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14349-z
FORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..Z. ) .4.2.2.8. ......... Date ......... F.. 9 .b.p.u.a..py..q.q ........... 19 ~3.~. THIS CERTIFIES that the building ........ ~ .e F..~ 9 .u.n.d.a..g .~ 9.n. ....................... Location of Property 370 0sseo Ave & 135 Opechee Ave. Southold County Tax Map No. 1000 Section ...... 0..8.7...Block ... 9.3. ......... Lot ....0.2.4. .......... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... S. e. p.g.... 2. .0 ......... 19~. 5.. pursuant to which Building Permit No..1 ).3.4..9 .Z .............. dated (? ¢.t.... ~ 5 .................... 19.85, 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 ......... ~ ~.w,. f o~.nd a ~i.an. wi.%h, f.~l 1. c.e.11 a r..u n d e~.. a n..e.x i s .t.ing. ~.~e $ li.n g .......... The certificate is issued to HELEN J. REDHEAD ..................... .................... of the aforesaid building. Suffolk County Department of Health Approval ......... ~/.A. ............................. UNDERWRITERS CERTIFICATE NO ................. ~/.~. ............................. Rev. 1/81 D Buil~nspector ~ ' ' 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) N~- 14349 Z Permission is hereby granted to: .......... ~.~..~....~(~. ............. ....... ~.~ .~.~-;:.~.~...~ .~.,.~. ..................... .... ,,~ .r....~.~=.~...,,.~...././...~...'~ .... ~ ~....~ ..~a~...~ ....... ~.~...~.~...~ .... ...u~E~...~....~~....~.~./l~ ................................................ ~ ........... ~, ~,~,~,,~,~ ~, ..... ~ .................. ~.~....~/~ ................... Q~ ..................... ....................................................................................................... ~g.~. ............................ ...... ~~..~s....~ ................................................................................................ co~w ~ ~ N~. ~oo~ s,~,~. ..g..~ ...... ~:~k .....Q..$. ........ Lo, N~...a.~ ........ Building Inspector. Fee $ ........................ Building Insl~ector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1~802 BLDG. DEPT TOWN OF SOUTHOLD _ APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted =. IJmJJ~aa 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 instalta- 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 features. 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 $15.00 Date..~'ld~:..3:. 1, i. ?.b. ...... / New Building ............. Old or Pre-existing Building . ../. ........ Vacant Land ............. Location of Property .... ~...~ i.. (.~ .(/~...0~..~...~.~, ~. '.~..' .~. '.~' House No. ~J str~,)~t Ham/et Owner or Owners of Property ... ~ .~'.'..~~ .............................. County Tax Map No. 1000 Section ......... ~. 7... Block '~ Lot. ~ ~zJ Subdivision .~.~. ).~.: .q..'/.~..~.~ .~. .... ~dj-[-........S¢C~ I. ...... .Filed Map No. ~.g.'T ~."?:~.Lot No. C ~,~ =..,;~1° ...... ~ cRt~$ Permit No ........ Date of Permit .......... Applicant ................................. Health Dept. Approval ........................ Labor Dept. Approval ...................... Underwriters Approval ........................ Planning Board Approval ..................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. ~.: .0 .O ....................... Construction on above described building and permit meets all applicable codes and regulations. Rev, 10-I0-7S TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 Jan.23, 1986 To Whom This May Concern, Tlze final inspection was made Jan. 22, everything O.K. We are unable to complete your Certificate of Occupancy because,of the following reasons. An application for Certificate of Occupancy is not on file. AFFLICATION ENCLOSED /5/ No Underwriters Certificate on file. The check is(outdated~not on file.) /Z/ No Health Dept. Approval on file. /5/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit ~ 3__ k_ ~_~ __~ _3_ Z Building Depto ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FIEL© INSPECTION FOUNDATION FOUNDATION ROUGH FRAME & PLUMBING (1st) (2nd) INSULATION PER N. Y, STATE ENERGY G,ODE COMMENT~ FINAL ADDITIONAL COMMENTS: FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL .... ~./~.~.~..z.,..~./.>.r. ..~.~ .~..,../.~. PLEASE TAKE NOTICE that your application datea ... _~,_~.~..F. ;. .... ~.~..O. ..... ,19 for permit to CO~t~..r'.~,..,C_~.~.. ~.~-7~.~..A~.~qX-~.C)./~... ~. ~././.~..Z~..-~.) ........... at Location of Property hb . ' ' ~~' Stro~{ ............ County Tax Map No. 1000 Section . D~¢ .... Block . .~.~ ....... ~t Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the following grounds ~..~. ~Z'(.~. · .~t~. ......... · ~z~ ~o~ ~~o~..¢... ~o~..~ .... .... /~ ~/~ .~ ~ , . ~. 49. ~. . ~c /~' . . ~ ~ . . ~. . , ...... ~ . . ~. ..... . .~/...r..~... :.... ~~...~. ~~ ~ ~. ~~.~.. ...~.. ~vE~o~ .......................................... RV ~/80 , 765-1802 BUILDING DEPT. INSPECTION oOUNDATION [ ] ROUGH PLBG. 1ST UNDATION ZND [ ] INSULATION [ ] FRAMING FINAL ' ~f-~-~J-~,c/-~.~O ~ ~5~ TOWN OF SOUTHOLD BUILDING DEPARTMENT ~~~ /~ ~ ')/ TOWN HALL ~ ~OUTHOLD. ~.Y. 11S71 ~ T E L.: 765-1802 TOWN OF SOUTHOLD Examin~..~.~..., 19~-- Received ........... ,19... ~pp~ow~ ~/c .~./~.'::.. :. .... ~ .... ~ .... ........................... . ..... ..... _ . (Building Inspector) APPLICATION FOR BUILDING PERMIT ' Date q~:~R ........... 19~ 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. e. 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 wh61e or in part for any purpose whatever until ~ 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 cbde, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature o~'applicant, or name, if a corporation) ~q.~. ~.v. e~. . .'~ ~. ~.' :?~. .~>74q-o.> .,v ~ . !!>:WY... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. Name of owner of premises .......................................................................... (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..~./.[.. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No . 370 .7: .... ~... I. Location of land on which proposed work will be done. ~t~A~ ~ ................ ............ [3~ .~.. ~/n~d,~.. &~L~...~, ~. ~ .... .... : ................. Street House Number :o.nty x o. 000 tion ...... ........ .... : ........... ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of propose~ construction: a. Existing use and occupancy .... ~'.~ m.~ ~:...~g~ ............................. :'. ......... R'epair ........... '. :".[ ilemoval .............. Demolition ...... Other Work ....~A'~..... ' 4. Estimated Cos~t .... ~ ~..~t~..,,.~. ............ Fee . ~ ..~ .O. ~... - ;.~;..- ' / ~ ~ " (to be paid on filing this application) 5~.If dwelling, number of dw611ing 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 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 .................. pth ' Hight St De .................. ;... e ...................... Number of ories ...................... ', ,8.Dimensions of entire new construction:, Front ............... Rear ............... Depth ............... Height ..... Nnmber of ,qtnria.q ................... 9 Size of lot: Front ' Rear Depth 10. Date of Purchase . . ~ ... ....... ~ ................ Name of Former Owner ............................. 1 1.Zofie or use district in which premises are situated .................................................... .. 1 2.Does proposed construction violate any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded ....... { .................... Will excess fill be removed from premises: Yes No !lg. Name of Owner ofpremises~..~.~ ....... Address ................... Phone No ................ .Name of Architect ........ i .................. Address ................... Phone No ................ Name of Contractor ....... i .................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or p] ~posed, and, indicate all set-back dimensions from property lines. Give street and block number or description accord'~g t, deed, am show street names and indicate whether interior or corner lot. - 50" STATE OF NEW YORK, S.S COUNTY OF ................. : .................. (Name of individual agnmg contract) above named. being duly sworn, deposes and says that he is the applicant (Signature of applicant) He is the ....................................... i ....... ~ ......................................... (Contractor, agent, corporate officer, etc.) of said owner 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 contained 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 .......... i~0. ~ ...... day bf. i .~,~J~.. .......... , 19 g.5~ Notary Public, ..~ ~-i ~);_/~fo¢_~ County NOTIFY B L)] L~NG ~65-1802 9~AM TO FOLLOWING IF,ISPEC~i:iONS: ' FOR PPL.JRFD CONCRETE 2 ROUG~ 4FRAMING 4. FINAL_ ALL CO~"M~.C iON ~HE RE~LH~EME~TS ~A~E. CO~DTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN O~