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Home My WebLink About13020-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z. ! .2Qs. q. ......... Date . .0.c.~.o..b.e?..3 J .................... 198.4. THIS CERTIFIES that the building Agricul .gur.a. 1..S.~.l.o. .................. L ...... 2755 Oregon Rd Mattituck ocauon ox rroperty ................... : .......................... House No. Street ............ h~t~io~ County Tax Map No. 1000 Section . . ! .0,0 ....... Block . .2. ............ Lot .... .6 ............ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... ~.p..~.i.1... ~ ........ 19.8. z~ pursuant to which Building Permit No. 1.3. .0.2.0.Z. .............. dated ....A.p.~.i..1...1. ~. .............. 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 ......... Agricultur'al Silo The certificate is issued to Robert G. Rowehl ..................... ?oV, n;;, .................. of the aforesaid building. Suffolk County Department of Health Approval ........... ~ [.It ............................ ¢;N658130 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev, 1/81 FOu~ NO. ~ TOWN 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? 130~0 Z Permission is hereby gronted~: ~ . .... .~..~~.....~.,.~.:....l..l..~..~.~......~... ,o ...0..~.~.....~. ~......~.....~. ~ ........ ~L~......~......~ ..... .~.~.~ .......... ~.~ . ~.~~ .. . ot premises located ot ~ ......... : ............................... County Tax Map No. I000 Section ..... !..~ ........ Block ....... ~ .......... Lot No ........ ..~', ............. pursuant to application dated .................................. , 19 ......., Building Inspector. and approved by the Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall · ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submltte~.,' ' '~;~**- ...... 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 peoperty showing all property lines, streets, buildings and unusual natural or topographic features, 2.Sworn statement of owner or previous owner asto use, occupancy and condition of buildings. 3. Date of any housing code or safew inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 ' / 2. Certificate of occupancy on pre-existing dwelling ! land use 3. Copy of certificate of occupancy $1.00 ~ --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 .. ./ .... .... New Building ... ~x~. ...... Old or Pre-existing Building ............ Vacant Land ....... . ..... Location of Property ..~-..'Z.~.'~../-~..~'. Owner or Owners of Property ............... {..~ ..~. .................... County Tax Map No. 1000 Section ..... /..O. .~. ....Block ........ /.~ .... Lot ..... g ......... Subdivision ................................. Filed Map No ........... Lot No. Perm it No./.~...O.~'..O. ~. Date of Permit ~.~//./~'..~.A pplican, ?.?. 0 ~.~.h..~.. ........ Z .L Health Dept. Approval ........................ Labor Dept. Approval ........................ /3o ...... Planning Board Approval ...................... nderwriters Approval iX/. .... Request for Temporary Certificate ..................... Final Certificate .......... ,~/ .......... Fee S~bmitted $ ............................ Construction on above described buildingp~L,permjt meets all appli~ab~,codes and,~egF41ations. Applicant ~~ ~ .. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF: ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK THIS CERTIFIES THAT only the electrical eq~ip~e~t as ~scr[bed ~lo~ a~d i~r od~e~ ~y t~ eppl~ca[k~ ~.~e~ o~ ~he ~b~e appl~catlon number in the prendses of in thefollowinglocation; ~ Base,neat ~ 1st FI, ~ 2nd FL ~ia~ Section Block Lot was examined on A~ 23~ 1~4 and found to be ~n compliance with the requirements of this Board, FIXTURE SWITCHES OUTLETS 3 3 FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS NCANDE$CENT FLUORESCENT VAPOR DRYERS FURNACE N~OTORS FUTURE APPLIANCE FEEDERS TIMECLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO, OF FEET SERVICE DISCONNECT S E R V I C NO OF CC COND A, W. G NO. OF HI-LEG A, W G, NO OF NEUTRALS A W, G OTHER APPARATUS: l~o+~: 1-9 3/4bp lzatlelb~axds~ 1-~ir. 12~ T.H. Cheshire & 8oa~ ]km. P. O. ttox 243 Calvertaa, N.Y. 11933 This certificate must not be altered in any manner; return to the office of the Board if incorrect. GENERAl. may be identified by their COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE I FIELD INS?ECTION FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL,: 765-1802 Examined ~ . [} .... , 19'{..~. Approved .I .~..., 19~.tJ. Permit No..]. '.~..0.~..D..-~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Dat~.~Ot~t ]- "~ ., 198.q INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspect~ ~4 ~ (Signature of applicant, or name, if a corporation) .I . p. . . . .,.r. .& . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .0 Name of owner of premises..'.J~...~..~,..~.}7..'~..,....~. :..f~ (~,..k~..~..~...~..,. ............................ (as on the tax roll or latest deed) If applicant is a co~}~)~i4~} §ig0~a~3i?o~du}~}~q~horized officer'. AI~P~C ...... ~ (Name~antJ ktleofcorpomte'offi~)~ ~ ] FEE: 15-~- ' ~ ' ' ~ "~PARTMENT AT tU '~ .- ~', t, · , ~ ~'?" !',~l NO~SIr'~ I3Ull Builder's Lic~nse~No: .... 2,..:. ~..,. ;,..,,.~ ;,..~, ~,. ~;¢,~, 765-1,o~2 9 ? ' ~ "% ~ PM FOR THE ~ .~ ,~ ' '~ ~, , ~ 'cWO REQUIRED Plumber s n~e No ............... k ., ,,~,~ ~.~ 1. Fr~l !ND/:''~ ~' ~ g"¥'i" r~?~ , F~ POU~ ' r~ , ' ' , ~;~ J( 2. p¢f~G!q - '~ PLUMBING Electrician s ens )~: {' ........ 3. Ih'"' ILAT'~' ' Other Trade's License No ...................... 4. F~'~t. - ~' ....... 5N MUST A[~ r'~NCn' ...... : .... r'~'t-k MEET 1. Location of land on which proposed work will be done ............... ~.r¢ .~5 ~Of I! ~: ...... ~ "~ <' mi 4 E ' N: ~; .... ..................................................... U'/+-'~g ' ', br ..... "*~ '~"mg~E ' 'FO~ .... House Number Street ~[s,~a~e~''', :7. 2..:C N ERRORS .lo.O ,000 ....... .... ,,ock ........ ...... :ct ...... ........... 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...d. ~ ?../7 ..~..]..~...ff-~......'~...l.T'. ~.... ~.~ ~.. '..~ ~ ~.(~ .... b. Intended use and occupancy . .~:: ./.:]0:~... ~...~]~:3 ~;4.¢~r[,0.~.:.¢ .. 3. Nature of work (check which applicable): New Building .. ~ .... Addition .......... Alteration .......... Repair Rem'oval Demolition Other Work , 4. Estimated Cost ............................ F ...... :...."77-.. ......................... ' (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage number of cars ~ .;.. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............... 7. Dtmenslons of existing structures, ff any: Front ............... Rear"7 ............. Depth ............ Height ............... Number of Stories: ........................................................ Dimensions of same structure With alterations or additions: Front ................. Rear .................. Depth .' Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height ............... Number of Stories ........................................................ 9. Size of lot: Front ..... j .... ~. ........... Rear ...................... Depth ...................... 10. Date of Purchase .... .e/.7.~ ................. Name of Former Owner . ~/~.l.g,.~.~ .6. C~'.O ........ 11. Zone or use district in which p~emises are situated ..................................................... 12. Does proposed construction, v, i01ate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ..... ~J~.O.. ............. : ....Will excess fill be removed from premises: Yes I~1o 14. Namei of Owner of premises~0~: .T',. ]~d ~ .tg.h .L-... AddressO,. t' ?f.'q .~/..l'q...3{.~TD.~,lt~one No~. oc?.Tb~.c~ ~ c~. Name of Architect ........ ~ .................. Address ................... Phone No ................ Name, of Contractor .... .~i~l-./7~d. :-~.~ .......... Address ................... Phone No ............. PLOT DIAGRAM Locate clearly and distinctly all buildings, 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 ~R,K; , CO UNTY~F ' 'c~r~m'~-J:~&f/~c_7~~ ,~. ,~/ ..... ..... · v..x .~ .~-~-~... · · .~ ....... being duly sworn, deposes and says that he is the applicant (Name of individual sigr ing contract) above named. He is the (Confractor, 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 cont:ained in this application are true tp 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 Nola~ Pub~lic, .,. ........ ,