The URL can be used to link to this page

Home My WebLink About12854-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Z.1.2.7.6..0 ......... Date ....... S.e..p.~....7. .................. 19 THIS ~ERTIFIES that the building...~.t, qr..agg..B..u.~.~.d.~..rig ........................... Location of Property .. 990 Beebe Dr. Cutchogue County Tax Map No. 1000 Section '...0.9. 7 ...... Block ...... ? ........ Lot ..... 9. ........... Subdivision Moose Cove MapNo.3 . 25 ............................... Filed .2.3 0. .... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Jan 6 19.8.4. . ..... ......... : ........... , pursuant to which Building Permit No. 12854 Z ............... dated ........ F.e..b ....2. ............. 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 ......... For an Agricultural storage building The certificate is issued to Alice Levien (owner, ~X ~r~t) o~ the aforesaid building. Suffolk County Department of Health Approval ........ N./.A .............................. UNDERWRITERS CERTIFICATE NO ................ #.~ 6523.(~ 2 ........................ Rev. 1/81 Building Inspector FOItM NO. ~ TOWN OF SOUTHOLD TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS pERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: .... ............ ................................. ...z~.~......~.~z~.~z~.~...~..:.~. ......... ~ ............ Y~ .......... ~.~:...~ ~.~ .................................................... at premises I~ated at ...... ~ ............ /~~ ....... ~,.....~ ....................................... .......................................................................................................................... ~ ....... .~~ ...... ~t ......... ~ .............. ~ ...................................... ~.~ ....................... Co~n~ ~x M~ ~o. ~00 Se~.o...~.~Z ........ ~ ....~.Z ........ ~ot No ..... ,~.~. ..... Building Inspector. Fee $ ...................... Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,~Jouthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted-~:~fl~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 HeaJth 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" Jand uses: 1. Accurate survey of peoperty showing ail property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owne~ as to use, occupancy and condition of bu ildings. 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 occupancy $5.00 2. Certificate of occupancy on pre*existing dwelling / land 3. Copy of certificate of occupancy $1.00 use--Pre-Existing C.O. $15.00 Vacant/lan~ C,O. $ 5.00 blew Building .... ~'. ........ Old or Pre-existing Building ...... 'Vacant Land . . Owner or Owners of Proper~ ~ ,~ ~ .... I ...... cK ..... .j. ........ Lot .............. Subd.v,s,on..J. ~ I ~.~..~ ........... Filed MaPNo ~ Lot No..~ ....... Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. ApprovaJ ........................ Labor Dept. Approval ................ Unde~riters Approval ...... Planning Board Approval ............. Request for Temporary Certificate ..................... Final Certificate Fee Submitted $ ...... ~ ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ]00[071 BUREAU OF ELECTRICIT~ [~ 85 JOHN STREET, NEW YORK, NEW YORK 1003S ~-~ ~ :~' ~ ~"~"~'~"~'~"~"~ ~ N 65;2362 THIS CERTIFIES THAT only the electrical equipment ~ described below and introduced by t~ applicant ~med on the able appl~at~[ ~r ~ the premises of in the followlng location; ~ Basement ~ Ist FI. ~ 2nd FI. Section Block Lot was exa~r~ined on and found to be i~t eo~piiance with the requlren[ents DJ this Board. RXTURE FIXTURES RANGES ~ OVENS DISHWASHERS EXHAUST FANS ? DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS; Panelbo~u~t~: 1-3cir. ,125~ps. ~ E R V I C OF CC. COND NO OF HI-LEG NO. OF NEUTRALS OF NEUTRAt ~ou~;hold, N.Yo 11~71 LiC~78 / This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspecto~ may COPY FOR BUILDING DEPARTMENT. THIS COPY FIELD INSPECTION 1. FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY qODE FINAL COMMENTS ~ O COMMENTS FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 Examined . . .'.~. ..... , 19 Received ..... r~ .... , 1 9 Disapproved a/c ......... (Building Inspector) APPLICATION FOR BUILDING PERMIT x 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 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 throug~hout 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 tlie construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, bu~/~ code, hausing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ins~t.~n~.fy/~ ~..f~-~...,/~ ~t;~'~ (Signature o~ a~)l~licant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . fi .['.! .C/;~..L~...~.l.~.~. ....................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..J~O.T~'P.k~..~',O/~,~.¢'1'?. ....... Plumber'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 Hamle~,) County Tax Map No. 1000 Section .... '~'~' 7 ........ Block :...7 ............ Lot...~ ............... 2. State existing use and occupancy of premises and intended nsc and occupancy of proposed construction: b. Intended use and occupancy ....... a. ......~;,,.~ ~im:.~9~ .................................... 3. Nature of work (check which applicable): New Building ...~. ..... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost '~¢~.,. ~ ....... Fee : (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 .... i .................................................................... 6. If business, commercial or mixdd occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Num her o f Stories ........................................................ D~ensions of same structure with alterations or additions: Front . ....~ ~ ....... Rear ...~ ~ .......... Depth .... ~ .......... ~... Height ..... 1.~ .~ ............. Number of Sto~s ...................... 8. Dimensions of entire new construction: Front ......... , ..... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ............ ........... Rear ...................... Depth ....................... 10. Date of Purchase .......... .~ ................... Name~f Foyer Owner ............................. I 1. Zone or use district in which pfemises are situated ....... I. ~ .......................................... 12. Does proposed construction vi61ate any zoning law, ordinance or regulation: ................................ 13. Will 10t be regraded ........ ~ .................... Will excess fill be removed from premises: Yes No 14. N~e of Owner of premises . .l .................. Address ................... Phone No ................ Nme of Architect ......... j .................. Address ................... Phone No ................ N~e of Contractor ........ ~ .................. Address ................... Phone No ................ PLOT DIAG~M Locate cle~ly ~d distinctly ~1 bufld~gs, whether existing or proposed, ~d, indicate all set-back d~ensions from property ~nes. Give street and block number or description accord~g to deed, ~d show street names and indicate whether interior or corner lot. STATE OF NE~I[~d.,.~' ~ o ,, COUNTY~~ ....... i ...... ............... (Name of individual si~ning contract) above named. duly sworn, deposes and says that he is the applicant He is the .................... ~' ag te off etc ) i ,'" ent, corpora lcer, · 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 contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manoer set forth in the application filed therewith. Sworn to before L.ne this .......... ....... ..... Notarv_Pu'blic ....... ,<-,., .... county tlY <./V/fl f , o' -"--/ ~ ~-~-~ 1~____,,~ // ~ (Signature of applicant) I