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Home My WebLink About13640-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ...... N..e.w..D.w..e .1.1.i.n. cj..w./...a.t.t.a.c.h..e.d..G..a.r.a.q?. ..... Location of Property . .3.8.5. ...... Gris sore Ave. Southold House No. Street Hamlet County Tax Map No. 1000 Section ,, ,0,7, 8, ...... Block 01 .Lot 029 Subdivision X .Filed Map No. . .-:...Lot No. conforms substantially to the Application for Building Permit heretofore fried in this office dated Dec. 17 19 .8.4 pursuant to which Building Permit No. 13.640g dated ...... .D.e.c. :..1.9. ............. 19..8.4, 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 ......... --- New Private One Family Dwelling w/ Attached Garage --- The certificate is issued to .... GERAGHTY, JAMES & DONNA (owner, te~x.e~m' t~anO of the aforesaid building. Suffolk County Department of Health Approval 14-SO- 213 UNDERWRITERS CERTIFICATE NO Pendin. g PLUMBER CERTIFICATION 9/23/85 Building Inspector Rev. 1/81 FOBI~[ NO. ~1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 13640 Z Permission is hereby granted to: ...... .............. : ................. ~.....~.. ~ ................ ........ ~~.~...~.~ ...... zz~7 , ,o ....~.~a~Z..~....a~....~z~.~....~Z~p....~zZ~,, ..~z~.~ ........ ~~ ..................................................................................... ~,,,.,,,,=oted ot ........ .~ff~...~z~z~..~ ...................................... ................................................................................................ ~~.....~ ................ County Tox Mop No. lO00 Section ~...Z .~... ...... Block ...~.../.. .......... Lot No...~.,::~.~.. ........ pursuant ,o application dated ..~.~..~.. ........... ~.Z ...................... , 19~...., and approved by the Building Inspector. 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 submitted ia II1~!1111~1 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 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 p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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. Certificat~ of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date.. ~.~.'~.? ./..~ ................... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~C)% ~ ' t~% 5~7~ ~'~ 02 House No, Street Ham/et Owner or Owners of Property . ~?.. ~ ?.',~...-~..-~, .~??..~. ..... ?.,~ .................... County Tax Map No. 1000 Section [-3'~ c~ Bl~ck . .(~.. [ Lot. Subdivision ........ ~.~.. ...................... \ I Filed Map NL .......... Lot NoI,~-/~ .............. Permit No ~L~ {~). Date of Permit~.~..~.\.oL[.~,~..Applicant..-~.q~.,.~.~....~.~..~?.S.~?..~I. ....... 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~ll applicable c~odes and regulations. FIELD INSPECTION COMMENTS 'FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL ]OMMENTS: TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner '~ ~v-'~% ~'.~A %M (please print)~ (please print)~ ~ I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. ~~umber's signature) .... Sworn to before me this .~ day of ~b~-- , Notary Public, County Notary Publ~ MARK T. GA¢~N "~7 NOTARY PUBLIC, State of New YOI~ ~ No. 4695~5D Oual~fled in Suffolk County ~ Commission Expires Mmch 30, 19~[ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT in dte following location; ~ Basement [] 1st Fl. FJXTURE ~ FIXTURES 43 62 53 [] 2.d FI. C~.~Cj~3~ At~'iC~, Outf~i~g~tlon Block and found to be in compliance with the r~q~irements of this Board. Lot RANGES : OVENS EXHAUST FANS SYEFEMS NO. OF FEET OTHER APPARATUS: E R V I C COND, r A, WG. PER ~ j OF CC, COND, I 2/0 NO. OF HI-LEG NO, OF NEUTRALS OF NEUTRAL ~'ctit~Jk~ NoY~ 11592 L~. 78~ 9ENE~A~,~NAGER Per_~ This certificate must not be altered in any manner,, return to the office of the Board if incorrect. Inspec]ors may pe ~;~d~b~'~heir credentials. 'FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD. N.Y. 11971 TEL.: 765-1802 Examined . ..~..../. ~. ..... 19t~:~ ? .... , l P ..'Permit No.Z.Y.(.. Disapproved a/c ~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... Date ...... ~. ........ , a. This application must be completely filled in by typewriter or in ink and submitted 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 Building Inspector will issued a Building Permit to 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 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 building for necessary inspections. (Si~cmTure of applicant, or ff~me, if~t corporat'o ) .. $,. .... ...... (Mailing address of applicant)( State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· ......... ................................................... Nameofownerofpremises ....--..,.151.~.g...,.~.O.-~..t~'~'~tr~ 3- ........ ............................ (as on the tax roll or latest [leed) If 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 No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ~..& .~]~S~./30...~....U..~. i ................ ..................... , ........ ........................... . ..... Hamlet House Number Street County Tax Map No. 1000 Section ..,.~77. ·~.' ........... Block ...... .(?.ff. ........ Lot..~. · .~. · .......... Subdivision . .~.]? ?.~..t/...~. !(.~..tS.~ ............. Filed Map No ............... Lot ............... · -- (~'ame) 2. State existing use and occupancy of premises and intended use and occupancy °f pr°p°sed c°nstructi°n: a. Existing use and occupancy .......... ~.../~..~.' .~. i ......................................... i. .... b. Intended use and occupancy ~ ...... ., 9. 10. 11. 12. 13. 14. f k (h k hi ppli bl ) ildi 'Additio ' Alt ati Natureo wot cec w cha ca e :NewBu ng .... n ........ ·.. er on., ........ Repair ............. . ~Removal ..., ....... Demolition ........... i · ' ' Other Work. Estimated Cost .......... ~, ............... Fee ..... : ......................... (to be Ipaid on filing this application) ~ Number of dwelhng umis on each floor If dwelling number of dwelling units · " If garage, number of cars .... & ..................................... I ........................... 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 o4 Stories ......... ,~ ........... H'hDimensi°nSelg t . ~ of,~.~entire., new construction:Number of StonesFr°nt . ~.~._.. .......... ~ ..... Rear .~ ~tJ' .. Depth .-~.~1 . .,! .... . .. · Zone or use district in ~hich premises are situated· ~.q$., · ........ ! ........ 7, .:... 71.' ...... Does proposed constructioo violate any zoning law, ordinance or regulation: .... '.~?.(~. ................... ..-~.., Will lot be regraded .... t.~? ....... . ......,. .......Will excess fill~be removed from premises: Yes Name of Architect .............. Address .............. i ....Phone No ............ i .~.' Name of Contractor Address ' Phone No PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate property lines. Give street and block number or description according to deed, and sho~ interior or corner lot. all set-back dimensions from street names and indicate whether STATE OF NEW YORK, COUNTY OF.,. S.S · .~.t~ .~..P.~ .... Cp.~,.~ O.~t.~ .................. '... being duly (Name of individual si~ning contract) above named. sworn, deposes and says that he is the applicant NO'h'~Y PUBLIC, Sta~e o[ New York No ,707878, ~uf~olk Comity ~ County , i (Signature of applicant) He is the O .t,42.}~a.~?d9,. ' ' I . (Contractor, agent, corporate officer, of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make and file this application; that all statements contained in this application are true to the best of hisl knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith~ Sworn to before me this ........... ~./. ~ ...... day of... ,,d..~"7.. .......... , 19 .~.g.'- Notary Public, .... .~4~.../~.:. ~9.~.../J/~.... 0 \ J~ wn~ O0 ~.og ~wo