inspector) 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 .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 streets )r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :orion. c. The work covered by this application may not be commenced before issuance of Building PeFnit. d. Upon approval of this application, the Building Inspector will issue a Bui!ding Pemtit to the applicant. Such permit ;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 Occupancy ;hall have been granted by the Building Inspector. A~PLICATION 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 Regulations, 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 Ldmit authorized inspectors on prentises and in buildings for necessary inspections. · ........ (Signatt~e of applicant, or~,~e, if a cOrporation) ...~,.o. :...~..~....~..~. ~ ~.~. ~~.,...~... (Mailing address of applicant) ] t '~,ff- ~mte whether applicant is owner, lessee, agent, architect, engineer, general contractor, electricia~, plumber or builde ........ O.,z ~..e.e ............................................................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Plumber's License No ......................... Electrician's License No. /~.~-r/./~ Other Trade's License No ...................... 1. Location of land on which proposed work wilt be done .............................................. ....a...c,..s:...s?. .................. ~.o...s~ .c.~.~. !~ .0,. ?..e,. .......... .,,¢/. .,, . ~. ,: .¢..,~ ~ ............ House Number Street Hamlet County Tax Map No. 1000 Section ..... ]../~tl~ ........ Block ....... .~ ......... Lot ....... /~ . .2~'A~.... Subdivision ..................................... Filed Map No ............... Lot ........... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: 3. Nature of work (check which applicable): New Building . Addition Alteration ~t -, , Repair .............. Removal .............. Demolition ............ Other Work ............... .~.~/* 0 .O: .O. Qi //~ ~ (Description)_ 1. Estimated Cost .......................... Fee . g.l,~/-.'. ................. .~ ........... (to be paid on filing this application) i. If dwelling, number of dwelling uniB ............... Number of dwelling units on each floor ................ If garage, number of cars ....... i ................................................................. [. If business, commercial or mixed ogcupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Numbe~ of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... 'Height ...................... Number of Stories ...................... I. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ....................................................... ). Size of lot: Front ............. i ......... Rear ...................... Depth ...................... ). Date of Purchase ............. [ ................ Name of Former Owner ............................ I. Zone or use district in which premlses are situated .................................................... ~..Does proposed construction violat~ any zoning law, ordinance or regulation: ................................ ,. Will lot be regraded Y.~s. .N.o ........... I ................ Will excess fill be_removed from premises: L NameofOwnerofpremises .~..:~.~...~}z. Address ,~9.g!..~.'s..../!/..c~r~'-C~hiKehoneNo ........... 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 number ~ description according to deed, and show street names and indicate whether terior or corner lot. (/I/o~P~.) OU~Y OF~~ .... ~ ~ , ..... ~ ~- ~.~. ~~) being duly sworn, deposes and says that he is the applicant (Name o~divi~al signing co~ract) ~- dove named. is the (Contractor, agent, corporate officer, etc.) said owner or owne~, ~d is dulyiautho~ed to perform or have performed the said work and to m~e and file ~is pplication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that ~ork will be performed in the manner ~et forth in the application filed therewith. worn to before me this ........... .... ...... ..... Iota~ Public, ..... ~ .... ~~~.~ County _ ~ "~'~e"~'~;; ~ ~ ' ' L (Signam~ applicant) : No. 52.8125850, Suffolk Cou~ ' Term Ex~lres March 30. lg~