The URL can be used to link to this page

Home My WebLink About13035-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...g.l. 3..1.1.6 ......... Date ... Jan. 8 198.5.. THIS CERTIFIES that the building New Building Location of Property 6615 Rt. 25 Lau r e 1 House No. Street Hamlet County Tax Map No. 1000 Section ....1.2.5. ..... Block 01 .Lot P/O 19 Subdivision .x Filed Map No ......... Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 4 19 .8.4. pursuant to which Building Permit No. 1303.5Z . dated ......... .Ap.r.J: 1....1.3. ........ 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 ......... New Building in a Business Zoned Area The certificate is issued to JOSEPH SHIPMAN row. e;, of the aforesaid building. Suffolk County Department of Health Approval MA-33 UNDERWRITERS CERTIFICATE NO ................. N668339 Building Inspector · Olt,~ NO. ~ TOWN OP $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COJV~PLETION OF THE WORK AUTHORIZED) N? 13035 Z Permission is hereby granted t~: . ..... .~,.....~,.~......~.~, ...................... ~. ......... .~.~,...~. ...... ~~ ............. , to ........ ~ ..... ~. ...... ~ .............. ~. ....... ~....~ ....................................................................................................................... at premises I~ated at ....~.~.!.~. .........~.~....~...~~ ............................................ Co,,~ T~ ~ No. lO00 S~t~o, ...L.~-.~ ..... ~i~k ...... l ............... ~o~ No..~.~. .............. Building Inspector. approved by the Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hail 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 of pZ'operty 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. 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 ' Date .. . .! ............. New Building .... ~ ....... Old or Pre-existing Building ............ - . Vacant Land Location of Property . .~.l~..I..~. ........... ' ......~..~..~... ! .................. House No. Street Hem/et Owner or Owners of Property ............................. County Tax Map No. 1000 Section . .~ ,~,-. ,'~. ....... Block .... 9, .[. ....... Lot. ,~,[,~,..\,c~ ...... Subdivision ................................. Filed Map No ........... Lot No .............. I°~..~- Date of P rmit ~,~ ~ Permit No .......... e ........ Applicant .................................. Health Dept. Approval...~..~. ~ ~ ......... Labor Dept. Approval .... ~ ............... Underwriters Approval ...................... Planning Board Approval ................. Request for Temporary Certificate.. :~';'~ ............ Final Certificate ....................... Fee Submitted $... ~ ....................... Construction on above described building and permit r~eets~l, applicable cod,es,and regulations. ~ Applican ........ ~. ..... ......................... Rev. 10-10-78 ~ FIELD INSPECTION FOUNDATION (1st) EOUNDATIO~ 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N, Y. STATE ENERGY C,ODE FINAL COMMENTS ADDITIONAL COMMENTS 100~T1 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ 8B JOHN STREET, NEW YORK, NEW YORK 10038 ,~ate ~W~ ],~ ~ ~,,~.,o~o.o~,~ ~/~ N 668339 THIB CERTIFIES THAT only the electrical equipment as ~scri~ be~w an~ i~t roduced ~ the applicant numed o~ the above application number in the premlses of was examined on ~ove~r ~ ~ ~.~ and found to be in co.~pliance with the requlrernents of this Board. RXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS 2~ DRYERS SYSTEMS NO. OF FEET R V OF CC, CONO OTHER APPARATUS: Motors: 1-gbg~ C 3/o lO. llar~d Electric Co, P. O. Box 143 ~attituck, N.g', 11952 GENERAL MAN~I~ This certificate must not be altered in eny manner; return to the office of the Board if incorrect. Inspectors may be ~denhfled by their credenhals. ~ COPY~FOR S~ LDING DEPARTME"T THIS COPY,O~CER~IF!~CA~~ ~U~T NOTBE SLURRED I~ ANY MAN"ER. FORM NO. 1 TOWN OF SOUTHOLD BUll. DING DEPARTIViENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved . ~: . .~.~'. .... 19 ?~. Permit No..'~}~.O.. Disapproved a/c .......................... ' ........... Application No ................. (Building Inspector) APPLICATION FOR BUILDING PERI, IT Date . .~.j~ .~.' .(.4/. .... ,19 ?.9; INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to I.he 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 be~bre issuance of' Building Permit. ' d. lJpon approval of this application, the Building Inspector will issue a Building Permit to thc, 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 Ce, rtificate or' Occupahcy shall have been granted by the Building Inspector. APPLICATION 1S ItEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Buildiug Zone Ordinance of the Town of Southold, Suffolk CounIy, New York, and other applicable Laws, Ordina~ces or Regulations, for the construction of buildings, additions or alterations, or ['or 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 buildings for necessary inspections. (Signature of applicant, or na~ne, if a corporatiot0 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... . ................................. Name of owner of premises .(~), · ,) /:as on the tax roll or latest deed) If applicant is a corporation, signature o/' duly anthorized officer. (Name and title of corporate officer) Builder's License No .......................... Plmnber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work 'will be done.../~~~.~'~.~'~'~' '"'-~ '?~ ........ .......... . .... ..................... House Number~ Street Hamlet County Tax Map No. I000 Section . . [..~.~ ...... 8lock ....... ~. ' ........ Lot .... '..~ ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises~ __and intended use and occupancy of proposed construction: , , b.a. Existing h,tended use use and and occupancy occupancy ..... ..... :1 _~'~ "5~~ :. .... -,- .~.. : :"::'"- ,,,rc'~: X~ - ;~,.: ............. ...... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ' Other Work Repair Removal ............ Demolition .............................. .............. (Description) 4. Estimated Cost .......... : ..................................................... : (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 bccupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structuresi if any: Front ............... Rear .............. Depth ............... Number of Stories ' Height ...................................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. D?th ..................... i' Hough ........... Number of 8tones ....... 8. Dm~ensions of entire new construction: Front ,w9 , /- Iteight . j), . Number of Stones .......... . ...................... ..... ; ............ 0. Date of Purchase . · .~,.~_. · Ii/. ~. -~. ............ N~ame .of Former Owner ~:. ~: ......... (~ ..... 1. Zone or use district i~&hich premises are situated ..... (g.. -/ ............................................ 2. Does proposed construction violqte any zoning law, ordinance or regulation: . ,-7'v~.2':: ........................ 3. Will lot be regraded .., .'~.-97 .............. ,., ......Will excess fill be removed from premises: Yes Name of Architect ....... ~ .................. Address ................... Phone No ........... Name of Contractor.. PLo'r DIAGRAM Locate Clearly and distinctly all ]buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty lines, Give street and block umber or description according to deed, and show street names and indicate whether ~terior or corner lot. ;TATE OF NEWnYORI~, ~ / S.S '.ouI, rrv OF.12~/~r~.-~-~/Z~<..~ ~, .~.~ ~ ~ ~-'~;~;"~ being duly sworn, deposes and says that he is the applicant . ~- (~ame of individual s~ sing contract) .bore named. Ie is the (Contractor, agent, corporate officer, etc.) ~f said owner or owners, ~d is duly authorized to perform or have performed the said work and to m~e and fide this pplication; that all statements coni~ned ~ this application are true to the best of his knowledge and belief; and that the york w~l be performed in the m~er set forth ~ the application filed therewith. ;worn to before me this .. ........ .,. . ..... qo~w Publi~/~~ '~'. L,~¢:¢~ . County