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Home My WebLink About13543-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 ..... .g.d.d.~. ~..5_.o.n. ................................. Location of Property $t[~dsb No. ' .... County Tax Map No. 1000 Section .. 7. 9. ........ Block ..... .0.7. .......Lot . .q 4..3...3. ......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore flied in this office dated ..... q q .~ .... 1. 6 .........193.4.. pursuant to which Building Permit No.. ~..3.5.6.3. .g ............. dated .~. 9y.... l 6 ................... 19 .0.4., was issued, and conforms to ail of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ... Ad.d ~.~.~.Q~..t.o..on..e.×i~.~.~.~g. ~.w.~ ~ ~k~g ...................................... The certificate is issued to ...~.R....~...M.~.~.....S.T.~.~ .L.ET..B.~ p.~.~. .......................... (owner, I~y~ ]~lXt~ X of the aforesaid building. Suffolk County Department of Health Approval ...... .~./.~. ................................ ~;N691517 UNDERWRITERS CERTIFICATE NO ................................................... Rev. 1/81 Building Inspector FORM NO. B TOWH OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NR 13543 Z Permission is hereby granted to: .... ...~.. -,~,~......~...........'z-.~..4~.....~. .......... ............................. ..,,,,~,.~,(~(,,~...= .~ .~. ....... ./.(.~.7..~ ~ ~,a,~ ,~--,--,.-/(/~ .. ~.~.....~....~,~.. ..... z ........... o.....,.,.~.,.~.~,..,...~. ......... ~....,~.~.~. ..... z~ ......... ~.~z,~.~ ....... · /,~ '~ /,,~ ~ ~..~ · ..~.;. at prem.$es located at ...... Z...~'(~.......Z~:.~.(S ...... ~ ........ //~'. ........... .."~"~..',~./~.~.g~..-.~...~" County Tax Mop No. 1000 Section ...... Z..~.. ......... Block ......(~...Z .......... Lot No.(~..~..~.~ .... pursuant to application dated ...... .~..~.~.~, ....... /,.(:~, ...... , 19 .~..~.., ond approved by the Building Inspector. ding Jnspector 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 in duplicate to the Building Inspec- tot 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 features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of dectrical 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 buildings. 3. Date of any I~ousing code or safety inspection of buildi,pgs 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 or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date . .?,~?/, ~..d., ........ , ...... New Building ~'7/~' ...... ]/..~.. Old or Pre-existing Building Vacant Land ............. Location of Property . House No. Street Hamlet Owner or Owners of Property . .~ r:~J. .~n~.. ~ ~e.q ./~ .~. ~f~.'?~ n ..................... CounW 000 Se ion ... Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept. Approval ........ .~E.'. ............. Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ........ --~ ............ Final Certificate ...~..~'..~ ............... Fee Submitted $ ............................. Construction on above described building and,~ermit meets all applicable codes and regulations. Applicant 3a I THE NEW YORK BOARD OF FIRE UNDERWRITERS ].000378 EUREAU OF ELECTRICITY : ~]. 85 JOHN STREET, NEW YORK, NEW YORK 10038 .a,e ~y ~.4,t~ A..,icatio,,No. on~il~ 33~04~/~ N 691517 Stanley Brown~ 1720 Lee~ar~ in the followlng location; ~ ~asement ~ Zst FI, ~ 2nd Ft. Section BIoch Lot was examined on ~/ 9 r ~ 9 ~ ~ and found to be in cotnpliance with the requlretnents of this Board. DRYERS RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS MULTI.OUTLET SYSTEMS NO. OF FEET OTHER APPARATUS: G.F.C.. I.-~ 3_ S E R OF CC, COND I C E NO, OF HI-tEG A W, G NO OF NEUTRALS A. W, G, OF HI-LEG OF NEUTRAL }{all Electric Inc~ P. O. Box 1268 Southold, N,Y., ].1971 GENERAL MANAGER . This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BI; LD NO DEPARTMENT TH S COPY OF CERTIF CATE <I~U~T NOT BE.ALTERED IN ANY MANNER. FIELD INSPECTION FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY FINAL COMMENTS ~ d~ ~C ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Disapproved a/c ....... APPLICATION FOR BUILDING PERMIT Application No. /..OZ/..~./. ,~.. ..... BLDG, DEPT. Date. 1..0./. !.~'. ........ , 19 .~.'('/ INSTRUCTIONS 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 D~partment for the isst~ance 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 in~tions. OD ~ ~'i'~t~li~ant,l~ ,fa corporatmn) . /P. . o, .~. ~. ..y.. ./, .,.x;,. ,,.q lo. 1~, . ~. 6/.,. .,. r~. 7. / . . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .../~. ~.,.l&r ............................................................................... Name of owner of premises /~..~..?....~.. ~.~.. ~..~. l.~.~.. ~..~.0~ n .............................. (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... I./. ~.. ................ Plumber's License No.?~ ~.~.. ~ .g.l !.~.~q ....... Electrician's License No. 3/.,././. ~./.e¢?/.~). c. ..... Other Trade's License NoCi~.?. O¢.~.r'..~. 7..]~O~?..Q 1. Location of land on which proposed work will be done .................................................. · t.v.zo../,L~ ~.,~.,~.~,-/..~. r.,.'v., ........................... ~'.o. ~...k.,. }.4 .................... House Number Street Hamlet County Tax Map No. I000 Section ..... 7. ~. ......... Block ...... 7 ........... Lot... 7.'~.~. .3. ........ Subdivision ..................................... Filed t~'-.,.av No ............... Lot ................ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy. ..... R~-$. t.~ .~..~..5.~....t~.~:~. ~.~;!.:. '" ~':' '~. :'','~" .~..~..lB. }.t ~.'). ...................... b. Intended use and occupancy ~.~.m .~. ~¥ ~'~'~~.. ~, ,,,~ ~';~ · ........... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... . ..__ ._~.~ . (Description) .~ ~L, 0 o.o.', .o. o Fee 4, Estimated Cost ............................................. .~,,~/,,D., , , .. I (to be paid on filing this application) 5. If dwelling, number of dwelling ,:units ..... ! ..... Number of dwelling units on each floor... ]... If g~rage, number of cars .. 2..! .................... ~ ..................... ' ...... 6. If business commercial or mixed occupancy, specify nature and extent of each type of use ."-' "'"; .. · ~-' r~.' ...... :q'" ........ 7. D SlOllS 9, f ~xisting structures, if any: Front ... Rear .... . . Depth. O ' - · z ..... - ............. H, /.: . , .......... Nu ber of Stones ............................... ...................... D! ions Of:same structure with alterations or additions: Front .~,J~.. ........... Rear .. ~ .~. ........... I), r. ~,~.,.~ ...... !.. Height . ,2,..~. .... r ........... Number ~f Stories. ,~_... .~ ......... 8. Di n~io~l[~t~e~ consffuction: Front..,,2, ~ ......... Rear . ,2, ~ ......... ~)epth i i/.' ........... H, t ...... NuMber of Stones ~. si~ ,?~t'"' ~- ~ '~ron~' -/~r' ~, Rea~.. ~ 'god,' ' 'b;;;~': .44. ~.'~ ............. 10. Dtt,t,,)f4~urchase . .,, ........................... Name of Former Owner ............................. 11. Zone or use d~stnct ~n whmh pmm~ses are s~tuated.. ~.. $. ic~.~ ~c~t.t.~.,/. ...... 12. Does proposed construction violate any zoning law, o~dinance or regulation: . ]~J o ........................... 13, Will lot be regraded ./,,,/.~ &,..~ ........ ~ ....z ..... Will excess ill! b~ r~movegl from premises: Yes~ 14. Name of Owner of prem.ses . ~ ~.,,t~ .......... Addres~t ~'~-F~.~/.~ ..... Phone No. r~.6~. Name of Architect .......... I ................. Address ......... ~ .....~ "~ h' Phone No ................ Name of Contractor .*.~:~ .'7~.¢ .I-/'7.7 ,, ..... Address ~ff~/'~'~'~) '~' ~'~I ' 'r~' ~' Ph°ne No. ~./~.-. PLOT DIAGRAM Locate clearly and distinctly all! bdildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block inumber or description according to deed, and show street names and indicate whether interior or corner lot. - "t'$8 'too.z5 STATE OF/~t~R[,/ ~ ,t&' 'S S ' above named, ,, being duly sworn, deposes and says that he is the applicant (,,zr('~ontracto~, 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 manne¥ set forth in the application filed therewith· Sworn to before me this ? ARE FROM FIE&D : 400 OSTRAND[ · -- M~VUAF-NT SUBDIVISION M,d P FILED I# T/f£ OFFICE dUNE '~,/97! AS FI/ENO. 5599. 400 OSTRANDER AVENUE, R~VERH~:~ SURV~ FOR: STANLEY G, B~OWN ~ MARGARET PART OF ~TS 50 ~ 51 "LEEWARD ACRES AT BAYVIEW" B AY VI E W SOUTHOLD ~Vl~S BANK TOWN OF GUARANTEED T~LE DIVISION SOUTHOLD AM~I~N TITLE ~SU~CE( · '~,c' F/rOM FIELD OBSERT~ATiO DATA OBTAIHED F.'~O.M OTHE~I~ ,( OF OCCilPAN,I[;¥ i~:~}~'f ~y~-;j;~M CANNOT :EXCEED ~/lo of 1% LEAD. Ap~,~V;D AS t~OTED ~T~BUILDING DEPARTME~ ~65-1802 9 AM TO 4 PM ~R~E ~OLLOWING INSPECTIONS: ~. FOUNDATION ' ~O FOR POURED co~CR~E ~. ROUGH ~ FRAMING & 3. INSULATION 4. FINAL ' CoNSTRUCTIO~ BE cOMPLETE FOR C. O, ~LL cONSTRUCTION SHAEL ME~ THE REQUIREME~S OF ~ATE CONSTRU~ION ~ ENER~ ~ODES. NOT RESPONSIBLE FOR ~GN. OR ~S~R~ EF~ s~ or ~es 7