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HomeMy WebLinkAbout13324-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z73207 Date February 8 ., 19 .8.5 THIS CERTIF IE S that the building ....... 0. n. ?..f.a.m..~ .3_2'. . d. y.e.i. 1. $ .ng. .................. Location of Property/:/~t~s~ h/o~ .3.4.5.. ~..~y.o.q .P.e.~.~...L.~.n.e. .................. .1~ ~.~.g. :~ .~ .u.c.!{ ..... Street Hamlet County Tax Map No. 1000 Section ...1.0.0. ...... Block ...... I ......... Lot ..... 7.~ .......... Subdivision .S.~ $ .~.a.~. p..% .E.s. ~. ~.~.e.s. ........... Filed Map No. q ~.8.2....Lot No..7.7. .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... 4 u. $ y..2. 5. ......... ,198. q. pursuant to which Building Permit No...7.3. 3..2 .4 .Z ............. dated ...... ~ .u g.u.s. ~...6 .............19gfi.., 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 ......... One family dwelling The certificate is issued to ... ?.r.HqTUY..q,. 3..~..~.~P.~. Bb.~. .~. 99.~.~. ....................... (owner,~q~'~ X X of the aforesaid building. Suffolk County Department o f Health Approval ....~ .4 .-.S..0 r .~ .3.~. ¢/.8./. ~ 5 .................... UNDERWRITERS CERTIFICATE NO ........... t2N5730p4 1/3/$5 FLUMBERS CERTIFICATION Jan. 4~ 7985 Building Inspector Rev. 1/81 lvOu'M NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT trillS PERMIT MUST BE 'KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1332~ Z Date .,~ ........................................ , Permission is hereby grantej;Lto: i~ ~ ~!..~ ........... '~ ................. ........ at premises located at ..~... ~...~. ........... ...L~..~ .................... ~ ............ , ....................................... County Tax Map No. 1000 Section ..... J....../-r~... ......... Block ......... } ............ Lot No ......... [..~. .......... pursuant to application dated .... ...~...~,..~..~. ....................... , 19.~.~., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOU~'HOLD 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 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 featu res. 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~3perty 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 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date ..... ; .... ~.~ ............. ............ Vacant Land ............. New Building .~. .......... Old or Pre-existing Building Location of Property ~5- ~ ~-~. ~ ........... ,, ..... House No. Street Ham/et Owner or Owners of Property ~-?. ,o~, ,~. , ,(o~,, .~,` ,~--~,, ~.o. 1~..~..~.~. .... . .~z:27...~-,_,_,_,_,_,_,_.~ ................ County Tax Map No. 1000 Section / ~-' Block ] Lot I .~ Subdivision. ,~,, ,R-! .~.. ! ~.~,,, , ,~,,,.~..~,-,'?~, ........... Filed Map No..~'J,~,~."~.... ,Lot No.. !7. ......... PermitNo. ~.~')-~/~-' Date of Permit ~[,~,~ .Applicant (~r¥c~,~F .~?~.)gP.~ Health Dept. Approval .... ~ .................. Labor Dept. Approval ........................ Underwriters Approval..~., ................... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ., ,,~. .................. Fee Submitted $, ?~.~- .... ~..~.../.0.~ ......... Construction on above described building and permit meets all applicable codes and regulations. Applicant..'~_~.~,...~..~ ............. ,.,.,o.,o.,a 13go 7 FIELD INSPECTION 1. COMMENTS FOUNDATION_.. (~ls~,!, FOUNDATION 2. (2nd) O~ ~c ROUGH FRAME & FLUMBING INSULATION, PER N. STATE ENERGY ~9DE FINAL ,! ADDITIONAL COMMENTS: TOWN OF SO--OLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 119?l TEL. 765-1802 CERTIFICATION Building Permit No. Owner--~0~ '~ t~:5:~ (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) Sworn to before me this ~--~ day of ~/~t~dA3J~ , Notary Public ~x~/~ f~ ~ County Notary Public 765.1802 BUILDING DEPT. INSPECTION FOUNDATION zST ~ [ ] ROUGH~ PLBG. FOUNDATION ZND [ ] INSULATION [ ] FRAMING [ ~FINAL INSPECTOR 7GS-~.802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ]ROUGH PLEIG. [~/FOUNDATION 2ND [ ]INSULATION. FRAMING .[ ]FINAL REMARKS: ,~/~,, ~, DATE INSPECTOR BUILDING DEPT. IHSPE 'rlON FOUNDATION XST [ ] ROUGH Pi'BG. tX FOUNDATION ZND [ *1 INSULATION ( ] FRAMING [ ] FINAL DATE, INSPECTOR THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 1003~ ~,.t~ a~.,,~ a.. ~..~s~ ~,,~.,,~. ~. ~.~,,~ 3~/~ N 6 7 3 0,9 4 THIS CERTIFIES THAT only the electrical equipment as described below and intr~uced by the applicant named on tke aboee application number in the pr~ises"of.~ ~. T, ~ole~ a45 W~ve~'e~t ~e, ~ttituck~ N.Y. inthefollowinglocation; ~ Basement ~ lstFI. ~2nd Fl. Section Block Lot was examined on D;~iI~/' ~0 ~ ~ and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES OVENS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT vA~oa DRYERS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: l~G, F~ C. I, 2--Smoke Det~ctoz,s ~ S E R V I C E  W.G. NO OF Hi. LEG A, W. G NO. OF NEUTRAL NO. E~C~COND. OF ~C COND. OF H,-LEO 1 AWG OF NEUTRAL Litebrito Electrical Coatrs, Inc. lB Ashford Drive, P. O. Box Lake Grove: N.Y. 11755 GENERAl. Per-- This certificate must not be altered in nny manner; return to the office of the Board if incqrrdct Inspecto?s may be identified by their credentials. [JILDING DEPARTMi !1,~ ~ CERTIFICATE N ANY MANNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 '" io .l!. ,ermit Disapproved a/c ..................................... Application No .... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date .J .uAy. . .2 .5. ,. .1. .9 .8.4 .... 19 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 tile 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~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o '~ Regulations, for the construction of buildings, additions or alterations, ,o.r .for removal or. demolitiRn, as herein described The applicant agrees to comply with all applicable laws, ordinances build]ng,ffode, housing code/jind regulations, and t< admit authoriz0d inspectors on premises and in building for necessary in~ec. Ji6ns. _~. /// - (Signature of applicant, or name, if a corporation) Garrett A. Strang · .P. :0., .B.qx...1.4.1.2...S p.u.t.h. 9.1.d' ,...N.ex .Xgrk. l J ~.7.1. (Mailing address of applicant) State whether applicant is owner, lessee, agent, ~chitect, en~neer, general contractor, electrician, plumber or builder. ~rchitect Name of owner of premises .... .T ............. i.e. Pool. e ........................... .i.raoth,z a. nd .Debb ..................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Build6r's License No .... N.. 9.~' ,S. 9.1.e.qt.e..d' .Y,e.t.... Plumber's License No " " " Electrician's License No, Other Trade's License No. Location of land on which proposed work will be done .................................................. ......... g .......... ..... House Number ,,^., Street County Tax Map No. 1000 Section 1 00 Sa. ltaire Estates Subdivision ................................... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: Vacant a. Existing use and occupancy ..................................................................... ............. ~,~.t it~.k, ...................... Hamlet Block ..... ! .... '. ....... Lot ..... .1.4. ........... Filed Map No. 4..6.8.2. ......... Lot ...1.7. .......... Sinqle Family Dwellino b. Intended use and occupancy ................................................................... 3. Nature of work (check which applicable): l~lew Building .. ,x. ...... Addition .......... Alteration ......... Repair .............. RemOval .............. Demolition .............. Other Work .............. ; (Description) 4. Estimated Cost ...... ~.7.5.,.QQ.0...QQ .................... Fee ..................................... ] (to be paid on filing this application) On e Number of dwelling unit~ on each floor 5. If dwelling, number of dwelling units ............................. numbe{: Of cars ! ...... If garage, ..................................................................... 6. If business, commercial or mixid occupancy, specify nature and extent of each type of uso ............... Dimensions of existin$ structures, if any: Front ' Rear Depth Height ............... Number of Stories ................................................. Dimensions of same structure with alterations or additions: Front ................. Rear ........... Depth ................... i.. · Height ................... Number qf Stories ........ n t etlon '5,4'; ar '.; ;.5.4~ ~.... Depth .3.6 8. Dime sions of entire new cons ru : Front ............... Re ........ 25 '. ' ' Number of Stories ~ ~ Height ......................................................... 9 Size of lot: Front 1 9.0 ' i ' ' Rear 99.57 ' Depth 240 .68 ' + Date of Purchase .M~3, ii 9,84. Name of Former Owner I 1. Zone or use'district in which promises are situated. A-Residentiai/Aqr icultural ' NO 12. Does proposed construction violate any zoning law, ordinance or re~uiarion: ............................... i3. Will lot be regraded ..... .N.q .................... Will excess fill be removed from premises: x Yes 1~0 14. NameofOwnaro remi~os .e. .............. Address ¢D;~t; ]a.N..,¥, .PhoneNo, 4~7:-.7,699 ...... h'ect G.A. S~ran~ . .......... NameofArc It ....... ,...~ ......... Address Southold,, ,~...Y.~..PhoneNo, 7.~5:-,5.455 ...... Name of Contractor .,..Np,~ .i~ ,eAe, c. ¥,e.d' .... :... Address ........ ~ .......... Phone No ................ PLO? DIAGRAM Locate claariy and distinctly all buildings, whether existing or proposed, and. indicate all set,back dimensions from property lines. Give streot and block interior or comer lot. STATE OF NEW YORK, ~OUNTY OF .... ,-~uf fo. lk.. See Attached G..a.r.r.e..t.t .A.: i.S.t.r.a.n. 9 being duly sworn, deposes and says that he is the applicant (Name of individual signin$ contract) .. ~bove named. He is the ! Architect , (Contractor, agent, corporate officer, etc.) ~f said owner or owners, and is duly authorized to perform or have performed the ~aid work and to make and file this :lpphcation that all statements c~ntained in this application are true to the bast of his kfl0~]ed~e and belief; and t.h,at work will be performed in the mal~n0r set forth in the application fil0d therewith. Sworn to before mo this I ..... . ,, 7 . .-: .......... ~OI^R¥ PO~t/¢, $,=,0, o' NOw ¥or~ (Signature of applicant_-- ~mber or description according to deed, and show ai~.roet n~mles and indicate' whether ~o ~z 0 fi. Oz LO z~ U2 :) ~.OE ,6b o91 ,,,,) 4...