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Home My WebLink About14618-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...z. ~..4.4.7.5. ........ Date ........... q u..n.c..4. .............. ,198..6. THIS CERTIFIES that the building ...... .~.n.g .r 9.u.n.d.. pp.ql. ........................ Location of Property q060 Hoore~s Lane ~1o. . .... q.P.e.e.nport h3ds'~ hiol ....................... 's'*;o3i ............. h3/~iei County Tax Map No. 1000 Section ..... .3.3. .... Block ........ 2. ...... Lot ..... .4.3. ......... Subdivision gas te~.n...s.h, qr .e.s' .s.c. 9.~' .2. .... Filed Map No..54.77...Lot No ..... 9..9 ....... conforms substantially to the Application for Building Permit heretofore flied in this office dated ·..F.eft. ( .u .a ?. y. . .2 .0 ...... , 19 .8.6. pnrsuant to which Building Permit No ..... q.4. 6. J $ Z dated ....... M..a ?.c.h...6 ............. 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 ......... ·..g.c.q e..s p.o.r,, y..i.n, gr.. 9p.n.d' . pp.qZ., The certificate is issued to .........CARL. J. & RUTH V ........... ?oY,,'~;f~i~ ~k~' ..................... of the aforesaid building. Suffolk County Department of Health Approval ............ i~/..~ .................... N742 35 UNDERWRITERS CERTIFICATE NO ........................ 7 ......................... Rev. 1/81 Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERAAIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14618 Z Permission is hereb/gronted to: :::::::::::: : ::::::: : ,o . . ~. ~. . . . .(x ~. . ~. . . ~,~. .~ ~ ...... ~ ~. . . ~ . ~ ............. ...~.....~~. ~ ................... ~ .... ..'. ..... q ~I [g ' 0 ~ * P ......................... '~ ................................. at premises Iocoted ot .,../.~,..~. .............. ..,~.~....~...~....,..~.;, ........... ,,~~ ...... County Tax Map No. 1000 Section .... ..O..,..~...~ ....... Block .... ...~..,,~. ......... Lot No ..... ,~.....~'.. ........... pursuant to application doted ..,~...~...,~;~..O.. ............... , 19..?...~., and approved by the Building Inspector. M Building Inspector Rev. 6/30/60 THE NEW YORK BOARD OF FIRE UNDERWRITERS [D~[~0~,,3 BUREAU OF ELECTRICITY ~.~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,.re a~=l.~, o:~, ~6 'pplic.tlo..No.o. Sile 38~87~/~6 N742735 THIS CERTIFIES THAT only the electrical equipment as described below and i~troduced by the applicant ~amed on the above application ~umber in the premises of in the followlng location; [] Basement [] ~t fl. ~] ~.d kl. 0urzi([e S~ction Block rot March 27, 1986 FIXTURE t FIXTURES DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS and found to be in compliance with the requirements of this Board. RANGES DISH WASHERS EXHAUST FANS TIME CLOCKS SYSTEMS NO. OF DIMMERS SERVICE DISCONNECT S E R V I C HO'OFpERCC'CON[~, OF A'Wcc. CON[3,G' t NO'OF HI-LEG I oFA Hi. LEGW'G' NO, OF NEUTRALS I OT~.RE AR OF NEUTRAL GENE/AL MANAGER FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in Wpewriter OR ink, and submitted ~ 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 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 sifnilar 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 buildings or premises, or other pertinent informa- lion required to prepare a certificate, Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.V~cant Land C.O. $5.00 5. Updated C.Oo $15.00 $15.00 Date .......................... New Building ... ~ ....... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . ./. ,~..G.O. ' /~ ~/~,r~ .~,,, ,~??,(,, .~('~,~, ,£,Z.., , ~_~,-.2~/~./~ House No. '''' 'S't/eet ......... /-t;~ /e't Owner or Owners of Property ...~..~?.~. ,~.; ,/1./¢/. j.( .~(., .;~ ?.u../,~'., .~; . .~¢/j, ~ County Tax Map No. 1000 Section -~ ~ Block ~- Lot. 4/._~, . Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. /.~. ~.J. ?. ~ Date of Permit .3./.?/,~,~., .Applicant... :~.~¢,. ?,: ,/Y. ,c~'~. ~,,?/, ............. Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval ., .~. ,' ................ Planning Board Approval ...................... Request for Temporary Certificate ...... ~4///~- . .Final Certificate V/ Fee Submitted $ ........ ,~..0.~: ?. ,O,. ] , .~, ,~,,..~. ,~,, Construction on above described building and permit~e~tc~all applicable codes and regulations, Rev, 10-10-78 COMMENTS ~'tELD INS~ECTION !. ~OUNDATION (1st) ,'OUNDATION (2nd) ~OUGH FRAME & PLUMBING ~NSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS', 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. REMARKS DATE INSPECTOR APPi~O¥~ AS ~OTED ~ r'-'~ ~ 7~-I~02 ~ ,Ak~ ~'0 4 PM PO~l. TH~ V V ~ ~---~ I ~ FOLLOWING ~N$;~PECTIONg: . I ~ , I I I II ~ ~ ~*rNi'E c~s-~{fJC'no~l & ~!NEm,}Y ~ t :t I ~:~,, I , ;i Il ~ ..~.,.. I ~ ~" ~ d:'-'.1 - ..: j ~ud ~I I ~ I' ~1 - ~ I f I s.~.., II I I I '~ ~ I I ~ * --. II I I I .' ~[ I '] o II I I I l! I ~I I ~ II. IIt~/ o~1 '1]., IIIII I --~II 1,, ~'~ ~. I I i" ::'.u' I I iii r:'[~ .. -- . .- '',, 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803' Examined..~0~..~..-] .... , 19~..~. Approved·..~..O4~..., ?..., 19~..~. Permit No. 1 .L~./. ~..'~., Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG DEPT IOWN OF SOUI'HOLD Received ........... ,19... Date /~.-....(7~,. ..... ,19~ INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 inspectioff. ]~/2~// j ................... (Signdt'ure o~fipplicant~,or na~ne, if a corporation) _ · . .:.:. , (Mailing address o£ applicant) ~/M~//./.~>vF State whether applicant is owner, lessee, agent, architect, e~ineer, general contractor, electrician, plumber or builder. ......................... ~" ' ~ ..... *T.J ..................................................... Name of owner of premises ~/~..'~.'. ~..~'...'.~....~.ff.fi./?./...'~.....~.?.~.~. · · ............................... (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. H ~/ Plumber's License No.' i ' .~.' .~.~. i [ [ i i i i i: i i: [ [ ] Electrician's License No...z~.~...~.~...~: ........... / Other Trade's License No .... ~ .............. I. Location of land on which proposed work will be done .................................................. ........ /.o..c,.o ....... ........... .......... House Number Street Hamlet County Tax Map No. 1000 Section ........ -~. ........ Block .... C~. .......... Lot .... ~ ......... Subdivisio .n~./?~.~..~.,~...~.. ,~..~..ff...~...~':~:,~q.. Filed Map No.. :Y~.~..~..~. · .~... Lot .... ~..~. ...... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ~. ~.:. ..........~.~../.~. ~/..~3~/..~._. ............................ b. Intended u~e and occupancy ...~.~..~.~.. /.Q/~'..-~.(./..~.~.).. >..~../w~."~,~./~,-/~..:..~.~..~ .c..~.~. 3. Nature of work (check which applicable): New Building ' Addition ~ Alteration ..... , Repair .............. Removal .............. Demolition ........... i'" Other Work ....... i ........ 4. Estimated Cost ................. ..~..,~?..~./5). .................... ~,~C) Fee ........ (Description) ~ (to be ~ald on filing this application) 5. If dwelling, number of 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 ....... i ....... Depth ............... Height ............... Number of Stories ............................ ! ............................ Dimensions of same structure with alterations or additions: Front ............ ! ..... Rear .................. Depth ...................... Height ...................... Number ofiStories ...................... 8. Dimensions of entire new construction: Front ............... Rear ........ i ....... Depth ............... Height ............... Number of Stories ............................ i ................... ~.'. ....... 9. Sizeoflot: Front .................... ~. Rear ...................... Depth .. .................... 10. Date of Purchase ............................. Name o{Former Owner .i .................... ........ 11. Zone or use district in which premises are situated ......................... ........................... 12. Does proposed construction vinlat¢ any zoning law ordinance or reml1~tt6n ...... 4 13. Wall lot be regraded ...~.~---~.~.~ .......,...:.. ~, ...... Will ex~ces's fill be r-emoved from premises: 14. Name of Ownerof premises ~..,4,/~. ?.,',,~.~' .... Address~.,~. ~',Z~, ~'~f-~.. ~..~..,~. Phone No Name of Contractor,.~../.~..,f/z~'d. '.~.~.~.q-~ Ad~d~oss ~.~/. ~..~.~'. Phone No ~.' .~2.'?~..~.~.. PLOT DIAGRAM //~' ~f' . Locate clearly and distinctly all buildings, whether existing or proposed, and, in, [icate all set-back dimensions from property lines. Give street and block number or des6ription according to deed, and sho~ street names and indicate whether inter/or or corner lot. STATE OF NEW YORK, COUNTY OF ................. S.S ·../f~...~'.../f~...~...-'~..~.~.....~.'.'~-~. · .~. · · .~. · .............. being d'uly sworn deposes and says that he is the applicant (Name of individual signing contract) i above named. He is the .......................................... , ........................... (Contractor, agent, corporate officer, etc.)l of said owner or owners, ~d is duly authorized to perform or have perfo~ed the s~id work and to m~e and file this application; that all statements contained ~ this application are true to the best of his/knowledge and belief; and that the work will be perfomed in the m~ner set forth in the application filed therewith· Sworn to before me this .......... ........... dayof... C . C ...... ,19 Nora, Public, ....... --- County Lot n?7 {/1 (3 c:: 0 ~ Z '11 '11 0 0 ..q