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Home My WebLink About11172-zN? 11:172 Z Permission is hereby granted to: TOWN BUILOiN~ TOWN 'HALL SOUTHOLD, N. Y. BUILDING' P,£RMIT;, (THIS PERMIT MUST BE KEPT ON THE PRE~ S~S UNTIL. lULL COMPLETION OF THE WORK AUTHORIZED) Date ..... ........................... , County Tax Map No. 1~00 Section ....(~..Z~...?..~. Block i..~ pursuant to applicationjdoted ................... i:... Building Inspector. Fie ~....~..: ....... Lot No..../.,).~,,.~- ......... ..... , t9~.~/..,, and approved by the - ~i ~ ~, . Rev. 6/30/80 FORM NO· 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and subr~itted Jn duplicate to the Building Inspec- tor with the following; for new buildings or new use: 1o 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" lend 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 buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. ,' C. Fees: 1. Certificate of occupancy $5.00 2. Certdicate of occupancy on pre*existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date ,. New Budding ............. Old or Pre-existing Building(X) x ....... ~/Vacant Land ............ Location of Property/~o,~6se5#o~-¢ r j_9.a~.t:.J, ne -Dr-J..ve ~, $o,u~ol~, .~ ..... ~ ................... Street Ham/et Owner or Owners of Property ,. f~J'~'~z' Do a~ '~zo~' A'.' '~aD'9 ...................... County Tax Map No. 1000Section .,.0~ ........ Block ...... ~ ........ Lot .... &5 ......... Subdrv~s~on .... ~'a'~bo~' '~g~ .~s~es ..... Filed Map No. ~362 ...... Lot No .... ~ ........ Permit No... ~L.~.?2 · · Date of Permit 5,/27/8~ ,Applicant ., ~a~. ~.,. Health Dept, Approval .... ~SD~? .......... Labor Dept. Approval ...................... Unde~riters Approval,..~. ~,~.~ ~, ....... Planning Board Approval .................. Request for Temporary Certificate ..................... Final Certificate ........ - ......... Fee Submitted S '5,80''/ .... ¢..~ ........ Construction on above described buildmng and permlrmeets all app~cabl~odes and regulations. Rev, 10 10-78 1000378 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITy 85 JOHN STREET, NEW yORK, NEW YORK 10038 o.te SePtember 28, 1982 ap,,,~c.ao. No.o,.y, le 139036-81 N 577920 THIS CERTIFIES THAT only the electrical equipment as described below and ~ntroduced by t~ applicant ~a~ed on the able application number in the premises of Harry ~. ~van~, ~rigacine Or. 650,c/o Anchor ~ ~rigaC~ne, ~ou~hold, ~.~ m the/ollowing Ioc,s~on; ~,Basem~ ~Ql~toFI ~ 2nd Fl. Section Block Lot . ,, ~ eptemner z ~, ~' and found to be in compliahce with the requiremer~ts of this ao,~d. FIXTURE FIXTURES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 30 25 DRYERS SYSTEMS NO. OF FEET O'~%~[A."^T~oom Heaters: 1-1.5 KW, 2- Smok~ Oegectors 1-Post Lite 1-4.5 KW R V I C NO OF HI LEG A W G OF Ht-LEG I 3/0 5-1.0 KW, 5-.65 KW, 1-o375 KW NO OF NEUTRALS 1 AWG OF NEUTRAL 3/0 Charle~ M. Hall Elec. 760 Long Creek Dr. $outhold, N,Y. 11971 lic. 657,% .GEN~[~AI. ~ANAOER Per~ \),..,-~" __ This cerhflcate must not be altered in any manner, return to the offmce of the ~ard if,inco~rrect, inspectors may be identified by themr credentials. COPY FOR BUI~ING DEPARTMENT. THIS COPY OF CmRt~cATE~USt NOT Bm ~[tmam~ i.' ANy --AN-,- FOUNDATION ( ls t) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ~1~ , . .. '~*:,4 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~JN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1803 Exa i ?./~../. ........ , ^pproved /~*.y. .-- .4. CZ.., 19£/. ~crmit No.. Z~/~ Disapproved a/c ~ (Bmldmg Inspector) APPLICATION FOR BUILDING PERMIT Date .~. ~f. ....... INSTRUCTIONS Application No../t//...~..~. ..... a. This application nmst be completely filled-in by typewriter or in ink and submitted in triplicate to the Buildi 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 stre< or areas, and giving a detailed description of layout of property must be drown on the diagram which is part of this apl: cation. c. The work covered by this application may not be conmrenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such pern 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 Occupan 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 t Building Zone Ordinance of the Town of Southotd, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ~ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code¢ and l'~gulations, and admit authorized inspectors on premises and in buildings for necessary inspections. ..... ~.~..~...~. ~.. ~?.~./.. .......... (Signatnre of applicant, or !lame, if a ¢ory~ration) .. ~../?.. ~ .a....~<....~:.. 2-? ......... CMailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buildc (as on the tax roll or latest deed) If apphcant is a corporation, signature of duly anthorized officer. (Name and title of corporate officer) £ Builder's License No.. ~.! ....... ~. .......... Plumber's License No ......................... Electrician's License No. Other Trade's License No ...................... House Number Street ' liamlet County Tax Map ao. IO00~Section ....... ~ Z~ ....... Block ......... ~ ....... Lot ................. Subdivision .... ~'~ [ Filed Map No.. z Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed const~ction: a. Emist-ingm se-and-o~cupa ncy ................................................................... b. Intended use and occupancy ........................................................... . . 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... I- Estimated Cost · .r .~.. Fee .............. ~. ......... : (to be paid on filing this application) 5. If dwelling, nu bet of dwelling Units . ~.t .... / Nmnber of dwelling units on each floor.., Ifgarage, numoerofcars ~.0'.~.~.?.~...~..o...} ...................................... 5. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................... 7. Dimensions of existing structurei, if any: Front ............... Rear .............. Depth ............ Height ............... Number of Stories ..................................................... Dimensions of same structure wiih alterations or additions: Front ................. Rear ............... Depth ......... . ........... ~.. Height ...................... Number o3' Stories .......... 'c~" .... 3. Dimensions of. en, l;ir.e new construction: Front ...... Gq? ...... Rear .... ¢. ~'. ....... Depth . . ,~. ........ Height .. ! ?.. ~eT. ~.... Number of Stories ......... ./ ......................................... 3. Size of lot: Fro~t,.,.... ,.~..~?.,: ........... Rear ...... ~...67~. ........... Depth .... f.F~ry. ............ ). Date of Pnrohase(g ..... , .......... Na ne of Vome,' Owner . G:. ...... 1. Zone or use district in which premises are situated .................................................... ~..Does proposed constructim3 yiol~te any zoning law, ordinance or regulation: .............................. t. Will lot be regraded ..... ~.-~.. f. .................. Will excess t~I1 be r.e~oved from premises: Yes_ L Name of Owner of premises ...[//..~.-,q ............ Address ................... Phone No.., ............. Name of Architect .. ~'7...[~ ....~ ............ Address ................. ~ ~ .4. ,a-~'~,,~ ~.~. ~.~}! .ct. ...... . Phone No. '~Z~' '-¢'¢Z .... Nmne of Contractor . h.. ~.~... (J ............... Address . . Phone No ...... ¥ ..... /~.,. PLOT DIAGRAM Locate clearly and distinctly all:buildings, whether existing or proposed, and, indicate all set-back dimensions from :operty li~treet and block number or description according to deed, and show street names and indicate whether ~terior or'~orner lo-XY-)~ TATE OF NEW YzORK, .... ~fi'~o-x ~r ~)L~ '~.~-~ ff'~ ~-'~-~ being duly sworn, deposes and says that ho is the applicant (Name of individual s~gmng contract) bore named. e is the .................................................................................... (Contractor, agent, corporate officer, etc.) f said owner Or owuers, and is duiy authorized to perform or have performed the sa. id work and to make and file this pplication; thai[ all statements contained in this application are true to the best of lus 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... rotary Public ................................. County FO~M ~0.~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL PLEASE TAKE NOTICE that your application dated ...~'.~'.,~./~..f..~...~...~.~., for permit to construct ~/~'/,~J.~../.~...~'-~ ...... at the premises located at ..'~....,~..%~...~......~.../~..~..~'~'P /~.~.o.....-......o...X.~.. ..... Block ....... .~...¢~............'" .. .......... Lot ..... ~..-,~..~..--.. ............................ Map is returned herewith and disapproved on the follow, ng grounds ............... . .~. .x~. ~. ~.-z. . . . . . .'/.m. z~ z~. . . . . . ~. . . . . ./S.~. . . ~ /. .c_ . . . . . . .~. x~. ~ ........ /~. x~ z.~. ~. .~. . Z-. i ~. ~. . . . . ?. ~ . . . 'x. . .<T~. . ~. ~. . r. x. ~ ~_ . ~ ....... .~. .,¢~. ~. .~.~. . . . . . . .Y. .~. . . ~. .~. ..... .~. . . .~. . .~.~ ~. . ~. ~. . ~.~. . . . . . : ........................ ~. ' z~.~: ......... ~..~...c....x~.~.......~.~ ....... l~.~./..~...,Zc.~.~ .................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-18013 Examined ................. 19... Approved ................. 19... Permit No ............ Disapproved a/c .................................. Application No .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . De.cerabe~ ../..d~,., 19 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 Budding Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for ~nspection 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 herein 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 inspections. (Signature of applicant, or name, if a corporation) · .3940. O ]tcha. rd. $ ~c..., · Q.r. ioia t.,..NY ........... (Mailing address of apphcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . .I. ta.r.r.y.E....and..t~lQre, n~.e. g,...Eva, ns .................................... (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 .... R'.' 'De- Vr~e ........... Plumber's L~cense No... Y~...aacol~i ........... Electrician's Lmense No. S....P..r.a.t.o. ............ Other Trade's License No ...................... ~, ~'5'~) 1. Location of land on whzch proposed work will be done· . ['la .4~ ,. car.. ,anchor..Iaa,..and. .......................................................... S.outhold ........................ House Number Street Hamlet County Tax Map No. 1000 Section ..... O. 7.~. ...... Block ....~...~. .......... Lot... ~.~..~. .......... Subdivision . .Harbtar.L~..Es.t...No....1 ........ FiledMap No. . .4362 ........ Lot...~ .......... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............ Voaca. n~;. I, ot ............................................. b. Intended use and occupancy ...qr~¢r.f[ar0i.ly..d..w.e.l.l.i..n~ .......................................... 10. 11. 12. 13. 14. Nature of work (check which applicable): New Building ... X ...... Addition .......... Alteration .......... Repair ' .............. Removal .............. Demolition .............. Other Work ............... ' (Description) Estimated Cost .... $2~0,00.ti ........................ Fee ...................................... (to be paid on filing this application) If dwelling, number of dwelling flnits, one .......... Number o f dwelling units on each floor ................ If garage, number of cars ........ LwO. ............................................................. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height '. .............. Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth; ................... '.. Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front ...60J .... , ..... Rear ... 6{>' ......... Depth ...... 4q)'. ..... Height ............... Number of Stories .............. % ......................................... Size of lot: Front ......... 2.0.0 ......... Rear ........... 2D.0. ....... Depth .......... 100 ......... Date of Purchase ...... 'l/2g./.'l 9 ............... Name of Former Owner . .'. J. ohn. 12,. SeA1.ig ......... Zone or use district in which prentises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or iegulation: . .yes ........................... Will lot be regraded ......... :... Y~. ............ Will excess fill be removed from premises: Yes No x Name df Owner of premises . .lt.~rl:y..~. ~-p..E.'V~ta.~tddress .3940' 'Orch'a~J'~.tPh°ne No. 3.23-, 26.2,1. ..... Name of Architect .......... ................. Address ................... Phone No ................ Name of Contractor .... Sel£. '. ................ Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all,buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block gumber or description according to deed, and show street names and indicate whether interior or corner lot. (see attached) STATE OF NEW YORK, 'S.S COUNTY OF ...Suf.£olk ...... ............ F.1.orerme. A....Evana ................ being duly sworn, deposes and says tha{;he is the applicant (Name of individual signing contract) above named. He is lhe ..................... .. ................................................................... (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. Sworn to before me this ........................ day of ...................... 19.. Notary Public .................................. County (Signature of applicant)'