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Home My WebLink About11156-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No . Z.1.Q853 ......... Date .... ~JAq¢ia?X. ] (* ................. 19,8,2. TillS CERTIFIES that the, braiding ................................................ Location of Property . 1~3..5 ...S. gU.n.d' . ?.J..e?,..Ay.e.~u.e. ......... ~o, .u.t.l~.ql..d ..... House No, Street Hamlet County Tax Map No. lO00 Section . .0.~ ! ....... Block . .0.1 ............ Lot 01 1 SubdJwsion .... ~ .......................... Fi]ed M~ip No. ~. ...... Lot No. ~. .......... '.. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...~pr.~l...3.0 ........... 19 ~.1. pnrsnant to whzch Building Permit No. 1.1. ! .5.6..~ .............' dated . .. t~.a.~.. 1. .8 .................. 19 .~.I. , was issued, and conforms to all of the requirements of the applzcable provisions of the law. The occupancy for which this certificate is issued is ...a ...... ~a.r.a.~.e...a.d.d.j:.~.tp.q..~.o..qt!~r.t'.a.m..i.17. dwelling & a conversion of existing garage to habitable use. The certihcate is issued to Richard ~.~angsbenburg (ownor,;~P~t) of the aforesaid braiding. Suffolk County Department of Health Approval ...... .N/.R. ................................ UNDERWRITERS CERTIFICATE NO ........ .i'1.5.2,5. .2~7.0. ................................. Building Inspector Rev. 1/81 l~OR~ 'TOWN OF BUlL.DING TOWN HALL $OUTHOL. D, N©. BUILDING ~PE~ITr (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL F~LL COMPLETION OF THE WORK AUTHORIZED) ? ll]S~ Z Dote ........... :ii ............ i...:~....~....A...?.. ......... ./.4 19..-.~../ Permission is hereby granted to: ....... ........ ~,,,,~,,, ,oc,,o~ ~,....;.....L.~.Z~ ........ 2g.~ ......... fft.~..~. ...... <.~.~ ............................ CO..~ Tox ~p ~o. ]qO0 SoCtion ................ 81o¢k .~..,,~.....[ .........~ t No ......................... pursuant to opplic~tion dated ............................... ~..~. ~0 19.~.i., ond ~pprovod by tho Bu!lding Inspector. Fee$ ..................... .Building ~nspector Rev. 6/30/80 FORi~ NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y~ 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Th~s apphcatton 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 featu res, 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 app~ oval of completed site plan requirements where applicable. B. For existing buildings (prior to Aprd 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual nal~Jral or topographic featu res. 2. Sworn statement of owner or prewous owner as to use, occupancy and condition of buildings, 3. Bate o~ any housing code or safety inspection ol~ buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Cert f cate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelhng or land u~ 3. Copy of certi ftcate of occupaocy $1.00 $5.00 Date, ~ ,3/..Z ,~. ,~ ........ New Budding ............. Old or Pre-existing Building ...~ ....... Vacant Land ............. Location of Property .(.~*.~.~. .... ~.,~. House No. Street ' Owner or Owners of ~roperty ..... . .................... Couaty Tax Mao ~o. 1000 Sect*on ...~..t ......... Block ...~ ............ lot., ,~ .......... Subdivision ........... Permit No ..... Date of Permit pplicant , ~. * ~ ........ Health Deot, Approval ..... ~ .............. Labo~ Dept. ApprovalS'. ...................... Unde~riters Approval ........................ Planning Board Approval .~; ~. ~ ............ Request for Temporary Certificate ..................... Final Certificate ... ~. ~ ......... Fee Submitted $.. ~,. ~ ............. Construction on above described budding and permK meets all applicable codes and regulations. Applican~.....~.~. ~ ....... Rev, 10-10-78 FIELD INSPECTION FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & PLUMBING INSULATION PER N.Y. STATE ENERGY C0 E FINAL COMMENTS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned ....................... . proved ................... Disappraved alc ................... .::..~ ......................................................... .............................................................. ......................... (Building Inspector) Applicotion No. /// ~'-~ .. APP"CAT,O, FOR EU"DING Dote .................... . INSTRUCTIONS a This application must be completely filled in by typewriter o~ 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 premmes, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 fo 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 Buillding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Reg~tions for the construction of buildings additions or alterations or for removal or demolition, as herein described. Z-hZe'~Jbp ~cont agrees to comp y w th a app cab eaws, ordinances, bu ding code, hous ng code, and regulations, and to admit authorized inspectors on premises and in, buildings for necessary inspections. ........................... -'[5ignat,~e of applicant, or name, ,if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..................................................................... If applicant ~s a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ......... ~....~:...~./. ......................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed,work will be done. Mop No ........................................Lot No ......................... Street and Number .....~~..(~..-,m.~'~z....('~P,~¢~ ................... ~.~~./~.../..,~..:.~.~ ...................... /Municipal it,/ State existing use and occupancy of premises and intended use and occupancy of pr?osed construction: b Intended use and occupancy ..Y~.~.?J ............ c,~-.- ~¢~........~... ................ 3. Nature of work (check which aPP cable) New Building .................. Addition ~ Alteration Repair .................. Removal .................. Demolition .................... Other Work ................................................... (to be paid on filing this application) 5. If dwelling,' number of dwelling units .......... ~ ................. Number of dwelling units on each floor .......................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ........... ~ .............. 7. Dimens,ons of exist,ng structures, if any: Front .......----.~....?. .......... Rear .......... -- ".~....~.'."' ........... Depth ~...~.. .......... Dimensions of some strueture~ with-alt'erot~ens' or additions:,' Front ......... (~...~ .................... Rear ................. 8 Dimensions of entire new construction: Front ~ Rear .......... ~ ............. Depth '~ Number,of Stories Height ......................................................................................................................................... 10. Date of Purchase ~.. ..................................................... Name of Former Owner ......-~. ................................................. 1 1. Zone or use district in which premises ore situated .......................................................... 12 Does proposed construction viotate any zoning law, ordinance or regulation: ...... ~..?.....~. .................................... 13. Will lot be regraded ...1::~....,~.. .......... Will excess fill be removed from premises:,~( ) Yes (>q) No 14. Name. of Owner of premises ~'~...J,~ . Address ..~..__hone Name of Architect/'~/'; -~-/~h ,'1 __I'' ''~' ........................................ Addressr, D ~ ..~ .................. Phone No ....................... Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all se~-back dimensions frorn property lines. Give street and bldck number or description according to deed, and. Lshow s~rf~et names and indicate whether interior or ~corner lot ~ [.,/~ ~ ~/] ! STATE OF NEW~YOR(, COUNTY OF ..... .~f ..~..~. ~.~-.~-¢ ........ f' .......... ~..~ ...... ~Z~?~,~ ..................................... being duly sworn, deposes and says that he is the applicam (Name of individual sigping contract) above named. He is the ............................................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is ddly 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 fo~h in the application filed therewith. Sworn to before me this .......... . No,o ...... ....... ..................................................... ~ / (Signature of applicant) THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY THIS CERTIFIES THAT only the elect~l,~9}~~pw ~t;g~.q~ ~he a~a~q$~q~pp~cation number in the premises of in the following Iocatlqltg~. ~) Basp~t ~ 1st FI. ~ 2nd FL Section Block Lot was examined on and found to be m compliance with the requirements of this Board. FIXTURE OUTLETS DRYERS TACLES SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUSt' FANS INCANDESCENT FLUORESCENT OTHER APPARATUS' V I C E NO OF HI-LEG gary Ilr;o~l~ 42 D Hormell !a~ INs certificate must not be ¢dtered m any manner, return to the office of the Bard ~f ~mco~rect. Inspectors may be ;denhfmd by th~k~ed~ntiols. ~/~ COP'/' FOR BUILDING DEPARTMENT. THIS COPY OF C~TIFICgiE[MOsT NOI~ B~/T~ED IN ANY MANNER. ~ AFteR, DYED AS NOTED NOTIFY BUILDING DEPARTME'NT A~ 765-1802 0 AM TO4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - ~0 REQUIRED FOR POURED CONCRETE ~. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION BE COMPLETE FOR C O. ALL CONSTRUCTION SHALL Mr'-~ THE REQUIREMENTS OF THE N STATE CONSTRUCTION & ENERCY CODES. NOT RESPONSIBLE F~R DESIGN OR CONSTRUCTION ERRORS.