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Home My WebLink About13385-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. .Z 13.4.81.. Date May 30 19,,85 one-family dwelling THIS CERTIFIES that the building ................................................ 5865 Soundview Ave. Southold Location of Property/~ b ~/oi ........................................................ $ Street Hamlet 58 i 3 County Tax Map No. 1000 Section ............ Block ............... Lot ................. · x x Subdivision... x Filed Map No. .Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated Au.g.ust 22 19 .8.4. pursuant to which Building Permit No. 13385Z dated August 27 198. ~ , 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 ......... private one-family dwelling..with pool and deck addition. The certificate is issued to Paulo & Jean Blower (owner, of the aforesaid building. Suffolk County Department of Health Approval 14- SO- 180 N690075 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 5OUTHOLD, H. Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 13385 Z Dot.~ ................ , ,~.~..~. ............... Permission is hereby grant~d to: 1~.~ County Tax Map No. 1000 Se~.(~...~.... ......... Block ........ ). ............ Lot No ......... ~ ........... pursuant to application dated '~,~.~......~'.....'~... ............... , 19.~..~.., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~uthold. N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions in dupl±~ate ~- A. This application must be filled in typewriter OR ink, and submitted~, ~ ;?~,, ~,:,~o`~.he 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 disposat-{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~opertv 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 predate 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.Vacan~ Land C.O. $5.00 New Building .... ~.. ...... Old or Pre-existing Building $15.00 Date.. ............ Vacant Land ............. Location of Property ,~.,~(P. ...... -~.OL%I%C~, ¥.I.C,M,).. ~i'.~/.~, .... ~.~"j'.~(~.c~. g...~ ~e~ House No, Street Owner or Owners of Property .~').(3~k~ t g%. ~ .~S.C..~'~. ~...% 1.(~ [~.~ .~. ......................... County Tax Map No, 1000 Section ...(~..~.~' ....... Block .... J'. .......... Lot.. ,?~ ............ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. [~>:~ ~.:J ~-~ Date of Permit~~. ~'~pplicant .~..1D.c~% ~g.~ ~P~ [:~ ~ ...... Health Dept. Approval .~. (~.~ ~q:~ .[~. ....... Labor Dept. Approval ........................ JJ, ~OO'~ 5 gB App Unde~riters Approval .................... Plannin card roval ...................... Request for Temporary Certificate ..................... Final Certificate . ,~ .................. 5' e0 ................... Fee Submitted $ ......... Construction on above described building and permit meets all applicable codes and regulations. Applicant..,(_~. ~.~,-~, '~'~7~'' Rev. 10-10-78 TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No.~,~ (please prih~) (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 day of ~ , Notary Public, ounty NOTARY PUSI.IC, SJate oJ New York NO. 472B376, Sufloll~ . Te,.rrn E'~p~res March 30. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT intheyollowingloc.~t~fl a]~St ~ lstFI. ~ 2nd FI. Section Block Lot FIXTURE OUTLETS DRYERS FIXTURES RANGES OVENS EXHAUST FANS SYSTEMS NO. OF FEET OTHER AFPARATUS: Motors~ l~-3/4hp E R V I C NO, Of CC, COND A W.G. NO, OF HI-LEG A W, G NO, OF NEUTRALS ~ 4/0 ~ J~G.F.C.t. 3-~tmo~.~ Det~tors~ 1-..,'~ ~lbn A/C Units, 1-2~ ~bn A/C Units, 1-5 Tc~z A/C uaits. Raland ~.ectrlc Co. ~~'~-~ P. O. Box 14i~ ' M~ttitu~ N.Y 11952 Lic. ~ 11 This cedHico~e must no1 be oltered i. ony monner; refurn to the office o¢ the Boord ff incorrect Inspecfo~s roof ~e identified by their credenfiols. c0pY~OR B?~LDING DEP~RTMENT, THIS COPY, OF CERTIF~CA/E,¢U~T ~o~,8E ~TERED NANY MANNER. ~L D~N S ~1EC T I ON FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE COMMENTS FINAL ADDITIONAL COMMENTS: 76S.1802 BUILDING DEPT.· IHSPE 'rlON [/FOUNDATION 1ST ~[ ] RouGH pLBG. FOUNDATION 2ND, [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKs: 76S.1802 BUILDING DEPT. IHSPEC?IOH [ ] FOUNDATION 1ST [ ] ROUGH LBG. [ ~/FOUNDATION 2ND[ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTOR ~/~ ' FORM NO. 1 -fOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL,: 765-1802 Approved~~ .~.? .... 19fl [./. Permit No. ~. ~ .~..~.4. ·~Z. Disapproved a/c ..................................... ..................................... ."'-' (Building Inspector) APPLICATION FOR BUILDING PERIVIIT 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 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. (Signature of applicant, or name, if a corporation)-- (Mailing address of applicaht) O,y. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builcler. E,.o. ................................ Name of owner of premises ...'~.Otkl .~.....~.lO.LO.l~. ............................................... ~ q- ~('~lO tOo,~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....q.~..~. .................. Plumber's License No...~.~..~ ..~..~. ........... Electrician's License No.. Other Trade's License No ...................... h Location of land on which proposed work will be done ..... ,~O.B. 15~ ..~. .....~. ~ .~..bO....~.V~., .............. ¥. l to ............................ llouse Number Street --' Hamlet County Tax Map No. 1000 Section . . .~)~.~ ......... Block .... .~ ............. 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 ..................................................................... b. Intended use and occupancy .......... [.. ~-.t;t. IOx't ~ y... h01/S.e....7..]rT..~.S. ?...e.~..c...~. ................ o 10. I1. 12. 13. 14. Nature of work (check which applicable): New Building . .~..' ..... Addition .......... Alteration .......... Repair .............. Rem6val .............. Demolition .............. Other Work ............... , ~.~.. (Description) Estimated Cost. ~. [~'O. O. 0)~.~ ~ .................. Fee...c~.? ~ *-' (to be paid on filing this application) If dwelling, number of dwelling hnits ... ] ........... Number of dwelling units on each floor .............. If garage, number of cars ..... !~. C.~.lt? ........................................................... 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 w~th alterations or additions: Front ................. Rear ................. Depth .................... i' · Height ....................... Number of Stories ........... l ......... Dimensions of. entire new constrUction: Front..."/~.'.(~ ?. ..... Rear . .'/./1t. ~. .........Depth . ~lO .t.q *.' ...... Height' . ~.cl: .+..':' ....... Nu.n)ber of Stories ...,=,ilL, ................................................. ': ...... ...... ................ .....:'::'-.'. ....... Does proposed construction violate any zoning law, ordinance or regulation: .. [~'P. .......................... Will lot be regraded ..... ~ '~'~ .... ~,'i ........... Will exc.e.ss fill be g~moved fr9~ premises: Yes Name of Owner of premises r~OlO...~.loto.¢r.. Address . .~t~llh~.l:[:.O~l~,~. :'~)hone No ............. Name of Architect L~.C~.. ~.,~,o~_, .......... Address ~.c}a~<3 ,~.~<~.1~.0~... Phone No. ~.~."~0,~,..,.~..:. Name of Contractor 'DIMI~$..i'~O..%. ...... Address dC. qL ' o.n ........ rhone No../'FZT: 17R :. PLOT DIAGRAM Locate ~learly and distinctly allI buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block ~number or description according to deed, and show street names and indicate whether interior or corner lot. 1.o :If:, oo C3 being duly sworn, deposes and says that he is the applicant STATE OF .NEW YORK, COUNTY OF ......... ........ I S.S (Name of individual sig~ing contract) above named. lie is the" [ (Contractor, 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 manner set forth in the application filed therewith. Sworn to before me this ........... · ~..~.. · .,'~.. .... day oi .... . ~ .......... 19 .~.~r Notary Public, . .... ~..~.~a~.~.&~... County NOI~F*¥ ~U~C, Sate ~f ~ '/0r~ (Signature of applicant)