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Home My WebLink About15996-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Z16386 Date November 10, I987 THIS CERTIFIES that the buridmg . Add.~.t (qn ............................. L°cah°n°fPr°pertYHou~el~8'5'o E.as.t. .Gfil. lette Dr. East Marion Street Hamlet 04 8 ! County '['ax Map No 1000 Section 03.8 ..... Block .Lot Subdivision .... Filed Map No .... Lot No .......... conforms substantially to the Apphcatton for Building Permit heretofore fried in this office dated April 7, 1987 pursuant to which Bmldmg Permxt No 15996. z dated ..... .M.a y..20.,..I. 98.7 .. ~ wasmsued, and conforms to all of the reqmrements of the apphcable prommons of the law. The occupancy for which ttus certificate m issued is .... · . Addi.~zon..~o.~r~ ~gis~i.ng The certificate is issued to .~.I C.HAE.L. of the aforesaid building qn.e .fa.m.i.12z .dwe.1 1.1..n.g .... AND KAREN SAGE Suffolk County Department of Health Approval . N/A ......................... UNDERWRITERS CERTIFICATE NO. N 828515 PLUMBERS CERTIFICATION DATEB: King Plumbing 10/29/87 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 COMPLETION OF THE WORK AUTHORIZED) N~ 15996 Z Date ...... .~.~ ............................ , 19..~..."7 Perrmss~on is hereby granted to: ,--, , at premises located at ....~...~..,,...~.,q~..~.......~.,~.~.~.~........~..~,.~ ......... County Tax Map No 1000 Section~...~..:~.~.. .... Block ...... ..C~...~. ....... Lot No ...... ,.~..:..! ......... ¢>ursuant to applicat,on dated .... ~J~...'~ ........................ , 19..~...7., and approved by the Building Inspector. Fee $....~....:..~. Building Inspector Rev 6/30/80 A B FORM NO. 6 TOWN OF SOUTHOED Building Depar?ment Town Hall ~ 5,~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Th~s apphcatlon must be filled ~n typewriter OR ink, and submitted ~n dupimate to the Budding Ins;~ec~ tot w~th the fotlow~ng; for new buddings or new use. 1 Final survey of property w~th accurate location of all buildings, property hnes, streets, and unusual natural or topographic features 2. F~nal approval of HeaJth Dept. of water supply and sewerage d~sposal-(S-9 form or equal} 3 Approval of electrical installation from Board of F~re Underwriters. 4. Commercial buddings, Industrial buddings, Multiple Residences and s~mdar buddings and installa- tions, a cert~hcate of Code comphance from the Architect or Engineer responstble for the building. 5. SubmK P{anning Boa~d approval of completed s~te plan requirements where apphcable. For ex~sting buildings (prior to Aprd 1957), Non-conforming uses, or braidings and "pre existing" land uses' 1. Accurate survey of peoperty show~ng all property lines, streets, buddings and unusual natural or topographic featu res. 2. Sworn statement of owner or prewous owner as to use, occupancy and condition of buildings. 3 Date of any housing code or safety inspection of bui!dmgs or premises, or other pertinent mforma~ t~on required to prepare a cert~hcate. C. Fees 1. Certificate of occupancy $5.00 / 2 Cert~fmateofoccupancyonpre-exmt~ngdwelhng/ landuse --~(-F~×:~st~n~ C.O. $15.00 3 Copy of ceruficate of occupancy $1.00 Vacant ~.~nd C.0. '~ 5.00 Date ..................... New Budding ........ Old or Pre-ex~st!ng Budding 'v/ Vacant Land Location of Property ..................... ~. House No Street Hamlet Owner or Owners of Property . ./.~(.~'~'~..-~..~...~....~ ~-,~¢...-~.. / .............. County Tax Map No. 1000 Section ............. Block .............. Lot ............. Subd~ws~on ..................... Fded Map No ...... Lot No .. Health Dept Approval .................... Labor Dept. Approval ................... Underwr;ters Approval ~ ..... Planning Board Approval Request for Temporary Certificate ................... Final Cert~fmate ...... v/.. ................ Fee Submitted $. ,~'~..~.c~ ............ lt95o99 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1~ BUREAU OF ELECTRICITY Au~,[t.qt 2~. 'J.987 B5 JOHN STREET, NEW YORK, THIS CERTIFIES THAT ~y the e~tr~ ~u~pment ~ ~scri~ ~ a~ m t~uc~ ~y t~nt ~m~ off the a~=e appl,cat~ number =n t~ prem~s of Hichael Sa~e.East C~l~ette Drive ~5.Eao~ ,aropm,Southold N.Y. u~sexammedon AU~US~ 17,1987 aetdfoundtobemcontphanceutththerequtrement~ofthtsBoard FIXTURES ~ RANGES ~RVIC~ ~ISCONNECT S E R OTHER A~ARATUS ~CI-2 Track I,~Rht!n~-6'Trade 7 Lites. COOKING DECKS OVENS DISH WASHERS TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET V I C E NO OFECCCONDpR~' A w G OF CC COND NO OF HI LEG EXHAUST FANS H P DIMMERS AWG ls~es P Sage 579 SterliaR Place Green~ort New York 11944 Per ~t COPY FOR BUILDING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF SOUTItOLD OFFICE OF BUILDING INSPECTOR P O. BOX 728 TOWN HALL SOUTHOLD, N Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. Owner /~z~T~/ ~ ~:please print) Plumber /~'l~3C, :/~/~t~ (p~ease print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s si~ature) Sworn to before me th~s c~ day of ~~t~ , Notary Public ~ Count~ N~y Public ~ NIA~%~LYt~ P NOi~KELYN ~ Notam/pubflc, State of ~ Y~ ~ No 52-460965 . Quahhed ~n Suffolk Co~.~ OUNDATIO:~ llst) OUNDATIO~! I 2nd ) OUGH FRAME FLUMBING I~SULATION PER N. Y. STATE ENERGY CODE FI~AL ADDITIONAL COMME~ITS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~,~INAL DATE I NSPECTOR~~~-~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [~ROUGH PLBG. FOUNDATION FRAMING 2ND [ ] INSULATION FINAL DATE INSPECTO~ 765-1802 BUILDING DEPT. INSPECTION FOUNDATION ~.ST [ ] ROUGH PLBG. FOUNDATION 2ND [~INSULATION [ ] FRAMING REMARKS: FINAL DATE 765-1802 BUILDING DEPT. FOUNDATION 1ST FOUNDATION 2ND FRAMING INSPECTION [~OUGH PLBG. [ ] INSULATION [ ] FINAL DATE 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [~RAMING [ ] FINAL DATE Examined Approved Disapproved a/c FORI~I NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL 765-1803 '~ ~,%-e) , 19~'1 Permit No /,5~c}c)~; (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ......... 19. INSTRUCTIONS a Tins application must be completely filled in by typewriter or in mk and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or pubhc stree or areas, and giving a detaded description of layout of property must be drawn on the diagram which is part of tins app~ cation c The work covered by tins apphcatlon may not be commenced before issuance of Budding Permit d. Upon approval of this application, the Building Inspector will issued a Buddmg Permit to the applicant Such perm 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 Occupant 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 tl Bulldmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of bmldmgs, additions or alterations, or for removal or demohtlon, as hereto describe, The apphcant agrees to comply w~th ail apphcable laws, ordinances, budding code, housing code, and regulations, and admit authorized inspectors on premises and m budding for necessary inspections. ,/~t.~4 (e.~../7/. ?),.z .,,_' (Signature of applicant, or name, it' a corporation) (Malhng address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or budde~ .... ................... Name of owner of premises /~//(ac< ~"-% gW.--- .................. (as on the tax roll or latest deed) If apphc.~ant is a co/potation, s~gnature of duly authorized officer ....... W.~: .. (Name and title of corporate officer) Bullder's License No .~.7.'~../.~.~.,~ .O .?./2 Plumber's Llcense No ............. Electrician's License No ....... Other Trade's License No ....... 1. Location of land on which proposed work will be done . .~ .~' 5 / t/~ .2..-( / .o.~.., .......... -- .... (/? ........ ftouse Number Street__ Hamlet ~ ~, ~ County Tax Map No 1000 Section - 0.3 Block .~t~. ...... Lot .~ ..... 2 Subdivision . . Fried Map No . Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction a. Existing use and occupancy cZ/ g.i.) ~//~,- vi ~ b Intended use and occupancy ~/,~ e .//,'-?t~ . ~ ~~.*[ 3 Nature of work (check which applicable) New Budding .. Addition ...... Alteration .~. Repair Removal .. . Demolition ....... Other Work .... 4 Estimated Cost Doc~ t ............. Fee ....................... (to be paid on fihng this apphcation) 5 If dwelling, number of dwelling units. // Number of dwelling units on each floor ~' If garage, number of cars ...d .............................................. 6 If business, commercial or mixed occupancy, specify na.C,ure and extent of each t~e of use ,..T~..-. ........... 7 Dimensions of existing structures, if any. Front. ~' .~ ...... Rear . ~ ..... Depth ~ O ....... Height .fg .~ ..... Number of Stories ... f .............................. Dimensions of same structure with alterations or additions Front .. 5:B.'.~. ~ .... Rear .. J]~.-m e ..... Depth ---r. ........ Height '~"'" Number of Stones f' 8. Dimensions of entire new construction' Front ........ Rear ...--T ......... Depth .......... / ~ Height . . 6 .... Number of Stones . /. ......................... ~, . ....... Slzeoflot Front ../,~.../ ........... Rear..../.~.~2-.! ........ Devth .../?~..: ........... Date of Purchase . ./.?~..g_ ............. Name o,f Forcaer Owner . .~.o.r.r., .~..~"-~. c./x' ~ 9.~.. Zone or use district in which premises are situated t'~.~..J.4 ~. *t(-~ ~ [..../ .................. Does proposed constructio,5.vlolate any zoning law, ordinance or regulation . ./k. ? .................... W~II lot be regraded . Lv ~ 9 10 11 12 13 14 ....... ~ ......... Will excess fill be removed from premises Yes N Name of Owner of premises .~t ~('~. ~..2.~ ~ .... Address .............. Phone No ............. Name of Architect ............. Address Phone No ..~.. Address .......... Name of Contractor,~°/?.gP?-ff .~'~.'g ~.'~. ~/~ .~'~¢ f. i~. ~?~/' Phone No t~7'Z~ '~ ~'~.." PLOT DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and indicate all set-back d~menslons fro~ property lines Give street and block number or description according to deed, and show street names and indicate wheth, interior or corner lot. STATE OF NEW YORK, S S COUNTY/~ ..... ...~---. ,~. . / J.--~ (Name of individual signing contract) above named. · . being duly sworn, deposes and says that he is the apphcar He is the ............. (Contractor, agent, corporate officer, etc ) of said owner or ownerS, and is duly authorized to perform or have performed the sa~d work and to make and file tt~ application, that all statements contained m th~s application are true to the best of his knowledge and belief, and that th work will be performed in the manner set forth in the apphcatlon filed therewith. Sworn to before me th~s Notary Public ..... D~-~. U~..., County/.~~ i~(. ~,4~., . L./~.,m.-~ ~ ~ · q, ~ t~llltl~. ~1~ ~ I~ ~1~ (Signature of apphcan -f t uAL E- E'J: b,'tOk!Ul',~ EN T .t,I<EA, }8,2~.'9 'b.r, ,Il ~--~CUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY -1 , ' ,.. ,~,. ,~,~m,:~-,;,' . '1 ;1 ,MIDDLE I ELKtN