The URL can be used to link to this page

Home My WebLink About13158-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y, Certificate Of Occupancy No....g.'l. 5q9.2. ....... Date ........ CI ° THIS CERTIFIES that the building '777.8. .d..:3.~.z.q~. ................................... Location of Property . .2.~..2~ ................ .~.5..~.o...~.e.e.k...R9.8.c~ ............ $91Zg~g~cl... House No. Street Hamlet County Tax Map No. 1000 Section ...Q~..0 ...... Block . .0.~. ........... Lot ·..0.Q~ ........... Subdivision....X. .......................... Filed Map No...X. ..... Lot No... ~ .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..~p.~.5.3,. 5.0 ......... ,1 9 ~3./4. pursuant to which Building Permit No...'1.5'I. 5.~..~ ........... dated ....... .~..~.2r..2~. ............. 19~../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 ......... ...a..n..~.d, d. ~.~._4,qn,, ,~.o, .~.VV..~. ~..~o. o..m.s, .~.9..8.n.. ~.~is.~. ~-.~g .d.V.e.~.Z. 5..n~ ................ The certificate is issued to .... ~.g23r~.~.L.. 5/,..&. ]~4~ .~I..~.... Q.' .~.~ ..................... {owner, of the aforesaid building, Suffolk County Department of Health Approval .. ~gP.~..~7o.q,ttS~ ......................... UNDERWRITERS CERTIFICATE NO .......... .31..6.~. 95~.~' .............................. Rev. 1/81 Building Inspector TOWN OF SOUTHOLD 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? 13158 Z ,o~_..Z~'~..,~.~..~.~.--.O~.....~.........~ ....... ~.~'z~.~:..~...~....~'C..,~... .,..~.,~..~.~.x:,~......~.,,.~/_/~ ................ .n. ....................... r......~..~ ...................................... at premises lo,at/ed at ......~'.. ,~..~..~....~......~'~"~:..~.~...~.......'~ ........................ C~n~ To× Mop No. ,ooo Se:,~o..Q. 7~ .......... B,o~k ..~.~ ........... ,_or No...~.rJ....~.. .... ,,..o., ,o .~,,..,,o. ~o,. ...~,,~..~.....z.~ ............ . ,.~o.. o,.,.rov... ~, Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall ~,'~uthold, N.Y. 11971 BLDG. DEPT. TOWN OF SOUTHOLD APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitte~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. Commemial 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. 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 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 dwe~ing/ landuse-~?re-~;×isting C.O. $15.00 3. Copy of certificate of occupancy $1.00 Vac~ [a~d C.O. ~ 5.00 Date...~,.~. ~.. New Building ............. Old or Pre-exi~ing Building . ~. ....... Vacant Land ............. Location of Property. ~.~.~...~.~..~G~. ~ ............ ~o.~ Owner or Owners of Property .~'"~ ....... ~.. ~-~....~... OounW T~x M~p No. 1000 Seodon ............... BIook ............... Lot ................ SuBdivision ................... T. ............ Filed M~ No ...... ~ .... LoT No .............. Health Dept Approval -; Labor Dept Approval Underwriters Approval ~ Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ..... ./~. f. · .'.~'~ ........... Fee Submitted $ .......................... Construction on above described building and permit meets all appli,eable codes and regulations. O._O 13 c ;L TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit NO. Owner F. (please print) P lumbe r_~2/~l ~, (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature) ry Public Sworn to before m~s ~ day of 19~f / Notary Publi County THE NEW YORK BOARD OF FIRE UNDERWRITERS 1195066 ~kl BUREAU OF ELECTRICITY~ Apr:L1 30,198.e~ JOHN STREET, NEW YORK, NEW YORK 10038 ..re n,,,plic,,tio.~'o.o..f.e 323872185 N689357 THIS CERTIFIES THAT P~131582 only the electrical equipment as described below and introduced by the applicant named on the above applicagion number [~ the premises of Dan O'Brien, ~725 P~ne Neck R~., Southold, ~.Y. in the follo~vlng location; [] Basement ~ 1st FI. [~ 2nd FI. Sectio~t Block Lot was examined on A~)~.~ 1 2 5 t ]' 9 8 5 and found to be in compliance with the r~quirements of this Board. FIXTURE OUTLETS SWITCHES DRYERS MOTORS FIXTURES RANGES OVENS EXHAUST FANS APPLIANCE FEEDERS TIMECLOCKS UNIT HEATERS MULTI-OUTLRT DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V ~1 C E OTHER PP RA US: 199 Waveores~ Drive Mastic Beach, N.Y., 11951 GENERAL MANAGER This certificate must not ~e altered in any manner; return to the office o~ the ~oard if ncor[ect Inspector~ may be identified by COPY I~OR B~ILDING DEPARTME FIE~D I~SPECTION DATE COMMENTS FOUNDATION (2nd) PLUMBING ~ODE FINAL ..... " ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 'IST /~']/ROUGH PLBG. FOUNDATION ZND [ ] INSULATION ~['/FRAMING [ ] FINAL ,~~~. o~ TOWN OF SOUT~IOLD OFFICE OF BUiLDLN'G L~SPECTOR TO%% .~ I-I. ALL SOU/HOLD, N. Y. 11971 765 M E M 0 R A N 'D U M SUBJECT: Building Permit Applications Buildin6 Permit applications for all new buildings' and additions to existing bul!alnms shall include the fol!owihg: ACCURATE PLOT SURVEY SHOWING: Eb:isting or proposed structure 0~'- : ....... n_ o£ set backs £rom all bomn / T,~~E SETS OF B~LDiNG PL.~NS TO iNCLUDE~ Foundatio9 plan ~ ~ . Foundation . Floor joist ~ . Ceiling joist ~ . Insulation , All construction detailing, shall me~t New York State Building Construction Code and conform ~o New Y~tk State _Ener~, Conservatio~ Construction Code. Approved ...~../'~fi~.. FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL,: 765-1802 Disapproved a/c ..................................... (Build lng Inspector) APPLICATION FOR BUILDING PERMIT 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 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. 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 Law% Ordinances or Regulations, 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspect~. ~//~7-~i ..... ............... (Signature of applicant, or name, if a corporation) 42 Penn Street, Port Jefferson Station, N.Y. Zip: ·. 11776 ................................... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises D..a.~. J?.l..V.:..O~..B.r.i?.n..an..d Eileen T: .O'.B..rJ:.?.n (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 ........ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be done .................................................. 2725 Pine Neck Roadt Souhhold~ N.Y. House Number Street Hamlet County Tax Map No. 1000 Section ........ .79 ........ Block ..... .6 ............ Lot .... ,2 .............. Subdivision ..................................... Filed Map No ............... ~ Lot 2:, :~,.. '.- ........ (Name) --- "~' ' 2. State existing use and occupancy of premises and intended use and occupancy of proposed constru_ction: - a. Existing use and occupancy Sea,sonal Residence " - .: ~ b Intended use and occupancy Seasonal Residence ............. 3. Nature of work (check which applicable): New Building .......... Addition .. ~ ...... Alteration .......... Repair .............. Removal ............ Demolition .............. Other Work ............... (Description) 4 Estimated Cost $.6.,.000. i $2.5 00 ; (to be paid on filing this application) 5. If dwelling, number of dwellingiunits .. 1 ..... Number of dwelling units on each floor If garage number of cars 6. If business, commercial or mixe~d occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front...S.e.~ ~ ..... Rear .............. Depth ............... One Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front . .S.e.e...~%p. ........ Rear .................. Depth , Height ..... Number of Stories 8. Dimensions of entire new construction: Front 2,0.. )[..21,2. ..... Rear ............... Depth ............... 'ght ,b ' .Or~.e Hei Nu erofStones ....... 9. Size of lot Front 9.0. ... Rear 90 n~nth 12.5 10. Date of Purchase Feb 11, 1977 lXl~m, ne Un~m~r c~ .....~ Ri~{ar . nters I 1. Zone or use district in which prlemises are situated .... .Sq.14 .tt].o.l.d' .F.l.r.e..D.i.S..t~.l.c.t. ........................... 12. Does proposed construction violate any zoning law, ordinance or regulation: No 13. Will lot be regraded . .l'tq.g .N.e.q~.s.s.a. rx. ....... . ......Will excess fill be removed from premises: Yes ' No 14. Namea of Ownerc ' of premises . .Ban-i-el~ .V....O'.Brz.en. Address Pore4'2' P.e..r~.jel:z:ersc~rl "S~ 'fTr"o'e~"' ..... s'ca, l~hone No 516 N me of Ar h~tect ........ ~¢e ............... Address .................. .rl~hone No ............. Name of Contractor ...... ?. ............ Address P. qz;t; .4e.f.f.e.r.s. qn..S..fa.,. Phone No. 5.1.6. .9.2.8-. ~?.%.... PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. SEE A~ACHED MAP STATE OF NEW YORK. COUNrYOF.. .tv. S.S ..... ~)~.~t.~...~.1~8~ ........................ being duly ~worn, deposes ~d says that hc is the applicant ' (Name of individual sig~ing contract) above named. He is the O~ : , (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is du~y authorized to perform or have perfo~ed the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the work will be perfo~ed in the m~ner set forth ~n the application filed therewith. Sworn to before me this ........ ..... Notary Public, . ........ County ~, ; // Nota~ pubhc, S~;~ o~ N¢~ York p No. 43-4643592 ........ (Signature of applicani) 2. x lo Yl~ TITLE C/Eo £.~ DRAWN BY DATE. J SCALEA./~