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HomeMy WebLinkAbout14385-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N.Y. Certificate Of Occupancy No. Z147~37 Date August 12 .................................................. 19.86.. THIS CERTIFIES that the building Addition Location of Property .,.. ~9.5..~r~q~. )3.3,¥ ,d: .................... E.a..s~..M.a..r.i.o.n. ....... t~ouso tva. Street Hamlet County Tax Map No. 1000 Section ...0..37 ...... Block 2 .... Lot 4 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · ...O. qt;.. 2.0. .......... 19 .8.5. pursuant to which Building Permit No. ,, J:, ,4.3,8.5, g, ............ dated .Q.cg....2. .0 ................... 19 .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 ......... Addition to existing dwelling. The certificate is issued to HERMAN C. & FLORENCE A. HEESS JR. {owner, I~F.~-tjL, eR~I:. of the aforesaid building. Suffolk County Department of Health Approval ........ N./..A ............................... N755342 UNDERWRITERS CERTIFICATE NO .................................................. PLUMBERS CERTIFICATION 6 / 18 / 86 Rev. 1/81 FORM' NO, ~B 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) No_ 14385 Z Dote ......... O ~ ............................ oqo , 19..~'..~." Permission is hereby granted to: ........................ .... ..JJ..~..~.l .......... ~.....u~.......L ~...~ .......... ~ ~, ~- . et premises Iocoted ot ....iL ........... ..~...~ ............................................... ~.. ....... County Tox Mop No. 1000 Section ......C~....~..~ ........ Block ..... .C).....~. ....... Lot No ..... ~ ................ pursuont to opplicc~tion dated ....~:::>..~..].....~... ................ , 19.~..~., and approved by the Building Inspector. Rev. 6/30/80 Bo 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 ~a ~ to the Building Inspec- tor with the followlng; 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. Commemial 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 property 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. Co Fees: 1. Certificate of occupancv $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 NewtOnS f-c~ct,ion ...... Old ?r Pre-existing Building ............ Vacant Land ........ Location of Property. L~/.. ~.' .~ i~.?~'~,~;..' :~:<~.~77 ......... ~<.:?. :.d/L4,e~.,~ U:.'. Hou~ No. Stree~ Ham/et Owner or Owners of Prope~y ~/~. ~. · · P~'~ / ' County Tax MapNe. 1000 Section..~..... ''-~ ~. .... . Block .. ........ ... Lot .......... .. . Subdivision ................................. Filed Map No ........... Lot No .............. Permit ~n Z~ Date of Permit .... Applicant.... .... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Cer?ficate ..................... Final Certificate ....................... Fee Submitted $.. .... ' ...... Construction on above described building and per~it meets all applicable codes and ~egu~ations. .. ,.-' Rev. 10-10-7S d. a:¢ THE NEW YORK BOARD OF FIRE UNDERWRITERS 1001375 BUREAU OF ELECTRICITY ~"~ 85 JOHN STREET. NEW YORK, NEW YORK 10038 ,~.~e 20, z9s6 N 755342 Date .4pplieation No. o, flf¢ 390364/86 THIS CERTIFIES THAT only the electrical equipment as d~$crlbed below and introduced by the applicant named on the above application number in the premises of Charles HEeeS~ 195 Parson's Bi¥~ (PrivatE Rd~5) FIXTURE SWITCHES FIXTURES OUTLETS FLUORESCENT 12 12 DRYERS APPLIANCE FEEDERS OTHER APPARATU: 1 Post ~"it'e 1-G.F .C.I. l-Smoke DeteEtor ~ 2nd FL Section Block and found to be in co,npllance u'ith the requ re.zents of this Board. RANGES ICOOKING DECKS I OVENS I DtSH WASHERS S ECIAL REC'PT AMp R V I C NO. OF HI-tEG Lot 75 &76 EXHAUST FANS DIMMERS DEnnis Claire, P. O. Box 284 Laurel, N oY. 11948 Li¢~2342E GENERAL MANAGRR This ,ertificole must no, be olfered COPY FOR BUILDING D*PARTMENT. THIS COPY O TOWN OF $OUTItOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. Owner /~,~ ,~ ~) (please print) Plumber ~'~C (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber's ~ignature) Sworn to before me this [~day of 19 ~ · Notary Public, // Not~J~?ublic County .~EOY~7 ~ K~G, NOTARY PUBLIC, State of New ~rm l~xplre~ March 3~, FIE~D I~SFECTION COMMENTS FOU__N D ~T I_O_N .... ~(J s t,), FOUNDATION (2nd) ROUGH FRAME & ?LUMBING INSULATION FERN. Y. : STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION XST [ ] ROUGH PLBG. FOUNDATION 2ND [/] I ~LATION// FRAMING [ d~/FINAL REMARKS: ~J~ ~U DATE ~iNSPEI~i-O' ,/~ 765-1802 BUILDING DEPT, INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND ~ INSULATION [ ] FRAMING .-'~ [ ] FINAL ~/~/ .-/7 REMARKS: /.~/x~/<' DATE /~/~ INSPECTOR ,. 76S-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST ~'" ROUGH PLBG. FOUNDATION :)ND [ ] INSULATION ~'~ FRAMING [ ] FINAL REMARKS: DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 7654803 Approved .o.~..gl.q .., 19 $ .~. Permit No. ~ ~.~ ~ ~ .~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19.. Date ................... 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. c. The work covered by this application may not be commenced before issuance of Buildihg 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary in§pections. ...... ; .... i .... (Signature of applicant, or n~t~e, if a co porat'o ) //.~',3 / ,.~ /.~.s'- ~'7-. (Mailing address of applicant) /4 / /¢ ,~n / , State whether applicant is owner, lessee, agent, architect, en~neer, general contragtor, electrician, plumber or builder. Name of owner of premises /., ,_ ,~ ,., r, . ,, ..... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Builder's License No ...... .~..~. '~7: ..... : ..... Plumber's License No ..... ~. ~.~. ~? ............ Electrician's License No.. ~.~..~.. · .~.~. ...... '.. Other Trade's License No ...................... ~.~ ~' '~""~') Location of land'on which proposed work will be done...i. ?.f.. ~....~JM~l~a~... ~...~ .... ltouse Num bar Street Hamlet County Tax Map No. 1000 Section .... ~..t~. ~. ....... Block .... ,~ ............ Lot .... ~f ............... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: y? e-. W© a. Existing use and occupancy ...... _JO _~ ~ _ l'T, J tl/,~-_~. ~V~... ! 0 ¢ ... ~ ~ ~. · . ,~... ~ ~I ....... .~ ~ b. Intended use and occupancy ..... ~i~ · .~, ~;., :~. t'~ ~-, 3. Nature of work (check which applicable): New Building .......... Addition .... Alteration .......... Repair ........ ' ...... Removal ..... , ........ Demolition .......... !... Other Work ...... :.: '. ..... 4 Estimated Cost : ~" (to beI paid 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 type of use ............. ! ..... 7. Dimensions of e/~x)sting structures, if any: Front .... ,~..~..t. .... Rear ...... ~ ....... Depth.. ,~g~. ...... Height .. ~..I~.' ........ Number of Stories ........ OW0 ~ ........... ?..~ o ....................... Dimensions of same st,q]cture with alterations or additions' Front ~..~1~ . Rear ......... Depth.. ,~.~,..~... Height .... ~/.~ ......... i iii~uml~;r of ~t;~i:s . /~ i', .... ' .' '. 8. Dimensions of entire new construction: Front ............... Rear ....... ~ ...... Depth ............ Height Number of Stories ' 9. Size of lot: Front .... /.t:~O. · . . Rear 10. Date of Purchase ............................. Name of. F~orme~ OwNer ! ......................... 1 I. Zone or use district in which premises are situated 7:... IE'.l~$lg~f4¢9~'I~l,.. i ......................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...~/'~.(P ........... 13. Will lot be regraded ....... /,~ O. ................. Will excess fill be removed from premises: I4. Name of Owner of premises Address ' i' Phone No ' Name of Architect ............................ Address ............. ' 'pr ' Phone No .... ~.:: .... ..~.,.. Name of Contractor .~'~q~'/*~l;...7'~t~*'t0.. Address ~.'2~i~ .,~'; ~}.. Phone No. 7.,~'~-.'~]'. ~... PLOT DIAGRAM Locat~ clearly and distinctly a/1 bu//dings, whether existing or proposed, and, indicate property lines. Give street and block number or description according to deed, and she interior or comer lot. all set-back dimensions from street names and indicate whether STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applies (Name of individual signing contract) above named. lie is the ............................................................ i ........................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the &aid work and to make and File ti application; that all statements contained in this application are true to the best of his knowledge and belief; and that tl work will be performed in the manner set forth in the application filed therewith. Sworn to before me this · ~'. ........... /'.5 .........day of...O.C~. ........ [ "' ..... NOYARY PU~I.~, stm of New York ................. ! ........ · . 4707878, Suffolk ._C~yi~,n (~ignature 'of~ appllcar O~UPAN~Y OR ~i~uTUNLAWR, JL - CEITnFICATE PLUMBER CEMTRCA~ION ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY ~ ._~ glUED IN WATER ON LEAD CONTEM' ,' U~UF~lisS~al ~,/1% $1./PPI.~&~t~TEMP~AWOT CERTIFICATE OF OCCUPANCY " ~:U'I[-tSu,,,.,,-,,,,..-"-'- ,~ ~ . ~.,'-',~..,,,o o, ,~ ,-.,,,:,.. , ,',,,=~ OCCUP/t~CY OR USE IS UNLAWFUL SUPPly sY~rgM EXCEED 2/10 of ~ LEAD. PUJMB~R ON L~AD CONTENT BEFORE CERTIFICATE OF OCCUPANCY :1 ~OTIFY BU~LD~r~IG DEPARTMENT ~T ,LL CO;dST~CTI~N SHALL , AE REQUI~:~ENTS OF THE N.Y ,~T~TE COt~TR~CrlON & ~ERGY Z L~Li' '