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Home My WebLink About14321-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16931 Date October 1, ......... 19 86 THIS CERTIFIES th t tl b ildJng Addition a le u ................................................ Location of Property 155 Antler Lane ~ C. utchogue House No. Street Hamlet County Tax Map No. 1000 Section 9 7 .Block ? .... Lot 8 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated September 12, 19,8.5. pursuant to which Building permit No. 16321Z dated ....O.c.~?.b.?¥. ~. .............. 19. ~.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 ......... Addition to existing dwelling & garage The certificate is issued to Charles Levien ..................... ioYn'& ..................... of the aforesaid building. Suffolk County Department of Health Approval .......... ~/..A ............................. UNDERWRITERS CERTIFICATE NO .................. ~ 7 .6 9.7.9.0. ........................ Plumbers certification dated August 29~ 1986 Rev. 1/81 FORM ~TO. ft TOWN OF SOUTHOI'D BUll. DING DEPARTMENT TOWN HAI,L SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 14321 Z Permission is hereby granted to: ......... ............. . ..................................... ........... ~..~ ...... l.~:~. .......................................... · ~qt,"~ ~,.~, ..... ............ ~;.~.~..~....~. ................. ~ ................ ~ ...................... ~ ................ ~.....~.~.....~. .......... at premises located at .................................. ~.~..~.. ....... ..~.J~,..~ ....... ~.L?.'.~..O...~.~.~../.~..j...~. ....... County Tax Map No. 1000 Section .......... ~...~. ....... Block ............ ~ ....... Lot No .......~.. ............... pursuant to opptlcatlon dated ......................... ~.../.../..~.. ................... , 19...~....~ and approved by the Building Inspector. ~ae ~.....~..:~.?. ...... 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 BLDG. DEPT. TOWN OF $OUTHOLD Instructions This application must be filled in typewriter OR ink, and submitted 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 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 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 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.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .............. .I~..~.J.' .'~.~. , , .~...(~..kJ.~. .......... .CT.o~C' t~..O.~.-~?..~_ ..... /-louse No, Street Ham/et Owner or Owners of Property ...0-'../f{t ~3~- L-~-_.~ ~ t/l ~:k) County Tax Map No. 1000 Section . .~..~. ......... Block...r~. .......... Lot ..... ~. .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No../.~..~..o~J.., Date of Permit ~0./IZ~;...Applicant..~.~ ,~r'¥,O. 9. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ....................... Request for Temporary Certificate ..................... Final Certificate ... ~ ................. Fee Submitted $...~.,.L?.(~. ..................... Construction on above described building an~je~mit meets ~__ a?ptica~bl~,,es and .~.~..t~ regulations. Applicant. ~>~..~..~.. ~'-~.~...~..~.} .................... $ Oq l (, Co% THE NEW YORK BOARD OF FiRE UNDERWRITERS ]00.'[D7]. BUREAU OF ELECTRICITY ] 85 JOHN STREET, NEW YORK, NEW YORK 10038 B.,. Sept~mb(,~' 1~,19~ .~pp,i.a,lo.~o.o,,~'ii. 370,~01/85 N 769790 THIS CERTIFIES THAT only the electrical equipment as described belotv and introduced by the Gppllcc~t~t framed o~ the above app[icatio,'~ ~m~er in the premises of Charles Levien~ c/o Antler Lane ~ BeeBee Dr.~ Eugene Rd., Cutchogue~ N.Y. in the foBowlng Iocatlon~ [] Basement [] Ist I'¥, [] 2nd FI. .Section Block Lot ~as e~mnined on ,¢] O~ t o]~be r ~ ]., 19 8 6 and found to be in compliance with the requlr~ments ~f this Board. 17 23 DRYERS SYETEMS NO. OF FEET OTHER APPARATUS: Hotors-l-5/4H.P. Pane~boards ;I-8 (cir.)125amps. 1-10. 0K.W. -Heat Pump 1-1~ Ton~A.C, [Init G.F.C.I.-2, Smoke Detector-1 Elec. lVater tteater- 1-4.5 K.W. E R V I C NO, OF CC COND PER ~' G ~ S E]ec. Box 215 Southold, N.Y., 11971 AWG OF CC, COHO 2/0 NO OF HI-LEO A W,G OF HMEG NO OF NEUTRALS 1 A, WG OF NEUTRAL zl0 lic.~578B This certificate must not be altered in manner; return to the office of the Board if incorrect, be identified by their credentials. any Inspectors may COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-I 802 CERTIFICATION Date Building Permit No. Owner C;J/~L(----~ (please print) Plumber r~ ~1~ F~ ~ (please prifit) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me thi~/ 97 day of ~~ Notary Public, .County (plumbe~ signat~e) Notary Public M~.CISLAUS WINIARZ Notary Public S~'oh~ of New YOrI~ No. 52-9703725 Suffolk County ~IELD INS~ECTION 1. ;'OUNDATION "OUNDATION 2. (2nd) ~OUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY/ . ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND ~ INSULATION [ ] FRAMING [ ] FINAL REMARKS: ~ ~/~ DATE 765-1802 BUILDING DEPT. INSPECTION I' ] FOUNDATION IST [ ] ROUGH pLBG. [ ] FOUNDATION 2ND [ ] INSULATION REMARKS: 7GS-1802 BUILDING DEPT. INSPEC T N FOUNDATION 1ST ~'/ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION / [/~FRAMING [ ] FINAL REMARKS:, ,, ,/~ DATE -'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180;3 Examined ..... ^pproved ..... ..... Disapproved a/c ..................................... Received. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 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 whole or in part for any purpose whatever until a Certificate of Occupa~.,cy 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 cbde, and regulations, and to admit authorized inspectors on premises and in building for necessary in)p/ections. · ..../v'?. ~ .vw~... (~...'x-.-..27.~._~c.: .... (Signature of applicant, or name, if a corporation) ~o.x.../..e'.¢..2,..,..//7..~..~. :..~,~r.~..~.., ~.././.a~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engdneer, general contractor, electrician, plumber or builder. Name of owner of premises ... . ~ .... ~g~'../. ~ ........................................ (as on the tax roll or latest deed) If appli~)is a corporatio, a), si.grjgture of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No. ,fl~..'Zz~.,~MLF../.~. .ff~-ff ~ Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. xg..: ........ Hous~ Number Street Hamlet County Tax Map No. 1000 Section ...... /...q. ...... Block -- Lot Subdivision ....................... .~ff. ........ 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 .. b. Intended use and occupancy ./:.. ~.. ~~'~'1$¢1~.~ y~..qli2q .......................... 10. 11. 12. 13. 14. Nature of work (check which ~pplicable): New Building Repair .............. Removal ....... Estimated Cost .~t.~.. '/' O00 . .. If dwelling, number of dwelling units ..... property lines. Give street and block number or description .......... Addition ...... Alteration .......... ...... Demolition ............. Other Work ............... (Description) (to be paid on filing this application) ........ Number of dwelling units on each floor ................ If garage, number of cars .... .................................................................. If business, commercial or mixed occupancy, specify nature and extent of.each type of use .............. - . Dimensions of existing structu~res if any: Front .......... ~ Re~'~'..~*.,.~ ....... Depth .............. · . Height ............... Number of Stones ................................................. D~ensions of same structure with alterations or additions: Front ................. Rear .................. Depth ~ HeiSt N tuber of Stories of entire new construction Front Rear Depth D~ensions ............................................. ~e~gbt ...... N-tuber ~f Sto~es .................................................... Size of lot: Front .. Z.~ .... i ............ Rear .... d ~ ............ Depth . ~ .~.~ ............... fP [ Nm ofF Date o urchase .......... . ................... e omer Owner ............................. . Zofie or use district in which premises are situated ....... ~ ~. ........................................ Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ...... .~ .................... Will exc~s fill be removed from premises: Yes N~ Nme of Owner of premises d~ ~.. Address .6~.~..~Phone No.. 7~..~.. Nme of~chitect . ~~ ~¢~.. ~... Address .................... Phone No ....... ........ Address~~. ~.. Phone $o.~. ~ ~ of Contractor PLOT DIAG~ Locate clearly ~d distinctly fll bufld~gs, whether existing or proposed, ~d~ indicate ~1 set-back d~ensions from accord~g to deed, ~d show street nmos and indicate whether interior or corner lot. STA'rE-rYI~ NEW YORK, / ........ ' ......... ' ........ being'duly sworn, deposes and says that he is the applicant (Name-df ihdi iv dual signing contraclY~-- above named. He is the ...... ~ · :: .x~L~. .............. I (Contractor, agent, corporate officer, etc.) of said ov2ner or owners, and is d¢ly authorized to perform or have performed the said work and to make and file this application; that all statements cogtained in this application are true to the best of his knowledge and belief; and that the work will be performed in the man,er set forth in the application filed therewith. Sworn to before me this ..... /. c~ ,~ ............ day ...... , 19. Notary Public, . ................. County'x. -