HomeMy WebLinkAbout14307-zT~VN OF SOUTHOLD
BGILDING DI'*PARTM£NT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
NB 14307, Z
Permission is hereby granted t.o: _ ~ n
"<L,J~ ~ ~.~.g,:L,..."~.
........ !.,&'.L~.....~....~ ......................
.~...~ ..........~.~.. ,/~ .~ ~.
~ .............................. :.~....;:.:...r----~ ....... ; ........ ~ ........ i' ...................... ;:;': .......... ;"
at premises located at ....I..~.....~.'.......x...~...%~ ....... ).~.-.-.~... ....... ~~ ............
County Tax Map No. i000 Section ...... .(~..'~...J. ..... Bk~ck .......(~..l ......... Lot No ...... L..~.. ............
by
the
Building Inspector.
Building Irk~tor
Rev. 6/30/80
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hail
Southold, N.Y.
Certificate Of Occupancy
No. Z16595 Date January. 19, 1988
THIS CERTIFIES that the building .... O.n..e..f.a.m..i.l.y...d .w.e.l. 1..i.n.g.. .....................
Location of Property 1600 North Parish Drive Southold
- - ....................... 's'ge i .......................
County Tax Map No. 1000 Section . . 0..7 .I ....... Block .... .1 .......... Lot . .2. 6. .............
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
· .S .e.p.~.:..4?. 1985 pursuant to which Building Permit No. l 4308 z
dated .. $.e.P.t.,..2.4. ~..1.9.8. 5. .......... 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 .........
..... 0ue..fi om~-.1.y.. ~l~a.e. 1. 1..~.n.g ,...a.t.t.a.c..h ?.d.. g .a.r.a.~ .e .. ...............................
The certificate isissued to NANCYE AND MACK RADMIN
..................... ?o¥0'o;, .....................
of the aforesaid building.
Suffolk County Department of Health Approval .... .8.5.-~ S. 97-.1.6. 5...1./.7. ./.8.8 ...................
UNDERWRITERS CERTIFICATE NO. N746711 4/25/86
PLUMBERS CERTIFICATION DATED: Henry J. Smith & Son 9/16/86
Building Inspector
Rev. 1/81
FOB*M NO. fJ
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)
14308 Z
Permission is hereby granted to:
.......... ,
et premises located at .':~....g.~..-~.O. ........ **~........~...)l~...,....~~ ............
County Tax Map No. !000 Section ...... ..(~..~...t ...... Block .......... I. .......... Lot No ....... ..~..~ ........
pursuant tO application doted .... ..~~.....!~ ......... , 19..~...~,~, and approved by
the
Building Inspector.
Fee $..~...~....~..,: ...~...~..,
Building Inspector
Rev. 6/30/80
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 typewriter OR ink, and submitted m~ 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 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.
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
topograph ic 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 required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre*existing dwelling $15.0 0
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00 ..~.C.p .~jJ
5.Updated C.O. $15.00 Date .... '~.'.../.~o..I ~ ./~.~ ....
New¢onstpuct±on ..... Old or Pre-existing Building ............ Vacant Land .............
Location of Property . J(pO.Q ' ) 14 . , ...... ~ ~.
House No. Street Ham/et
Owner or Owners of Property .. ~.~ ~...~.t¥. j ~[~.~jf~ ..~.q.~ ~_) .......
- 0/91 i
County Tax Map No. 1000 Section ........... Block ............... Lot ...........
Subdivision ................................. Filed Map No ........... Lot No ..............
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ ........................
Construction on above described building and perr~it meets all applicable codes anI regulations.
Applicant .(,:~.~/~,. ~. ~Y.'.~..'..~'..~.~'. ~.¥..~...)...~.; ./~.-. ...........
Rev, 10-10-78
"- ' ~ ' StNGEE FAMILY DWELLING ONLY ' - . ,',
' Th'e sewage*'diSpg~l 'a~d water sul~p y f.aC ti~ for.th=
' Ioca(~on, have bee~ insCtect~d by this Department and/lit'
' Ch OdBur~uof Wa:Stew~-~anage~eM ,
THE NEW YORK BOARD OF FIRE UNDERWRITERS
100107~
BUREAU OF ELECTRICITY
~{][ 85 JOHN STREET, NEW YORK, NEW YORK 10038
Rate April 25,1986 /lpplicationNo. onfile $78555/86
T.,S CE.T,~,BS T.AT N746711
only the electrical equipmertt as described below and introduced by the applicant framed on the above application number in the premise# of
Hack Radmtn, North Pa:¢ish Dr~ off N. Bayviow, Southold,
~ · Section Block Lot
and found to be in compliance with the requirements of this Board.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
OUTLETS RECEPTACLE SWITCHES INCANDE$CENIFL_UC,~RE_S~E?; ~ ~ AMT. K W. AM% K. W AMY. K.W AMT. K.W AMT. H. P
6 I 3 6
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ;PECIALREC'PT TIMECLOCKS BELL UJ~IIHEAFERS MULTI-OUTLET DIMMERS
SYSTEMS --
AMT K W, O1[ H P GAS H. P AMT ~qO, A W. G AMT AMp. AMT. AMPS, TRANS. AMT H P. NO. OF FEET AMT. I WATTS
2, F
SERVICE DISCONNECT NO. OF S E R V I C
METER E
AMT. AMp. TYPE EQUIP· ].g2W 1~'3W 3.g'3W 3~'4W NOD COND OF~CCOND NO. OF HI-LEG A.W.G NO. OFNEUTRALS AW.G
OF Hi-LEG OF NEUTRAL
t 200 cb × 4/0 1 4-/0
OTHER APPARATUS:
Box 215
Southold, N.Y., 11971 GENEI~AL MANAGER
This certificate must not be altered in any manned return to the office of the Board i~: .......... Per__,
This certificate must not be altered ~nany manned b'h~r~r ~redentlqls ,~
COPY FOR RUI/DIN~ r~PAE~TJbll:Ar'r *l"Ul~' ~'~'~nv ~,e-
DF ~ ; MUST NOT BE
HENRY J, SMITH & SON,
P/UMelNG, HEATING & FUEL OIL
MAiN ROAD
SOUTHOLD, N.Y. 11971
(516) 765--3690
Jr]o.
CERTIFICATION
Building Permit No._~j~Z
Owner M.Rad~D~_~3~_~j~_~j~e, Southold
Plumber HenK[ J. Smith & Sonz Inc.
I
system
certify that the solder used in the water supply
contains less than 2/10 of 12 lead.
Sworn to before me this
16th day of _~~_,
~__.
Notary Public, S_u_ff_o_lk County
[IER~/'~DETTE L. TAP[IN
NOTARY PUBLIC, State of New York
Residing in Suffolk Courliy
Commi$$io. Expires March 30, I9zz
FIELD INSPECTION
1.
FOUNDATION
2.
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
765-1~02
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] ROUGH PLBG.
] INSULATION
] FINAL
DATE
INSPECTOR
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
~OUTHOLD, N.Y. 11971
TEL.: 765-1802
Examined .~'~-m .~...~.~.., 19 ~
~ ,Ta)~,~lu~ ,l>{ Pe~itNo.
A~ov~ ............. ~f. .~.~ ~.¢~.%.
Disapproved a/c .....................................
. ....
(Buildi~nspector)
APPLICATIOM FOR BOlLDI~G PERMIT
INSTRUCTIONS
Received ........... ,19...
Date .................. 1
a. Tins 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 applicable laws, ordinances, building code, housing code, and regulations, and to
admit authorized inspectors on premises and in building for necessary inspections.
... ~//.~.. ~.~,:... ~.~. ~e..~,~..
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ....... · .~.$(~/~. ¢kJ~t6/d~5,g. · · · ~t~/~/..~- .................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.4:. . . . ......... .............
(Name and title of corporate officer)
Builder's License No ..... ~.~' ..................
Plumber's License No. /.~.~.~..Lff....~..df../~..e ....
Electrician's License No. ~ ~te' ~
,
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 ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ..... .~.~..C.'~f ['7~. ....................................................
'7
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ..........
Repair .............. Removal .............. Demolition ....... ; ...... Other Work ...............
4.
Estimated
(to be paid on filing this application)
5 If dw lli mb of dwell'nj units Numb of dwelling units n each floor
e Ag, nu er 1 ............... er o ................
If garage, number of cars ... .
6. If business, commercial or mixed occupancy, specify ~aJure and extent of eac¢~ype of use .....
'Depth ..............
7 Dim nsions of existing structures if any: Front ctr~ Rear ?. t:~oe' '
Hight ./~. e Nulnb r of Stories
Dimensions of same structure With alterations or additions: Front ...,i~q. ......... Rear .
Depth ................... ~ Height Number of Stories
8. Dimensions of entire new construction: Front ............... Rear ............... Depth ...............
Height ............... Number of Stories ......................................................
,
10. Date of Purchase
......... ~ ................... Name of Former Owner .............................
11. Zone or use district in which piemises are situated .....................................................
12. Does proposed construction viglate any zoning law, ordinance or regulation: ........... 42.0. .................
13. Will lot be regraded ........ I ....A~]~ ............. Will excess fill be removed from premises: Yes r'< No
14. Name of Owner of premises Zq'ge~.. ~'/~0~(,~ .... Address .Zq.t~ ./9.~/_~ ..... Phone No ................
Name of Architect . ~ ..... ! ......... .~ ....... Address ...... ~. ~t/~ ....... Phone No ...............
Name of Contractor ~.¢.*¢[4,0 .~.~'~-'./~A .t~gv/ff/.~¢~. Address . ~~ ....... Phone No. Xrd~.~.).,~.'...
PLOT DIAGRAM
,ocate cleariy and d~stinctl¥ a~l buildings, whether ex~stmg or proposed, and. red,cate all set-back dnnensmns from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or coruer lot.
STATE OF NEW~OPdq,
· . .......... [.~.~ ~_.¢...0.:..~.{ [.~h'~ .............. being duly sworn, deposes and says that he is the applicant
(Name .... ''
of mdiwdual a~mg contract)
above named.
(Contractor, agenti corporate officer, etc.)
of said owner or owners, ~d is drily authorized to perform or have perfo~ed the said work ~d to m~e and file this
application; that all statements co~tained .~ this application are true ,to the best of his ~owledge and belief; and that the
work will be perfo~ed in the m~fier set forth ~ the application filed therewith·
Sworn to before me this '
Notg~
NOTARY PUaLIC, Store o/New Yo~ ..... ~ ' ~'' ..........
No. 52.452477~ (Signature of applicant)
QualiIie~ in
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