The URL can be used to link to this page

Home My WebLink About11144-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14287 Date March 19 19~..6. THIS CERTIFIES that the building .... gj~.o.v.~, g.r.o. ¢D.d..D 99.]-..q[¢~l..f..~. ¢ 9.0 ....... Location o f Property ....... 68.0.. T r ~ ~ ~..?.~ ~; g ........... .E.a.s. t~. ~I.a.p. ~. 9 l~ ............. House No. Street Hamlet County Tax Map No. 1000 Sectmn 031 .Block 12 . .Lot 002 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... A p r J-.~.. 20 ........, 1981. pursuant to Milch Budding Permit No ..... 1. ! .~ .4.4. Z. .......... dated .. ~.a.y....q .1 ................... 19.8. !, 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 ......... · g. hove..gp, ou~.d, p o.o.1, an.d., fcn.c.q, e n.cJ. o~ ~.~.e .................................. The certificate is issued to ... J.QH~J. galD. EZHEL. ~LLSD. g.N ......................... of the aforesaid building. Suffolk County Department of Health Approval .. N / ~. UNDERWRITERS CERTIFICATE NO. ~ 5 3 7 1 8 5 Rev. 1181 Building Inspector (THIS PER/VgT COMPLETION OF THE WORK AUTHORIZED) N9 11144 Z FOB~I NO. ~ TOWN O~Fi $~UTHC~D~ BUILDIN(~- Ib'~ARTA~N~ TOWN HALL SOUTHOLD, ~ BU;LD~NG ~ERM~T~ CoUnty Tax Map No. 1000 'Section ...~..~,,~.~.....~..L;. BIo. ck Bhildin~ Inspoctor. Permission is hereby grarited · ...... .~.o.~...~.~. ...../;:~..~....~...~/J..,..,, ............... ~....~ ................. .... ~.~.~.,,~z..~z.~:~.~:..~,..~.,....~'/ ,o ..... .~...x~..,:...r.,....~.~c ...... ~..,/...,~a.u~....~.,,~o.a~.....~.{ ~z_,_...~ ........................ ....... ~..a,,:~.~.. >. ~:,,:¢,~...i..-. .......... =: ........... ' ........ '"'""'" '~ ........... '~' ........................................ at premises located at ~.'~.~. .......... /.,~..:~.~.~,~.~/~'~.'~.,..-~/~.-..,!......1 ................................. · .' ..................................... ~ .................... ~ .................................... i-: ..~..~.=~..Z.~.~,~z~./.~..~...~ ~. .......... ~Lot N0. ./-_~.O4~. ......... ..... , 19~., and approved by the Fee $../....'~.. ............. Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Buiiding Departmen~ Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Th~s apphcatlon 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 sunzey of property with accurate location of all buildings, property lines, streets, and unusual natural or tooograohic features 2. Final auproval of Heaith DepT. of water supply and sewerage disposat--(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 buiMings. 3. Data of any housing code or safety inspection of buddings 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 or land use $5.00 3. Copy of certificate of occupancy $1.00 New ~uddmg ~ ...... Old or P re-existing Building(X) ........ = fVacant Land .......... Hou~ No. Street Ham/et Countv Tax Map No 1000 Section ...Qb! ...... ...... ..... Lot .... Subdivision ~ ............................... Filed Map No ........... Lot No .............. Health DeOt. ~prov~l ... -- .... Cabot DeOt. Ao~roval ~ ~equest for Temooraw Certificate ..................... Final Certificate ..... ~ ......... - Fee Submitted S .......................... L' ' Con struct,on on above described bu dd mg(/~r~]')~,~codes and regu lotions. Re~,. 'JO I0 78 ,/ / 6./ FOUNDATION FOUNDATION 2. ROUGH FRAME & FLUMBING (2nd) INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL CQMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1802 APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No/.././..~. ~.. ........ Date ~A''t'~ ZU 19<../. 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 descriptlou of layout of property must be drawn on the diagram which is part of this appli- 'ation. 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 ,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. 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 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 premises and in buildings for necessary i~sl}ect/)ons;,~ /hSig~ature o/c//. ~?/ j applican[~(name, ifa corporation) ............ (Mailing address of applicant) State whether applicant s~ow~r,~essee, agent, architect, engineer, general contractor, electrician, plumber or builder. qame of owner of premises .. ~.~..q .................................................. (as on the tax roll or latest deed) If applicant is a corporation, siguature of duly authorized officer. Plumber's License No ......................... Electrician's License N°'~' ' "~'J~' ' 'ff'~' 'ff-:'~'~ Other Trade's License No, . ~ ........... 1. Location of land on which proposed work w~l be doge ............................... y' ' ' ' 4 ~' ........ , .... .............. ................ ............. .... House Number Street Hamlet County Tax Map No. t000 Section ~. ~ .......... Block ...~.~ ........... Lo~Q~ ............... Subdivision ..................................... Filed Map No. ~... ~ ........ Lot ............... (Name) 2. State existing use and occupancy of premises and int~d use and occupancy of proposed construction: a. Existing use and occupancy ........ ( ................................ b. Intended use ~d occupancy..ff~. :~ ~./~ ~/~ .................... 3. Nature of work (check whicl~ applicable): New Building .......... Addition .......... Alteration ........ ~ Repair ............... Removal ............ Demolition .............. Other Work ............... ~ Estimated Cost '~ -- "- (to be paid on filing this application) ~ If dwelling number of dwelling ~nits Number of dwelling units on each floor .... If garage, number of cars ..... i ................................................................... ~. If business, commercial or mixe~l occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structur0s, ifany: Front ............... Rear .............. Depth ............... . Height ............... Nmgber of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear ................ Bepth ...................... Height ...................... Number of Stories .................... 1. Bimensions of entire new construction: Front ............... Rear ............... Depth ............ Height ............... Number of Stories ..................................................... ). Size of lot: Front ........... ! ........... Rear ...................... Depth ................... ). Date of Purchase ........... . .................. Name of Former Owner .......................... 1. Zone or use district in which pr~mises are situated .................................................. ~..Does proposed construction violate any zoning law, ordinance or regulation: ............................. t. Will lot be regraded ........ i ................... Will excess fill be removed from premises: Yes No L Name of Owner of premises .................... Address ................... Phone No ................ 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 or description according to deed, and show street names and indicate whether terior or corner lot. rATE OF NEW YORK, . ............ ~ ~.~... ~ i gA ) .~ ~ ~ ....... being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) cove named. .e is the ..................... ' .................................................................... (Contractor, agent, corporate officer, etc.) f said owner or ownem, ~d is duly authored to perform or have perfo~ed the said work and to m~e ~d file ~is pplication; that all statements contained in this application am true to the best of his knowledge and belief; and that the ~ork will be perfo~ed in the manner set forth in the application filed therewith. worn to before me this - ~0. s~.~5~4~n ~ (Signatur~ of a licant) ' uahhed in Suffolk Count r ~ (Si pp : ',Commlsslonq Expires March 3o,Y 198~/~ , ~:)~,;~(Ju3 THE NEW YORK BOARD OF FIRE UNDERWRITERS [% BUREAU OF ELECTRICITY, ~ . ,~ . ~,-85 JOHN STREET, NEW YORK, NEW YORK, ~ ~ 10038 ~ ~ ' ~ THIS CERTIFIES THAT ~ ' ' ' ' ~ [] ~' ~ ~ ~ ~' in the following location; E~k Basement [~ 1st Fl. FIXTURE OUTLETS F~ECEPTACLES SWITCHES FIXTURES iNCANDESCENT FLUORESCENT DRYERS SYSTEMS NO OF FEET OTHER APPARATUS' J E R AWG OF CC COND NO OF HbLEG AWG OF HI-LEG NO OF NEUTRALS z. zc. 2941-g AWG OF NEUTRAL GENEdAL MANAGER This cerhflcate must not be altered in any manner; return to the office of the Board if [nC;brrect Inspect~ors may be identified by their credenhals ~ COp~ FOR ~U,LDING DEPArTMeNT. THI~ Cg~Y ~F~C~AI?~~~~ t