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Home My WebLink About14902-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No Z.t.5 168 Date Jan. 6 198.7. THIS CERTIFIES that tbe building F~.r. r0 I3.u.(l ~13~.g ' Location of Property...~.~.9. q9' EA.~..~. aOAD... .. ' SOUXUOLD House. No. Street Hamlev County Tax Map No. 1000 Section .......... 75 Block . 6 Lot .7 .' .1 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated 14902z ..... ¥ .ay.. 1. 9. .......... 19.8..6 pursuant to which Building Permit No ...................... dated .... ~qy._.l.9. ................. 19 .8.6., 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 ......... FA~RM BUILDING ..-.. The certificate is issued to . . T I.M.O~THY COFFEY of the aforesaid building. Suffolk County Department of Health Approval N/A N784782 UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 .....5P~,. ~...;~~.. ~ 1~ '~ding Inspector .......... TO~N 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) z pursuant to ~ppiication dated .............. ~~ ........ ~...~...,.., Ig..~...~ond~' approved by tNe Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOW. OF SOUTHOLD NOV I 019~s Building Dapartment Town Hall Southold, N.Y. 11971 765- 1802 TOWN of SOUTHOLD Receipt NO. 5 1 0 6 / Town Hall Southold, New York 11971 ,.c ivedo .......... ...... .............. - ~ ~-~ ~1~ ~_ ~ ............................ .... ~ ................. ~ ................ : ~.~...,,~ ~.~-~.,,,..~ ......................................................................... ~ ~ oo ~ f - ~~ ~ ~ ~ ~or ~ rea or ~ Fee for Fee for ~ ~rtlficate ~ Yard Sale ~ ~ ~ H.I.C. ~ Building Permit ~f Occupancy ~ Misc. 5. Updated C.C. $15.00 NewC°nstructi°n ...... Old or Pre-existing Building Budding Inspector ~l~'~ ~ate..O.C~ L~..:.'f~ ....i.i.. ~// ·/.'~. ........ Vacant Land ............. Location of Property .,~,~ .d~O,l~.. ~J ~ ] ,/?.. ~. ~ ......... : ,r~..~, ~ H n .t .~ ................ Hou~ No. Street Ham/et Owner or Owners of Property ~ ~ .~ZI~.Y... ~ F: ~: h~ .............................. County Tax Map No. 1000 Section .... ;7.~ ..... Block ...... ~ ....... Lot.. ~&/.... ~/~ Subdivision ................................. Filed Map No ..... Lot No ........... Permit No. L~.~?%. Date Of Permit ~ ~ ?.ff~An.cant~o~'/~...... 'r ....... .~ ..... ~, ., ........... ~ (oFF(~ "' ... Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval ........................ Planning Board Approval ...................... Request for Tempora~ Certificate ..................... Final Certificate ....................... Fee Submitted $ .................. .; .......... Construction on above described building and pTrm~. _~j~Z?~/codes and regulations, Apphcant . ~ ~ Rev, 10-10-7B 7GS-18G2 BUILDING DEPT. INSPECTION FOUNDATION IST [ ] ROUGH PLBG. FOUNDATION 2ND [~SULATION FRAMING £ ] FINAL REMARKS:~~~d~------ INSPECTOr_.._ 765-t802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [~i~U~TION ( ] FRAMING FINAL REMARKS: DATE INSPECTOR ioooi l THE NEW YORK BOARD OF FIRE UNDERWRITERS E~UREAU OF ELECTRICITY ~[~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 TH~S CERTIFIES THAT o~y the electrical equipment ~ ~scribed below and int~uced ~y t~ applicant ~med on the o~ve applicat~o~ number in the premises of 'r~thy ~f2ey~ 4~0 M~ln I~ad~ ~utt~ld~ N.Y. (B~) in the/ollowlng location; ~ Basement ~ Ist ~. ~ 2nd FI. Section Bl~k Lot ~sexamlnedm~ D~ ~ ~ attdfoundtobeincontpliancewiththerequlrenents~ftt sBoard. FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS FIXTURE SWITCHES 2O 25 DIMMERS SYSTEMS NO. OF FEET )THSR APPARATUS= 1-50 Recpt For Generator L~-G,F,C.L 1-L~r,o~ D~tector Pmlolboa~ds; L-.14cir. 125m~ps R R V '1 C E NO OF CC COND. A W, G. PER ~' ~0OF CC, COND 1. NO. OF HI-LEG 3/0 Paul Burn~ 27'5 Toval Harbor Lane Soutl~ld, N,Y. 11971 Lic. 252E GENERAL MANAGER Per_ This ¢eHifi¢ote must not be aHered in any manner; return to the office of the Board if incorrect, fnspedors ma), be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. U~ I$ UNIA~L FIELD INS[~ECTION FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL.: 765-180:3 E×amined 19 Disapproved a/c ..................................... Received ..... (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. FOe acqordtng to schedule. b. Plot plan showing location of lot and of build~ings 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 al~plication may not be commenced before issuance of Building Permit. d. Upon approval of this application the Building Inspector will issued a Building Pemoit,ta:~h¢ applicant. Such permit shall be kept on the premises available for inspection throughout the work, purpose ~t~ll u~til~a~,'C~r,~i, ca~o,~flD~Cgl~p ancy e. No building shall be occupied or used in whole or in part for any ...... shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the:i¢~uanCq~o~~m?rsuant"~ "-~ -- to the Building Zone Ordinance of the Town of Southold, Suffolk County, New Y6f!f;, ah~oflk~a'~rda%~l~ Ordinances or Regulations, for the construction of buildings, adtht~ons or alterations, or~ f-b¥~fflOv~llt The apphcant agrees to comply w.~th all applicable laws, ordinances, admit authorized~ inspectors, on premises~_ and. .... in~ ,.building~ .... · for, .n, ecessary.. "'ta as herein described. regulations, and to >r name, if a corporation) kmgiling address of app zcant) State whet~r applicant is owner, lessee, agent, architect, eno~neer, general contractor, electrician, plumber or builder. Name of owner of premises . .~..'.//~..O ................................. ' .................... / (as on the tax roil or latest d~ed ,' If applicant is a corporation, signature of duly at~h6'rized officer. (Name and title of corporate officer) Bdilder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... ~ . Other Trade's License No ...................... ~'~).o..?~'. [.~'. ~~ County Tax Map No. 1000 Section ...... 7-~.. ....... 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.....~..~..~../~...'.--../ff..~.~,J[ ,.~.J ....................................... b. Intended'~}e and occupancy ..... .ffT.'~..'.~..2~....-7../~...~.~...~.-.~'.'.~.~ ................ [3. Nature of W~ork~check which applicoble): New Building ..... . .... Addition .......... Alteration .'~.... .... ! Repair ...~,,~J. ...... Remova!~ .............. Demoli:tion ......... ../.. Other Work ....... ! ....... ~ - , ~ ~'~ ~ (Description) 4. Estimated Cost ~J.~.Q.O.,'.'~ "Fee .. f.~.c~. ?.t. [to be Prod on fihng th~s apphcatlon) 5 Ifd elling mb ofdw Iii gu its Nu 'b rofd elling 'tS neachfloor · w ,nu er e n n ............... m e w unl o ................ If garage, nmnber of cars ............................................ i ............................ ' 6. If business commercial or mixed occupancy, specify ~aature and extent of each typ~ of use ...... ' 7. Dimensions of existing structures, if any' Front fi (~0 i Rear . .'~O ! De-th "' i ..... i .... Height .... 1~. ........ Number of Stories ........ ~.:~./P~...~'~..~,~ ......................... Dimensions o~same structure with alterations or additions: Frbnt ............ i .... Rear .................. Depth... ................... Height .............. '..: ......Number of Stories ...................... 8. Dimensions of entire new construction: Front ............. :.. Rear ..... : · · I ......Depth ....... . ........ Height ............. Number of Stories : ..... j 9. Size oflot: Front .l~.~.~[4q, M~...~.~. ..... Rear ........ ' ...... Depth ............. 10. Date of Purchase ...~)~1~. ] O..-~'~ ............. Name of Former Owner . 1 ............... 11. Zone or use district in ~,hich premises are situated ........... i · · · ~ .... ~. · · 12. Does proposed construction violate'any zoning law, ordinance or regulation: .... , ................... ~ ....... 13. Willlotberegraded ...~.,:.~.., ............ ,.. ....Will excess fill be removed fr~n premises: .Y~s 14. Name 6f Owner of premises . .]. J. ~]0f./5/~. ~..O~Address .~i~.c]~0./~.~/../~. ~..~. Phone No.. ~. ~..~-7..~-..57.,..~ Name of Architect .................. U. ...... t. Address ............... i... Phone No .......... Name of Contractor .......................... Address · i' Phone No ' 15. Is this property located withint.00 feet of a tidal wetlan~.";'Y;~'. .... ~'o' .~..~: ...... · If yes; Southold Town Trustees Permit may be required. '~ 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 t6' deed, and show street names and indicat~ whether interior or corner lot. , APPROVED NOTIFY BUtIOtNG DEPAR' 766-1802 9 AM TO 4 FOLLOWING INSPECTIONS: I FOUNDATION TWO RE' tUIRED FOR POURED CONCRETI 2 ROUGH FRAMING & Pi, JMBING 3. INSULATION I · 4. FINAL CONSTRUCTIONIMUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHAL~. MEET THE REQUIREMENTS OF TH ~ N.Y STATE CONSTRUCTION & ENERGY CODffS, NOT REE4~)ONSI'BLE FOR r~EStGN O~ CONSTRUCT~Of 'MENT AT FOR THE STATE OF NEW YORK, ¢OUNTYOF ......... ........ S.S [ ................................................. bemg duly sworn, deposes and says that he as thei applica,t,t (Name of individual signing contract) ,above named. He is the ............................................................. , ................... ,.. ...... (Contractor, agent, corporate officer, etc.)! ~ file this ~ that the of said owner or owners, and is duly authorized to perform or have performed the s~id work and to make ah application; that all statements contained in this gpplication are true to the best of hisi knowledge and belief; an work will be performed m the manner set forth m the apphcat~on filed therewith. Sworn to before me this ................. ]~. ..... day~,f. .... .')'f~... ,./',~ ........... 19 j~ ~//'(S~g~lature of applicant)