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Home My WebLink About13347-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. Certificate Of Occupancy No. Zq 3648 Date July 9 85 addition. THIS CERTIFIES that the building ................................................ Location of Property 2780 Peconic Bay Blvd. ]3aur.el House No. Street Hamlet 23 County Tax Map No. 1000 Section .... 'J .~?. .... Block .Lot Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated August 8 8¢ ~ 33~7Z ...................... 19... pursuant to which Building Permit No ...................... dated August ~ 3 8tI ............................ 19..., 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 ......... Addition to existing one-£amily dwelling. The certificate is issued to AL WES~EE (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval t~/A . UNDERWRITERS CERTIFICATE NO .... Ix1672608 Building Inspector Rev. 1/81 1~0~ NO. S TOWN OF SOUTHOLD BUILDING DI~PARTMINT TOWN HALL SOUTHOLD, N. Y. BUILDING PER. MIT (THIS pERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N°. 133~t7 Z ~oto ....~~../..~ ......... ....... Pe~ission is hereby grante~ t~.' , ~.~..~....~.,.~,.:....t.~.~..~..~ ..... ~ . ,o .~~....~..~.~...~.....~.....~.~ ......... ======================================== ============================================== :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: County Tax Map No. lO00 Sectiop.~.../.~,~. ....... Block ........ ~ ......... Lot No ...... ~..'~ .......... pursuant to application dated .....~....~f~.....~.......~../~ ~) ................. , 19.?...~., and approved by the t 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 Instructions A. This application must be filled in typewriter OR ink, and submitted ~- ~ 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: I. Accurate survey of p2"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 $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date .... /,-- ~ --c.~: ............ New Building ...... Old or Pre-existing Building .................. Vacant Land ............. Location of Property (~?...~y.~..:~?..~. ~,. ..... ~ ......... ' ' . ..... ;.t .°..~. .. Houee No. Street Ham/et A Owner or Owners of Property ........ v.., ....................................... County Tax Map No ................... 1000Section 1~..: ...... Block .. 0(~' Lot. ............... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. l..~.~.7.~Date of Permit S. S: .~:...Applicant..(~. ! .~!(~..F:. J;J.'~....~ !~.~)~L'%~)....-~..~.... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .... ~.,.~..(~... i~.~. '. I(0(~ Construction on above described building and permit meets all applicable codes and regulations. ~¢.4~.--Ct.O. ~¢5 Applicant ............................................ Rev. 10-10-78 FI~LD~NSPECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING e INSULATION FEE N. STATE ENERGY QODE FINAL ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS ol BUREAU OF ELECTRICITY ~- 86 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment as described below and i~troduced by the applicant named on the above application number in the premises of A1 We~tee: ~/~ P~au~c L~y ~lvd~, Ioral~ N Y in the followlng location; [] Basement [] 1st FI. FIXTURE FIXTURES OUTLETS RECEPTACLES SWITCHES FLUORESCENT 5 ~ 7 [] 2nd FI. Section Block Lot and found to be in compliance with the requirements of this Board. RANGES COOKING,DECKS OVENS DISH WASHERS EXHAUST FANS DRYERS OTHER APPARATUS: E R V I OF CC, COND. C E A. W.G. NO OF NEUTRALS NO OF HI-LEG OF HI-LEG OF NEUTRAL 121 Acacia Tbs certf ...... Per i?~e`~r~v~r~r~;i~`~V'i~i~`~:~`~"~.`'~e`~e`~~~care musi' not oe alterea in any manner;, return to the office of the Board if incorrect. Inspectors may be identified by th~'~ 'FORM NO. 1 ToWN OF sOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ;xam /.% o .,~ ....... ' ' ~ \pproved ~X4~%. ) 3., 19~'~' permit No..~:'.~:..~.~' '~' ~ 3isapproved a/c ..................................... ........ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ..... -~- '~ '(~f ...... 19 ' '~'~ INSTRUCTIONS This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3.. a. lot lan to scale· Fee according to schedule·, relationship to adjoining premises or public streets~, sets of plans, a. ccurate P. ~ · and of buildings on premxses; . ,~A ~ .... m which is part of this applij h. Plot plan showing !ucation o.f 1.ot ....... t of ~roperty must be nrawn on uL~ ~-,-~ or a~eas, and giving a detmled description o~ ~ayuu t- cation. ' mmenced before issuance of Building Permit. ' ' ~ this a hcatlon may not be co . . - · it to the applicant. Such permit · ed b PP ' ' sued a Building Perm c. The work cover .Y ..... ~ ~-,~ l~snector will ~s d. Upon approval of this appucauon, m~ ~,~, ..... ~ ~' ~ 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 OccupanCY shall have been granted by the Building Inspector. Permit pursuant to the other applicable Laws, Ordinances or APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and as-herein described. Building , .~.ou~,~d~ regulati°ns' a~i. t.i Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, (Signature of applicant, or name, if a corporation) · ' ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, cng)neet, general contractor, electrician, plumber or builder. C*, ................. ............................. ............... ¢. :., ....... .'. Name of owner of premises ............. (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: J.'. ·: ................ ~ 's License No ......................... : ~. plumber ~f ' E[ectrician'sLicenseN° ............. '':::;:3;). , "5~: Other Trade s License plo ........... 1. on which proposed work will be done .................... Location of land ¢.~.(...? ~.~ U .~ (,-, .. ...................... .......... Hamlet ................ Street ,.~ .~. House Number ' ~ ' /.~.~ Block.. · . ..... Lot ................ County Tax Map No. 1000 Section ...... ' ' Filed Map No ............... Lot ............ Subdivision ................ (iq'a'n~ ~)' ............... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy ......... a. b Intended use and occupancy ....... ''8. 10. 11. 12. 14. Nature of work (check which applicable): New Building ..... ' .....'Addition .~%.~ .tF.C.'.. Alteration .......... Repair .............. Removal ............ Demolition ............ Other Work ............... ~ L[l (Description) Estimated Cost ............................. Fee ..................................... (to be paid on filing this application) If dwelhng, number of dwelhng iunits ............... Number of dwelling units on each floor ................ If garage number of cars If business, commercial or mixed occupancy, spec/fy nature and extent of each type of use .................... I)nnens~ons of ex,isLing structuros, ff any: Front ....... ~. ....... De ...;~. ~. ....... Height ...r.~ ~ Number of Stories ........... Dimensions of same structure with alterations or additions: ~ront .......... Rear .. F.q TM . . Depth ..... ~?.':~.o: [ ....... ~.. Height ........ ':@ ......... Number of Stones ................ Dimensions of entire new construction: Front ............... Rear ............... Depth .............. Height ............... Number of Stories ....................................................... Size of lot: Front i Rear Depth Date of Purchase ~ Name of Former Owner Zone or use district in which premises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lo~ be regraded ....... /Ni°. .....~ ~ ........... Will excess fill be removed from premises: Yes Name of Owner of premises .. i .[44.¢.~.~ ......... Address . .~..%...~.~ . ~. ~.o.,.... Phone No.. ~.~18':': ~.~...D..~-'~. Name of Architect ........ ~ . Address ~ . Phone No. Name of Contractor . .~.~.TI... ~q~. s.T.l~q~.o.%.. Address . .~.~. ~9~-..~,.~. J ...... Phone No..?.~.q ?.~1.O.~... property lines. Give street and block interior or corner lot. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate ail set-back dimensions from or description according to deed, and show street names and indicate whether STATE OF NEW YORK, ~S.S COUNTY OF ................ ' (Name of individual sigfiing contract) above named. ...... being duly sworn, deposes and says that he is the applicant He is the ..................... : ............. ~ (Contractor, agent, corporate officer, etc. ) 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 ail statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. · Sworn to before me this .. County Notary Public, . .... NOTARY PUBLIC Stat~ of New Yo k . ; ., 2 .......... i No, 4707878, $~ffolk ~Ounty ' ",' ~ (Signaturelof applicaitt) Term £xp~res Marc~ 30, 19,ff__~'"' ' , ." ' ID DIST. I000 SECT, BLK. LOT 128 06 2S ~AT LAUREL TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK ,R UNAUTHORIZED ALTERATION OR ADDITION TO THIS ~IURUEY IE A VIOLATION Ofr SECTION ?EO~ OF THIE NEW YORK STATE EDUCATIpN LAW. SURVEY FOR ALPHONSE WESTEE MARGARET WESTEE DATE ; MAR*SI, 19S2 SCALEI I #·40' NO. I GZ' 144 GUARANTEED TO~ LONG ISLAND TRUST COMPANY USLIFE TITLE INSURANCE CO. OF NEW YORK V/"%l IKIt~_ ~. V/~I IKI/'~_ 4000STRANDERAYENUE ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND ,AND SURVE,R NXS. LICEN*E N0.1284, HOWARD W. YOUNG, LAND SURVEYOR