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Home My WebLink About13313-zFORM hlO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z.]3.7.8.~ .... Date August 21 1985 THIS CERTIFIES that the building A d d i t ± o n Location of Property .... P.~.:.?.d.:..~Pfi.3. 2360 Peters Neck Re'ad Orient House mo. Street Ham/et County Tax Map No. 1000 Section ..... 3.2. .....Block .... .0.1 .........Lot .. 0 ? . Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated July 23 19 8..6pursuant to which Building Permit No. ~ 3313Z dated .... ................ 19.8.6., 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 ......... · .&tlc Lt.J, QO..~.q .e~;L3.~.5..rig..d.~..e.l.~.~.n.g.. ........................................... The certificate is issued to Peter Blank (owner, le2[~[~rXt~nff~[ X X of the aforesaid building. Suffolk County Department of Health Approval .... N/A UNDERWRITERS CERTIFICATE NO ................. .~7.q0, q..2.2 ......................... Rev, 1/81 Building Inspector 1~0~ NO. ~ 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) N? ~33~3 Z Date Permission is hereby grantecL~: __ ~ ....~r~,~..~.....!.,~..L~ ...........................................v _~ ~,C..~../../..cL.-~ .~.,~.~,.~.?~ .................. .~....., ......... I ..... ~ at premises located at ......,~,.~...~,~,,~. -~,,,'.....~,, ........... ,.~.,~....~,~.~,~,...~....,..~.~ ...... ..~,~ ...... County Tax Map No. 1000 Section ...... ..(~......~....;~..... Block ..... ...C)....! ......... Lot No ........ ~ ............. pursuant to application dated ...... ~.....~...:[~ ...................... , 19.?...~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 TOWN OF SOUI'HOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. ! ,~ Owner (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber s signature) Swor~n~to beforef)me this day of ~c ~/~ ~A , s Public J.~OTARY PU~I~, State o~ No. 4702900 Quahfied in Suffolk Courtly Commission I~xpires March 30, 19~y iooi~i8 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001~18 BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK i003~ ..re ~uiy i~, i~8~ ~p. llcat,o,.No.o. Sil~ ~,~i~/8~ N 700123 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of Peter ~lank~ ~vt. Road, off ~arrow River Rd., O~ien~, ~Y in the fotlowi,~g tocatlon; [] Bese,ne,~ [] 1st FI. ~ 2nd FI. Sectlon Block Lot tvas exa~rtlned o~ ~nd found to t)e in complla~ce ~vlth the requirements of this Board. July 08, 1985 FIXTURE OUTLETS DRYERS FIXTURES RANGES FLUORESCENT DISH WASHERS EXHAUST FANS SYSTEMS NO. OF FEET E R NO, O E COND' OF ~C. COND, OT~EE ApPARAT'0S: ~lec~ric ro~ hea~ers~l-g. Skw. ,3-2.0kw.,l-.75kw. ~ Track lighting: 8 feet 2-Li~s 1-G.F.C.I. Y I C NO OF HI-LEG OF HI-LEG NO OF NEUTRALS OF NEUTRAL 515 Elton ~treet Riverhead, ~ 11901 Li=~3186E ~E~RAL MANAGER This certificate must not be altered in any manner; return to the off[ce of the Board jf ~nco~rect, Inspectors m*y be identified by their credentials. COPY~FOR COPY O~ FORM NO, 6 TOWN OF ~OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ to the Building Inspec- tot 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 unusuat 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 $15.0 0 3. Copy of certificate of occupancy, $1.00 4.Vacant Land C.O. $5.00 Date .......................... New Building ............. Old or Pre-existing Building ,,, ,~,, ...... Vacant Land ............. /.y.,..y. [:~ .~.' ,~ . Location of Property .......... .. ~ .... ./?~../... House No. ~.~ Street / H~hlet Owner or Owners of Property .... ~. f;,: ......- · ~. ~.~/M~.~. ........................... County Tex Map No. 1000 Section ... = ./..L~r-. ....... Block ........... kot... ~J! .' ....... Subdivision ' ' Filed Map No '-~ .... Lot No -- Permit No. .~ . ate of Perm cant .................................. HeathDept Approve .~.//~, ~....V. LaborDept roval. ........... ..................... App . ..... Underwriters Approval ................. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and permit'meets all applicable codes and regulations. Applicant ........ ............... FIELD INS?ECTION 1. FOUNDATION (1st) COMMENTS i' (2nd) FOUNDATION 2. ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY FINAL ADDITIONAL CO~ENTS: 2'65-t802 BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ ] ROUGH pLBG. [] FOUNDATION ZND [ ] INSULATION [c,']/ FRAMING [ ] FINAL REMARKs: 7GS-'~802 BUILDING DEPT. INSPECTION~ UNDATION '~ST [ ] ROUGH PL G. FOUNDATION 2ND [ ] INSuLATiON [ ] FRAMING [ ] FINAL REMARKS;,, DATE INSPECTOR FORM NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved. . .,~..., 19~..~. Permit No. l .~. ~. ! .~..~.. Disapproved a/c .................................... Application No ................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date .... /~ ~ a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with ' 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 street :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 permi 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 Occupanc~ 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 th; iBuilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o ~Reguiations, 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, buildin~ode, hoUSing code, ,,~ reoulations and t( admit authorized inspectors on premis0s and in building for necessa~~ ' ( ignature of applicant, or name, if a corporation) il~a~ling address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ./f({C . .~.~ .t-.~. r . .~... '.~ ~,~ i.~..~. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and ti.~le of corporate officer) Builder's License No. .~.OU Plumber's License No ........ Elect~cian's Licen~ No Other Trade's Lican~ No I. Location of land on which proposed work wHl be done. ..... .............. ..... .............................................. House Number ,,,, Street Hamlet County Tax Map No. 1000 Section ............. Block ............ ~.. Lot .............. Subdivision ..................................... Filed Map No .............. Lot ...... (Name) L State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... ~i ~.~ ............ ?,.~..~. ~. ,~4~-, :'~ ............... b. Intended u~ and occupancy..... I. ~ ........ . ,...,,,:.,' .~,,¢~,~¢., ~.,.; ¢ ,,~,. ............. 3. Nature of work (check which applicable): New Building .......... Addition .... ~, .. Alteration ......... Repair .............. Removal ..... , ........ Demolition .............. Other Work .............. 9~ ~o^ i ' (Description) 4 Estimated Cost .,,~,.C2.../(~..l?..(~. Fee · (to bo paid on filing this application) number of dwelling units o .. ° :ri.. : : Number of dwelling units on each floor 5. If dwelling ......................... If garage, number of cars ~ ' 6. If business, commercial or mix0d occupancy, specify nature and extent of each type of use ................. ' ' 7. Dimensions of existing structures, if any: Front ............ Rear .......... Dep ...... , Height ..... ~ ...... Number of Stones ....... ~. ............................................ Dimens/ons of same structure With alterations or additions: Front ...... 7.Z~ ~. ...... Rear .... "?.~,~ ...... Depth .... '~' ~. .......... i... Height ...... ~ .q.~ ............ Number of Stories ...... ~ ........... 8. Dimensions of entira new construction: Front .., ,' .~.~.' ...... ~ Rear ... '~,Z.~' ........Depth., ,~.(~, .... ~,~I ! Nu[aber of Stones ~. Height ' Size of lot: Front l~.c~ ~ ' Rear ~O.c::~ Depth ~ ~.C9 ' 10. Date of Purchase ......... i ................... l~ame o/_Fo_rm, e~ Owner ........................ Zone or use district in which Premises are situated 12. Does proposed construction vtolate any zoning law, ordinance or regulation: .... /q~. ........................ t3, Will lot be regraded ....... i... ~ .............. Will excesz fill be removed from_vremises: ["~-es~ No Name of Contractor .... .,. i,....j. ;. ........... Address ........ , .......... Phone No ................ PLOT DIAGRAM Locat.e. clearly and disttnctb' ~11 buildings, whether, existing .or proposed, and, indicate ail set-back dimensions from ~roperty lines. Give street and block number or description according to deed, and show street names and indicate whethe£ interior or corner lot. S'r^T OF ov r¥ S,S .....~,~'.~..~..~.~/.-Z~.....~..'...~'./-~..~..~..~.. f .......... being duly sworn, deposes and says that he is the applicant (Name of individual si~ning contract) lbove named. He is the (Contractor , agent , corporate officer , etc , ) ~f 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 wilt be performed in the manner set forth in the application filed therewith." ~wom to before me this ! .z.. ............. ...... dayior ...... ......... , 19 Notary Public, ...:.. · : .~...~ ...... County ~ / NOTARY PUBI.I¢. S~ate o~ Nl~w ¥~ .... N~ 47300~ ..... ~ - (Signature of applicant]