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HomeMy WebLinkAbout13456-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13644 Date ............ .~.u, 1, y, .1,7. ............ 19 ¢.5. THIS CERTIFIES that the building ...... qq .e .-.f.a.m..i.ly..d. ¥.e.l.!i..ng.. ................... Location of Property . .9.8.5. ......... Sou t.h,v i ew D r. 0 r i e n t House No. Street Ham/et County Tax Map No. 1000 Section ..... ~..3 ..... Block ......... .3 ..... Lot ..... 5.: J ......... Subdivision ............. .x ................. Filed Map No....x ..... Lot No ...... .x ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... fi.u, g .u .s.~.. 3. .0 ..... 19 ~..4. pursuant to which Building Permit No .... 1.3. 4..5.6.g. ........... dated ........... .S.e.p.~.e..m.b.e.q..2.6... 19[}. t)., 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 ......... .... 9.n.e.r .f.a.~A!y...dy.e. ~..~.~.n.g: .................................................... The certificate is issued to ............... .E.D.W. ARD & DORIS LINKER (owner, ~X~t~O~' of the aforesaid building. 14-S0-159 Suffolk County Department of Health Approval .......................................... N699485 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13456 Z Permission is hereby granted to:/ -- / ~ ...... ~/~.~......&~..~.o......~, .... .... ~.~.: ....... .~ ......... ~..~ .................. ,o ...... .~/~.~.~.~.......o.~.~ ...... .~..~~......,..~z.,.~...~.~... ........... z~~....~......,~%~......Z~.~~ ......................................................... at premises located at ......~/.~...~..'~... ........ ~..~.~...~//~'J~'~...../~.~.* ................................. ............................................................................................................ ~.~.~.~.....~.. ............ County Tax Map No. 1000 Section ..(~.../,.~.. ......... Block ....(~....~. ........... Lot No. ~.~..'~'..'.(. .... to application dated ..... ~.~;~Z.,,~,,..~..~, ............. ,19.~ and a~rov~ by the pu~uant / Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD 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: 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, or buildings and "pre-existing'! land uses: 1. Accurate survey o{ peoperty 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 / land use ~/ ['5.00 2. Certificate of occupancy on pre-existing dwelling fr 3, Copy of certificate of occupancy $1.00 Date J~..~-,~...(.~..[ .~.~.~'. · .., New Building . ~ ........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property .......... ~.~ o ~"~ .*~. ~ ~ ~,~,~ ~. {;~, . ~..~, ).~..~..-~; . .~. :y~.~.. ................................ House No. Street Ham/et Owner or Owners of Property ~ .~,~'~ ~' County Tax Map No. 1000 Section .. ,(~.l,~, ....... Block .... ,~. ......... Lot ................ Subdivision..~.0,..o..,~...~...~... ~. (, .~. ........ Filed Map No ........... Lot No .............. Permit No.l$. r Kb. 9ate of Permit ~.~.~.~/.J.~?A~pplicant .L.I. ~,.O...~..~. ,1~.%.~...~-. ?...~? ,,. .... Health Dept. Approval ~OL..~t/ ~'.~ ~¢~. ~' ..... Labor Dept. Approval Underwriters Approval ........................ Planning Board Approval ........ · .............. Request for Temporary Certificate ..................... Final Certificate ...................... Submitted ....... Construction on above described building ~u3d peri, it meets all applic~able ~odes and regulations. Rev, 10-10-78 FORM NO. 6 TOWN OF ~OUTHOLD 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: 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, or buildings and "pre-exi~ting<_ land uses: 1. Accurate survey of peoperty 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/ land 3. Copy of certificate of occupancy $1.00 use--Pre-Existing C.O. $15.00 Vac~ land C.~0~$ 5.00 Date ././., ,C~, ,'~, ?, ~ ,~.. ,--~,...~. _~. New Building ..... --,'..~, .... Old or Pre-existing BuildiQg ... ~ ..... Vacant Land Location of Property ..~.. ..... ~ ...... /.~.~--.~,..~.~..~.~; ......................... Owner or Owners of Prope~.~ ~. ~~~C~ ........ County Tax MapNo, 1000 Section,.,.~ ........ , Block .... , Lot,,., Subdivision.... ....... .~.. le~ .]~/~T ..... Lot~No. Permit No ........... ' ....... ~'.- pp' ~/.( ....................... ~ Labor Dept Approval Heakh Dept. Approva~ .............................................. Unde~ritersApproval,,,, .............. .,.,.. Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ................ Fee Submitted $ ............................. Rev, 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 CERTIFICATION TEL. 765-1802 Date Building Permit No. I~S& (please print) (please print) 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 ~u[~[ , 19 ~. Notary Public,~%~/~ County ~[Jsozx THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ O~L 85 JOHN STREET, NEW YORK, NEW YORK 1OO38 .a~e ~ ~' ~ ~p,,~.,,~,,~.~n~,,~ ~0~4 N 699485 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the ub~e application number in the premis~ of ~d ~', ~. Vi~ D~ ~t ~ ~1, Ori~ ~ ~ inthefollowlnglocation; ~ "asement ~ lstFI. ~ 2nd FI. Section. Ol~loek Lot 51 J~ ~ ~ ~ ~85 and found to be in compliance wi~h the r~quirements of this Board. FIXTURE OUTLETS 64 DRYERS SERVICE DISCONNECT FIXTURES RANGES K,W ~PECIALREC'PT R COOKING DECKS OVENS DISH WASHER .85 : 7.3 L .2 TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLE · NO. OF FEET V I C EXHAUST FANS DIMMERS OTHER APPARATUS: EQUIP. 1-3/4 Hi~ 2-~az~ Detector Lightn~j g'-0" - 4-iit~s OF CC COND. INO OF HI-LE( AW, G, OF HI-LEG NO. OF NEUTRAL! AW, O OF NEUTRAL 4/0 3327 This certificate must not be altered in ony manner; return to the office of the Board Jf incorrect. Inspecto~rs LDING GENERAL Per may be identified FIELD~INSI~CTION FOUNDATION (1st) FOUNDATION (2nd) 2. ROUGH FRAME PLUMBING INSULATION PER N. Y. STATE ENERGY C?DE FINAL o~ ~E COMMENTS ADDITIONAL COMMENTS: t=ORM NO. a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL PLEASE TAKE NOTICE that your application d.~ated.., d~..~ ..... wtST~..~ ..... , 19~..~. for pe~it to ~OO~*~. OO~. ~~ .(~~ .......... a~ County Tax Map No. 1000 Section . ~. ~ ....... Bloc~ ...~ ~ .' ...... ~ Filed Map No ~ Lot No Subdivision ................................................... is returned herewith and disapproved on the followMg gro~ds~.~.. . . o . . . . %.ae 76S4802 BUILDING DEPT, INSPECTION [~/FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE /o///~/~/ INSPECTOR 76S~X802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [~J/FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: ,, DATE INSPECTOR FORM NO~ 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1802 ]sapproved a/c ~ 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 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 Bttilding 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 i~pect~ns. (Signat.urq of applicant, qg,u_ame, j,f_a corpgration) ·/¢.o. .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................... . . . . q. ?.. .o. .o.:. : .......................................... Name of owner of premises ~ ~.O-t. ~%~a.¢~>. .~..~..o..~f.$...~..( .~t..~..~..~ ...................................... (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.. · .]'4(~fi..-...g.o?.~..~.a./-..~. .... Plumber's License No....~..q..~...-..? ............ Electrician's Liceuse No.. ~..~..?.-. ~ ........... Other Trade's License No...-m. .................. 1. Location of land on which proposed work will be done..'~/~. :..~77:. ?.~.~.4..tg.l.~. W-......~..Ig..l y.~.. .............. ........ . .......... .o.. ¢'.,.,?.'T.. .... .......... House Number Street Hamlet County Tax Map No. 1000 Section .... . .~....(~f.~.... Block . ..~. .............. Lot.. ~ ./. ............ Subdivision·..~..~..O..~..~. ~.... ~.d ~Z.~ .......... 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 .O..)~..~-....~.~?.'-?./.~..~... ~..~f.~..b.~./(~..~. ' ;' "~' 3. t.ur~ o~k (check which applicable): New Building .... : Addition .......... Alteration .......... "~?Repalr' .....~ ..... .-¢ ....Removal ........... Demolition Other Work ........ (Description) ~" ' ' i ............... . (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ...... ~7. ...... · Number of dwelilng units on each floor~....-. ?.. ~..~..O.,. If garage, number of cars ..... i~. .............................................................. 6.If business, commercial or mixed occupancy, specify nature and extent of each type of use 7.Dimensions of existing structureS, if any: Front ............... Rear .............. Depth .............. Height I .............. Number of Stories ........ : .............................................. i~h alterations or additions: Front Rear Dimensions of same structure w .................................. Depth .................... ,.. Height .......... ~. .......... Number of Stories ............ ,~ ........ 8. Dimensions of entir~ new construction: Front.· .~'.O ......... Rear·..~. .......... Depth .~.~. .......... Height . .. ~ ~. ........ N. uml)er of Stones .... .,f~ ........ _ 10. Date of Purchase .... /~.~,.~ .................. Name of Former Owner ............................. 11 Zone or use .... ' ' ' · d~stnct ~n which premises are s~tuated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .../~. ~. ......................... 13. Will lot: be regraded ..... P/~. ................... Will excess fill be removed from premises: Y_es PLOT DIAGRAM Locate clearly and distinctly all ibuildings, 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. STATE OF NEW YORK, COUNTY OF ................. ~S.S ..... .~.~ ~.., ,~ ~. ~.-~..,~A$,~!. ~..,~. ............... being duly sworn, deposes and says that he is the applicant (Name of individual sign'ing contract) above named· He is the ......... ~.~ ~.~. ~*~.o.I, .o. lq- ....................................................... ....... (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 applicationl 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 ........ ,-~,~..~q'. ..... dayo~ .~ ....... , 19 ~. .... : I ~ot~?t~l(~ ~ ~ Ne~ Y0r~ ...............