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Home My WebLink About13372-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy NoZ1~175 Date Jan. 21 ................................................... 1986 THIS CERTIFIES that the building.. A d d ~.t. 5, o n..g r~ cl..a.], ~ ~ .r.a.t.i. 9 .n ................... Location of Property ..... 80 9..P.a..r .k..A.v..e .. .......... M a t t i t u c k House No. Street Hamlet County Tax Map No. 1000 Section ...1.2.3. ...... Block ...7 ............ Lot 5.2 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..& q g ....2,(~ .......... ,198. 6.. pursuant to which Building Permit No..12.a 7 ~ ~ .............. dated ..... g u g.,.. 8 7 ............... 19.8..6, 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 ......... The certificate is issued to ....W.]]L L Z~M. J....&. J.0AI~. ¢...C..0 N.W.A.Y .............. (owner, ~][~d~ of the aforesaid building. Suffolk County Department of Health Approval ....... .N [.A. ............................... UNDERWRITERS CERTIFICATE NO .N.711 9. 9.3 Flumbers certificate 12/20/85 Rev. 1/81 Building Inspector lrOB~ NO. 9 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) N? 13372 Z Permission is hereby granted to; ..... ..~.., ...~....~...=.~.,.~....-.~:V, .............. .~.~.:~.~=~...~.~...~..~. ................................................... ot premise~ located at ............................................................................................................................ Mo No I000 Sect' .~ '~-"~. Block ..... ~ Lo ' ~ Coun~ To× p .~.., ................................ t No......~ ................. pursuant to application doted ..~.~.....~.,.....~.....~.. ............... , 19..~...~.., °nd approved by the Building Inspector. Fee $.~...;~....: ............ Rev. 6/30/80 TOWN OF SOUTHOLD 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 featu res. 2. Final approval of Health Dept, of water supply and sewerage disposal-iS-9 form or equal). 3. Approva~ of e~ectrica[ 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 property 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. 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 ....~..O.O. .... ~.~..~..~...~..l{.f.~..~...~. ...... .~..~..T. ?..t .T..~..C..~....../~..y:...[/.~..~. 2- House No, Street Ham/et Owner or Owners of Property ...~.{/././.~ ./'3., .~-.....'~..... ,'>7, .o.~..A~... C ..... ~./.~..c~../~.. ~. ....... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo. ,~:.l.3.'.3.7..?'.~. Date of Permit ¢-?-7-g~- . .~/.,///./~. ,.~....~_,~.~.q~.~..~. .......... /~pplicant .... Health Dept, Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ... ~ ................ Fee Submitted $....?..~.~.....7..~.. !77..5~. ..... //~ Construction on above described buildin~Q~p~!~; al~'~a~i: c~o~es and regu lations. THE NEW YORK BOARD OF FIRE UNDERWRITERS 10QO771 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~ Oc~obe~ 08, .L9~5 325934/85 .a,e .~p,,,,ea,,o,.,'~o.o.~,,e N 711903 THIS CERTIFIEB THAT only the electrical equipment as described below and introduced by the applicant r~a~ed on the above application number in the premises of William J. Conway, S/S Par~ Awmue~ 800'¥;/0 Ha~rat.ooka R~ ~ Ma~ituck, ~ i. the/o,,owi.~,ocatio.~ [] ...eme., '~[] ,. FI. %~ 2.d F,. S.ctlon Block Lot ~vas examined on Of~tO~)®~2 031 ~ 985 and found to be n compl ance w th the requirements of this Board, FIXTURES OVENS DISH WASHERS EXHAUST FANS FIXTURE OUTLETS SWITCHES FLUORESCENT 35 25 DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS= 1-G,F~CoZ E R V I C OF CC, CONb NO. OF HI-LEG OF HI-LEG NO~NEUTRALS OF NEUTRAL ~u~.and ~,.~.eo~ic co. : ~~//~ ~""~~ P.O. J~ox 143 ~a=tltUck, NY 11952 L~c~242E GENERAL ~NAGER ~ m . Per ~ ~ This certificate must not be altered in any manner; return to the office of the Board if incorrect nspecfors may be dent {ed bv the r cred~nt~a COPY FOR BUILDING DEPARTMENT. THIS COPY~FCtRIIE[C~ MU~ N~T B~ALTERE~,IN ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 U L~L~~.~'~ ........ .' ~ BLDG. OEPT. [ TOW?~..~...,,,,,~OF SOUTHO~ J CERTIFICATION Date Building Permit No. ~ ! (please print) Plumber ~TI l~J Cl~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) Sworn to before me this Notary Public, ~F/~)~/~ Notary Public County DANIEL V, BRI$OYTI NOTARY PUBLIC, State of New Y~rk No. 4782371 QuaLified in Suffolk County ¢~*,mmi~slon Expires March 30, F1ELD INSFECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH F~a ?L~MBING INSULATION PER N. STATE ENERGY CpDE FINAL ADDITIONAL COMMENTS: OEO 18 198,5 TOWN OF SOUTHOLD ~'~y, //ddt' ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL &.,ct'. SOUTHOLD, N.Y. 11971 · TEL.: 765-1803 Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .................. , 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 st'feets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap. pli- 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 Regulations, for the construction of buildings, additions or alterations, or for..r.e The applicant agrees to comply with all applicable laws, ordinances,~ildi~.ce admit authorized inspectors on premises and in building for necessa~ ~n~p~9~s. and other applicable Laws, Ordinances or tov~ or demolition, as herein described. _.. i, and regulations, and to /15Plicant, or m/me, if a corporation) (Signature ~ (Mailing address of applicant) I t' oo ! State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....~.(//~..~..,~1. ',~ ~- ~]'o~t~ C (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...~.~~ .......... Plumber's License No ......................... 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 / Z 3 Block 7 Lot .... Subdivision ................................. -:... 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 ,l~ ~ g t 0£,~ 'Ft,,'~ ~- · ntendcd use an occupancy .................................................................... 3. Nat re of work (qheck which apphcable): New Building .......... Addition ...... Alteration .......... Repair .............. RemOval .............. Demolition .............. Other Work ............... ~ ~ ~ (Description) 4 Estimated Cost /.~.~..O-A~... Fee .'~..'~q~ ~ " ~ "' (to be paid on filing this application) , ( 5. If dwelling, number of dwellingI units ............... Number of dwelling units on each floor ............... If garage, number of cars .... i ................................................................... 6. If business, commercial or mixdd occupancy, specify nature,,and extent of each type of use .................... 7. Dimensions of existing structures, if anv: Front ~-/~ ~. R~ 4~l?'' .g ' , [ .... .. ................................ Depth... ~ ......... Height ./..3..~' ....... Number ofStories ! ................................... Dimensions of same structure with alterations or additions: Front ?.- 6 '~" Rear .. ~. ~. .... Depth ...3.. ~ ...... . Height .~,-i[.~.~. .... Number of Stories 2. .. 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... .,H. eight ............... Number of Stories ....................................... ~ ................ 9. Size oflot: Front .... .~..O.:~. .......... Rear ...... ~.O'............. Depth ../.~...~}...~.~... .... ..... 10. ,D, ate of Purchase .././..-..7.~. i ................... Name of Former ..Owner . (Z t~ .~..~.~ .... 11. Zone or use district in which pr~mises are situated.. ~ ~ ~gt ~,~r/~ c- z ................ 12. Does proposed constructio.n vioilate any zoning law, ordinance or regulation: ./I/.o. ........................... 13. Will lot be regraded ...~.O.. ,. ................... Will excess fill be removed from premise~: Yes No 14. Name of Owner of premises //~/~ .~. ~.~t~. Address~..,~.~?.'?.~. .~?. 6. t.~.~p'.~.cff?~'o~n~o'. '.~.~.~. 7.~.7~.. Name of Architect /~q.~Pr&lT.[~.~,y4~... ~Address goq?~/(.~.~R~°vr~t~l~ ..... Name of Contractor ' Address Phone No Locate clearly and distinctly all property lines. Give street and blocl~ interior or corner lot. PLOT DIAGRAM buildings, whether existing or proposed, and, indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether STATE OF NEW YORK, COUNTY OF ............................. ~ .................... being duly sworn, deposes and says that he is the applicant (Name of individual sign ng contract) above named. He is the ...................... ................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul 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 h~]T~,RY f~6(IC, S~a~ O~ t~e~t York Term t~rmes.blareh 3§, 19~~