HomeMy WebLinkAbout14576-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Buildin§ Inspector
Town Hall
$outhold, N.Y.
Certificate Of Occupancy
No...Z.l. 6. 5..6.3 ......... Date ....J.a.n.u..a.ry..6. ,. 1988
THIS CERTIFIES that the building A d d i t i o n
2460 Paradise Shores Road Southold
Location of Property/:/~s~ ~V'o] .......................
County Tax Map No. 1000 Section ...Q .8.0 ...... Block ...q ! .......... Lot ...7.: .1 ...........
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
J an. 2 I, 1986 pursuant to which Building Permit No. 14 5 76 Z
dated P e b. 27, 1986 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 .........
Addition to first and second floor of existing one family
..... d~ l'l'fd~' 'a'tld ' kt'e'dl[ ' h'd'd i t i'o'ri: ...........................................
The certificate is issued to .....CALLI S.TA & PAUL TULLY
............ ..................
of the aforesaid building.
Suffolk County Department of Health Approval ..... ~./.~. .................................
UNDERWRITERS CERTIFICATE NO ............. .~.7.5. 8..6 .4.7 .... .7./. I. 5. ./.8.6 .................
PLUMBERS CERTIFICATION BATED: Roger Mc Carvill 12/22/87
Building Inspector
~o~ NO. 0
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
CQMPLET~ON OF THE WORK AUTHORIZED)
lq? 145Y6 Z
Permission is hereb/granted to:
.....'Z~.~,.../..~.~,..z.... ........................................
...~~&.....~..:%.u...~.~..~ ..............
............. -~ ............... :~u-~. ..... ~'-';": ...................................................................
of premises located at .a..~....~..~....~,~.°~-¢¢~.~.,,..~.......~...:......~..'.'~..
County Tax Map No. 1000 Section ..... (;~..~...~.. ...... Block ...... ~..J ......... Lot No ...... ..-].,../. .........
Building Inspector.
Building Inspector
Rev. 6/30/80
FORM NO. 6
TOWN OF $OUTHOLD
Building Department
Town Hall
Southold, N.Y, 11971
765- 1802
APPLIC'ATION FOR CERTIFICATE OF OCCU
Instructions
A. This application must be filled in ~pewriter OR ink, and submitted m~ to the Building Inmec-
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
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 pEoperty showing all property lines, streets, buildings and unusual natural or
topographic features.
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 buiJdings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees: Additions $25.00
I. Certificate of occupancy New Dwelling $25.00, Accessory '$10.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land c.g. $ 20.00
5.Updated c.g. $ 50.00 Date ..........................
NewC OhS tpuc tion ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property .~.~ .'[?..~..3 f2 .... f.~.%-?.3... /.%P ......................... ~..~. o. F.~. ~?.q .......
House No. Street Hamlet
Owner or Owners of Property .~. ?. F.c. f?.T...~ .... '~. ....~.?C¥ .( ..... ./.-~..Z.~.~ .....................
/
.County Tax Map No. 1000 Section ............... Block ........... J / .... Lot ................
Subdivision ................................. Filed Map No ...... ]....Lot No ..............
Permit No. l .t[..~..~.~.-~ Date of Permit .......... Applicant ......... [ ........................
Health Dept. Approvat ........................ Labor Dept. Approva
Underwriters Approval ........................ Planning Board Appr(
Request for Temporary Certificate ..................... Final Certific
Fee Submitted $ .............................
Construction on above described building and permit meets all applicable
Applicant ...... ; ..................
)des and regulations,
Rev. lO-1~7e
33 77
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
~ EB JOHN STREET, NEW YORK, NEW YORK 10038
o. te July ]5, 1986 404975/86
THI~ CERTIFIES THAT
i. the fot~o~i.~ Ioeatlon~ ~ B~e~nt ~ I~t FL ~ 2nd FL Section Bilk Lot
~sexaml.edon July 7, 1986
FIXTURE
OUTLETS
DRYERS
SERVICE Di:~CONNECT
OVENS I DISH WASHERS
L 4.8 1 1.2
FIXTURES
,u....cE ,,,Zy.s,. I ,uLu. R, A..,,jo,,,CE
RANGES
K W
,,.jlA, .ECj,
1 30
TIME CLOCKS BELL
UNIT HEATER!
¢0. OF S C
~AETER
i 1/0
OTHER APPARATUS:
MULTI-OUTLET
SYSTEMS
NO. OF FEET
NO OF ~UTRAL:
EXHAUST FANS
DIMMERS
AWG,
OF NEUTRAl
1/0
1-G. F. C. I. ]:xi~oke Detector
O & S Electric
Box 215
Southold, N,¥, llg71
lac,
GENERAL
Per_
This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BUILDING DEPARTMENT., . , THiS COPY OF CERTIF CATE. ~UST NOT BE:ALTERED,~ ,__ ...... N ANY MANNER ~
TOWN OF S@UT~OLD
OFFICE OE BUILDING INSPECTOR
P.O. BOX 728
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL. 765-1802
CERTIFICATION
Building Permit No.~_
Owner.~[ /~_~-g~ ./~/,~/~/
(please print)
~lease print)
I certify that the solder used
contains less than 2/10 of
in the water .supply system
lead.~~tur~~~/ ) '
Sworn to before me .this
Notary Public, o~~ County
Notary Public
· . 4707878
'~erm Exp r~ ~ch
FIELD ~NSFECTION
FOU__ND~TIO__N~(.J~t,)~
FOUNDATION 2nd)
ROUGH FRAME &
FLUMBING
COMMENTS
INSULATION FERN.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
765-1802
BUILDING DEPT.
INSPECTION
Fo FOUNDATION IST [ ] ROUGH PLBG.
UNDATION 2ND [ ] INSULATION
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND [ I~N~NsULATION
[ ] FRAMING
[ ] FINAL
REMARKS: ~) ~
7GS-:1.802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
FOUNDATION 2ND £ ] INSULATION
[ ] FRAMING
[ ] FINAL
DATE'*, ~///~/~:),,,( INsPECTO" ,/~~
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1603
Examined .~.'~q~..']., 19 ~.~
Approved .~.~ .~p~4..~.a.~., 19 .~.~. Permit No..~.~..~.?.~...~.
Disapproved a/c ............................... ~
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
_
BLDG. DEPT.
TOWN OF SOUTHOLD
Received ........... ,19...
Date ... ' .......19
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 Buitding 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 inspections.
...... ....
(Mailing address of applic, ant)
State whether applicant is owner, lessee, agent, architect, eno~neer, general contractor, electrician, plumber or builder.
Name of owner of premises . .~ff .z-..'777..~.z:.~.x. .....................................................
(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. g/F5'~'~-
'
Plumber's License No .........................
Electrician's License No ........................
Other Trade's License No ......................
Location of land on which proposed work will be done ..................................................
.......... .q .... . . . . . ., ............. o ..............
House Number Street Hamlet
County Tax Map N6. 1000 Section .... dj>..~..d? ........ Block ...... .d:>~. ........ Lot ..... 7./. ./. '
Subdivision ..................................... Filed Map No ............... Lot '
(Name)
State existing use and occupancy of premises ai~d intended use and occupancy of proposed construction:
a. Existing use and occupancy ...... . .~.,s .<42~..~(.7~ .~.~..~r ............... ' ..............................
b. Intended use and occupancy ..... . .~.~-..~r ?.~. ~.,;W/.7.~..,~.z~.../..tkO.... ~ ......... '
property lines. Give street and block number or description according to deed, and show
interior or corner lot.
3. Nature of work (check which applicable): .New Building ..... ' .... ~. Addition ~ ....... Alteration ...... ~..
'Repair .............. Removal .............. Demolition .... ..... ....'.i.. Other Work ...............
4. Estimated Cost ............... ,. Fee ':
(to be paid on' filing this application)
5. If dwelling, number of dwelling units ...... l ........ Number of dwelling unit~ on each floor... ..............
If garage, number of cars ................ ~ ........................................................
6. If business commercial or mixed occupancy, specify nature and extent of each tyl/e of use .........
7. Dnuensmns of e_xjt~ng structures, xf any. Front ..... /. ......... Rear .... .c~. ~.i ......Depth ... ~.~.. ......
Height ... f. ~ ........ Number o f Stories ........ /. .................... i ...........................
Dimensions of sa~qe structure with alterations or additiol~s: Front .... /..~.:.. [ ... Rear .... /..Y-~.~. ..........
Depth .. ?..~. f. .......... Height ....... .~../..~. ........ Number of Stories ...... ~ ..............
8. Dimensions of en~tire new construction: Front ..... [.~./. ...... Rear . /,,~ ~ . De~th ~f~'~. .
Height ... ~. .......... Number of Stones ....~. ........................ . ......
10. Date of Purchase ......................... :... Name of Former Owner . .: ................... ~ .......
1 1. Zone or use district in which premises are situated ..... .~ .xp.,~..~?.~. q.% ..... , ...........................
12. Does proposed construction violate any zoning law, ordinance or regulation: ..... i. ~..O. ......................
13. Will lot be regraded .... /v.~z.4 .... ~ ........... Will exc.~ess fill be Lemoved~fr,om premises: ~ No
Name of Architect ............................ Address ................ !... Phone No .....
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and~indlcate all set-back dimensions from
ie whether
STATE OF NEW YORK, S.S
~OUNTY OF .................
................................................. being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
~e is the ........................................................................................
(Contractor, agent, corporate officer, etc.) .
)f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that ail statements contained in this application are true to the best of his knowledge and belief; and that the
~ork will be performed in the manner set forth in the application filed therewith.
~worn to before me this
o- !~.,~.. (Signature of applicant)
rL
, ,OF OCC~P,4NCY
o~UPANCY OR
OF ::~UPANCY
NOTIw BUI~ING DEPARTMENT AT
765:18029 AM TO 4 PM' ~R THE
ZrROUGHr ~:F~ING & ~UMBING
~ .~O~sTRUcT 0N MUST
. ME~' ~
'CONSTRUCTION ERRORS,,
Phone 47%0400:
'l
It
?hone 477-0400 ~ Main Road
,ir
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