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Home My WebLink About16164-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of OCcupancy No .... .zr..68.4..4 ...... Date ...~.ay..6.,..1.9.8..8 ................ THIS CERTIFIES that the building ...R..E .N.O.V.A..T.I.O.~. ................................. LO ..... 55750 Main Road Southold N.Y. ca~lon oI rroper[y ........................................ , House No. Stree County Tax Map No. 1000 Section 062 .Block 03 .Lot 08 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated June 16, 1987 pursuant to which Building Permit No. 16164 z dated Ju 1 y I, 1987 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 ......... RENOVATION TO EXISTING BUSINESS BUILDING AS APPLIED FOR The certificate is issued to T. FORD PRIME & JOHN C. DOXSEE ..................... /oho'o;, ' of the aforesaid building. Suffolk County Department of Health Approval ............. ~ ./.A. ......................... UNDERWRITERS CERTIFICATE NO ...... ~ 8..3 .2.1.4. 9.. T..S.e..p .t .e.m.b..e .r.. I. 6. :..I.9. 8..7 ........... PLUMBERS CERTIFICATIOI~ DATED: N/A Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N*_ 16164 Z Permission is hereby granted to: .~ ..~... ~ ' ~ .~..~- ...· .....~...~.a...!.~ .................................................. ......... , ~,,,,m,,,,~,ed ..~. ..................... ~. ......................... ~ ............................ County Tax Mop No. 1000 Section ..... ..~....~..~ ..... Block. ..... ...~.....~.. ....... Lot No... ~....~. .............. pursuant to application ~lated ...... ..~,'~Z...~. ......................... , 19..~.l.., 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 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. ~rhis application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec- tot 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 property showing all property lines, streets, buildings and unusual natural or topograph ic 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: Additions $25.00 POOLS $2.5.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory~$10.O0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00. over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... New C on s t z'u c t i on Old or Pre-existing Building Vacant Land Location ofProperty.w~'.?..7.~..'..e~.' J/~P~//t,/ ~ ......... ~.d.(e-.~..Z, ~[.... ......................... . House No. Street Ham/et Owner or Owners of Property ...7~'... ~,~'~...r;...~..~.l..~p.~e~...,~..."~..0.~.~,....C:....'~.~..~.~,.~ ......... County Tax Map No. 1000 Section ............... Block ............. Lot .............. Subdivision ................................. Filed Map No ........... Lot No .............. Permit ,o. ~ .~.).~. ?..~.. Date of Permit ")/.././~..~..Applicant..~.d..~..~... ~ .~'...~.~o..[..~....C~q.. 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 permit,mee,~ all applicable codes and regulations. Applicant ... L;.. ,,~...'77...~ .................................. Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~0~071 BUREAU OF ELECTRICITY E5 JaN. STREET..EW ¥OR, ..EW YO.,' ,O0 B 02 149 THIS ~ERTIFIES THAT o~y t~e e[~tric~[ ~ipment ~ ~rlbed be[o~ a~ i~tmduced by ~h~ applicanE ~ed on the a~ve application number in the prem~es of Points East Realty Corp, ~a~n Ro~ Nex~ To Wu~et 9 9 9 MUfTI-OUTLET SYSTEMS NO. OF FEET OTHER APPARATUS: 1-Smoke Detector Track Lighting 56' O L~tes E R V I C E NO. OF CC COND A. W G, NO OF HI-LEG A W G. NO. OF NEUTRALS z 2/0 .t ~ & S Electric Box 215 $ou~bO]d, 11971 Lic. 578g This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors be credentials. COPY FOR ~UILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST ~-OT· BE, ALTERED, I~-ANY MANNER. ~ INSPECTION FOUNDATION 1ST FOUNDATION :)ND FRAMING REMARKS: ROUGH PLBG. INSULATION FINAL DATE_, /~///~/"~ 765-~.802 BUILDING DEPT. INSPECTION [/'1 FOUNDATION ~.ST [ ]/~UGH PLBG. [ ] F//OUNDATION 2ND [~] INSULATION / [~ FRAMING [ ] FINAL REMARKS~/:~~ ~ UNDATION {2nd) UGH FRAME/ FLUMBING O SULATION PER N.y STATE ENERGY CODE ADDITIONAL COMMENTS: BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FOMM NO. I SURVEYL..~:,- .... TOWN OF SOUTHOLD CHECK~'/' · · ~' ' ' BUILD~NGDEPARTMENT SEPTIC FORM ............. TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-18~,~ ) ....., 19'~7. Permit No. ./. .~.f. ¢.~'.~. ~ ,~ Approved .... · Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PIZRMIT NOTIFY CALL ................ MAIL TO: INSTRUCTIONS a. This application must be completely filled in by typewriter 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. e. No building shatl be occupied or used in whole 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 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections.. ,...~ ~ ............. ................. (Signature of applicant, or name, if a corporation) ..... .23. ./. u.o. 1 ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ................................................................................ Name of owner of premises . ~ ~.r~. · · .~,.. l.~ .S.~.~. ~....T~...~.O4Z.~....~.&.l~b..~. ................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co,orate officer) . ALL CONTRACTOR'S M~ST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section ...... .~..~ ....... Block .... ~ ............. Lot...~. ............... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... /~..~..~..t..~..~. ....................... ..... .......................... b. Intended use and occupancy . . .D...~..~.. ( 6 ~ '· 3. Nature of work (check which ~pplicable): New Building ..... ' ..... Addition .......... Alteration t//" .Repair .............. Removal. .............. Demolition .............. Other Work ............... (Descrip~tion) 4. Estimated Cost ............ ~ 45'~[O ,.~ .................... ~. Fee ...................................... ~ ~ (to be paid on filing this application) 5. 'If dwelling, number of dwellin~ units ............... Number o f dwelling units on each floor ................ If garage, number of cars ............ i ........................................................... 6..If busin~ss, c~qmmercial, or lm>~ed occupancy, spemfy nature and extent of each type of use. f~40.75,./} ¢.~ ~.w. ?~.. 7. Dimen~i~n's"M e~istb~g?~t~41tt~es if any: Front'...~ ./. ....... Rear . .Z.q/ ......... Depth. '..ff..of ......... }te ght ......... ' {il er of Stones .... ) ................................................... Dim~efidonst~lt;~all~tu] ~'~i.}h alterations or additions: Front ....... .~ ~ ....... Rear . .~. ~ ........... :. Depth.....~..~ .~.~../~.~. Height . ~ ).5: ................ Number of Stories... } ................. , --.8. DiCensj~..¢In~ l~[~i~ction: Front .......... ' ..... Rear ............... Depth ............... Ho]ght ~.~;a/~ ~thhrber of Stories ..................... 9. S zeor D gl. [ .......... Rear .... O ........ ,......... Depth .~rd. .................. 10. Date of Purchase ... f/~./d/.g',7 .................. Name of Former Owner .~.-./'~.~..~ ................... 11. Zone or use district in whicl. ~remises are situated.. ~ ................................................. 12. Does proposed construction viplate any zoning law, ordinance or regulation: . 04.4 ............................ 13. Will lot be regraded .. ~ ....................... Will excess fill be removed from premises: Yes ~ 14. Name of Owner of premises .~ .~ .~.4/, ~.,?t~ ...... Address ~..iq..~74 .~...(4.~.,.~ .~. Phone No. ~.Z.').. ~.6'..3.~./. ~--~ Name~of Architect .......................... Address ................... Phone No ..... ..~ ........ Name of Contractor ....... ! .................. Address .... : .............. Phone No ....... [ ........ 15. Is this property locate~ within 300 feet of a tidal wetland? *Yes ..... No .~..~lt~ ~ *If yes, Southold Town T~ustees Permit maybe required. ' PLGT DIAGRAM 7~" ~'~ Locate clearly and distinctly ~1! buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and bloc~ number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~ COUNTY OF ; S.S (Name of individual .signing contract) above named. being duly sworn, deposes and says that 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 to make and file this application; that all statements cor~tained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manher set forth in the application filed therewith. Sworn to before me this ~', ~(5}'~/..0~.. Count .'/ ~..~._ Nota,~ Public, .... 7~--~'...... Htt[N K. DE VOl~ ~ ~m Expires March a0,1~-4~r (Signature of applicant)