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HomeMy WebLinkAbout13411-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ....... Z. ] .3.63.5. .... Date .............. g.u. 1. ¥..1.7. ...........19 .8.5. THIS CERTIFIES that the building ...... g~..e .e.n.h.q .u .~.e.. .............................. Location of Property ...R.: .O. ~ ........ K. ~_¥.~.u.p...L.~.n.e. .................. ~.a.~.~.~..~.u.c.k. ..... House No. Street Hamlet County Tax Map No. ]000 Section .... 1.2. .1 ..... Block ........ .3 ......Lot ....... .7 ......... Subdivision .............. .x ................ Filed Map No....x ..... Lot No ..... .~ ........ confoxms substantially to the Application for Building Permit heretofore filed in this office dated ........ S.~ p.a.%nib. 9 r..6., 19~3.4. pursuant to which Building Permit No .... q. 3. .4 .q .l . Z. ........... dated ...... ~.e.p. ~..o .m.b.e. ~.. 5 ......... 198. 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 ......... ..... ~3~.~ ~ O~.o.u.~ ~... ............................................................. LAUREL GREENHOUSES, INC. The certificate is issued to ........................................................... (owner, ~(e~oZ of the aforesaid building, Suffolk County Department of Health Approval ................... .~ [.A. ................... UNDERWRITERS CERTIFICATE NO ......................... ~ 6. 9.2.1.9. 2. ................. Rev. 1/81 Building Inspector FOB.M NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTNOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N? 13411 Z Pe~ission is hereby granted to: County Tax Map No. 1000 Section ..... l.,,.:~,,,I ......... Bilk ........,~ ......... Lot No .......~, ................ Building Inspector. Fee~ )~,"'" ond approved by the Building Inspector 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 ia IIIBII~ 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. For existing buildings (prior to April 1957), Non*conforming uses, or buildings and "pre.existing" land uses: 1. Accurate survey of p~operty 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 $15.00 4.Vacant Land C.O. $5.00 .~. Date ............... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ............ ~.~ (~,t'~) F L~, ~.~. ~,~ ~ House No. Street Hamlet Owner or Owners of Property ...... . .~, .~. Q.~..~j.[ .... .~..~..~<~....~ .~.C)..~.~..~..). ~..~.' .......... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Perm it No./.~. ~..~.'~..'~.. Date of Permit .......... Applicant.L~.,C~M~. ~/~-~ .~. · · .~.. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporarv Certificate ..................... Final Certificate ................... Fee Submitted $.. ~.,.f~ .................... Construction on above described building anla~l~e~nit meets all a~lpligable co~es and regulations. C.,~.~',,~,, "J/~D~<~d~~ Applicant .~/JJ.~..~. · .~.~ ............... Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000663 BUREAU OF ELECTRICITY ~ ~-kl es JOHN STREET, NEW YORK, NETM YORK 1OO3~1 "a,e May 17,1985 Applic.tlo. No.o.y.,, 308!~76/84 N 692192 THIS[ CERTIFIES THAT only the electrical equipment as described belotv and introduced by the applicant rtamed on the above application number in the pre,tlses of Laurel Greenhouses, Kirkup Lane, Cox Neck Rd.& Berqan Ave.,Matti~ N,Y. in the yoltowing local,on; [] Basement ~] 1st FI. [] 2nd FI. Section Block Lot was examined on May 13,19 8,5 a,~d found to be in compliance wlth the requirements of this Board. 14 23 7 OUTLETsFIXTURE SWITCHES FIXTURES RANGES COOKINGDECKS OVENS EXHAUST FANS DRYERS FURNACE FUTURE APPLIANCE FEEDERS TIMECLOCKS blNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S OTHER APPARATUS: E R V I A'W'G NO, OF HI-LEO i 500 mci NO OF CC. COND PER ,~ NO O NEUTRALS OF NEUTRAL 1 500 mom Furnace Motors- i~SH.P., 6-F H.P. Special Rec~pt.- 1-50amp.~ 4-20amp. Motors- 1-5 H.P., 14-F Panelboards; 2-5 125amps. Glenn R. Bradley Box 382 Laurel, N.Y., 11948 !7' GENERAL MANAGER 11 t ' . Per ' ?', ~,. . This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspecto may be identified by their credentials. FOR BI ENT. THIS( ANY MANNER. FOUNDATION (~st) FOUNDATION (2nd) ROUGH FRAME & ?LUMBING INSULATION FERN. STATE ENERGY COMMENTS ~ODE FINAL ADDITIONAL COMMENTS: 'FORNI NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y, 11971 TEL.: 765-1902 Exan ined Approved · .~. ~..~.~..: 19~.~. Permit No. ~.~l~ Disapproved a/c ..................................... Received...~./~.. (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 purpos~ whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 'x 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, builC~Ig code, housing t;ode, and regulations, and to admit authorized inspectors on premises and in building for necessary insp~t//ons[~/~ ~////.~./J/~'~ ,~5/ ~e~ 0,/-~ (Signature of a~ppli~a~[;; name, ifa corporatio ) ...... .... ........... (Mailing addres~ of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises...L.~$4~.. Y'..~ .~ .... . .~.~. ~.~. L). 4;~9f~..~.~..-~... ~.. jO C.-. ........... (as on the tax roll. or latest deed) If ~ica~n/~p~. ayn, signature of duly authorized officer. ...... Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done. O. ....... ~ .................. [ ........ ~. · · .g.~.~.~.. ~ .......... -t**~a~...k..~.. ×~ .~ ....... ~...~.~., .............................. House Number Street Hamlet County Tax Map No. 1000 Section ...[..~..I, ........... 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 ..... .~...Vq..'~....~. ..................................................... b. Intended use and occupancy ............. ~ ............ 3. Nature of work (check which applicable): New Building . ....~Q..... Addition .......... Alteration .......... Repair .............. Rem6val .............. Demolition .............. Other Work ............. , (Description) 4. Estimated Cost. ~.Q.d:>./...t~... ............ Fee ..................................... '~ ............ ~" (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ............... If garage, number of cars ..... ~ ................................................................... 6. If business, commercial or mixe~ occupancy, specify nature and extent of each type of use ..................... 7. Dimens!ons of existing structure~, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................... i. · Height ...................... Number of Stories ...................... 8. Dimensions of entire new constrUction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ........... : ........... Rear ...................... Depth ...................... 10. Date of Purchase .... : ...... .................. Name of Former Owner ............................. 1 I. Zone or use district in which pr~mises are situated ..................................................... !12. Does proposed 9onstruetion violate any zoning law, ordinance or regulation'· ................................ 13. Will lot be regr~ded ......... ~i ..... : ............. Will excess till be removed from premises: Yes No 14. Name of Owner of premises ~:o~- ~.~ ~..l~C., Address .ItY~I~'ERr~.~3.©. .I.~., ~.,.. Phone No.~q..8'.-:..~'1~..~. .... Name of Architect .M. ~.1].,.. ~ 0'~ l ~l.~J .......... Address I~'~.~L:-.& .... .~.-~.... Phone No ................ Name of Contractor .~Jo*ao.... C~r-~,~'. ........ Address . ~/~l~.~.tr~e.~... ~[.)(.,. Phone No..~q.~ .h'7~ .... PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. AI~, , ,.*,$ NOTED NOTIFy ~' HI qtNG DEPARTMENT AT 765-18¢~ 9 AM TO 4 PM FOR THE FOLI.~*~tN~G INSPECTIONS: 1. FOUN%~TION - ~O REQUIRED FQ~ P~tJR:D CONCRETE 2. ROUGH - FRAMING & PLUMBING 4. FIN*~ Cm~"STRLJCTION MUST BF C~a*~FTE FOR C.C. ALL C~NCTR~JCTION SHALL MEET THE RFO~"PrMENTS OF THE N.Y. STATE CCNqTRUCTION & ENERGY STATE OF NEW YORK, CODES. NgT RESPONSIBLE FOR ~S.S DESIGN OR CONSTRUCTION ERRORS. OF ........ ., ........ ~MI.~.. ~.,...[~. ~.~] .................... being duly sworn, deposes ~d says that he is the applicant (Name of individual sig~ing contract) above named. He 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 r , · ~ ~d~ayof ....... ~ , 19.. ~ /7 Notary Public .................... /..~Co y ~[tm ~. t~ ~1~ ' '~7"~'~'~r 'w ~-'~' ~ "-~-' '-' ...................... NO rARY PUBliC, ~lat, ~ ~ ¥0t~ (Signature of applicant) .~ i~, 470787& Suff0/~ ~ount~ le~ E~p~ uS Ma ch 30. 19~.