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Home My WebLink About12994-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13092 Date December 28 .... 19 ~.~. THIS CERTIFIES that the building ...~ ~ ¢ A.h 5. 9 a..~ o. ex.J.~ ¢ ~-~g. d ~.e.11 i n,¢ .......... Location of Property 620. S i g. s..b.e.e...~ 9.a.d' ...... Mattiuck House No, Street Hamlet County Tax [flap No. 1000 Section . 1. ~..3 ........ Block ...... 1 ......... Lot ..... .8. .......... S ..... Mattituck Park Property ~.',-.,MapNo. 801 .LotNo. 12-1~ ...... conforms substantially to the Application for Building Permit heretofore ~ed in this office dated ·...M.a.v..c .h..2.6. ........ ,19 .~q pursuant to which Building Permit No... J ~.9.95 g ............ dated .... J.p.r..t ~..9. ............... 19.8.4., 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 ......... Addition to existing dwelli, ng. The certificate is issued to ARNOLD BOCKSEL (owner, I~ ~t~ X of the aforesaid building. Suffolk County Department of Health Approval ..... .N/fi. ................................. UNDERWRITERS CERTIFICATE NO. ¢! N 671166 Building Inspector Rev. 1/81 FORM NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING P~.RMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1299~ Z Dote ...................................... 19.. Permission is hereby granted to: ..... ...!..~!..~..~......~.~..~.~...: ........... ~.~....~~...~..:..~?~.....!.:..~..~.~.. ~ .............. ~., ~. ~ ,o. ~ooo sec,o. ..... ~..~.~ ....... ~, ......... ~ ........... ua, ~o ....... 3 ............... pursuant to application doted .... ~~...**~P. ................ , 19~.~., and opprov~ by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD BUilding Department Town Hall ,~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Ao This application must be filled in tvpewriter OR ink, and submitte~F.!!cct~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 peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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. Fees: 1, Certificate of occupancv $5,00 / 2. Certificate of occupancy on pre-existing dwelling/ land use 3. Copy of certificate of occupancy $1.00 --Pre-E×.isting C.O. $15.00 Vacant ~and/C.O. $ 5.00 Date .~"~'R .'~/~' ............ ~ · New Building~ ............. Old or Pre-existing Building .......... Vacant Land ............. Location of Property ¥~,~0 C~/~"~'/'i~ e~'~' ~ ~ Z~Z~C/~ ~ ..................................... , .................. Hou~ No. Street Ham/et Owner or Owners of Property ~0 ~ ~d~ ~..~ ~, CounW Tax M~p ~o. 1000 S~ction ~ ......... ~[ock ............... kot ............. Subdivision ................................. Fi~ed Map ~o ........... Cot ~o .............. ~~ Permit ~~Applicant Permit No ........ ~.. oate of .................................. Health Dept, Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval , .~ ..................... Planning B~ard Approval ...................... Request for Temporar~ Certificate ..................... Final Certificate ................. Fee Submitted $.. ~.. ~.."'. ,~ ................. Rev. 10-10-78 Construction on above described building and p.c/'mit meets all applicable c~tes and regulations. Apphca ................................. :tOOC~7 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~g 85 JOHN STREET, NEW YORK, NEW 8 .'p,,'iea.on on/,,e 671166 THIS CERTIFIES THAT N only the electrical equipment as described below and introduced by th~ applicant named on the above application number in the premises of Bocksel, ;~,9C ~l~-.~bee Road, ~'~tltu~k, N.Y. in thefollowlng location; [] Basement [] 1st ~7. [~ 2nd FI. Section Block Lot was examined on DocemL~:, (~ 1~)84 and found to be in compliance with the r~quirements of this Board. FIXTURE OUTLETS DRYERS SERVICE DISCONNECT NO, O METEI EXHAUST FANS DIMMERS OTHER APPARATUS: 1--G.~. I. 1-~oke Dot ec~or. RANGES S COOKING DECKS OVENS DISH WASHERS MT K W, TIME CLOCKS / ERLL UNIT HEATER! MULTI-OUTLET NO OF FEET R V I C E OF NEUTRAL TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 November 21, 1984 TEL. 765-1802 Mr. Arnold A. Bocksel 78 Miller Boulevard Syosset, N.Y. 11791 Dear Mr. Bocksel: In August you sent us an application for a cert- ificate of occupancy along with your check #0483. We tried calling you but never reached you. On October 30 I wrote you a note telling you that in order to issue the certificate you must have an underwriter certificate for the electric work that was done. Please check this out with the man who did the work and see if he ever had the work inspect- ed. Please help us clear this up. Thank you. Yours truly, Building Dept., Sec. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [~ ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION ~FRAMING [ ] FINAL REMARKS: DATE FIELD INS?ECTION 1. FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . ..Lq_ . Approved ..~tx. .~ ..... 199)t. Permit No..).~..~..~.q.'.~.. 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 th{s 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 pe/'mit 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 regulation_s, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) //TCG State whether applicant is owner, lessee, agent, architect, engineer, "~-'"---~ ~/ electrician, plumber o Name of owner of premises...~.??~...~..o./.~.....~.....~.. '.~..~.~./. ........................................... (as on th~ tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) B uilde r's License No .... w.9~... ~ 7 ./.~.~. ..........~.O Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... ~ ~, 6 1. Location of land on which proposed work will be done.~...~.../.~.-.~'..~..~..&~.../~..c'~.d.. . ..... ........................................... House Number Street Hamlet County Tax Map No. 1000 Section ..... ]..~.~. :.: .'~. .... Block ........ ,. ~' Lot ..... g ............ Subdivision...~...a~. '.~wk. (Name) .... Filed Map No .... .~..(~J ...... Lot...]..~.~'. ! .~. ..... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... /..~.~../,~.....~.~ ...... ~ ........................................... b. lntended use and occupancy .. // '/')~?/~' ~/d'O~///~.~.~. 3. 5~ature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other'¥~o~k ............... . (Description) 4.Estimated Cost .........................Fee .. ................................ i (to be paid on filing this application) 5. If dwelling, number 0f dwelling, units .............. Number of dwelling units on each floor .............. ,.. If garage numbei of cars 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 ........ . ....... Number of Stories ........................................................ Dimensions of same structure w~th alterahons or additions: Front ................. Rear .................. Depth ................... ,I... Height ......... .... ............ Number of Stories ...................... 8. Dimensions of entire new const~, ction: Front ..... /..~. ....... Rear .............. Depth . ~(7'.~..4:-. ~ .... Height ............... Nuraber of Stories ......... i ........................................... . 9 Size of lot: Front ! Rear ' Depth 10. Date of Purchase .. ! .......... Name of Former Owner 11. Zone Or use district in which premises, are situated ................................................... . . 12. Does proposed construction violate any zoning law ordinance or regulation: ................... 13. Will lot be regraded ........ ~ ............... '.. Will excess fill be removed from premises: Yes 14. Name of Owner of premises .. .................. Address ................... Phone No ................ Name of Architect ' Address Ph one NO Name of Contractor ! Address Phone NO PLOT DIAGRAM L6cate clearly and distinctly al! buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and blocl~ number or description according to deed, and show street names and indicate whether interior or corner lot. SVATE OF'NEW YORK, S.S COUNV¥ OF ................. ......... · '.. i.. ~..~rg~ .//~/..~.C~]w%..~.,~ ..... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ..?ff...~7 .~...~.~.,QfD..~.-?.,~.~.. ] ~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 conthined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manndr set forth in the application filed therewith. Sworn to before me this ' ~ .... ~1'o. 52-460(~637, Suffolk County ~erm EXpires h~arch 30, 19~ (Signature' of applicant) , 400 SURVEY' FOR: r ( ON , 75.d