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Home My WebLink About13599-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. ..Zfi. 4.54.2. Date June 20 198..6. THIS CERTIFIES that the buildhig o n e - f a .mi 1 y d w e 11 i n g Location of Property ....4.5. Q '. ............. .B.r.i.g.ap.t.i..n.e..D.r... ......... S.o..u.t.h.q 1..d ....... House No. Street Hamlet County Tax Map No. ]000 Section ....79 ....... Block ........ /t. ...... Lot ....... z[.2. ........ Subdivision .......... .X .................... Filed Map No .... .X .... Lot No. X conforms substantially to the Application for Building Permit heretofore filed in this office dated · ~l.o.v.e..m.b.e.p...2.7 ........ 19.8.4. pursuant to which Btfilding Permit No ..... 1.3.5..9.9.Z. .......... dated ........ .N.o.v.e..m.b.e.r...29 ....... 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 ......... ?r~¥ate ore f~il7 dwelling The certificate is issued to ......... .VJ.N.C.E..N.T..T.,..&..d. 9.A.N..H..E.F.F.E.R..N.A.N. ................. (o ~vner, of the aforesaid building· Suffolk County Department of Health Approval ............... .~.4.-. s. 9r.~.2. 7. ............. UNDERWRITERS CERTIFICATE NO ......................... .N. 7. 0..17.4.4. ................ Rev. 1/81 Building Inspector TOWN OF $OUTHOLD BUILDING DEI'ARTM£NT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJ~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ,,.d. 13599 Z ~,te .................................... ~ ............ , Permission is hereby gronted to: ......~.~' ~-~.~,, .............................. ,,b,...~.. ............. .....~.~z..~..~.~ ................................................ ...~~.,.~...~..:.h.........!.!..~.~: ..... ,o...~.....~ ...... ~,......y~ ....... ~,~.~.I..+......~.... ........... Ot premises Iocoted ot .....~....~..~......~..~.~.....~.........~.~ ........... ....... ~...~....!~...~...:;;..~ .......... ~.~ .................................................................... ....~,,.....~ ......................... ~ ............ ~.._,~ ............................................................................. v O-7C~ L~ Coun~ Tox Mop No, ]000 Section ............... .I ....... Block .......... ~o ........ Lot No. **.~.. ................. Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLO Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted I ~ 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 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, o¢ buildings and "pre-existing" land uses: 1. Accurate survey of property 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 $5.0Q 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 ~' ~J~ Old or Pre-existing Building Vacant Land Location of Property...Z~ ~'.~.. ........... ./~./~. { .~..~. ~..~./.'/9 C- No. . '"' ...................... o ,,r o, O n,, ?... County Tax Map No. 1000 Section .... ?. 7. ,~ ...... Block .. ~..~, ........ Lot.. ?,..~. ~ ...... Subdivision ................................. Filed Map No ........ i..Lot No .............. Permit No./.;~?...~.~..~, Date of Permit . pplicant .................................. Health Dept. Approval .... IJ.~.~.~..2.':'..~.~,~.7...Labor Dept. Approval ....................... Underwriters Approval · · .~NJ. ?..0.1 .'~ .L/..~-//.. ..... Planning Board Approval ..................... Request for Temporary Certificate ..................... Final Certificate ...... ~ ............. Fee Submitted $ .(~f ..... ~/.~.~. ~.~..~ ....... Construction on above described bu ilding and permit meets all applicable cod~es and regulations. · n .. ~ ,~ppHcant . .~ ..... . .'-~'~..~¢'~ ...... .~....~F~--i~.-~. .'-....~?yy~'~... ........... % % ............ Rev, I0-I0-78 ~oo~o7~ THE NEW YORK BOARD OF FIRE UNDERWRITERS 01 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 Oate ~y 2~,, l~ ~'p,,,ic..o,,No.o.~ile 3~.~9/8.~ N 701744 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number i~ the pretnises of A, Heff~, Bri~tine ~, ~cher ~ ~ ~r Lts ~, ~uthold, N Y was examined on J~ ~ ~ ~ and found to be in cornpliance with the requirements of this Board. OUTLETsFIXTURE ! SWITCHES FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS FLUORESCENT VAPOR 37 gl 33 37 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCK~; UNIT HEATERS DIMMERS SYSTEMS NO. OF SERVICE DISCONNECT OTHER APPARATUS: ~otors 1-1/~ ~ 1--Gb~Jl, 1-~mo~e Dete[ctor S E NO. O~,~CC. eCON 0. R V I r C E A. WG. / NO. OF HI-LEG A. WG NO. OFNEUTRAI A.W.G OF CC. COND. OF HI-LEG OF NEUTRAL this certificate must not be altered in any manner; refurn to the office of the Board if ~ncor~'ect Inspectois may be t' FOR BI IILDING DE IlS COPY I IFI, r NOT B.E .a INER, TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 119?l TEL. 765-1802 CERTIFICATION Owner ~99~/~5~/% (please print) (please ~rint) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this ~ day of _ ~y Notary Public, ~-6~ (plumber Notary Public County ~$~ FIELD INSPECTION FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & (2nd) COMMENTS PLUMBING INSULATION PER N. Y. STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ,~OUTHOLD, N.Y. 11971 TEL.'. 765-1803 Examined ./~...~&L'~. {h~..~r~., 19~q. Approved .~0.~44'r4 .l~. ~., 19~.~. Permit No..J .5 .~.--.~.c/.. ~ .. Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ' a. This application must be dompletely filled in by typewriter or in ink and submittdd to the Building Inspector, with 3 :ets 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 )r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ration. 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 ;hall 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 :hall 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 tuilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Fhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in building for necessary inspections. Heidtmann & Son, Inc. (Signature of applicant, or name, if a corporation) ...v... 9 :, (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor Nmne of owner of pre[~nises ....V. J:.n. 9.e.n. ~ · .2'.... 5..'lqa..n. .H.o..ffl. q r..n.a.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) 10 Builder's License No .......................... Plumber's License No...M.a.L.L. ~.~.u.c..k..P. 1..u[n.~.J:.n.g. &Heating Corp; Electrician's License No...E..E 9.0.. E..i.e.c. ~ .r ?..c...C9.r p. Other Yrade's License No ...................... I. Location of land on which proposed work will be done .................................................. z./ A'~10 ' ' ' th ' - Br~gent~ne Drive Sou old House Number Street Hamlet County Tax Map No. 1000 Section 079 Block 4 Lot 42 · HarbOr Lights 4362 23 Subdivision ..................................... Filed Map No ............... Lot ............... (Name) \, \ ; 2.State existing use and occupancy ,~f premises and intended use and occupancy of proposed construction: · -~. ........... v~-~.. ...................... ~0iI,:..' ' 7.' · i,,,?: · ~ · · '~] .... b. Intended use and occupancy .......... .Y;?. · ."/.~:,..~~ ........................... applicable): New Building x,,x . Addition Alteration 3, Nature of work (check which ......... ~ .................. Repair Removal Demolition , Other Work ' (Description) 100~ 000 O0 ' 4 Estimated Cost .'~ ' (to b~ paid on filing this application) If dwelling hum ~r of dwelling units on~ Number of dwelling units on each floor Ifgarage, numbe of cars tiWO .~ , ' 6. If business, com~ .ercial or mixed occupancy, specify nature and extent of each tjpe of use .................... 7. Dimensions of e: :isting structures, if any: Front ............... Rear ...... ] ........ Depth .............. Height ............... Number of Stories ...................................................... Dimensions ofs tme structure with alterations or additions: Front ........... I ...... Rear ................. Depth ...................... Height ...................... Number o'f Stories ........ · · . .5.9.'4" ~. 59'4"-- ',35" ......... 8. HeightDlmensi°ns of]~tire new construction.w,, ber of StorieFr°nts ............ xtear ....... ~' ...... Depth one ' ' ........... ? ' 100'Fro i 0 b 2 O'(J r 9. Size of lot: Front ...................... Rear ...................... I Depth ..................... 10 Date of Purchase Name of Former Owner i 11 Zone or use district in which premises are situated [l.es.J, qt~p.t.i..a). ' 12 Does proposed construction violate any zoning law ordinance or regulation .BP. 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No fp ¥,. l-leffernan A~t~t~3 HeBr,v, Courl: 14. Name of Owner o remises ............................. a, I~io.D~'ic~ · · · Phone No ................ Name of Architect ........................... Address ' .............. ..... Phone No .... Name of Contractor He.idtmann & Son, ' INc, ' ' ' 73'/-;2T4'8'~'' ......................... Address Cutchogue, ,N, Y.Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. ihdicate all set-back din).ensions from property lines. Give street and block number or description according to deed, and sh6w street names and intimate whether interior or corner lot. ']TATE OF I~OI~,K~_ ! l~' :OUNTY, 0~c~</~%~.,.., . / .... .' ~'(Nante of individual signing contract) tbove named. .... being duly sworn, deposes and says that he is the applicant , He is the ..................... .x~.. ~ i' .~ ........................ ! .................... ......... ~ ~ ( ~.,.~Contracto~agent, corporate bfficer;etc,!) >f said owner or owners, and is duly authodze~erform or have performed the isaid work and to make and file this ~pplication; that all statements contained in this application are true to the best of hlis knowledge and belief; and that the ~ork will be performed in the manner set forth in the application filed therewith. ~wom to before me this ............. C~tff. ~.4 .... day of .... //c". l'~.(~, 19~ ~)j qotary Public .............. ~<:~,., ,~,~,~,., ,/~County ~ / ~~,. .... (Signature of applicant)