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Home My WebLink About13045-zFORM NO, 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13308 Date April 2 1985 THIS CERTIFIES that the building . .I.n. r ¢ F.qu. .n .d..p.o. 9.1..a.n..d..f.e.n..c .e .................. of Property/2/~t~s~h/o[. East Marion Location County Tax Map No. 1000 Section .. 0..2.1 ....... Block .... .3 .......... Lot ... ! ............. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore flied in this office dated ..... P:. P, ?.J-.~.. ] 7 ....... ,19Bfi.. pursuant to which Building Permit No.. J 2.(14 5 Z ............. dated A. 12 r.~.z. . ] 7 ................... 1 ~.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 ......... In-ground p. ool and fence The certificate is issued to ..... ~S?[I. ~L.E.~. ¢ ~.E.V..E F.H.A.N. ..... F.../~/.A.. G.~p,v.~.n..n.e.~.~i. ........ (owner,~,~/~,~ ~tXtX X X of the aforesaid building, Suffolk County Department of Health Approval ....... I~/..A ................................ #t¥¢4729.2 UNDERWRITERS CERTIFICATE NO ............................................. Rev. 1/81 Building Inspector 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? 13045 Z Permission is hereby granted to: I'o ..... .,/~. · .".", ...................... at premises located at ..:~.~... ...... : ......................... County Tax Map No. 1000 Section ..... ..~.....~..~ ......... Block ........ ~ .......... Lot No ...... [ .................. pursuant to application dated ...... ~.....L.~. .................... , 19.~...~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG. DEPT. 'I'O_WN OF_ $OUTHOLD 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 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 815 · 00 pO0~- 3. Copy of certificate of occupancy $1.00 ~ 4.Vacant Land C.O. 85.00 Date New Building Old or Pre-existing Building Vacant Land House No. Street Hamlet County Tax Map No. 1000 Section ,.. p.A.~ ........ Block .. ,~. 3. ......... Lot .... /, ........... Subdivision ................................. Filed Map No ........... Lot No .............. Perm it No. J. '~0 .~,. ~...Z~. Date of Permit .~//JT/~'~ · .Applicant . ~)(~1/Z.,. ~-~... D3 ~ ~,.;... ~.,e_~:).. ..... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ..... ~,,Zl ~. .................. Construction on above described building and permit meets all applicable codes and regulations. Applicant ....."' ,~ .... .¢1~.~.'/".. · .................... Rev. 10-10-78 FIELD INS?ECTION COMMENTS FOUNDATION (1st) FOUNDATIO~I ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS ~(~4JL)~5~ BUREAU OF ELECTRICITY ~ 86 JOHN STREET, NEW YORK, NEW YORK '10038 o. te ,~e .ZZ, ~ ~,~..o,,~o.o./.~ ~?~?/~ N 647292 THIS CERTiFiES THAT only the elec tdcal equip~ng as described below and int~duced by the applicant ttam~d on the able appltcat~on number ~n the premises of ~tsi~ i~ the fo~lo~g {oc~t~o~; ~ Baseme,~t ~ 1st FI. ~ 2nd FL Section Block Lot was exa~nined on ~(~ ~l ~ ~ and found to be ia cootpliauce with the requiretnents of this Board. FIXTURE OUTLETS FIXTURES SWITCHES NCANDESCENT FLUORESCENT RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF EEET DIMMERS SERVICE DISCONNECT S NO Oi~ERCC~CONO./ A W G. NO. OF HI-LEG A*W.G. NO OF NEUTRALS A.W.G. John Blodorn Bc~ 1203 Sag }~rbor, N.Y, 11~3 Lic#17gO This certificate must not be altered in any manner; return to the office of the Board if incorrect. YHIs COPY OF ( GENERAL MANAGER ~MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 765-1802 ..~.~ 3."1 .... , 19 ~t./. Permit No. )..~-? ~pproved )isapproved a/c ..................................... Application No .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building .nspector, 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 ~r areas, and ~ving a detailed deschption of layout of property must be drawn on the diagram which is part of this appli- :ation. c. The work covel~d by this application may not be commenced before issuance of Building Pevnit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such pen'nit ;hall 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 ;halt 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 3ui!ding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or aegulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. thc applicant agrees to comply with all applicable laws, ordinances~ building code, housing code, and regulations, and to tdmit attthorized inspectors on premises and in buildings for necessary inspections. (Signature o[' al~plicant, or name, if a corporation) Clifford Ba~hm~n ~4-50 Vetera~ H. wy. ................................... B6~e~rd ' ' ' · (Mailing address of applicant) gtate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· Oenera~ Co~traetors Giovann~ '~mne of owner of premises ..... .S..'.M~..eg .............................................................. (as on the tax roll or latest deed) [f applicant is a corporation, signature of duly authorized officer. (N~ne and title of corporate officer) Builder's License No. 3585 HI ~ ~7~ Plumber's License No ........................ Electrician's License No ....................... Other Trade's License No ...................... South ~ide of Aquavi~w Ave and S/E corner Location of land on which proposed work will be done .......................... 0~' RO ~.k~' PbZfft' RO~ ..... House Number Street Hamlet County Tax Map No. 1000 Section 21 Block 3 Lot I Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and ~ccupancy ~f premises and inteuded use and ~ccupancy ~f pr~p~sed c~nstructi~n: Existing use and occupancy 1. family residence b. Intended use and occupancy ...... ingr..0und swimming .p.0o.1. 3. Nature of Work (check which app!icable): New Building .......... Addition .......... Alteration .......... Repair Removal ' Demolition Other Work ,~ (Description) ~ Estimated Cost 54010.00 Fee .... -- ............ .' (to be paid on filing this application) ;. If dwelling, nmnber of dwelling uhits ............... Number of dwelling units on each floor ............... If garage, number of cars ...... :'. ............................................................... L If business, commercial or mixed ~ccupancy, specify nature and extent of each type of use ................... 1. Dimensions of existing structures if any: Front ..... .5.~ ...... 52 ' Depth ·. Rear ........................ Height .............. Number of Stories ....... ! .............................................. Dimensions of same structure with alterations or additions: Front ................. Rear ................ Depth ..................... i. Height ..................... Number of Stories .................... 1. Dimensions of entire new construction Front ............... t~ear ..... v ......... Depth .......... Height ............... NumberofStones ........... !~.~.'~.~." ..... ''" "' " ' 150 <90' L Size of lot: Front !50 00[ Rear ...... : .......... Depth ) Date of Purchase .~ Name of Fo]mcr Owner l Zone or use district in which pre,bises are situated !. Does proposed construction viol~te any zoning law, ordinance or regulation: ...gq ........................... t. Will lot be regraded .......... .n.o ............... Will excess fill be removed from premises: Yes No L Name of Owner of premises .. $ ~¢~¢.g. ~4~qV¢~Cf~f-Address . ~O. ~¢¢V¢¢~0. ,5V¢... Phone No.. '~77:1 ~ ...... Name of Architect ....A~..Rg.b¢ ~.~.e4...n ........... Address ? 4. B;too.[ Pa/ch . . Phone No. 0V Name of Contractor ...P¢~..~.'..~ .P.oq.~.. ........... Address..................~-gb'V~fit~t" ' Phone No. '5~§'i~bb"i;~i........... PLOT DIAGRAM' Locate cle~ly and distinctly all ibuildings, whether existing or proposed, and. indicate all set-back dimensions from :operty lines. Give street and block humber or description according to deed, and show street names and indicate whether terior or corner lot. FATE OF' NEW YORK. OUNTY OF ..... y.o. ..... is.s Clifford Barthmar ........................... ~ ..................... being duly sworn, depose~ and says that he ls the applicant (Name of individual stgmng contract) oove named. .e is the. ~ ..................................................................................... (Contractor, agent, corporate officer, etc.) f said owner or owners, and is d~ly authorized to perform or have performed the said work and to make and file this pplication; that all statements con.rained in this application are true to the best of his knowledge and belief; and that the ~ork will be performed in the manher set forth in the application filed therewith. worn to before me this i :f,,..~.~ C7_/' ~IOTARY pUBLiC, St,:~te of Hew York ..... ~. ..... ' ' No 52-34~820 ........... day O ........ , 19 .~. { } (,~ ~9 ~,z_ ' sion Exr~i,e~ ~ Commis ~ ' - lotary Public, ........ Coux ty (Signature of applicant) ,<