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Home My WebLink About13197-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPAP, TMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z..1.3.0.6..1 ......... Date ................................ December 13 .... 19 84 THIS CERTIFIES that the building .... .R.e..n.o.v.a.t..i.o.n. ............................... Location of Property ...3. 5. .5..S.c.c..o.n.d..by.e.....&..2.3.9. .5..3.a.c..k .s.o.n...Ay.e... ..... N.c..w..........Su f fo Ik House IVo. Street Hamlet County Tax Map No. 1000 Section ...1.1.7 ...... Block 09 . .Lot .. 025 Subdivision ........... X. ................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .M.a~ 30 19 .8.4. pursuant to which Building Permit No. 13197 g dated ............... 3..u.n.e....8 .....19..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 ......... Reconstruct Burnt Damaged Dwelling The certificate is issued to ............... T..HQ..M~.S...&. AN. NE LOWRY (owner, ~s~e'.e'r-'t~ ................... of the aforesaid building. Suffolk County Department of Health Approval ......... .Iq//{ ............................. UNDERWRITERS CERTIFICATE NO ..... I't668783 & Iq668799 Rev. 1/81 Building Inspector ~OBM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TO~VN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13197 Z Permission is hereby granted to: . ..~...o..~..~....~...~..~. ........ ..~..~L,...~.:.~..~. ...................................... , ~o ..,.~.:..~....~....~.~.~......~........~ .......... · ~. ... :. .............................................................................. ~. .......... County Tax Map No. 1000 Section ....~...i.!..~..~. ......... Block ........ ~ ........... Lot No ......~...~. ........... pursuant to application dated ....... .~.....~..~... ....................... , 19.~...~..., and approved by the Building Inspector. Fee $ ..L,9~ .................. 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 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 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 peoperty 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 or land use 3. Copy of certificate of occupancy $1.00 New Building ............. Old or Pre-existing Building ..... X ...... Vacant Land ............. Location of Property ...~.~ ~c..o.n.d...A??..~ .~?.~ .~.'~.c.~.o. ~..,~!~e. .... ~?.z..~.~...~.o.?.1~.,....~.¥... House No. Street Ham/et Owner or Owners of Property .T, b0m~.,~ .&../~.~e. Low~F .................................... C0u nty Tax Map No. 1000 Section ...l.LT. ......... Block .... ~ .......... Lot...2.~ ............ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No..13~.9,7.... Date of Permit 6/8/~J$..ApphcantE~v~onme~.~, · '~as.~ · Ino · ,%s' .agent Health Dept. Approval ........................ Labor Dept, Approval ........................ U nde~riters Approval .~. ~.~.~ ~ ~ ........... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... .~. ................. Fee Submitted $ ...... ~,D0 ............ ,/~'~i .~ /'~,//'~ '~ Construction on above described building/~~od~s and regulations. zooo]~c~3 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 D.,~ ~ove.~r~,~ ~ ~,,~.,,~.~o. on~,,~ ~0~/~ N 668799 was examined on ~ ~ ~'~ ~ ~'~ and found to be in compliance wi~h the requirements of this Board. FIXTURE OUTLETS 18 DRYERS RECEPTACLES SWITCHES 35 19 FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OTHER APPARATUS: Motors; I~G.F.C.I. 1--Smoke Detector. S E R .o, %.%~o.o j A, WG OF CC COND. C NO, OF HI-LEG E A. W. G. ~NO OF NEUTRALsT A, W' OF HI4EG / This cerfiiicote must not be offered in o.y monner;, return ,o the office of the Boord if incorrect, inspectors moy be identified by the~'J~enti'~'~:.[ COPY FOR BUILDING DEPARTMENT, THIS COPY OF CERTIFICATE ~UST NOT BE ~LTERED IN ANY MANNER THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY [.~a~,O~5 85 JOHN STREET, NEW YORK, NEW YORK 10038 'eh~L'te ~ovember 2.6, ~.gaa .,plic,.i,,.~o.o,,.siie 25a962/a~ N 668783 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant na~ed on the above application number in the premises of T. Lo~ry.~ 2nd S~ree~ & Jackson Avenue~ Now SU££oik, ~,¥~ in the followlng location; [~ Basement [~ 1st rt. ~ 2nd Fl. Se,.tion Block Lot t~as examined on and Jound to be in compliance with the ~equlrements of tkis Board. FIXTURES RANGES OVENS EXHAUST FANS FIX'lURE OUTLETS SWITCHES NCANOESC~NT FLUORESCENT DRYERS FURNACE MOTORS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT S E R V I C E 1 3 I 5 BlCoun:y Electric Corp~ 1004 Jeruaalem Avenue N', Merrick, N.Y, 105~6 Per~ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspecto, fs mc~y be identified by their credentials. COPY FOR B? LD NG DEPARTMENT THIS COPY OF CERTIFICATE MU~T NOT ~BE LTERED IN ANY MANNER. ~E~' INSPECTION COMMENTS FOUNDATION (~st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING 3. INSULATION PER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: r Ernest Prezio$o ~ 0 O IOI. 'JACKSON STREET '~OTE: · · MONUMENT FOUND SCALE= 1"-20' NOV. II , 1966~' D~C 3, 1966 SURVEY FOR THOMAS C.F. LOWRY 8~' ANNE LOWRY 4'NEW SUFFOLK TOWN OF SOUTHOLD SUFF. CO., N.Y. eUARANTEEO TO: THOMAS C.F. Ill ANNE LOWRY HOME TITLE DIVISION OF CHICAeO TITLE iNSURANCE CO. FO~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved .. 19..~..J... Permit No ..... 1..~.!.~...'~.....-'~?~... ........ Disapproved a/c ............................................................................................ Application No ................................. (Building Inspector) APPLICATION FOR BUILDING PERMIT a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 issue 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 whol~ 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 ihe Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additiods 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 i~ buildings for necessary inspections. (Signature of applicant, or name, if a c~rporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractorr electrician, plumber or builder. . .......................... .......................................................................... .......................................................................... Na~,m.e,,~f oTner of premises .....~.~....~..~.....~.....~_~.:...~.:.,....~....~.~......~......~....~ ............ i.. ~mame ana title at corp~o}e officer)' Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Subdivision Location of land on which proposed work will b~ dane. Map No.: ........................................ Lot No ..... ". - Street and Nu, mber ....~...'~... ........ ..~..~...~../~t.'~....~ ........................... ~ ~.l,~,'.~.'~.~'.~'"I .... ...... ....... Sta~e e~s~ng u~se and occupancy of premises and in~ended use and occupancy of proposed construction: a. Exisiting use and occupancy b. Intended use and occupancy ................ .[.,...~.:.i~...~I.JQ~......~...~... ,~..,. . ....... County Tax Hap No. Dist. 1000 Section 3. Nature of work (check whicl applicable): New Building.. ....... :. Addition .................. Afferation ................. Repair .................. Remove IJ .................. Demolitior. .................... jOther Work ..................................................... ~ ~ ~ i (Description) (tq be paid on filing this application) 5. If dwelling, number of dweliing units ........ .~ ............. ~....Number ofi dwelling units on each floor ..... ...~'~ ................. If garage, number : ~ If business, commercial ori mixed occupancy, specify nature and extent of each type. of use ............................ Dimensions of existing structbres, if any: Front ............................ ROar ................................ Depth .................... Height ........................ Nur~ber of Stories ................................................................................................................. Dimenslons of same structure, with alterations or additlans: FrontIi ..................... R,~ar Depth ................................ .Height ......................... ;..Number of Siories .................... ( ........... ~ ~) Dimensions of entire, new cdnstruction:, Front ...~...~ ......................... [.. Rear ........ ..z./..,~/, ............ Depth .....~%..~.. .......... He,ght .....~. ........Number of Stones ................~ .............. ~ ........................................................................ t... Date of Purchase ........................................................ Name of Former Owner ........................................................ Zone or use district Jn which premises are situated .......... .t .................................................. 12. Does proposed construction violate any zoning law, ordinance or t'egulation: ~ 0 13. Will, lot be regraded .' ...... ~'.]~J ............ Will,,~excess fill be removed jfrom I 15/~J~prem[ses:~r(~..~ ('~) Y. es, ~ PLOT DIAGRAM Locate clearly and distinctly 0Il buildings whether existing or proposed, and indicate all set-back dimensions from property lines. Give street end block number or description ~ccording to deed, and show street names and indicate whether interior or corner lot. STATE OF NEWc'~DRI(, /'~' COUNTY O~ ~~....i~~' ........ ~.~...~.~C~.........~...~.~w...: ................................. being d~y ~wom, . (Name of individual signing: contract) above named. ~ ' .. ..................... He is the ...........~.. ................................................................................................................. , (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dH y authorized to perform or have performed the said work and to make and file this application; that all statemeqts contained in this ~pplication are true to the best of his knowledge and belief; and thor the work will be performed in lthe manner set fo~h in the application filed therewith. Sworn to before me this j ~ ~' of ............... ~A~ ~BCIC, StBtO of New ~ork ~ - ~. 52.8t2~, ~'~u~ I FORM NO. 10 APPLICATION FOR DEVELOPMENT PERMIT In the Town of Southold Type of Development Proposed: Addition and/or Alteration[] New St'ructure (including storage ta~ks~ Flood. Proof Below Base Flood Elevatzon[~ Other (specify) 2. Elevation Data in relation to above mean sea level of: (a) Lowest floor elevation, including basement feet 'inches (b) In a V Zone, bottom 9f lowest structural me~--~ __~ fe~"' inches ~. Location of Property: County Tax Map No., District, 1000, Section O~'~ Block ~ Lot(s) ~/~ Subdivision ~~ Filed Map '#~ Lot~ s) 6. Pe~iss~on to be g~nted: ~wne~ as above'New 0~er ~ -~ ~ [Under Contract1 ~ Lessee~ ~Contractor 7. .Approval from other(s) before Per, it is issued: WETLANDS (Town Board) ~]~ -ZBA DEC HEALTH SERVICE BUILDING PERMIT ® 0~n~--~, New Owne~_~, Under Contractl-~., Lessee/---~, Ag?nt~__~, Con% tract~-~, and agree to comply with all applicable sectzons of the ~ode of the Town of Southold; County, and State and to admit authorized in- spectors to premises authorized to,perform or have performed the said work and to make and ftre this application, that'all statements contain- ed in this application are true to, the best o£ mY knowledge and belief and that the work will be 'performed in the manners~t forth in the application filed there%~ith. STATE OF NEW Y0~RK COUNTY OF Not~ P'mblic I , slgnature ..... HELEN g. DE VOE , NOTARY PUBlIC, Sta~e of New York No. 4707878, Suflolk Comity .--. ~erm Expires March 30, Applicant's mailing address and phone # if not given above: 4/80 P~O. BOX SOUTHOLD, NY 11971 FORM NO. ~.0 TOWN OF SOUTHOLD BUILDING DEPARTMENT (516) 765-i802 TOWN HALL MAIN ROAD ~" ' SOUTHOLD, NY ~' 'APPLICATION FOR DA~;ELOPMENT PERMi~ Instructions: The application to the Building Inspector includes (each Tn dupiicate).l. Foz~a No. 10 fille~ out in in~ or typewritten, 2. Sur- vey of premises with ~levations above mean sea level, 3. Drawings of pro- posed work. The application must give complete information to show'that the proposed can comply to the Local Law No. 1-1980, Chapter 46 of'the Code of the Town of Sbuthold known as "Flood Damage Prevention Law" of the Town ofmSouthold~ The applicant must submit approvals that any.other agency requires. ' General S~andards as ~equ~red in Section 46-17 6f~the law to minimize flood A. Anchoring of Btr~ctures, including tanks and mobile homes B. Use of construction material and methods C. Design and lopation of utilities D. Subdivision pmoposal with drainage, public utilities design and base flood elevations ~peciftc Standards asi'requlred in Section A. Residen'tial cbnstructlon B. Non-residentilal construction C. Mobile homes i The applicant must submit plans and specifications as well as any other information requestedI by the Building Inspector, to substantiate the facts that the structure has or will have the lowest ~$1oor, including basement/ cellar, elevated abovle~the base flood elevation or; if permitted by the Federal Regulation, that: 1. such structure,~ floc? proofed in such manner that below thel base flood level the st~ugture ms water tight with walls substantially and impermeable to the pa~sage of water, 2. that structural component~ are capable to resisting ~ydrostatic and hydrodynamic loads and effects of ibuoyancy, 3. applicant ~ust sub, it certification by a registered professfonal engineer or archite~t, tha~ the standards set forth in Section 46-~8B (1) (2) (3) of the Set, Sold Code are satisfied. ~oastal HiMh H~zzardiarea (V Zone) 46-19. Ap~icant shall submzt plans, spe6ificaOlons ~ncludin~-the mequired certifications and such other in- formation as the Building Inspector may requi~e in that ~he provisions of 46-19 are complied w~th. Mobile homes are'prohibited. The lowest portion of the structural.me~bers of the loMest floor cannot be lower than the base flood elevatmon with all space below open except breskaway walls. Sand dunes. If sandldunes exist on the premise~ and the applicant pro- ~oseS t~ ~lter same,!plans and specification ~ust be shown in detailed nature of any altera$ion submitted. Building Permit. A Suilding Permit is also r~q~i~ed for any mStrUCture. ~$0th a Development and a Building Permit must be issued before any work can start in a special flood hazzard zone. A, written~disapproval or a permit must be issue~ within ten (10) working days. During construction,~ithe inspector ~hall be notified in time so he may make the required inspections. Upon completion, theirequired certificat~on fa ~he final elevations and work must be submitted before the approval to use or occupy can be. approved. 4/80 (Fill ! ~ut the form on the back o£ this sheet)