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Home My WebLink About13477-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Zd 360~ Date July 9 85 .................................................. 19 ... THIS CERTIFIES that the building accessory ~ara~e. 4&0 Cox Neck Road ~attituck Location of Property., ....: ......................................................... t~ouse lye. Street Ham/et County Tax Map No. 1000 Section q q 3 .Block ~ z[ .Lot 9 Subdivision ........ x .Filed Map No. x .Lot No. x conforms substantially to the Application for Building Permit heretofore filed in this office dated September 2~ 198..0. pursuant to which Building Permit No. ~I 3~77Z dated October ~ 9 198.&.. 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 ......... ...499.e.s.s..o.r~ .~. ~..r.a.~.e... ......................................................... The certificate is issued to ..... Rg. NDY & CAROL 7EINBERG (owner,~ of the aforesaid building. Suffolk County Department of Health Approval ......... .N~.A. ............................. N/A UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 FORM NO. 0 TOW~ 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? 13~77 Z Coun,¥ To,, Mop No. ,ooo Sec,lo,, ...... L../.~ ......... B,o~k ...L.~ .......... Lo, No..~.~ ........... pursuant to application dated .... .~..~....~... ............................ , 1 and approved by the Building Inspector. Fee $./...~......~..(~.. ..... ~~ Inspector ' "";'""~"~Bulldlng Rev. 6130/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY JUL Instructions A. This application must be filled in typewriter OR ink, and submitted ~ IIIIIII1~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate ~ocation of a~ 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 Amhitect or Engineer responsible for the building. 5. Submit Planning Board approvaJ 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 o 00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 New Building ............. Old or Pre-existing Building ;~ .......... Vacan~ ............ Location of Property ...~¢~0... ~(~..~,~-~.. ~. ............ ~'(-[~ .......... House No, Street Ham/et Ow.er or Owners of*roperty . ¢.¢~..0.~... ~ .~..~....~.~..¢~...¢..~...C~.. ............... County Tax Map No. 1000 Section .... I~.l... ~'~_-_-~ ....... Block ... [."t ......... Lot, .~..~ ........ Subdivision ................................. Filed Map No ........... Lot No .............. / Permit No. ~.~27.~Z,. Date of Permit ~,-~.~..~pplicant., ~2~V'~, ,~. ~/[~ ....... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ................ i ....... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $...~. ¢~0...~'..~. ~1..~..(~. ...... c~ C.~nstruction on above described building and perAeets %ll%a~plicable es and regulations. ~ 0':~-~ ' ~ ~OOq Applicant ...... .¢.~~ ................ '~,-t~, ~q% ......... Rev. 10-10-78 FIELD INSPECtIONs. DATE COMMENTS 1. FOUNDATION (lst) FOUNDATION ( 2nd ) =~ ROUGH FRAME & __ ?LU~ING 3 INSULATION PER N. Y .... STATE ENERGY qODE 4. ~-3~6~ f~r- 6~ ~/7~ ()~ FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000879 BUEEAU OF ELECTRICITy July 1985 B. te ~',,,,,,catio,,No. on~,,e N 701,246 THiS CER~TIFIE$ THAT only the electrical equipment as described below and introduced by the applicant named on the above applicatlo~ number in the premises of Baudy Fe~oerg~ Cook Neck Lane~ Mattituc~ N.Y in theJollowlnglocatlon; ~ Basement ~ 1st F~ ~ 2nd Fl. Section Block Lot was examined on July 15, 1985 and found to be in compliance with the ~equirements of this Board. FIXTURE FIXTURES 2 ? 3 2 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS RANGES OVENS DISH WASHERS EXHAUST FANS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E OTHER APPARATUS: R V I C NO O E O~40 OF ~C, COND Imwell Thomas Box 10 Medford, N.Y. 11763 899 This certificate must not be altered in ony manner; return to the office of the Board if inco~'rect. Inspectors may be identified COPY?On B~ILD Ne DEPARTMENT THIS COPY, 1' NOTBE/~ TERED I~ ANy MANNER, '~FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 (~./(Building Inspector) APPLICATION FOR BUILDING pFRMIT Date ................... 19... INSTRUCTIONS a. This application must be completely filled iu 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 Departme~nt 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 f~removal or demolition, asl]herein described. The applicant agrees to comply with all applicable laws, ordinances, building ~ode, housinlg qode, and ~/gulations, and to admit auth°rized inspect°rs °n premises and in building f°r necessary inspecl~°?[ ~~ ............ .."-:~ ~ ~ ....... .2 'V ...... ; ...... (Signature of applicant, or name, if a corporation) ....P&..~.o. ~..~ '..x~.. ~ ..... 5h~....t ~3..~. tp54 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ ~.c..o.¢...~.. .......................................................................... Name of owner of premises... ~m .qo..~....(.. ~p.~... ff~: ~.3..~. ~..c~.. .................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and ~itle of corp~, ~,o~er) Builder's License No ..... ~'7 ........... Plumber's License No ......................... [ BLD~, DEPT. TOWN OF,,$OUTHOLD Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ......... 7.~.4 ........ c~. ~.c4~_. ?-o. ............ ~~:¥~~ House Number Street Hamlet County Tax Map No. 1000 Section ..... I.[ .~. ......... Block ..... [.~. ........ i. Lot...~. ............... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... [ .... ~.~.~F~... I..L-.~. ...... 0 MO.~. L4.M Ikfl/-~-- b. Intended use and occupancy ...... 5'..~...~. ...... ~...t.Fq...~. ....~~.. .................. 3, Nature of work (check which a plicable): New Building ..... '~ ....'Addition .. ~ ..... Alteration .......... Repair .............. Removal .............. Demolition .............. Other .Work ............... 4, Estimated Cost .......................... Fee ............................ i ~' (to be paid on filing this application) 5. If dwelling, number of dwelling iunits .... · .........."- Number of dwelling units on each floor ~- . If garage number of cars ' ~ t].~-~ ............... 6. If business, commercial or mixed occupancy, specify nature and extent of each tyne of use .....--x. .............. 7. Dimensions of existing structur4s, if any: Front .... ~.~7~. ....... Rear .... .~Y..~. ..... Depth...".2,: .L~. .... Height ............... Nun3ber of Stories ....................................................... Dimensions of same structure with alterations or additions: Front ,.. ~.~. ..... Rear ................. pth ~ 'ght oj'S,t ' De ...................... Hel ...................... Number ............ 8. Dimensions of entire new construct~on: Front r.,. Depth mb ri Height ..... ~ ......... Nu er of Sro es ....................................................... Size of lot: Front ...... [ .~.O ........... Rear ..... [ .~O ............ Depth ............. [)ate of Purchase .......... .. .................. Name of Former Owner ................... ' '~] .g41 Zone or use district in which premises are situated .................................................... Does proposed construction vioiate any zoning/aw, ordinance or regulation: ............................... Will lot be regraded ........ ! ................... Will excess fill be removed from premises: Yes No Name Of Owner of premises ..: ................. Address ................... Phone No ................ Name of Architect .......... ! ............ L .... Address .................. Phone No ............... Name bf Contractor 30/~4.1.v-D..i .I.~J.~ .... Address i .~.' .' .1"~.~ ......... Phone No, PLOT DIAGRAM buildings, whether existing or proposed, and, indicate all set-hack dimensions from number or description according to deed, and show street names and indicate whether ,9. 10. 11. 12. 13. 14. Locate clearly and distinctly all property lines. Give street and block interior or corner lot. , ' STATE OFNgW YORK, ' TM : COUNTY OF .................~?.S ~ ly s ppli .................................................. being du sworn, deposes and says that he i the. a cant (Name of individual signing contract) above named. He is the ...................... , ................................................................... ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dui , authorized to perform or have performed the said work and to make and file this application; that all statements cont. [ned in this application are true to the best of his knowledge and belief; and that the work will be performed in the mann( set forth in the application filed therewith. Sworn to before me this ... ...... ¢./. ....... day o;. NOIARY PUBLIC, State el New Yor~ ........................ .,... NO. 4707878, SuifCk Co,nt~ ~ ~etm ~,ros ~arch 30. l~,~i (Signature o~ applicant)