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Home My WebLink About13552-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No .................. July 3~ 198..5 Date ................................ , . THIS CERTIFIES that the building ...s~_.i.t.i. 9 .m: ................................... Location of Property . 370.Cl ................ .V.~3~.o.~...R.d.,. .......... .~.~.~. 9.h.o.c~...e ...... House No. Street Hamlet County Tax Map No. ] 000 Section ... O .~.~ ..... Block ........ ~ ...... Lot . .! ~ ............. Subdivision ............... 7g ............... Filed Map No .... .x .... Lot No ...... ~ ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated October 2z% 19~.q'.. pursuant to which Building Permit No. . .q. 5.,5.5.~.~. dated......................3T°vember 20 .... .. 19 .~.~ , was issued, and conforms to all ofthe requirements of the applicable provisions of the law. The occupancy ~r w~ch t~s certificate is issued is ......... Addition to existing one-family dwelling. The certificate is issued to ............... ~GBERT. HcIdLU. GF~h~ ....................... (owner,~ of the aforesaid building. Suffolk County Department of Health Approval .......... UNDERWRITERS CERTIFICATE NO. N6q 3762 Building Inspector Rev. 1/81 MOB~ NO. ~1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. NO_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) 13552 Z ~ot~ ../~.~:~,.....~..e. ............ , ~..~.~ Permission Is hereby granted to: h'~..~. ..~~..~.....~..:~.:....u...~..a~. .... ,o ...~~ ........... ~ .................. ~ ........................ r ................. ~..~.~.....~.......~.~...~.:. ................................................................................... o,,..,,.,~.~,...~.~ ............ ~f~ .................... ~~~....~...~. ........ co~,~ ~ ~ ~o. ~o00 S,,o, ........ I.~.~. ......... m~ ....... ~. ........ ~o~ No ....... /..~ ........... ~u~u~., ,o ~,,~.o. ~,~ ....~.~...~.~ ................. , ~.~.~., ~.~ o,,rov~ ~ Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 BLDG, DEPT. TOWN OF SOUTHOLD 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 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 p2~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, Certificate of occupancy $§.00 2, Certificate of occupancv 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 ............. ................................ $ /¢ N -b Location of Property .. ................ .~. ....... House No. Street Hamlet Owner or Owners of Property ..................................................... County Tax Map No. 1000 Section ..... ~/./( ....... Block ...... ~7 ........ Lot ..../.~ ........... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No /'~ ~* .5~.~. 7~ Date of Permit f./~ .~.~/~.~..Applicant ///~ ~ ~. ~;- ,,,ff',~ AC/,z~ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ...... ~,~¢- ............... Construction on above described building anc~perfnit meets all applicable codes and reguJations. "" .... ........................... THE NEW YORK BOARD OF FIRE UNDERWRITERS '[)~ BUREAU OF ELECTRICITY ~-- 85 JOHN STREET, NEW YORK, NEW YORK 1OO3~8 V. te AuguSt 22, :[983 Ap. licatio. No, o.tile 229252-83 N6 1 3 7 $ 2 THIS CERTIFIES THAT ~ only the electrical equipment as described below and introduced by the applicant named on the above application number in the preotlses of ~.qobe~c Mc Laughl~ Vanstc~ Rd.- Nassau Pt~ ~ Cutchofp3a, N.Y. in the following location; [] Basement ~ 1st FI. wasexa.a.edo. A~q~t~st 15, 1983 FIXTURE I FIXTURES OUTLETS ECEPTACLES SWITCHES NCANDESCENT FLUORESCENT DRYERS FURNACE MOTORS [] 2nd FI. Section Block Lot and found to be in corrtpliance with the r~quirements of this Board. RANGES OVENS DISH WASHERS EXHAUST FANS FUTURE APPLIANCE FEEDERS TIMECLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: S E R V I C E NO OF HI-LEG A. W.G. NO OF NEUTRALS J A. W G, OF H~-LEG OF NEUTRAL · 1 b Robert Mc Laughlin Vanston Rd. - Nassau Pt. 6htchogn~ N.Y., 11935 GENERAL MANAGE,R/ 11 : This certificate must not be altered in any manner; return to the office of the. Board if iincorrect. ,Inspectg~s may be ~dent f ed by their COPY FOR BUILDING DEPARTMENT. THIS COPY OF ( ER. FIELD INS?ECTION FOUNDATION FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE C OMM EN TS FINAL ADDITIONAL COMMENTS: BUILDING DEPT. INSPECTION, [ ] FOUNDATION 'tST [ ] ROUGH pLBG. [~//FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS, DATE ,INSPECTOR, ~ Examined. ~ ~..~...~.o.., 19 ?.~. 'FORM NO, 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 · Approved . .~. ~.~....~..0., 19 .$.~. Permit No. 1..~.&.-~.'~.~,. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BLDG. DEPT. TOWN OF SOUTHOLD Received ........... ,19... Date ................... 19... 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 tl~is 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 .c~e, housing code, and ~gulations, and to admit authorized inspectors on premises and in building for necessary ins~e~, t~., . j/ f State w~eth~¢r applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... ~...~. [~w~ ~.....~....C'm..~..~q.~ [.[:k, ........................... (as on the tax roll or latest deed) If applicant is a co~oration, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .................... ~ .... Plumber's License No...P...7./.1 ............. Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ..................................... .............................................................. ..... House Number Street Hamlet County Tax Map No. 1000 Section ....... t [.[ ........ Block ..... .'~..~. ......... Lot .... /..~. ............ Subdivision /I/~q XXw~ '~D/.~. ~ Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .. / .................. ............................ b. Intended use and occupancy . . .~..-~..~. ( ......................................................... 3. Nature of work (check which appli,.cable): New Building. ..... ' ..... Addition ........ Alteration .......... Repair ......... Removal ......... Demolition ........... i... Other Work ............... 4. Estimated Cost ......................... Fee .................. '~ (to be ipaid on filing this application) 5. If dwelling, number of dwelling units ..... [ ........ Number of dwelling uniis on each floor.....'-~.. ......... If garage number of cars ....':'.. '. '..--. i · 6. If business, commercial or mixed occupancy, specify nature and extent of each tv~e of use · · %i. . 7. Dlmensmns sting structures, ff any: Front...~-~ ......... Rear ....... ~ ....... Depth ........... Height ...... ~ ........ Number of Stories .. ! ......................... ! .................... Dimensions of same structure with alterations or additions' Front ,,~. R~ ~ ......... Depth ..... ~.~. .............. Hei?~rt ...... · ............ Numbetr of Stories ... I 8. Dimensions of entire new construction Front ~ . Rear ~ D~*,'*~'"~') .......... Height .... ./~..~ ........Number of Stories ..... ! ...... ................ ! ................... 9. Size of lot' Front [/.~ ~ ~ Rear q~.8:~ t /~ ......... · : · .~ ......_. .... ,~_ ..: .................. ~Depth ....... ,, ............... 10. Date of Purchase . .,4~.~..~.~...+~... l.~.&.7. .Igame of Former Owner ~.¥~- ~..~..~[~-~.~. .... 11. Zone or use district in which premises are situated .~.~..~.tp.~...~.W.t..~..~... ii'iii.'i, i'.. iii' i.i. ii ' 12. Does proposed construction vie!ate any zoning law, ordinance or regulation: . i '.~.,O. i .... i... i.. 13. Will lot be regraded ....... -.~.0......~ ~. , .. Will exce~s fill be remove~ from premises: 14. NameofOwnerofpremises ~t~:p. le~l~iILl~. Address r~zt.. ~O£t¢14 ~ v~,,,,~x~,, ~ Name of Architect t~.O ~.,.~...'7Z. Address . Ph~-~ Name of Contractor .~t: .~..5'.~..~.55.d. ............. Address ~..~..~'. p.t.~..~..~.q~ .b .. Phone No ~ ~. 7 ~.~ . ~ ~,v~ t.~-~ : ' ....... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate ail set-back dimensions from property lines. Give street and bloc~number or description according to deed, and show street names and indicate whether interior or corner lot. ~" CO~N'Tyo~STATE OF NEW~K~[/~ S.S ff~ . beln dul sworn de Osesandsa sthath ...................... ' ...................... ' g y , p y e is the applicant (Name of individual signing contract) above named· He is the ...... ~~ ~ ~... d~ ~.~ ~ .~ ........................................... (Contractor, agent, corporate officer, etc.)~ of said owner or owners, ~d is duly authorized to perform or have perfo~ed the s~id work and to m~e and file this ~'pplication; that ail statements contained ~ this application are true to the best of his e and belief; and that the work will be perfomed in the m~ner set forth in the application filed therewith. Sworn to before me this ~.Cf. 5. ......... day o[ .~.~.. ............. , 19~ State ~? ~2- 466348~ ['~ ~t~r~.[' (~gnature of appli~cant) °'"'"~°n EXplre~ Mar h an ~ ~ ~~' ~. ~' ~'~ {~ ~ ',~ PL' OLDER rJpPL Y S '~XCEED If copper submg is use for water distributing system; piping shall be of types K or L only OCC~fPANCY rSED IN WATER YS TE~NO T z/zo DATE: "/a ~/2~.P. FEE: ~ ~' / BY: NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE , FOLLOWING INSPECTIONS: ,]. FOUNDATION - ~WO FOR pOURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSUI A'[ ,4, FINal - C~N'STRUCTIGN ~UST BE C")?'P~ ~'TE FOR C. O. 'ALL COF4STR'~CT}ON SHALL ~EET THE REQL.HRF~AENTS OF THE N.Y. ',STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR ,DESIGN OR CONSTRUCTION ERRORS.