The URL can be used to link to this page

Home My WebLink About14047-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..z.q.3.~ ~9 .......... Date ..... d. ql. y..5. ..................... 19.8.5. THIS CERTIFIES that the building Add±t±on Location of Property ......... .1).5.o...~.a.~.~ ~. ?.a .~. r.~y.e ............. ~.~..~.~.~.~..~.~.k .......... House No. Street Ham/et County Tax Map No. 1000 Section . .0.9..9 ....... Block 05 Lot 22 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore Cried in this office dated ·...6./. ~. ! ./.8.5. ......... ,19... pursuant to which Building Permit No. q 404. 7 Z dated .... .7./. ~. 7/.8.5. ............... 19..., 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 ......... ... j[.~ ~.~.i. qB..~.o..~;~ ~_~.g. 5,~g..qram..f.~r0 .~.l.y..d..~.e.~.~ ~[ag .............................. The certificate is issued to .... ~4..hg~ ............................................... (owner, I~(.sj[e~ ~t~rj~j~ 2( X of the aforesaid building. Suffolk County Department of Health Approval ..... ~/fi. ................................. #N6y8989 UNDERWRITERS CERTIFICATE NO ................................................. PLUMBERS CERTIFICATE 6/20/85 Building Inspector Rev. 1/81 FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 14047'Z County Tax Map No. 1000 Section ..... ...(~.....~..~. ...... Block (~'~"-' Lot No. ~--~ - ~,,rsuont to opp,~o, on dotO ...... ~5~..U~...[.} ...................... . l~..X.~ond opprov~ ~ t~e Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ia ~ 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 instaila- 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 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. 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 / New Building .... · ./.. · .... Old or Pre-existing Building $15.00 Date ...... 2. i,~, .~. ~.~. ......... · ~ ........ Vacant Land ............. House No. Street Hamlet Owner or Owners of Property ..... Z~/. . ,/~/////;~. ........................................ County Tax Map No. 1000 Section . . . ~ ~.~. ....... Block .... 4~2 ~. ...... Lot....~..~. ........ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. /:,~/.Q~.~..;?-. Date of Permit .~..-'./.?T~.~..Applicant .... .,~.....'/~.~, .-~--. ................ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval... ~Z .~..~..~ ........... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ... ~ ................. Fee Submitted $ "~ ¢) ¢ ~ ¢~ Construction on above described building and permit meets al~ a~licable codes and regulations. Applicant .... ~..~~ .......................... Rev, 10-10-78 MARIANNE LANE 1. 6 8 AL LANE F~84[. SOUND SHORE ROAD :ate to the Building Inspec- ' lines, streets, and unusual 2. Final approval of Health Dept. of water supply and sewerage msposm-t~-Y 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 pZOperty 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 cm~ificate. 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 $].5.00 Date .......................... New Building ............. Old or Pre-existing Building .... ~ ....... Vacant Land ............. Location of Property . ~.~.~'~'~2 ..... z~/.z~:~.~. .~:.~'. ..... ~.~.1~.~ ....... ~.~.-/. Hou~ No. Street Ham/et Owner or Owners of Property /~4 County Tax Map No. 1000 Section ../~. ?..?~ .~.~)..,. Block ... ~)~) ..... Lot.. Subdwm~on ................................. Filed Map No ........... Lot No .............. Permit No../~.O.//z~... Date of Permit ~.-J~":~-.'Applicant .., ~.4../~ ./,/./~. (¥~ ................ 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 permit meets altapplicable codes and regulations. Applicant ........................................... THE NEW YORK BOARD OF FIRE UNDERWRITERS iooo~?i BUREAU OF ELECTRICITy 85 JOHN STREET, NEW YORK, NEW YORK 100~8 o,t,~ Febn.tau:y 15,1985 .~ppiic,~tio, No. o,, file 296S62/84 N 678989 THiS CERTIFIES THAT only tko electrical equipment as described below at~ introduced by t~ appl~cat~t ~med on the ~b~e application number in the premises of ~ ~'e, 1450 S/S in the /ollowing locati.n; ~ Basement ~ 1st FI. ~ 2nd FI. Section Block Lot was examined on ~ 7 t~985 andfou~d to be in cornpliance with the requirements o~ this Board. :OOKING DECKS OVENS DISH WASHERS EXHAUST FANS 17 21 23 17 DRYERS FURNACE MOTORS FUTURE APPLIANCE F,EDERS SPECIALREC'PL TIMECLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS 8'- O", 3 ~ ~. O. ~ 143 GENERAl. This certificate must not ~e a tered Jn any manner; return to the office of the Board Jf incorrect, inspectors may be identified by their credentials. -= ALTERED IN ANY TOWN OF sOUrHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit No. /~9~ ~ Owner /~,,~/ (please print) Plu~er ~'~.. ~c (please I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. I~o,. 47674215 (~i, lllll~led n Suffolk CounW .. Sworn to before me this Notary Public ,~,~County FIELD ~NSFKCTION FOUNDATION (1st) COMMENTS FOUNDATION 2. (2nd) aROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ~FORNI NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined . .~.~ ;. · .~'/~...~'.~ . .., 19 j. . ~k/. ..~ ., 19.~.~. Permit No. approved ·..~'~:~-....~."J. · ' .I.~ 9.'~ .~. ~. Disapproved a/c ............................. -'"D (Building Inspector) APPLICATION FOR BUILDING PERMIT TOWN Received ........... 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 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 inspecti~.~ j~.~ ~,,~ (Signature of applica~'ti(o~name, if a corporation) .o.T.f. .z. . . . ,c?. . ,/f (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... i ..... ............................................................................. Name of owner of premises .... /fi/.-....~.~../J.'~.~. ...................................................... (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 ...................... 1. Location of land on which proposed work will be done .................................................. .... Z .FSY. .................... .W.d ....P. d./. v. eT. ......... .......... House Nmnber Street Hamlet County Tax Map No. 1000 Section ... ~). ff, ~. e.,~. ..... Block .... .t~..~. I~..~ ....... Lot...~.~..~ .~: ..{tip.d) ...... Subdivision ..................................... 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 ..... ff./..,~..~ .~. ?.....~./fl../~./.,t ~.-.'..~.~./~.-.~,~..~'~/~.~.d'.Z../...~....~..~,.~..~? b. Intended use and occupancy ~./~.~.c~ 3. Nature of work (check which ~pplicable): New Building ..... ' .....'Addition .......... Alteration ., .P~., Repair ~ ~. [ .. Removal .............. Demolition .............. Other Work ............... [ ~ (Description) 4. Estimated Cost ..... · ...................... e .: ................................. I ~' (to be paid on filing this application) 5. If dwelling, number of dwelling units. ~,.../~. ........ Number of dwelling units on each floor .... /, ........... If garage, number of cars ': .~.~..A~..ei.-~F.~ff.. ff..TJX..~?'ff(.~....,,~. ~A~.~.. ~ .~.~.~'~.~.. r?60...~../~../.~..~..~.~40.~.~ 6. If business, commercml or m~xed occupancy, specify nature and extent of each type of use ...................... 7. Dimensions of existing structures, if any: Front . ~..~' ~.~. ............ Rear ........... Depth..,r~ .,':7~~. ...... Height ............... Number of Stories ..... /. ............ "' ~; .................... F ............ Dimensions of same structure With alterations or additions: Front . ~ ~ Rear . .~ ~. Depth ~ ~. ~. I Height . Number of Stories · 8. Dimensions of entire new construction: Front...~2~. ......... Rear ............... Depth ........... Height ..... ~ .......... Number of Stories ..... ]. ............................................ 9. Sizeoflot Front M/tT~ i ... Rear . ~Od) . .. Depth og. ~9~9 ..... I0. DateofPurchase .~. ~(2. b.'/T /g~/ ./~..~..~. ..... Name ofFormer Owner :.g(2/g.~..f~.~...~.4~' .... 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...2~.Q .......................... 13. Will lot be regraded ..... .A(..O ........... '.z ....... Will excess fill ~e removed from 'ur~emJses: Yes 14. Name of Owner of premises .i ,~]'g. · -g ~.~- ...... Address~..°~'~.~...~P.~ .~.~. f..~.~(..~'P~'~'~o.°~.,~.~. Name o f Architect ...~/.~.. ~.l ¢6(.~.~..4-~.. Address l.~2~.W~i .~./2'~. ~./~.,~one No ................ Name of Contractor ......................... Address .................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate ail set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or. corner lot. STATE OF NEW YORK, COUNTY OF... ~ .t4 ~ F.'~. ~'?.~ $.S (Name of individual sig~ing contract) above named. ..... being duly sworn, deposes and says that he is the applicant He is th (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dqly 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 mannler set forth in the application filed therewith. Sworn to before me this ......... if ...... , 1 ~: ~ ~.~_~. ~t~i~t"~Tt~k ' (SignaturL~rf~applicant) NAUOLE~ DRIVE Curb .N 71o. 19'. $OUE IOQO0 f'dj Survt NAUGL.E5 CE'RTIFI~I) TO~ rANO SURV~YOt~ NoY.$. LI~. NO. 1596 BOANOK~ 11901 DRIVE /..£5 · · , Ni oIF SURVEY FOR AL LANE ,~ T MA TTI TUCK TOWN OF SOUTHOLD SUFFOLK' COUNTY, T~X MAP NO. Iooo- SCALE: I '= $0' MAY Prepared in accordance with the minin~ ~tandard, far title ~ur~ey$ the ~ I. A. ~ ~ and app~ a~ aden for ~ T~le ~. 85-190