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Home My WebLink About14597-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Build/o§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy NoZI6422 Date November 18, 1987 THIS CERTIFIES that the building . A.Gg.I.C.U.L%p.RS..L..~F.~.~P.~FP .......................... Location of Property 39695 CTY. RD. #48 SOUTHOLD House No. Street Ham/et County Tax Map No. 1000 Section 059 .... Block 9 .Lot 30.6 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Pem~it heretofore filed in this office dated · Feb. 6, 1986 pursuant to which Building Permit No. 14597Z dated ...M.a.r .c.h..2 .,. ! .9.8.6 ............. 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 ......... Construct (move) Agricultural building, as applied for. The certificate is issued to .... STEPHEN D. MUDD ................. io'.;;e~, )~;~× .................... of the aforesaid building. Suffolk County Department of Health Approval .... .N/.A ................................... UNDERWRITERS CERTIFICATE NO. NS01302 PLUMBERS CERTIFICATION BATED: N/A Rev, 1/81 FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) 1~? 14~97 Z Permission is herebt granted to: /'~__ , ~ ~ ~..'~,, ~ x.). . I/?~1 __r? ............. ~. .... .~ ............ ~ ............................. ..~ ..................................................................... at premises located at ....~..CL~.......~.. ........... .~ ....... .~...~ ......... ~>..~ ......... co,,~w To× Mop No. ~000 Se~t,o, ...... .0..~':~1 ...... 8~o~k ....... ..C.[ .......... Lo, No...~.q.,..& ...... pursuant ,o application dated ......................... ~~ .~ ................ , 19~., and approv~ by the BuiJdlng Inspector. Building Irks~ector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Depertmont Town Hall $outhold0 N.Y. 11971 765- [802 APPLICATION FOR CERTIFICATE OF OCCUPAN~ instructions A. ~This application m.ust be filled in Wpewriter OR Ink, and submitted e,~ to the Building Inq3ec- "[or 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 tho 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-existin§" land uses: 1, Accurate survey of p333port¥ showing all property lines, streets, buildings end unusual natural or topographic features, 2, Sworn statement of owner or previous owner es to use, occupancy and condition of bu*ilrlings, 3. Data of any housing code or safety inspection of buildings or premises, or other pertinent informa* tiaa required to prepare a certificate. C. Fees: I. Certificate qf occupancy New Dwe I 1 ~.ng. $25. oo,~ce.,.~ory ;$ i0 ~ Bue 2. Certificate of occupancy on pre-existing dwelling $ 50. O0 3. Copy of certificate of occupancy $ 5.'00, over 5 yeare $10.00 4.Vacant Land C.O. $ 20.00 ~. ~.~ 5.Uodated C,.O. $ 50.00 Date...?.~ ~ .............. 6. ~lteratlon $25.00 NewCons truct, ion ...... Old or Pre-existing Building ...~.. .... Vacant Land ............. . . ........... ocat,onof pty .... ......... /louse No. ~, ~ Srl'eet ^/~ Ham/er Owner or Owners of Property ..~.~~ .... .J~), ,,. .... /~.; .C."~ ..................... . County Tax Map No. 1000 Section... ~ ..... Block, ....... ~, ...... Lot...~..-~,,:, ,(~. ,~.. ' ' ' Flied Map No Lot No Subdwlslon ............................................. Permit No Date of Perm t.. ....... ~.,..App , t ..... , ................... Health Dept. Approval .................... Labor Dept. Approval .................... Underwriters Approval ~ Planning Board Approval ~ Final Certificate Request for Temporary Certificate ............................................ Fee Submitted $ .... Z(~. ...................... Construction on abovo described building and permit m.ects all ar~licablo codes a~d regulations, It~v, 10.10,7g THE NEW YORK BOARD OF FIRE UNDERWRITERS j~ BUREAU OF ELECTRICITY ~1 1~, l~J'j 85 JOHN STREET, NEW YORK, X ~XTUgE I SWITCHES OUTLETS FIXTURES RANGES OVENS DiSH WASHERS EXHAUST FANS DRYERS MULTI-OUTLET SYSTEMS NO. at: FEET E R I C NO O~ CC. COND pER ~/ AW.G OF HI-tEG E JNO OF;EUYRAL$ AWG, OF NEUTRAL Steres Elect. inc. g. O. BO:< 1268 Southold, N.Yo 11971 LiC$3494E /l GENERAL MAN.~GI~R~ This certificate must not be altered i~ any manner; retur~ to the office oJ the Board if incorrect, inspectors, may be identified by their credentials. COPY FOR BUILDING DEPArTMeNT TH S COPY OF CERT FICATE MUS~BOT BE A~ERED ~ ~ ~l ~LD INS~'ECTION DATE COMMENTS ~OUNDATION {1st} ~OUNDATION (2ndl ~OJGH FRAME & PLUMBING iNSULATION FER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL e, OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved . .~....O~...:~....., 19~..~.. Permit No..l.~..~777...~. . Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT sets of plans, a c e. b. or areas ,~l~g~4~ -~! c. Th~~~ d. [1 be kept ~~ffie e. No bu~g~Eupied [1 have been g~ ~ the APPLICATION BLDG, DEPT. TOWN OF SOUTHOLD Received ........... ,19... Date ............. 197.~ INSTRUCTIONS .g.y typewriter or in ink and submitted to the Building Inspector, with 3 to schedule. 'rl~l~of buildings on premises, relationship to adjoining premises or public streets ~f layout of property must be drawn on the diagram which is part of this appli- ~may not be commenced before issuance of Building Permit. d. the Building Inspector will issued a Building Permit to the applicant. Such permit shall be ke for inspection throughout the work. e. or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been Building Inspector. 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 colt% and ~egulations, and to admit authorized inspectors on premises and in building for necessary inspecti '" i~i~]iu~~: ~ 'n]~n'e,~if a corporat'o'n') .... .....C~......~..~...?. ¢. .... 7.~...,~..z,,..o..~b.... (Mailing address of applicant) APP~O¥~D AS. ~OTE~D State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumoeFo-r builder. D~TE: .............. (D~.~i?_~ .................................... Name of owner of prmnises .~..~-'..~.~.P//.~..zqf. .... b.~..~n, ih~e. t~ax r~oli &~ (as o t ' ~ ' l:~,~t'~M~h'i~ ,~..,. FOR ~HE If applicant is a corporation, signature of duly authorized officer. (Name and title of co~orate officer) ~ FIN,~V.,~, ~:v' ZT-~i/f:Tv.~,,~ MUST Builder's License No .......................... Plumber's License No. 3:irATE ' ~ ' , , , ........................ Electrician's License No ....................... ,. ...... ~¢~. ~¢ .... ~4 ~.. ~.cg<~ ~h... ~..[&~.~.~...~o.~ ....... House Number Street Hamlet 000 ............ ...f ............. Lot.. Je,6. ........ 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...V./..~..~.--~r~. b. Intended use and occupancy ...~~.~.... .... .~...~..../fi~t~..~.O?..O../--'~~ ................ r3. Nature of work (check which applicable): New Building ..... '. .... Addition.. ~ ........ Alteration.,~... Repair .............. Removal .............. Demolition ....... ~.,...... Other,.W, o,9~rl~,~. ~U/Z~.~. 4. Estimated Cost . .0.0. ........................... Fee.. ~.~,~.i~.~. ........................ (to be paid on filing this application) 5. If dwelling, number o f dwelling units ............... Number o f dwelling units on each floor ................ If garage, number of cars ............................................ i ............................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ....... ! ....... Depth ............... Height ............... Number of Stories ............................ : ............................ Dimensions of same structure with alterations or additions: Front ............ ! ..... Rear .......... : ........ Depth ...................... Height ....................... Numbe~r of ~tories ...................... - 8. Dimensions of entire new construction: Front . .,~ ~. ' ~. /z Rear . .r~d~/ ~ /~' r~nth ',~ Height . ~.~. .......... Number of Stories ................. 9. Sizeoflot: Front ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Former Owner . ! ............................ 11. Zone or use district in which premises are situated .... ~ .................. ! ........................ 12. Does proposed constructio,n violate any zoning law, ordinance or regulation: ...~..O ..................... 13. Will lot be regraded ...~/¢ ...................... Will excess fill be removed from premises: Y~es No 14. Name of Owner of premises,,~r~J)lCC'"'f..... ~..~./~. Address . .~x~...,~..t~..)..~(~.. ~... Phone No...7.~. ~. Name of Architect ........................... Address ............... ;... Phone No ................ 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. I STATE OF NEW YORK, COUNTY OF $.S ................................................. being duly sworn, depo4es and says that he is the applicant (Name of individual signing contract) i above named. H,e is the .............................................................. i ........................... (Contractor, agent, corporate officer, etc.)~ of, said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this al~plication; that all statements contained in this application are true to the best of his iknowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .......... f.. ........ day of ~-,Z~ 19 .o?.~ ", $otaryeublic, ...~...~.~....~.~.Jd~..,.,,,..,,~._~ Count.~ ~...~? .'~. ~fK{