HomeMy WebLinkAbout14921-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
.Z 15095 November 14 86
No ................. Date ................................. 19 ...
THIS CERTIFIES that tile building Addi.t. ion.
' ~cl 1
Location of Property . 1530 S3,~{s. bee Rea Laure
House No. Street Hamlet
County Tax Map Ho. 1000 Section [44. .]Block 01 ..... Lot 008
Subdivision ............................... Filed Map No ......... Lot No ........ ..... .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
..... A.~ .r.i.1.. 4. ........ , 19.8. 6. pursuant to which Building Permit No.. 1..4 .9.2.1. Z. .............
dated ~a.y. 30 ........... 1 86
............... 9 .... 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 .........
Addztxon to ex~stlng dwelling.
The certificate is issued to James and Vera Taheny
(owner,~Z~
of the aforesaid building.
Suffolk County Department of Health Approval .... NJ, h ..................................
UNDERWRITERS CERTIFICATE NO N76. 9797 '
· ~Building 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
COMPLETION OF THE WORK AUTHORIZED)
Permission ~s hereb/granted to:
........... .....................
..... /.~./:....././ .......... Z.o. ............ ~a,~,~. .......
...... ~.~.~.~.rc~/~...~..~..~..../(.5..~..'7
~o ................ ,r.~. ...........
.............................................................. ~~ ......... ~...-...~....Y..... ......
the
Building Inspector.
B~ld'mg Inspector
Rev. 6/30/80
FORIVl NO. B
TOWN OF SOUTHOLD
Building Department
Town Hall
Soutbold, N.Y. 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
ThL~.analication must be filled in ..ty?writ~r _O.R..!_n_k., and submitted ~ a~am,~a to the Building Inspec-
TOWN of SOUTHOLD
Receipt NO. ~ 0 / ~ (j) Town Hall
Southold, New York 11971
-- .........
.......................... :..~.. /L ~ o
......... ~ .................... ~ ~ / O0
~o~ ~O,~ g/~9.~ ~.~-' ~ ........................................
................................ ~..., .................. ~~ ......... ~....~.
Fee for u ......................
Fee for Fee for Fee far ~rtificate
Chsh
: ................ ~..~. ~ ....................
Building /nspector
Location of Property .................................. -
~' '~ flamlet
,o,,o ~o. x~..~.~ //S~e, ~.r~
Owner or Owners of Property ' · .C~'..cff~.¢4~...~'~':f~.--;% · · J'. l.~'. ~. ~:~ .2, ~ .......
co,,,~ T,, ~,, ,o. ~ooo S,c,io, ../.~..L ..... ,,.,-~ ~/ ,~.
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No. .e~ ~,,~. Date~f Permit ,~ ~ ~.App cant .. g ........................
Health Dept. Approval ........................ Labor Dept. Approval ........................
~/ .._
~de~riters Approval ~.'~ ~ '~.~ Planning Board Approval
Request for Tempora~ Certificate ..................... Final Certificate .......................
,~ su~,,.. ~ ~,.~.() ....................
Construction on above described building and~, errnit meets all applicable codgs and regulations.
ooo? 4 THE NEW YORK BOARD OF FIRE UNDERWRITERS
~,~ BUREAU OF ELECTRICITY
1 85 JOHN STREET, NEW YORK, NEW YORK 1003.8
THIS CERTIFIES THAT
only the electrical equipment ~ ~scrlbed be~w and in troduced by the applicant ~med on the a~ve application number in th~ p~mise~ of
Ti~iny, Stgsbce Rd., ~ain Rd.-Paco~ic Bay Blvd.~ ~fattituck, N.Y.
n tbefollowinglocation~ ~ Basement ~ Ist Fl. ~ 2,,d FL Section Bilk Lot
~s exatnlned on ~ ~ ~¢~lbc F ] ] ~ ~ g ~ ~ attd found to be in cot tpl ante u' th the re t ~ire,~ents of ti is Board.
FIXTURES RANGES C~KING DECKS OVENS EXHAUST FANS
FIXTURE
SYSTEMS
OTHER APPARATUS:
E R V I C
4
OF HI,LEG
NO. OF NEUTRALS
OF NtUTRAL
4
Richard Rely~a ~~d~
PoO, Box 372 lic.#2148E
L~ure, 1 ~ N.Y., 11948 GENERAL MANAGER
11 ,, /~
must not be aJtered in any manner; return fo the office of the Board if incorrect. Inspectors may be identified by their credentials,
COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST ~OT BE ALTERED IH ANY MANNER.
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] IHSULATION
[ ] FRAMING
REMARKS: ,
)FINAL
DATE , ~ ~/ INSPECTOR
BUILDING DF. PT,
INSPECTION
FOUNDATION XST [ ] ROUGH PWG.
FOUNDATION ZND [ ] INSULATION
[ ] FINAL
[ ] FRAMING
REMARKS:
Pd~-'~-- ~t-/.~'/~ ~-~/,~/~'~ BU: LD' NG DEPT,
' SPECTIO
]FOUNDATION 1ST [ ] ROUGH PLBG,
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING
[ ] FINAL
DATE .... ,~/'//~ INSPECTOR
7GS-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST' [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
REMARKS: ~/ ~ ~
DATE , F~ ~ iNSPE~OR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ ] INSULATION
FRAMING
[ ] FINAL
FLUSHING SAVINGS BANK
961-5400
5/27/86
To: Mr. Hinderman:
trust the enclosed plans are now satisfactory.
I am having a friend of the family do the
renovation for me.
I have or would like to make one minor modification
on the plans -- make the room on the right hand
side smaller (move the wall to the right of the
opening of the existing door rather than as shown).
If you have any questions, please call me.
~'~Thank you.
Vera Taheny
$-01
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
for pemit to ~ ~?~i.. ~~ .......................... at
Location of Property .~ous~ ~ ~o. .... ~ ~' '~'~ ~' ..... ~4~~ .....
Street Hamlet
County Tax Map No. 1000 Section ...~ ...... Block ...O/ ........ ~t . .QO ~ ......
Subdivision ........ '-7. ........ Filed Map No. -- Lot No ....... '"'?. .........
is returned herewith and disapproved on the following grounds ."~2Z~(~..~/~E-./r~Q~.'~. .......
~c~r~.~.. ~... ~,~.. ~ ~~.. ~ ~ ~...
~/~ ~... ~~. ~.~... ~~..o ~.. ~~ ~..w..
. ~ ~., ...,~ ~¢ .~. ~.. ~.~.. ~ ,~..~~. ¢ .5~
. .~~{~CA..~ .............................................
~ ~ 7~ ..
...,...~~~... ~m-.Q~-..~7~¢~..~..~...
Bu~ldin~ Inspector
RV 1/80
1530 SIGSBEE ROAD
Work To Be Performed
1. Extension: 15 X 28
Two Rooms: 15 X 18
15 X 10
2. Replace new shingles
extension).
feet
on entire roof (including
main door.
insulated.
reinforced mesh with concrete and tie-down bolts.
7. Two outdoor lights.
8. Install two vented skylights.
9. Install two interior doors.
10. Electric work to code.
11. Install storm door and new outside
12. Insulated all walls (R-19) fully
13. Concrete slab and footing to code.
Steel
(Raise roof 3 to 6 feet to get proper pitch
Install new vinyl siding, brown vinyl trim,
gutters and leaders.
of house.
4. Square-off left rear corner,
5. Sheet rock and spackle b~t~%ooms..';"J~
6. Six foot sliding glass dooC on left side.
'FORM NO.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11(371
TEL.: 765-1802
Examined.. ~¢~....f.C~..., 19~..
Approved ./~¢~e¢....~...., 1~. Permit No../.~.¢~..
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
:eived ........... , 1
BLDG. DEPT.
TOWN OF SOUTHOLD
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 applic~tble laws, ordinances, building code, housing code, and regulations, and to
........ ,*~-:~.~ :~ ~+ ..... ' ...... ,4 ',, b ..... n.~ for
~.~ii~g.?7~e o ~ ~'~o; ~_o r a~t i o n )
.... . /. . ......
'~v ~'~' -~/l"ilin¢ a "(Mailin~ address ot' applicant)
State ~vhether applicant i~iessee, agent, architect, engine~ general contractor, electrician, plumber or builder.
...............
. n.~' ·: ......... - ..... ~;¥)' 'E./ ...................... _¢.z¢ .... .a ...........
¢'l'as on the tax roll or late )
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer) /
Builder's License No. ~ ...... .~L-~- .?..~.....
Plumber's License No .............. .// .........
Electnc[ans Lzcense No .......................
Other Trade's License No ......................
1. 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 ...............
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a Existing use and occupancy ..'~.~~¢ ~'F~ ~
bl Intended use and occup an cy '~5~~~.' ~
· ' ',' 3. Nature of work (check which applicable):
New Building . ' .. Addition .......... Alteration ..... .~..
Repair .............. Rembval .............. Demolition .............. Other Work ........... ~..
0i ~'~ tbSr00.0. 00 ~ 450 00 (Description)
4. Estimated C s ...... : .... ,~. ............. Fee ........ ' ............................
4, (to be paid on filing this application)
5. If dwelhng, number of dwelhn~ ...... / ....... Number of dwelhng umts on each floor.. ~. ...........
If garage, number of cars . . . ~ .............................................. j//]~ .............
6. If business, commercial or mixed occupancy specify nature and extent of each type of use ../g/t"~ ..... s ........
7. Dimensions of existing structures, if any: Front .~. .. ~..~./. Rear .... ~.~ .... Depth .~tg...: ........
Height ~./~ . .~..~/.O.t . Number of Stories . ~. ............. ~..~ ......
Danen~8~_~if%~tmeture w~th alteratmns~or add~tmns: Front ..... ~ ~..t... Rear .... ~r...~.'. ........
Deptl~ . ~.~,57-../. ......; ....i. ·. Height .~--e/~tr~.~. ............. Number of Stories .... .~ ................
8. D~mens~ons~of entire n~w const~uchon: Front ... ,2- .~. ....... Rear ...-~g' ~. ........ Depth .,3~. .........
'Height .~..../~/.~t~-~... hlmhber of Stories .... .~. ....................................... z_ .........
9. Size o,flot: Front .. ~..r.~.. i ............ Rear .... .'%~. ! ............. l~epth ~ ./._~.~ .~..~-~ ........
10. U te rP 'oh se ] ............. Name o Fo 'mer Owner .B .............
11. Zone Or use district in which premises are situated ......................
12. Does proposed constructi~ofi~ vi0.1ate any zoning Iaw, ordinance or regulation: ..................... ;~ ......
13. Will lot be regraded .../~./9.~. '~ ................... WilI excess fill be remove, cl. from premises: {.~es j No
14. Name of Owner of premise~7/'~'~52.a~.~.~ .~..a..~. Address/.07/. -f/..~.~. ?.al../~. ~hone No. ~/~5~~~..
Nme of Architect . , .'.~.~ ..... Address ...... ... Phone No..; ............
" ' ·': .... . ..... Address ~ ' ' -~ :'~;: Phone No~' ~ ~; ,;~' 7
Name of Contractor,s/)
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. ,
STATE OF NEW YORK, iSS
coJ. t ' OV ........ ..... ,
... '.~~. ~.~i ........ being duly sworn, deposes and says that he is the applicant
(Name of individual signing contra~
above named. ' ~..~ ,,o
He is the ................. i' ' ' (Contractor, agcnt, c~ri~or~t~
of said owner or owners, and is dgly 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 man,er set forth in the application filed therewith.
Sworn to before me this ;
Notary Public,..~.~..~..~.,.~~County ,.~/ ~'~~ ~
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