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HomeMy WebLinkAbout14542-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No....g.1.4. 4..5.4 ........ Date ...... .~.a..y..3.0. ................... 19 .8.6. THIS CERTIFIES that the building ........ .a.d.d. 5. ¥ ?_.o.n. .............................. Location of Property ..... .5.~.0.0. ............. .C.o.x. '.s...L.a.n..e ............ .C.u.~. c..h.o.g.u.e. ..... - House No. Street Hamlet County Tax Map No. 1000 Section @6 . .Block 6 .Lot 3 Subdivision ............. ,X ................. Filed Map No .... X. ....Lot No. × conforms substantially to the Application for Building Permit heretofore filed in this office dated December 18 19.8.5. pursuant to which Building Permit No. 14542Z dated ..... .F.e.b.r..u .~.r.y.. ! .3 .......... 198..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 ......... Addition to existing agricultural building fop office. The certificate is issued to PLANTINGS BY THE SEA, INC (owner, ~.~OX ~,tO~ of the aforesaid building, Suffolk County Department of Health Approval ............... ,N,/, A~ ....................... UNDERWRITERS CERTIFICATE NO ...................... .N.7.4. ~..2.3.3. ................... Rev, l/81 Building Inspector 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) ~qo. 14542 Z Permission is herebt granted t~ ....~..~..~.....~e.. ........................................ ....... ~.~-~.~.~.~..~:.~.....zz..~..~- ,o ...... ~o.~..~.~.~.....~..~.~.z~.~.~...;..~.~.....~.~.~..~.~ ..................... /~ .c ~. ~ .~ .~........~.. ,.~ ~..,~ ~....~....~.~..c~ .......................................... ot premises located at ..... ~..(~...C? .......... G..~.....~....S ........~...,~. ~.,. .............................................. ............................................................................................................ ~.~~,..zv...~ County Tox Mop No. ]000 Section ..~..~.....~.. ........ Block ..~....~. ........... Lot No. ~...~. .......... pursuorlt to opplicotion dote~ ...... /.~.. ............................ , ]9..~...~..Tond approved by the Building Inspector. Building Inspector Rev. 6/30/80 / / / K4A~ OF: LAME) 6~V~¥ED FOR. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY  85 JOHN STREET, NEW YORK, NEW YORK 10038 ~.te ~ 2,z. ]~ss ~ppli~.,o, No.o,~,iie SS2~..USSN 742233 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of Plgn~inff~ L~y the h~ I~. C~or. of Coxs L~me ~ Route ~8~ Depot ~ Bridge, L~m~, O~t~¢~, N. in the followlng location; [] Basement ~ 1st Fl. was examined on ~P~'(~) L7 ~ 198S FIXTURE I FIXTURES OUTLETS RECEPTACLES SWITCHES FLUORESCENT 7 8 3 2 5 DRYERS FURNACE FUTURE APPLIANCE,FEEDERS [] 2nd FI. Section Block Lot and found to be in compliance with the requirements of this Board. RANGES OVENS DISH WASHERS EXHAUST FANS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: Electric Roc~ ~at~s: 1-4.0kw pemelbe~'ds: 1-4ciro S E NO. O~ERCC~,COND R V I C E A, W.G. NO, OF HI-LEO A. W, G NO. OF NEUTRAl A. W, G CC, COND OF HI-LEG OF NEUTRAL Cu. tehol~e~ N.Y. 11935 Lie. 2000 E ~. GSNi~A[ MANAGER This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 To Whom This May C~ncern, We are unable~to complete your Certificate of Occupancy because,of the following reasons. /_~ An application for Certificate of Occupancy /is not on file. ~z~ ~~ _~ No Underwriters Certificate on file. J--_~ The check is(outdated/not on file.) /Z/ No Health Dept. Approval on file. /Z/ No final inspection has been made° Please contact our office on this matter. Thank you for your cooperation. Building Permit # ~_ ~~ ~ .~ ~_ Z Building Depto **~/Z/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April. 1,1984 ) FIELD ~NSI'ECTION ~I)ATE COMMENTS FOUNDATION ( 2nd ) 2. ROUGH FRAME & .... PLUMBING - INSULATION PER N. Y. _ STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted iII-~I, 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 featu res. 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 pztOperty 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- tion requ ired to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 New Building ~g~ ,'~,..¢~:~.l;k~,e, xisting Building $15.00 ............ Vacant Land ............. Owner or Owners of Property ......... .c~.. (.. . .~.~..; .......... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. it No Perm ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .. ~ ................. Fee Submitted $ .~(~', .~..../'-~..~, ." .LT~..~ ........ Construction on above described building and per 'n~eets~l appl'~.J~odes and r~lations. ~'t ~ '~ Applicant ...... ...................... L.. F~LOV£~ 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined...?././..~. ...... 19~..' Approved.. ~/./..~ ....... , 1 .~.. Permit No../.~/..~.~..~.. Disapproved a/c ....... ~(Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS TOWN OF '~oUTHOLD J Received ........... ,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 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 wt~le 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 SoutholdL',~uffolk 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. ·. 6'. ....... (Signature of apphcant, or name, if a corporation) //. (Mgiling aA~d~ress of applican~)'~ State whether applicant is owner, lessee, agent, architect, engineer, general conff'a~tTor-, le ectric~ffi, plumber or builder. ..... ........................................................ - ......................... Name of owner of premises . (as on the tax roll or latest deed) If appli~.~s a/~p~natur~ ,duly authorized officer. .... /~ c:. ~....,3Z~_..,.../7.../~4...- ........... (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... '-~4~/O~ Location of land on which proposed work will be done..~.~.~. ~ :"~' ...... ~ r:...~¢::..~.'O. ~.. (. ~.'./].~ ............ ..... ~...~...,.,~..y./~.....z.z .......... ~..r~. ~.o.~. ~ .................................... House Number Street Hamlet County Tax Map No. 1000 Section ...~..~..~. ......... Block .... ~.~. .......... Lot....O..O. ? .......... 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 .... ./~. ( .C.: .t:f,~,./,.C,~'..~,~/// ........... ?...~ ............................ b. Intended use and occupancy . .,(t/~cr.e~¥,..o./.~!z4. e,. ......................................... 3. Nature of work (check which applicable): NewBuilding ' - .. Addition .... Alteration .. Repair .............. Removal '. ........ - ..... Demolition ............ ~.. Other Work ............... , (Description) 4. Estimated Cost ...... ~ .'-.. . .'zn. .............. Fee ..... ............................ ' (to be Eaid on filing this application) 5. If dwelling, number of dwelling units .............. ., Number of dwelling units on each floor ................ If garage, number of cars ............................................. : .................. ~.., ~... 6. If business, commercial or mixed occupancy, specify nature and extent of each typo of use /~tO/s,c.< .~.t-/ 7. Dlmensmns ofpx~shng structures, if any: Front...~.{> ;~ /..a.o... Rear .... . Depth ....... ; ...... Height . ~'.: ......... Number of Stories ...................... ~, .......i:. r ........................ Dimensions of sa ne structure with alterations or additions: Front ...2..o..~....~..O.... Rear .................. Depth ...................... Height ......... , ............ Number of Stories ...................... 8. Dimensions of entire new construction: Front ...~.O...~. ~..o.r. . Rear ......... ! ...... Depth .' .............. Height Number of Stories 9. Sizeoflot: Front ...................... Rear ...................... Depth : ..................... 10. Date of Purchase ............................. Name of Eormer Dwner . .i. ' ......................... 11. Zone or use district in which premises are situated...~.~'~.~/..'~...~../~..'. ~..~..~ .~.~q .~.t~.~./. ................ 12, Do~s proposed construction viqlate any zoning law, ordinance or regulation: ../~..O. ...................... ,~.~,. 13. Will lot be regraded ...... gt~.'~,...,. ','..,....,.,. ..... Will excess Ifil b,e removedi from premises Yes (,,.N~ 14. Name of Owner of premises . .,~'/~t~TO~C.O'g. OJCJe.~ddress .~.o..~..../~z..t,f¢ .... !... Phone No. 7.~.q-.. Name of Architect ........................... Address ................ i... Phone No ................ Name of Contractor .......................... Address .... ' . Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. ind property lines. Give street and block number or description according to deed, and show interior or comer lot. }'Blb~t..& RC~,'~ Q, ~, 2.'7 icate all set-back dimensions from street names and indicate wheiher STATE OF NEW YORK, COUNTY OF ................. S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .............................................................. i ........................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sa}d 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 manner set forth in the application filed therewith. : Sworn to before me this I ........... lg.YZ ........................ dayof .... Notary Public, . ...... ~"~'" '0~'"~"°~''" C°unty "