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Home My WebLink About13161-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z16387 Date November 10, 1987 THIS CERTIFIES that the building A d d i t i o n Lo ati rPr t 225 Pine St. Mattituck c on o_ oper.y ..................................................... House No. Street ..... /21~r~ /e~ County Tax Map No. 1000 Section 14 I .Block 1 .Lot 34 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... S..e p.t. ,...I .3 .... ] .9.8.3. , pursuant to which Building Permit No ..... ! 3, .1.6.1. Z. .......... dated ...M.a.y...2.6.: . .1.9.8.4. ........... 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 ......... Enlarge and enclose porch The certificate is issued to KARL AND MARJOR.IE BAUNACH of the aforesaid building. Suffolk County Department of Health Approval .. N/A UNDERWRITERS CERTIFICATE NO. P e n d i n g PLUMBERS CERTIFICATION DATED: N/A .... 'l uii ii 'I~l};c't;; ............. Rev. 1/81 FOBM NO. S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWH HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERN~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COJ~APLETION OF THE WORK AUTHORIZED) Date ........ ,~.. ..................... , 19... Permission is hereby granted tq: ..~.~.~..~ ....... ~ .................. ...... ~.... ........... at premises located at ............................................................................................................................ County Tox Mnp No. i000 Section ........ [,.~.,.J ....... Block ........... [ .........Lot No ...... .~..~. .......... pursuant ,o application dated ......... .....~..~..~..~ ................... , 19..~...~.., and approved by the Building Inspector. Fee $..'..~. ·..~..~.. :~... Building Inspector Rev. 6/30/80 FORM NO. 0 TOWN OF SOUTHOLD Bu;lding Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERT]FICATE OF OCCt Instructions A. ~his application m.ust be filled in typewriter OR ink, and submitted ~a Imm==~mm to the Building In,pec- k[or with the fo~lowmg; for new buildings of new usa: 1. Final survev of property with accurate Iocatio. n of all buildings, property lines, streets, and unu~al natural or topographic,features. 2. Final approval of Health Dept. ef water supply and sewerage disposal-(S-9 form or equall. 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 Coda compliance from the Architect or Engineer responsible for the building, 5. Submit Planning Board approval of completed site plan requiremedts 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~opert¥ showing all property lines, streets, buildings end 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 [nspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificata of occupancy New D~ellln,,;.$25.00, 'Acce.~aoty ~$10.00 lluazne,; $50.00 2. Certificate of occupancy on pre-existing dwelling $ SO. O0 3. Copy of certificate of occupancy $ .5.'00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Uodatod C.O. $ 50.00 Date .......................... 6. Alteration $25.00 New C on s t ~' u ¢ t i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property., .c~¢~.~ ......................... ', ,'. ........................ HOUSe No. Street Hamle~ ;¥1 Lot County Tax Map No. f000 Section ............... Block .......................... · ' · Flied Map No Lot No Subdivision ...................................... , Permit No ........... Date of Perml~ .......... Applicant .................................. Health Dept Approval Labor Dopt Approval . Underwri[urs Approval Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ~"~ "~ ConsZruction on above described building and permit meets all applicable codes and regulations· Applicant..~,.~ ........................................ ,,,. ,o.,o /, c THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000663 BUREAU OF ELECTRICITY o.~. ~u~,,o. ~o. o,./,~ 470436187 N ' ~' ' ~ THIS CERTIFIES THAT o~ly the el~trical ~uipment ~ ~scribed below and int~uced by the applicant ~med on the a~ve application n~mber in the prorates of i~ thefo~o~ing location; ~ Basement ~ Jst FI. ~ 2nd a. ,~ectlon Bilk Lot wasexaminedon O~O~Y ~$~ ~$7 andfoundtobeincontpli~nceu, iththe~equiremenrs~fthisBoard. FIXTURE OUTLETS DRYERS FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS UNIT HEATERS MULTI-OUTLET SYSTEMS NO, OF FEET E R V I C PER ,e'COND AWG, OF CC, COND NO OF HI-LEG AWG OF HI-LEG NO OF NEUTRALS Clenn Bradley 602 P.O. Box Laurel~ N.Yo 1.1948 Lic, ~227 GENERAL ~NAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COP, Y FORiBUILD!NG DEPARTMENT. THIS COP' ER. ~OU:II)^TJON (l~t,) FO~JIID ~ T forl ( Pnd ) },ou''u F}I^I.IE & C.ODE AI)D 1T TOtal ~.L C 0 H H F, N .T. ~S.',._ .......... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1803 Examined....~..~.~. ~.., 19~,~ Approved . . .~..~ .~..~.., 19~]. Pemit No.1. ~J.~ J. ~. Disapproved a/c ..................................... Received .......... ,19... (Building Inspector) APPLICATION FOR BUILDII~ INSTRUCTIONS a. Tins application must be completely filled in by Wpewriter 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 tkls 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 shah 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 ~f the Town of Southold, Suffolk County, New York, and othcr applicable Laws, Ordinances or Regulations, for the cohstruction of buildings, additions or alterations, or for removal or demolition, as herein described. Thc applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulation_s, and to admit authorized inspectors on premises and in buildin~ for necessa~ inspections. ....... :__. -' -- ~ -'~- -. Jq4.~ .% .... -' d .............. ~'e~', ~~ '' ;i~gnatu:eVo:~aa~:IYcca~kj o; nj' ,' o p ' n') .... .a. . . .(.,k. e.. . ..... .In . .,q'.7, (Mailing address of applicant) l/?g'~' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... ...... .5. ................................................................. Name of owner of premises .. Kc~.d.../~....~. ~.~M .~. ff.. ............................................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duiy authorized officer. (Name and title of corporate officer) Builder's License No... ?.q-.Z..~. ............... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... l. Location of land on which proposed work will be done ............. ,~. ....... t.. ,. ........................ House Number Street Hamlet County Tax Map No. 1000 Section ........ ~..~f. ..... Block ......... /. ........ Lot .?P... ~.~. .......... Subdivision ................................... Filed Map No. .3: ,~., .~. .... Lot ,.., .-GT.. 7.. ? ..... (Name) 2. State existing use and occupancy of premises and intended nse and occupancy of proposed construction: a. Existing use and occupancy.. ,/....~.:~ZTm.':. I .L~. ~ .kO &. ~!.} ..~. ~. :i ...................... : ...... b. Intended use and occupancy 10. 11~ 12. 14. property lines. Give street and block inumber or description according interior or corner lot. Nature of work (cheek which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~ ~ ~' (Description) Estimated Cost · .J. ~%.~.i ..................... Fee .... ~ .,. · ' - . ................... : (to be paid on filing this application) If dwelling, number of dwelling Units. . ............... Number of dwelling units on each floor .. ............. . If garage number of cars If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structures, if any: Front ............ Rear ......... Depth ............. Height Number of Stories Dimensions of same structure w!th alterations or additions: Front ................. Rear .................. Depth .................... I.. Height ...................... Number of Stories ...................... Dimensions of entire new const~uction: Front ......... , ..... Rear ............... Depth ............... Height Number of Stories Size of lot: Front .............. Rear Depth Date of Purchase ' Name of Former Owner Zone Or use district in whichpr~m~ses' ' are situated ..................................................... Do~s proposed construction violate any zoning 'law, ordinance or regulation: .... t ............................ Will lot be regraded ......... ~ ................... Will excess fill be removed from premises: Yes No Name of Owner of premises ~ Address Phone No Name of Architect .......... ! ................. Address ................... Phone No. . Name of Contractor.. i . Address Phone No. i PLOT DIAGRAM Locate clearly and distinctly alll buildings whether existing or proposed, and, indicate all set-back dimensions from to deed, and show street names and indicate whether ' STATE OF NEgJ.~RK, S S COUNTY 0~~.,. : ' . ...... //' '" '/(~I~I si~n,i;l~' above named. being duly sworn, deposes and says thane is the applicant s the ................. ~!~--~'. -- .-~A. .................................................. (Contr'~ac or, agent, corporate officer, etc.) of said owner or owners, and is du{y 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 will be performed in the mannir set forth in the application filed therewith. Sworn to b~fore me this - '- ........ .... ~ ~t~. ~t~ ~ ~r~' ~J ' (Signature of applicant) / i-.