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Home My WebLink About15696-zFORM NO 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N Y. Certificate Of Occupancy No ... ~.1.~774.. Date May 21, 1987 I 5045 Main Ba view Rd. Southold Location of Property.. ..................... ~r ...... ,House No Street ................... County Tax Map No ' 1000 Sechon . . .7.6 .... Block , 0 2 .Lot Subdivision , X Filed Map No. .X... Lot No .. X conforms substannal~y to the Apphcatlon for Building Permit heretofore filed m this office dated ..... .Pebrlo~]Ty. ~.,.. ~.~87 pursuant to wbach Bmld~ng Permit No. 15696Z dated ...... Eebr~.aa:y. 2,3,. 19 [~ 7. was issued, and conforms to all of the reqmrements of the apphcable provisions of the law The occupancy for wluch tlus certfficate ~s issued ts ....... Addition to. an existing one-family dwelling. The certificate ~s ~ssued to ...... .I~R,..&. M. RS., R~..LPH..S.OTO. ............. [owner, ;~[711~/-.f~F~ of the aforesaid bmtding N/A Suffolk County Department of Health Approval ................................. N801297 UNDERWRITERS CERTIFICATE NO .................................. PLUMBERS CERTIFICATION DATED: Budding Inspector Rev 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETIION OF THE WORK AUTHORIZED) N~ 15696 Z County Tax Map No. '1000 Section .... ..0.,"~.,~. .... Block ..... ..(~.....~:,. ....... Lot No. Budding Insp~tor. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Buildmng Permit No. \~ ~ Owner ~Z ~$' ~ ~TO (please p. rint) . , ~ ~ Plumber ~ R ~ 0Z ~z~c (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me th~s .c~..;F~ day of t/~.~ t~ 19~:v~ . Notary Pub~ ~c~/~ (plumber's signature) ~~N~Otary Publmc ~ County Ei. Cr.,~ETH ~ NEVILLE FORM NO. 6 TOWN OF SOUTHOLD Building Deper[men~. Town Hall Soutnold, N.Y. 11-271 APPLICATION FOB CERTIFICATE OF OCCUPANCY c 0 dP A. Th~s apphcat~c n must be filled m typewriter OR ink, and submitted m duplicate to the Building tar ,.vlth ~he fcliowmg, for new buildings or new usa. 1, Final sur','e/ of prcperty w~th accurate location of a~ buildings, property lines, streets, and unu natural or t¢oc~raoh~c fea~ras 2 Fm~ aogro~al or He,;th Dept of water suool,/and sewerage d~soosaf--(S-9 form or equal). 3. Approval or, electrical ms,ailau, on*' from Board of F~re Unce~znt~rs 4. Commerc~at humMinGs, [ndust, tal but[drags, N1u[ttple Restdences and s[mdar buddings and lnst~ t~ons, a cert(ff~ca~e*' of Code comphance from th~ Architect or Engineer respons~ule for the budd 5. Submit Planmng Board approval or completed s~te plsn requirements where applmable. B For exacting ~uHdmgs (prior to April 1957), Non-conforming uses, or buildings and "pre-ex[stn [and uses 1. Accurate ~p~ey of peoperw showing ali prooerty hnes, ~reets, buddings and unusual natural topoGraph ~c ~featu res. 2. Sworn statement of owner or previous owner as to use, occuoanc,/and condition of buildings. 3 Date of any~hous.ng code or ssfety [ns2ection of buildings or premises, or other pertinent C. Fees' 1. CB~ff~cate ct occuoancV ~ ~ 00 2 C~¢t~f~cs[e of occupancy on pre-ex~s~ ng dwell ng or ]and use 85 00 Health Dept Approval ~ Labor~epr Approval Un~ee,vnters Approval ~ Planmng Board '" Bequest for Tem~er~r~ Certmc~to .................... Fm~ Certify,cate .... ~ ........ Construction on above descrmbed bumldmm] a~c ~ets all apohcabl~odos and ~ ~ ~ regulatmons THE NEW YORK BOARD OF FIRE UNDERWRITERS "J(~l")]2], BUREAU OF ELECTRICITY ~, BB JOHN STREET. NEW YORK, NEW YORK 10038 ~,.t~ ^~":~] ~-, ~ ~.,,~.,,o.~...~,~ ~/~ N 801297 THIS CE~IFIES THAT ~ph ~, ~ lb~ ~rey ~k L~e, ~ld, N.Y. RXTURE ~ FIXTURES OUTLETS SWITCHES FLU~E~CENT RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS TIMECLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS OTHE~ AI~ARATUS Paul ~I~n~ms Z75 To#n llarbor Irene 8ou~hol~ N.Y. 11971 Lic. 282E Per This certificate must not be a~fered In (zny manner, return to the o)Cf~ce of the Board ~f incorrect Inspectors may be ~denhfmd by thmr credenhals COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER OUNDATION (1st) OUNDATION (2nd) OUGH FRAME & FLUMBING NSULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: 765-1,802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING FINAL Disapproved a/c ... 'FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N Y. 11971 TEL . 765-1802 (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19.. Date..~/~./..O. .... 19~. INSTRUCTIONS Tlus apphcatmn must be c mpletely filled in by typewriter or in ink and submitted to the Building Inspector, with ,sets of plans, accurate plot plan tolscale. Fee according to schedule b Plot plan showing locatioh of lot and of buddings on premises, relattonshlp to adjoining premises or pubhc stree or areas, and giving a detmled degcnptlon of layout of property must be drawn on the diagram Much is part of this appl catmn. I c. The work covered by flus apphcatmn may not be commenced before ~ssuance of BuRdmg Permit. d. Upon approval of th~s apphcatlon, the Bmldlng Inspector will issued a Bufldmg Permit to the applicant Such perm shall be kept on the premises avaflfible for mspectlon throughout the work. e. No budding shall be occupied or used m whole or m part for any purpose whatever until a Certificate of Occupant shall have been granted by the Budding Inspector APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Building Permit pursuant to tb Bmldmg Zone Ordinance of the ~'own of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances Regulations, for the construcuonI of braidings, additions or alterations, or for removal or demohtmn, as herem describe, The applicant agrees to comply with all apphcable laws, ordinances, budding code, housing code, and regulatmns, and t admit authorized mspectors on premises and m building for necessary s ect~ons (Signature of applicant, or nat~e, if a corporation) (Mallmg address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bmlde~ Name ofownerofpremises /e~r (.jr~.~$ ~/f ~ ~O'-~2~ ......... ~ (as on the tax roll or latest deed) If apphcant 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 ... l. Location of land on which proposed work will be done House Number Street County Tax Map No 1000 Section ?. ~. ...... Block Hamlet ...... Lot ...c~/ ..... 2 Subd~vlsion ' (Name) .... Filed Map No. .. Lot State existing use and occupancy of premises and intended use and oc,cu, pancy of proposed construction ...... a Exlstlng use and occupancy' ., b Intended use and occupancy 3. Nature ot~w'c~r~(cl{eb~Mi~l~phcable) New Bufldmg . ' . . Addition ...~. -- .. Alteration . . Repair , .. _ .... )R~'~al ............ Demolition ......... Other Work ............. ""~ ~ l{/ ' (Descnpt~on) "~ ~*"'.~e' ?' ~ ~u~r [ " (to be prod on fihng this apphcatmn) 5. If dwelling, n'u~welhng units .. /. ..... Number of dwelling umts on each floor.. J ......... If garage, number of cars . 4 ' ' ~ ................................................. 6. If business, commermal or rmxed occupancy, specify nature and extent of each type of use .. 'V. : ........ 7. D~nensmnsofex~stmgstru~tures, lfany Front ~"-.~ .... Rear . .K-.O.~ ....... Depth .,~. t/. ~ .... Hmght ~.c,>. ( ......... Number of Stones .. ..~-~ ............................... --' - v ........ D~mensmns of same structure wgh alterations or additions' Front .J~-r.~/. ......... Rear . ,5..O. ......... Depth ~. $/ ' I Hexght -~ O. f ........ Number of Stones... z~. ...... ~ .... 8. D~nensmns of entire new cqnstmctmn Front .~Oa' ...... Rear . .0'7-0. ....... Depth .~.. ~. ........ ~¢..O ........ Number of Stones Height 10. Date of Purchase ......... ~ ......... h. ~.Narne, ofEormer Owner .................... 11. Zone or use district in which premises are s~tuate~i 12. Does proposed constrt~,ctlon violate any zoning law, ordmance or regulation /~.~ ..................... :,2. · 13. W~ll lot be regraded /K4'~t .~ ....... ,, ,., .~ .,. . Will ex_cess fill_be removed~r~.m premises Yes Name of A~ch~tect ... ' . .1. - ~ ......... Address ............ r ~_, Phone No. Name of Contractor~e o ~ ~ /er t-T-.~ _~, ¢oo/-t ,.j~.~,,,,, = . .... ................... Aaaress F,~t~l~ o' T d 'IU 7 "Phone No.7.&~-~.7~'~ PLOT DIAGRAM Locate clearly and &stmctly, all bufldmgs, whether ex~st~ng or proposed, and. indicate all set-back dimensions frm property lmes Gave street and blhck number or descnptlon accordmg to deed, and show street names and mdmate wheth. mtenor or comer lot / o o. o ~ STA~ OF NEW YORK, S S cou~7~ oF..~. ~ ..... . ~. FJ...g ~. q .................... being duly sworn, deposes ~d says that he ~s the apphcan (Name of ~ndw~al s~gnmg contract) above named He ~s the ........ (Contractor, agent, corporate office~, etc ) of smd owner or owne~, ~d ~s duly authored to perfo~ or have perfo~ed the smd work ~d to m~e ~d file ~ apphcatmn; that ~I statements contamed m th~s apphcatmn are tree to the best ofh~s lmowledge and behef; ~d that th work will be perfomed ~n the m~ner set forth m the apphcat~on filed therewith Sworn to before me th~s ............... day of ......... ,19.. roi' Water d~ L~iJ~tJting systsm; pipif~g Ihall be of types K or~ ontJ~ SOLDER U$~u ' ':vATER SUPPLY SYSTEM CA~/NOT EXCEED 2110 of I% LEAD. PLUMBER CERTIFICA ~ ; 9 ' ON LEAD CONTENT BEFOt~E CERTIFICATE OF OCCUPANCY A.mmI~OVEB AS NOTT~3 NO'F1FY BUILDING DEP*"TM~ AT ~CLOWIN6 ~, NOT ~ ~