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Home My WebLink About13417-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z13293 Date ..... APRIL 1 ............................................. 19.85.. THIS CERTIFIES that the building ...g.D.p .~?.I.O.~ .................................... Location of Property ..1.~..2..5. NORTH SEA DRIVE ORIENT House lye. Street Ham/et County Tax Map No. 1000 Section . .0. 1. .5 ....... Block 0 5 ..... Lot 2 ? Subdivision..O.~.I..~.N.T.. B..7..T.51E...S.E.4 ......... Filed Map No..3.~..4 9...Lot No ..... 6. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated · ...&~.qu..s ?..3. ! ........ 19 .sfi. pursuant to which Building Permit No....1.3fi.1. 7. .Z ............ dated .. S..E.P.TE.~ .B.E.[. 6. ............. 19 ~.~., 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 ......... FOR AN ADDITION TO AN EXISTING DWELLING The certificate is issued to ...~ $ .~ %.0. ~..C p.L.L..I .~.S. ....................................... {owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...5!/, .A .................................. UNDERWRITERS CERTIFICATE NO.. ~q..fi ~ 9.2.0.3. ...................................... Rev. 1/8t Building Inspector TOWN OF $OUTHOLD 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? 13417 Z Dote ...~ .......................................... , Permission is hereby granted to: .... .......... ............. ~., ........ :..% ......... ~....~ ....... to ........... ;P.. ......... at premises Iocateid at ....J..~...~....~..~.....~...~....~.~ ........ ~ ................ County Tax Map No. 1000 Section ...... ..~..1...~.. ...... Block ........ ...~... ........ Lot No......:~...-J.. .............. pursuant to application dated ..~...It~<~..'~.........~.J ............... , 19.~..~.., and approved by the Building Inspector. 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 in duplicate to the Building Inspec- tor with the following; for new buildings or new use: I. 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 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 $ :[5.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ....... House No. ' ..................... , ~ I ' Street Ham/et Owner or Owners of Property .~.~. ~.. ! .~.~.....~.~.0. (((..~...~ .................... County Tax Map No. 1000 Section .... .~./, ~ ..... Block ..... ~.'~, ........ Lot .... ~ ~, ........ Subdivision ......... ~ ..................... Filed Map No, .~. ....... Lot No, :. .......... Permit No./.~.. L//~.~-..,.. Date of Permit ,~,4 ~ .Applicant......~.~.~,, ,Z~: ~ Health Dept, Approval ........................ Labor Dept Approval , Und rwrit rsApp al ~.Q '.(~.~.¢).~.O..~. Pi ni gB dApp e e rev ......... an n oar rova ...................... Request for Temporary Certificate ..................... Final Certificate ................... Fee Submitted $ ............................. Construction on above described building and p.ermit meets all app,[icable codes and regulations. App cant ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW ~ORK 1OO3~ ~ February 2,5, 1985 314~0/85 '~ ~ ~,,..,.. ~. o.~,,~ N 680203 THIS CERTIFIES THAT only the el~trical equ~p.~ent as described be~w and introduced by the applicant na~ed on the above appllcat~on number in the premlses of M.V. Coll~s, 1425 Nor~ ~a ~1~, ~ient, N.Y. was examined on and found to be in compliance with the require.tents of this Board. FIXTURE OUTLETS 3 DRYERS ~ECEPTACLES 5 SWITCHES '3 FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS SYSTEMS NO. OF FEET E OTHER AP R TU: E R 'V I C NO. OF CC COND, PER ~ OF CC COND NO OF HI-LEG OF HI-LEG NO. OF NEUTRALS OF NEUTRAL C~.rles M. Hall Electric Inc P. O. Box 1268 ;~:~tthold, N.Y. 11971 Lic. 657 GENERAL This certificate must not be altered in any manner; return to the office of the Board if indorrect Inspectors may b~ identified by their cOPY FOR ~UILDING DEPARTMENT. THIS copy OF CERTI! IN ANY MANNER. FI LD INSFECTION COMMENTS FOUNDATION (~st) FOUNDATION ( 2nd ) ROUGH FRAME & FLUMBING INSULATION FERN. STATE ENERGY ODE FINAL U ADDITIONAL COMMENTS: 76S-1802 ~ BUILDING DEPT., 'INSPECTION FOUNDATION 1ST [ ] ROUGH P~BG. FOUNDATION 2NDE .] INSULATION~ FRAMING £ ~ FINAL REMARKS: ~,/~ INSP£CTOR [] FOUNDATION' 2ND [ ] INsu ,[~1 RAMING [ ] 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved ............... } 19 ~..~. Permit No. Disapproved a/c ..................................... Received.. . ,19... (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 tile 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 Law% 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 cod~, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary.inspectS___ ---- ~,~. ~',-~.~ (Signature of applicant, or name, if a corporation) .... (Mailing address of applicant) State whetber applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . .fi~/'}. '~.Algn/....V.:..C.o.4,? .~.~. .............................................. (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../Z/.~.C. 2~'ff.~./.'W(.~ ....... Plumber's License No ......................... Electrician's License No... ~..~'. '~.7 ~.. ........... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ·. z4 .d. ........................ .......... ....... House Number Street Hamlet County Tax Map No. 1000 Section ...... .O./.~. ...... Block ........ '-,%.'~. .......Lot...~,,. · .~,..'-/ ..... Subdivision..(~)~.~.~. F..~.~'{..-~.~&'.. i~.~..~ ........... Filed Map No. ~.~. ~/..4. ...... Lot. ~.'.~ .......... ~J (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy...'~ .... (~ r~ 'k3'~,~,~'c,~ ........................................ '*-7~ '" c- b. Intended use and occupancy .. (.~.q..,7.r.Z:7..:~/~$~dK,V. ~- ............... 3. Nature of work (check which applicable): New Building ..... ~ ..... Addition . ~ ..... Alteration .......... Repair Removal Demolition Other Work (Description) 4. Estimated Cost ............ .~l~ .°..~..'Tt~'. ................ Fee .................................... (to be paid on filing this application) 5. Ifdwelhng, numberofdwelllngumts ...... [ ........ Number of dwelling units on each floor . . ./. ........... If garage, number of cars .... i~:i? .......................................... .......... 6. If business, commercial or mixdd occupancy, specify nature and extent of each type of use ...~...~:... ........... 7. Dimensions of existing structures, if any. Front....4'. ~. ........ Rear ... ~O. ....... Depth . ~ .......... Height .. k~.* .......... Number of Stories .... ] ....................................... Dimensions of same structure With alterations or additions: Front .... ,~O. '. ........ Rear...'~i~.'}. ........... ........... Depth ... ~ ~ ~. '. .......... ~... Height ...... l.~.~ ............ Number of Stories...i. .................. 8. Dimensions of entire new construction: Front .../..&~... Rear ...~. ~,.' ...... Depth ...2 ........... Height .... I,~.' ........ .Num, bet of Stories ...... ~. ......... }. ........................ } ............... 9. Sizeoflot: Front ..... /.Mr'.~'.I ............. Rear .... ./.6~..~. ...... Depth i4~, . 10..D. ate of Purchase . .~..c~. i' J?.2~. ............ Nam; o'f~d~dr 6~vn;r . t~)d2/.o.~...{/; ] ~.o.' .~.~.'4' ~ i]]]]] 11. Zone or use district in w~ich premises are situated..'J~/;~JD.F.-d.~./.~r.L~. ....... ../ ........................ 12. Does proposed construction vio'lat~ any zoning law, ordinance or regulation: .../Y.o .......................... 13. Will lot be regraded .. ~. e .r'. ',;' ./~.~¢4{.~.~..~ ........Will excess fill be .removed~from premises: Yes No 14. Name of Owner of premises ~agl~A g. [.'¢H~t~ Address /~.aC. rt* .8~. ~t¢.~ Phone No. ~$- ,?-4;~.~ Name of Architect .. :,.., .,', .................. Address .................. Phone No ........ : ........ Name of Contractor ~, ~. :,~.a.¢~ ............... Address t¥]r, .~.~.~.4~.. ,,4~i.. Phone No. 7'(~,-< :.4.~ ?.... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property ilnes. Give street and block, number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ........ . ......... S.S /rig' (Name of individual siga'ing contract) above named. ' being duly sworn, deposes and says that he is the applicant 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 .. , ...................... day of ..... ~¢~ ........... , 19..'.~ Notary Public, ...... ~. ~ .~..,9. ~..8t~,-. .... County Lo+ t4~ I01 ¢~, ¢.,, ,., r)