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Home My WebLink About14869-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that tile building porch addit ion . Location of Property ....2.3..0: .V. ~.n.qe.n..g..S.~r~.e.t. .............. ...... t~ouso tva. Street Ham/er County Tax Map No. 1000 Section .. 3~ ........ Block . .3. ............ Lot . .~z~ ............. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..M.~y. ~.B., ........... , 19 .l~6pursuant to which Building Permit No. 1. ~8.6.9.~ .............. dated .. ~lp~.y.. J~ 2., .................. 1 93.6.., 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 ......... porch addition to existing one £amily dwelling The certificate is issued to ........ M..a.rj.o.. 8..I.r.~../~n. l:gj~a,~:~ j. ........................ of the aforesaid building. Suffolk County Department of Health Approval ............. 21/.-5 ......................... UNDERWRITERS CERTIFICATE NO ..................... 2t/~ ......................... Rev. 1/81 Building Inspector I~ORM NO, O TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOI.D, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) 14869 Z Permission is hereb¢ granted to: ..~~.....~.:..~:.....o...~.~.,~ .... . ,o .0~.~.....~..~..~...~...~.~....~..~.~ ..... at premtses located at ....~......,.¥.~6.C,~.......~.....~.~.. .......... .(~)~ ........................................ County Tax Map No. 1000 Section ..... ..0....~...~..'~. ....... Block ..... .0.....~. ......... Lot No....!.~ ................ pursuant ,o application dated ..... ......~.....~..~. .......................... , 19.~'/~..~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall ' $outhold, N.Yo 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m Ilaaaaa~aa~m 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 natu raj or topographic fearn res. 2. Final approval of Health Dept of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical instal=ation 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 app~ oval 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 properW showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner 0¢ previous owner as to use, occupancy and condition of buildings. 3. Dote of any housing code or safety inspection of bui[dings or premises, or other pertinent informa- tion required to prepare a c~,rtificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $ 3,5 o 00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 .~/.2~..2~./~,.~. 5. U~dated C.O. $15.00 Date .............. NewC°nst~uCt±on ...... OM or Pre-existing Building ............ Vacant [.and ............. Location of Property .......................................... . . . .... House No, Street Hamlet Owner or Owners of Property ............................. .. . County Tax Map No. 1000 Sectior, . ..... -- ........ Block .............. Lot Subdivision ................................. Filed Map No ........... Lot No .............. PermitNo.~Y~ZZ'. Date of Permit ¢~.f~.?.( Applicant ~<h~¢¢~ /~.~//4-4L Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwri ers Approval Planning Board Approval Reques, ;,~r Temporary Certificate ..................... Final Certificate ....................... Fee Subhdtted $ ............................. Constru~,~io~ on above described b,Jilding and permit meets all applicable codes and regulations. Applicant Rev. 10-10 1000708 THE NEW YORK BOARD OF FIRE UNDERWRITERS I"t~ BUREAU OF ELECTRICITY ~-- 85 JOHN STREET, NEW YORK, NEW YORK 10038 only the electrical equipment ~ ~sc~bed below and introduced by the applicant named orr the able application nu tuber in the premises of ~rio $~to~zzi, V~cent St., E/Of Village I~., O~a~t Po~t~ N.Yo ~ ~mi.~d o. Sept~er 26, 1983 and found to be in compliance with the requiretnents of this Board. FIXTURE OUTLETS IECEPTACLES SWITCHES FIXTURES RANGES :OOKING DECKS OVENS DISH WASHER EXHAUST FANS FLUORESCENT DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS: E OF CC. COND C NO. OF HI-LEG AW.G OF HI-LEG NO. OF NEUTRALS 1 AWG, OF NEUTRAL Sal Prate, Elect. Wiggins Lan~ Gree~loorc~ N.Y. , 11944 LIC. #1049 o m Per_ . This certificate must not be altered in any manners return to the office of the Board if incorrect inspectors may be identified by~ t~elr~"~-'~credent~als.' COPY FOR BUILDII ~IENT. THIS COPY OF CERTIFI ' BE ALTERED IN ANY MANNER. 76.5-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ]/OUNDATION 2ND [ ] INSULATION FRAMING [~FINAL REMARKS: DATE INSPECTOR ,, ~ F1ELD~ IN S~ ECT ION 1. FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION FERN. STATE ENERGY CODE Ye FINAL ADDITIONAL COMMENTS COMMENTS: ) AS NOTED NOTIFY BUILDI.G OEPARTMmT AT 78~-1802 S AM TO ~ PM ~R THE FOLLOWING INSPECTIONS: FOR ~OUR~O ALL CO~iST~tJCTION ~HALL, ~EET THE ~EOLt~M~NTS O~ THE STATE CONSTRUCTION & ENERGY ~IGN OR CONSTRUCTION E~RORS, FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1802 Examined . . .~. ~M'-~/.~. .... 19~9. Approved....~.c~ J...~...., 19~..~. Permit No. !.~..~.~. ~..~. · Disapproved a/c ..................................... TOWN OF $OUTHOLD , Application No .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 shall 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 insp~ections. (Signature of applicanffr6r name, if a corporation) c/ (~lailing ~ddress~of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................................................... Name of owner//of premises..db.f.'/~. ~./.~.... f~..~.~. ~ ~?../...¢.~7...{~./..{.~--~. ............................ (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... [~.-. [:.~. ~../.O..~. ......... Plumber's LicenseNo ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. ........... . ......... . , ........... ..... c .................. House Number Street Hamlet County Tax Map No. 1000 Section ¥~ ~' Block '-~ Lot. /' ~ ~ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .~. ~.A-~. vE...t~.....O..Cc. ~ .C~/?./.~. ......................................... b. Intended use and occupancy . ?.~../~...~.. ........ .~V~t0/~,,~"tq~, ................ '4 a ~;~. a,.~f ~ .J:.~.~.~:~. ,,,, .................. 3. iNature of work (check ~l~ich applicable): New Building .... ...... Addition........../// Alteration .......... R ' * ' ;' ~ ~ ' Re 9 al Demolitio Oth r Work ~ epm~;~;! ~:~. . . .:;~ m v .............. n .............. e ............... ~o! (Description) 4 Estin~a~edCost,~...~...~.'~.'} ~ Fee (to be paid on filing this application) 5. If dwelling, number of dwellingiunits.. .... ·......../ Number of dwelling units on each floor. If garage number of cars 6. If business, commercial or mixed occupancy, specify na[pre and extent of each type of use . :..-~:x. :;. 7. Dimensionsofexistingstructur~s, ifany Front ~; .' ........ Rear .,~,/~.~;f.t ...... De~t't~ Height ~;~..~..~ Nutnber 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 Sto_ri,.~s . . ./ ........' ............................................. 9. Size of lot: Front ... ~' ~.. :::~' · ~. ~.-,~.,5~.. Rear . .~'~. ~..,~.?. ............ Depth ./.0 ~',. {;.62...~..~. 10. Date of Purchase .z~rt~/..~..7--i,, [?.~'. ~. ........... Name of Former Owner ...~.t~., F,.~.~O./<..'~. pf/~..~..... 1 1. Zone or use district in which premises are situated ............................................ 12. Does proposed construction wolate any zoning law, ordinance or regulation: ............................. ~,~ : 13. Will lot be regraded .../'.~. O. i .................. Will excess fill be removed from premises: Yes (No~ 14. NN~eeoO~AO;~2~p.r.e~i::s' ' "' .~.,~.hone.N.~,PD.~.~.~.~f~.~;~. *~.t'noneNo. ·-'''''----~ Name of Contractor, ~ Address Phone No PLOT DIAGRAM Locate clearly and distinctly all 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. t o f2_ STATE OF NEW YORK, COUNTY OF .07" ............................. i .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ...................... , ................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulg authorized to perform or have performed the said work and to make 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 filed therewith. Sworn to before me this ............. ......... dayo ..... ........... Notary Public, ..~-~?..'.~.-..~.g~..~..~.~;....County Term t~'f~h (Sigffa~fe of applicant)