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Home My WebLink About12876-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Sou:thold, N.Y. Certificate Of Occupancy No...zj .3.7. 0..6 ......... Date ..... J.a.n..u.a.p.y...3 ................. 19.8.5. THIS CERTIFIES that the building ....5.n.. gyp. u.n..cl..s.~. ~. [n.m.i.n.g.p.qq i. ................. Location of Property 360 SUNSET AVE. MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section .~ .7.~. ........ Block ...... .3 ........ Lot...0.0. 4...~..0..0 ~ .... Subdivision ............................... Ft~ed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Jan 11 ,19.8.4. pursuant to which Building Permit No. ~2876Z dated . .F.e.b. ,..2fi. .................. 198..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.g?.q~¢.d s.~-rn.nl~.ug p.o. 9~- .... The certificate is issued to .. RUSSELL CHARLES NINE & WIFE (owner, ~,y~qg~g~ ~w~)x X of the aforesaid building. Suffolk County Department of Health Approval .... N/A UNDERWRITERS CERTIFICATE NO ..................... 4). g ~.~' 245. $ .................... Rev. 1/81 Building Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12576 Z Permission is hereby granted to: ..... .~--~,~. ~;....~:~. .................. ...~....~.. ............. ~ .f...:.~ .................. ..~~- ~.z,....~...~..z~z7 ....... ~~......~..,~ ./..~.~......, ........... ~s~d......~.~,....; .............................. et premises I~ated at County Tax Map No. 1000 Section ..... Z./....~,.'~.. ....... Block ...~)..~. ........... Lot No..(~...C¢/..(.~...c~..~.Q pursuant to opplicotion doted ........................................................ , 19 ......... and approval by the Building Inspector. Fee $../....~. .............. '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 submitte~pl[c;tc 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-iS*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 featu res. 2. Sworn statement of owner or previous owner 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. C. 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 land C.0. $ 5.00 New Building ...... Old or Pre-existing Building Vacant Land 5 Location of Property ,~.~... ~..~5..~..A~..~.~7.;7-..I /¢~ r)?~q TT House No. Street Ham/et Owner or Owners of Property ~J;~'~'L-~ E',, i~-/g~L~'"';-5 ~ I ~ //5r 3 lot ................ County Tax Map No. 1000 Section ............... Block ............... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. °~-~ ~' '~/~- f~ ?~<~ Construction on above described building and permit meets all applicable ~codes and r~ulations. Applicant. ,~, ,~. ,~.,..?,~~ ...................... Rev. I0-10-7a THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the eJec trlcaJ equipment ~ described below and interlaced by the applicant named on the able application number ia tl~ premises of l~ell C. ~ne, 440 S~se'g Av~nuo~ l~t'~lt~k, N.Y. in the followlng loca~ion; ~ Basement ~ lst Fl. ~ ~nd Ft. ~tside section Block Lot ' · ~Y ~ ~ and found to be in compliance w th the requirements of this Board. was exam nea on FIX~U~ FIXTURES RANGES COOKING DECKS OVENS DISH WAFHER~ EXHAUST FANS OUTLETS DRYERS MULTI-OUTLET SYSTEMS NO, OF FEET R V I C NO OF CC A, W G, NO. OF H~-LEG A W, G NO, OF N~UTRAL$ A. W, O. PER ,g OF CC, COND, OF HI-LEG OF NEUTRAL IOTHER APPARATUS: ~elbo~cds: 1-Stir. 125~mgs. 3-G.F.C.I. ~w~'~__~g_~)~ Th~s ~ifics. t,e ~vers ~li~ce at t~ ~e of inaction only. '~a~ of ~1 envlror~nents it Is ~v~able ~ ~ve f~at test ~or l'ep~z~ ~_ssell C. Nine, 440 ~unset Avenue b.~tl;l%uck, N.Y. 11952 This certificate must not be altered in any manner; return to the office of the Board if ncorrect Inspectors may be COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE NJ UJ~T ~OT BE/~TERED N ANY MANNER. rg~L 9_~.I~N ~ F~_E.C T 10 N FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING 3o INSULATION FERN. Y. STATE ENERGY C~ODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:~ ....................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No.. ,~. ...... 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. c. The work covered by this application ~nay not be commenced before issuance of Building PeFnit. d. Upon apprgyal of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit ;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 ;hall 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 3uilding 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. Yhe applicant agrees to comply with all applicable laws, ordinances, buil~,k~g code, housing code, and regulations, and to tdrnit authorized inspectors on premises and in buildings for necessary ins~.~O.:.~~ (Signature of applicant, or name, if a corporation) ...... (~.q .~.o. ~,..~. ~ ~...~-~q ~ ~c.q,.o..~. ? ..,~, .... (Mailing address of applicant) grate whether applicant is owner, lessee, agent, architect, engineer, general eontra~t0r, electrician, plumber or builder. .. ~. ~ ~..r-¢..T. ........... ................. qamc of owner of premises ... c2> $ k~,...~. .... ,l~., ,h)~ ........................................ (as on the tax roll or latest deed) [f applicant is a corporation, signature of duly authorized officer. ~ (Name and title of co)~orate offi?er) · .~..g Builder's License No....~..'~...~. ..... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ ...'~: ' so ~J s,_."-r ......................... .. ~ ................ /~ ~.. . vx t~:'x. :~ .~.w...'9..c. ~<,.. House Number ,~ 'O Street Hamlet County Tax Map No, 10130 Section /'[ S- ~ c.~. :i .................. .~ Block .................. Lot ............ Subdtv~smn...'~.~..~..~. ~r. [ .~.~. B ........... .': . ..... Filed Map No ............... Lot (Name) 2. State existing use and occupancy of premises and intended use and Oqcupancy of proposed construction: m{fl- use and occu a. x.s..nu ncy .................. .., . . .,F~ :,~,; ................................. b. Intended use and occupancy Repair ......... Rembval · ' .... Demolition ........... Other Work .... /.~'.~.o..(.~-..'.. , ~ (Description) , . - ~ Estimated Cost (to be paid on ~ing this application) ;. if dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ............... If garago, number of cars . k If business, commercial or mixed occupancy, speedy nature and extent of each type of us~ ................... L Dimensions of ex~sting structure's, if any: Front ...... ~'.~ ..... Rear ... ~ ....... Depth..~ ....... Height ...... ~ ...... Number of Stories ....... ~ ............................................. Dfinensions of same structure with alterations or additions: Front ................. Rear ............... , Dep~ .................... i. · Height ...................... Number of Sto~es ................... t. Dimensions of entire new construction: Front ...... ~ ~ .... Rear ...... [.~. ..... D~pth .. ~ ~ ...... Height ............... Numb~ ~f Sto~es .................................... 1 ................ t. S~2e of lot: Froat ........... :~. ~.lx ~ 5. Rear ...... ~./.G.~. 5.~ ...... Depth .. ~ O. 3 ........... ). Date of Purchas, ........... ~ .... ~.~ ~.~ ......... Name o~omer Owner ......... I ................ 1. Zone or use district in which r'misesare'situated . , . ~ % . .. P ~ ................. ~ .................... 2. Doe~ proposed construction v~olate any zoning law, ordinance or regulation: ..... ~T. ~ .... . ................. ~. Will lot be regraded ...... ~ ~ ...... ; .......... ~, Will excess fill be removed from pren rises: ~ No L Nme of Owner of premises ...~. ~.g ~..~ddress . ~S .~. ~.q~Phon~ No. Name of Architect ........ ', .~ ................. Address ................... Phon No ................ N~ otContractor . I,~ ...... Address . . ~[ ..... Phon No ................ PLOT D~AG RA~ Locate cle~ly ~d distinctly ~1~ bufld~gs, whefl~er existing or proposed, and, indicate ~1 s~t-back d~ensions from :ope~ fines. Give street ~d block ,number or description according to deed, ~d show street nm acs and ~dicate whether terior or corner lot. ............. .. · · ~ ............. bein u sworn, deposes and says that ho is the a cant . (Name of individual signing contract) oove named. e is the . ~ (Contractor, agent, corporate officer, etc.) ; ~ f said owner or ownem ~d is'duly authored to perform or have p~rfomed the said work and to m~e and fil~ pphcat~on; that all statements contmned m th~s application are true to the best of his knowledge and belief; ~d that ~ork will be performed in the manner set forth in the application filed therewith, worn to before me this , .......... ~ .~ ..... day o.f ....~, ~ ............ , 19.. ~ County~ · ,otaiy Pubh ' ' ,L~,,, ~ v~'~ ~ ...... ............ c~,,~,a ~,, s,~,~ c~,,~, (Signature of app~cant) ~oo · ~. I' 2Z'~O"W $ U N .% F_.,'t" AVENUE ('3 O~ +,Cu.. ~ I ('J '