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Home My WebLink About12829-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z12631 Date Jul.y 23 198..4 THIS CERTIFIES that the building ...... replaced existing porch w/wood enclosure 725 Grange Rd Southold Location of Property ................................... : ........................... House No. Street Ham/er County Tax Map No. 1000 Section ...0.7.5. ...... Block ....... 0.4. ...... Lot ..... .0.1.8. ........ Subdivision ~outh Harbor Homes .Filed Map No. 4096 .Lot NO. 14 conforms substantially to the Application for Building Permit heretofore filed in this office dated January 3 198.4. pursuant to which Building Permit No. 12829Z dated ..........................-.January 5 19.8.4.,wasissued, andconformstoalloftherequirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Replaced existing porch enclosure with new wood enclosure unhe.ated area. The certificate is issued to ............. W.~.LLACE C. & LILLIAN D. MOLE ..... ...................... of the aforesaid building. N/^ Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO ............. ~.6.379 P.6 ............................. Building Inspector Rev. 1/81 FO~ NO. ~ 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) 12529 Z Permission is hereby gronted to: ....... ~:.~.:.,.,,/..~.~: ........ ::.:Z.:..: ................. ....... .~..>.<:.(/..':.~::..~.~2.=./.:,.~...~./.: ........ :./..~.:/. ,.,t ,,rem,se, ,,~o,ed ot ..... ......... ~..:.:?.,=....'~. .:..~.:,.'.:. ....... ..... ~..).:.:~..z,/.:./.. .:.~.. '.:...:...: ......................................................................... Co,,n~, To× ~o~ No. IO~O Se~,o, ..... :...:',7..:;.~--... B~ ....:....~ ........ ~ot No..m./.. :~...' ......... ~.~.o.t ,o o~,,~o,,o, doted ..~'.~.a...; ......... Building Inspector. Fee $.. :~'L~. ........... Bull~ing Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,~outhold, 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 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/ land 3. Copy of certificate of occupancy $1.00 Removed ol& metal enclosure Rebuild e, ll out of wood. use --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 New Building .............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...?,2,5 ................. Q~e,~,G~ .~9~4 ................... ,~gt~t~93,~, ..... House No. Street Hamlet Owner or Owners of Property ...~[alle,~e .C,..A~t~ .~ill~.~ .~,..Mo~.e ......................... County Tax Map No. 1000 Section .... Q~.5 ........ Block .... 04 ......... Lot., .0[~ .......... Subdivision...,~ out, h .~a~b o~. ~ome~ ............ F lied Map No.. ~,0~ ..... Lot No .... 1.~ ........ Permit No, .12,~2,~..~. Date of Permit .~[~.~3.5/,~,~} .Applicant .... ¢~g~'g~.~, .$e.~' ............... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval .................. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ..... : ....................... Construction on above described building and p~mit meets all appli~le~des and regulations. - }.000121 THE NEW YORK BOARD OF FIRE UNDERWRITERS was examined on M~L~Ch 11 ~ ].D[:~zT~ and ~ound to be ~n complla.ce with the requirements of th~s Board. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 1 5 1 1 DRYERS FURNACE MOTORS APPLIANCE FEEDERS TIMECLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT ~THER APPARATUS: S E R V I C E NO OF CC COND. A W G. NO. OF HLLEG A W O. JNO OF NEUTRALS A~W. G. PER ,~' OF CC, COND. OF HI.LEG OF NEUTRAL [ To~ }~rbor Lane 8outhold~ N.Y, 11971 LAC. 232 GENERAL MANAGER COPY FOR BUILDIng DEPARTMENT. THIS COPy OF CERTIFICATE MUST~-NO,T BE ALTER ' MANNER. . :..~~; . I " 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [] ROUGH PLBG. [ ] FOUNDATION 2ND j1fINSULATION t>\ FRAMING [ ] FINAL REMARKS: DATE :;'/17/ cp tj ~;;a INSPECTOR AG^ '/Q-\ \ I' FIELQ INS~ECTION DATE COMMENTS - . "- ;;; (\) 1. ~~ ---~-~-- '"""'-0 FOUNDATION ( 1 st) "~J -. - - - - -- -- , c (1], FOUNDATION (2nd) t'l~ (I, 2 . ~/ /7/'0 t/ _ /_~ / /ft.A", z: 0"-.1 ( / ( / ,/' .. {\.J ROUGH FRAME & \,'\ PLUMBING '\ '\Ii f (I]~ 3. ;;;-<l\ 2/ /7/~' t..j /..Z , ... ~ - t'l'" A t'l INSULATION PER N. Y. I '/ ( , ~ '""~ - \ STATE ENERGY c,ODE ~~!\ /7^ I J , / " , - , t'l 4. (lair!, ~ ,#J.... ((0. OW 1--3.,. ( )1'-. I I /) I , FINAL /iU /jJ) ~7, ./ '''-'o~ /' /' '''; . z: ADDITIONAL COMMENTS: t'l :xl " ':} 0" " .- ~ . - . t'l::---.l ~ ~~. '"" . ~ ~J z: r " ~ 1 :r: t'l i " r-< '"" :r: . ' t:1 ,t'l ." '"" .. ~ t FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 ., TEL,: 765-180~ Examined ~. ~'...~ ...... , 19~,f.- ,-;~ · · · :..:: ...... , (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ~..~ ............. 19~. INSTRUCTIONS a. This- application must be ~orhple'tely 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 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. w~hatever until a Certificate of Occupancy e. No building shall be occupied or used in whole or in part for any purpose r ,r~ . 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 all applicable laws, ordinances, buil~ng code, housi~g code, and regulations, and to admit authorized inspectors on premises and in building for necessary insl~, tions. // .~ ' ~~~:me, if a corporation) .... /- (Mailing address of applicant) //;9 Y ) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Builder ................. Name of owner of premises ...W~.}~.~.e.e..O .... ..~..d.. Lill t~.n..D.....Flp.l.e..' ................................... (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... ~3.8. ................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of Iand on which proposed work will be done .................................................. ..... 7..2.5. ........................ O.r.a.n.~ e. ?.o.a.&. ..................... S.o.u.~.~o.l.d: ..................... House Number Street Hamlet County Tax Map No. 1000 Section . . .0.7.~. ............ Block .0. q ............... Lot 018 Subdivision.. Squ.~.h..~.~.r~.o.r .~.o.~e~. ................. Filed Map No. . .~0.9.~. ........ Lot 14 (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... P. rJ.v~te .Home ....... (.8ea~on~.encl, q~e4 .~reh) ................... b. Intended use and occupancy .Same ............................. .,~ .............. 3. Nature of work (check which applicabl~): New Building .......... Addition . .XXX:~x~:.. Alteration Repair .............. Removal .............. Demolition .............. Other Work ............... . ~jo).,~. o~ (Description) 4. Estimated Cost..~..QQQ,.QQ ! Fee .... (to be paid on filing this application) 5. If dwelling, number of dweilin units..~ ............. Number of dwelling units on each floor ................ If garage, number of cars ........... . ............................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if an~: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure With alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new 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 p~emises ate situated . 12. Doesproposedconstruct~onvlolateany~zoninglaw, ordinance or regulation: ... 13. Will lot be regraded ........ ~ .................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .~l, laq~..Mql, q ...... Address .?..I~5 .Qr.a,~l~q .l~cl, ...... Phone No..7./15-~2tl, qT. ...... Name of Architect ......... i .................. Address ................... Phone No ................ Nam~ of Contractor . .0. e. qr..~qi .~.....l~.u.e.r. ......... Address 8outhold, ~ · 'Bd:~ ' '~(J8~ '_~' ~HdlP/~,°ne No...?..&5-,27.22 ..... PLOT DIAGRAM Locate clearly and disthuctly all buildin'gs, 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. Removal of existing Metal enclosure, and rebuilding all out of Wood, over existing cem~t slab. ..... .O.e.o,rge. ~... ~.a.fi.o.1;. .... .~..: ...... [ ........... being (Name of individual sigging contract) " above named. ! | duly sworn, deposes and says that he is the applicant He is the . 0o. At. rAc. tor, , of said owner or owners, and is duiy autho~ application; that all statements cont!ained in work will be performed ' ~n the manner set for Sworn to b~fore me this , lerm Expires Ma!ch 30, 19~ Contractor, agent, corporate officer, etc.) ized to perform or have performed the said work and to make and file this !his application are true to the best of his knowledge and belief; and that the h in the application filed therewith.