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Home My WebLink About13206-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Zt3508 Date JUNE 10 198.5. THIS CERTIFIES that the building ADDITION Location of Property 1405 NARROW RIVER ROAD ORIENT House IVo. Street Hamlet County Tax Map No. 1000 Section .. 0..2 7 ....... Block . .3. ............ Lot ... 6. .3 ............ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. Ha c ¢ ia. ,g .......... 19 .Rq pursuant to which Building Permit No....~ .3.2.0. ~..Z ............ dated ........ .d.u.r~e.. J .1 ............19.8.q, 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 ......... .... q~ui~ge.. ~¢.d.% t)~.oyL .~9..o.X ~..s.g.Ln.g. pp.e.. ~.a.m. 5. ~ y..d.~.o..1 ?_.~.qg: ................... The certificate is issued to ....... B. E. ~ .~.T.. L..~ .L.L.I. ....................................... (owner, I~[ ~lxt~r~[~ X of the aforesaid building. Suffolk County Department of Health Approval iq/A f~N6¢2183 UNDeRWRITeRS CERTIFICATE NO ................................................. Z.B.A. #3228 Rev. 1/81 Building Inspector FOU.'M' NO, B TOWN OF SOUTIiOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON TIlE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 13206 Z Dote ...~.~......//. ....................... , I9.~..I. Permission is hereby granted to: /~ ...t..~....~'.:....~.~.~.....~,~ ............ ..... ,o et premtses Iocoted at ...~~.~.....~.~...~. .......... ..~?.~ .................. County Tax Mop No. 1000 Section ~) ?~..].-~... Block ~ Lot No. ..~.....~. pursuant to application doted ...... ~1~:,.........~....~.,: ............. , 19.~..U~.., and approved by the 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 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 comp{iance 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: I. Accurate survey of p~operty 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 $15.0 0 3. Copy of certificate of occupancy $1.00 4,Vacant Land C,O. $5,00 Date .... ~ ............. New Building ..... .~/.. ..... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ........ ~.~ ......... ~ ........................... House No. ~ ~ Street HamNt Owner or Owners of Property .... ~...~ ...................................... County Tax Map No. 1000 Section ............... Block .............. Lo ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.../.~..,~.d.~..~? Date of Permit .~/.f'/.~ Applicant., .~.h-.~..~.. ...................... Health Dept. Approval .......... ~. ............ Labor Dept. Approval ...... ~. ................. Underwriters Approval ....................... Planning Board Approval ...................... Request for Temporary Certificate . .Final Certificate Fee Submitted $ ..... .~.--. o. o ~ Construction on above described building and permit meets all applicable codes and regulations. Applicant ..... /)~... ..... .~.-~ .~/..~:~-r-r.. ...................... THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000773 BUREAU OF ELECTRICITY Jo.. STREET, .EW YORK, THIS CERTIFIES THAT in the ~ollowing location; ~ Basement ~ 1st FI. ~ 2~td FI. ~ Section Block Lot was examined on ~y ~ ~ ~ ~ at,d found to be in compliance ~ith the rvqulrernents of this Board. FIXTURE SWITCHES OUTtETS ~ 4 3 FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS NCANDESCENT FLUORESCENT VAPOR 2 TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C NO. OF CC COND, A W, G. NO OF HI LEG A W.O. NO OF NEUTRALS A, W, G. ITHER APPARATUS: Ar'~ur ~ln l~ad C~:l.en~, N.Y. 11957 11 'his certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be ,identified by . · CO~Y ~OR I]~II. DING DEPARTMENT. THIS, COP~ 0F~CE~!R~ ~u~T.N~B~ ~A~?~ERED I~ ANY MANNER. F~ELD~INSPECTION FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING 3. INSULATION PER N, STATE ENERGY qODE COMMENTS FINAL ADDITIONAL COMMENTS: ,: THURS., APRIL 19, .bsent, ~f any: and Location: ~/~ Charles Grigonis Resolution made by: Seconded by: ( 1984 Appeal No. Applicants: Serge Robert Gerard Joseph Doyen Douglass Goehringer Sawicki ACT ION: ) Approve as applied ) Deny as applied ) Deny without prejudice ) Deny Subject to County Planning Referral Subiect to Planning Board approval Subject to D.E.C, ) l'/ithdrawn ¥,:ithout Prejudice as requested ~)~-Approve with the fo. llowing Conditions: [21 [3] [41 ( ) Special Exception criteria applicable ( X ) Prior application conditions applicable, if any NOTES: VOTE OF THE BOARD: Ayes: Nays: ( ) CG Abstain: ( ) CC Absent; ( ) CG Resolution was passed: (~/)) unanimously Resolution was not passed: ( ). This application was recessed until ( ) SD ( ) RD ( ) GG ( ) JS ( ) SD ( ) RD ( ) GG ( ) JS ( ) SD ( ) RD ( ) GG ( ) JS ( ) by majority vote FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ ~o ?~-~. ~...Z,q~,¢.~. .......... PLEASE TAKE NOTICE that your application dated ..... ~ff~. County Tax Map No. lO00Section ~.~.~ ..... Block ~.~ Lot Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the follow~g grounds. ~~-~. /~o,+~.., .... ~,~. . .X~. . . ~ .... ~. . .-~. . . ~ . . .~.,-, .... ~ ~.~. .~/-~ :,..~, ,~ ..... ~ .... ~ , ~ /~, ~ ~ ............. , .............. -~' ~ ~'~ ............ ~:~i:~'~:t~> ............ R¥ 1180 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.: 76~-1803 Examined . ., 19~?.. ', Approved ...... , Disapproved a/c .......................... ' ........... .~~..7_..~.~..,.. ~,~,,~ - APPLICATION FOR BUILDING PERMIT Application No .................. INSTRUCTIONS 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 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 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 whole or in part for any purpose whatever until a Certificate of Occupahcy 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 Laws, 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 al! applicable ~ws, ordinances, building eode;~hcusing code, and regulations, mhd to admit authorized inspectors on premises and in buildings for necessary inspections. - (Signature of applicant, or name, if a corporation) .../'.o....~.. 2/..~. ¢ ~. ~..~ 4. ~...s..~...~//rr..e. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 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....~c~......~..~...~/..~--7.. ..... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. f .?. . . . . :KM .............................. .............. House Number Street Han~let C~[mty Tax Map No. lo00 Section ...q..~..~. ......... Block ,., .O..,~. .......... Lot...~. ~. ,~ .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed constraction: // a. Existing use and occupancy .. ~.. ~ .............................................. b. Intended use and occupancy ..... /~. ..................................................... 3. Nature of work (check which apphcable): New Building .......... Addition .. . Alteration .......... Repair ........... ~... Removal .............. Demolition ............. Other Work ............... ~ I , ~ - (Description) 4. Estimated Cost .................... Fee .................................... (to be paid on filing this application) 5 If dwelling .... Number of dwelling units on each floor · , number qf dwelling units .............................. If garage, number of ~ars ' ..... ]" .......................................... ea'c~ typ'e o~use ii i ............... 6. If business commercial or mixed, occupancy, specify nature and extent of ................ 7. Dimensions of existiqg structures, if any: Front ............... Rear .............. Depth ............... Height .......... ~ .... Number. of Stories '. ....................................................... D~rnenslons of same structure with alterations or additions. Front ................. Rear ............ ~ ..... Depth ....... l . ' 'i' ' Height ...................... Number of Stones ...................... 8. Dimensions of entire Inew construction: Front ............... Rear ............... Depth Height ............... Number of Stories ....................................................... 9. Size of lot: Front ........... ........... Rear ...................... Depth ...................... 10. Date of Purchase .......... ; .................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regnlatlon: ................................ 13. Will lot be regraded ....... q i ................... Will excess fill be removed from premises: Yes No ' 14. Name of Owner of premlses ..~ ................. Address h ................... P 0 e ..:/: ... ^..... ..., Name of Architect ......... ~ ......... .r'; ..... Address [ii .... 1- ...... P e o. . Name of Contractor . .~.~{ (~.~.k.l~... &D~[ .ff.d.¢ ..... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly ail 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. STATE OF NEW YORK, ' S.S COUNTY OF ................. (Name of individual sig~ing contract) above named. : being duly sworn, deposes and says thai he is the applicant He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d~ly authorized to perform or have performed the said work and tt ~ake 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 manner set forth in the application fil~d therewith. Sworn to before me this ................ (/~../~. · . . .day~ .......... 19.~.7 Nota. Public,. Count NOTARY ?UBUC, State ul New , No. 4707878, Suffolk Cotmt.v (Signature of applicant) Term Expires Marc~ 30, 1t15 i NOTIFY BUILDING DEPARTMENT· AT 7.65-1802 9 AM TO 4 PM FOR 'TH · FOLLOWING INSPECTIONS: 1. FOUNDATION --TWO REQUIRED'< FOR POURED CONCRETE 2.' ROUGH - FRAMING'& PLUMBI'NG 3." I.NSULAT!ON · 4 'FINAL CONSTRU .... ION MOST BE C~MP! ~'.TE FOR C. O. · ALL CONSTRUCTION SHALL ,.MEET~ THE REOI.!IR~MFNTS OF THE N.y. STATE CONSTRUCTION & CODES. NOT RESPONSIBLE FOR DESIGN OR'CONsTRUCTION . . . · . . · , · - · ;.. · i i ~i~ ~ i ...... ' i ii~ I :~ '11 ~11111 Iii Iii ~ ~1 I ' ~' ' ' ' I I I II IIIII1'11 Illlll II IIIII · I I i I J I~ ~ ~11 II! I -- II Jll IIIIIIII II