HomeMy WebLinkAbout14066-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
CERTIFICATE OF OCCUPANCY
No Z-22242 Date APRIL 5, 1993
THIS CERTIFIES that the building ADDITIONS & ACCESSORY
Location of Property. 12585 SOUND AVE. & 4140 CTYRD. #48 MATTITUCK, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 141 Block 3 Lot 38.1
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 5, 1993 pursuant to which
Building Permit No. SEE BELOW dated ........
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 ACCESSORY BUILDINGS & ADDITIONS TO EXISTING BUSINESS BLDGS ~**
The certificate is issued to
of the aforesaid building.
G.L. PENNY, INC.
*** THIS CERTIFICATE OF OCCUPANCY UPDATES THE FOLLOWING :
BP #3333Z-C0 Z-2757 DATED 7/20/67 FOR ADDITION & ALTERATION ON ~
EXISTING BUSINESS BLDG. & OFFICE SHOWROOM.
BP #5921Z-CO Z-6301 DATED 1/14/75-NEW BUSINESS BLDG.,(oFFICE USE)
BOH APPROVAL DATED 1/14/74-UNDERWRITERS CERT. %N-57920 DATED 11/29/72.
BP #8938Z-CO Z-14636 DATED 7/14/86 ADDITION TO EXISTING OFFICE LUMBER
YARD SHOWROOM - UNDERWRITERS CERT. #N734440 DATED 2/6/86.
BP #11202-Z-CO Z-14637 DATED 7/14/86-STORAGE & SALES BUILDING
UNDERWRITERS CERT. #N-734438 DATED 2/6/86.
BP #14066Z-CO Z-14634 DATED 7/14/86 - ADDITION TO EXISTING BUSINESS
BUILDING (CARPET STORE).
BP #14071Z-CO Z-14645 DATED 7/15/86 - ACCESSORY STORAGE BUILDING
BP #14072Z-C0 Z-14646 DATED 7/15/86 ACCESSORY BUILDING - UNDERWRITERS
CERTIFICATE #N704533-DATED 8/13/85
BP #17285Z-CO Z-17357 DATED 9/27/88 ALTERATION TO CARPET STORE,
UNDERWRITERS CERT. #N-038891 DATED 10/12/88.
B~'~ng Inspector
Rev. 1/81
TO~N 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 14066 Z
Permission is hereby granted to:
~..o...~...~...~ ..................................................
, ~ ~.,
~, ~,.~,,e, ,~,,~ o,...~aa~ ................................. ~..~., ......... ~ ................
County Tax Mop No. 1000 Section ........................ Block ...................... Lot No .........................
p,,rs,,ont to application dot~d ......... ...~..~......~.~. ..................... , ~9..~., and approved by the
%
Building Inspector.
Fee $,,L ....................
Building Inspector
Rev. 6/30/80
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Halt
Southold, N.Y.
Certificate Of Occupancy
No..z1462A ......... Date ....... Jl~J-.y.. [.4., ................. 19
THIS CERTIFIES that the building .... exi,s, tiu[t. J~u~ine$$..w. itb..o~4d. &.tj,q~3 .......
Location of Property ....4.2.5. 0..C.o.u.n..ty..R.d. :. ?.4. 8. ......... .M.a..%.t.i.t.u..c.k.,..N....Y.. ..........
House Ho. Street Ham/et
County Tax Map No. 1000 Section .. 1..4.1 ....... Block . .Q 3. ........... Lot... 3. .8: .1 ..........
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.... 4U¢~..1, ~ ......... ,19.8. ~ pursuant to which Building Permit No.. 1..49.6.6. Z. .............
dated ... J. une. 3.9., ............... 19.8.6., 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 .........
Construction of an addition to an existing business
The certificate is issued to George L. Penny, Inc.
(ownor2~'~r2Flla~
of the aforesaid building.
Suffolk County Department of Health Approval ........... N../.A ............................
N 704533
UNDERWRITERS CERTIFICATE NO ..................................................
Rev. 1/81
Building Inspector
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N,Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. 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 disposel-(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.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of p:Coperty 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
$15.00
5.Updated C.O. $15.00 Date ........................
New Building ~'9'~"~, , Old or Pre-existing Building ...... Vacant Land
Location of Property...~.~.~...'~ ...... ...~..~..~..~. ....... m ~ .C,!.~-.. ....................
House No. Street Hamlet
Owner or Owners of Property ~'~c"°~',C'~E ./T'...'~....~'~.../~..~ .;.~. ~; ....
County Tax Map No. 1000 Section .... /..~../ ....... Block ..... .(~...~ .......Lot..~...O.,..~.~.,..~..~...
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No. ~ .~O/~,~ . Date of Permit .././.~./~,~ .Applicant..~?.?~..~.~. L. ~'~:xJ.~..~ )N~ .
Health Dept Approval - Labor Dept Approval ~
Underwriters Approval ........................ Planning Board Approval . ~
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $..~?t ~ ......................
Construction on above described building and permit meets all ap~'cable codes an ions.
Applicant .........................
Rev. 10-I0-78
FIELD ~INS[~CTION COMMENTS
FOU__ND~TIO__N .-- ( 1 s t )
FOUNDATION
2.
oROUGH FRAME &
FLUMBING
(2nd)
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
. , FORM NO, 1
TOWN OF SOUTHOLO
BUiLDiNG DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
Disapproved a/c .....................................
R()ceived ........... , Ig..
(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
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 street.
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is pa~ of this appli
cation.
c. The work covered by this application may not be commenced before issu~ce of Building Permit.
d. Upon approval of this application, the Building Inspector will i~u~ a Building Pemit to the applicant. Such permi
shall be kept on the pre~nises 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 Occupanc,
shall have been granted by the Building Inspector. '
APPLICATION IS HEREBY MADE to the Building Dep~tment for the issuance of a Building Permit pursuant to tht
Building Zone Ordinance of tbe Town of Southold, Suffolk County, New York, and other applicable ~ws, Ordinances o
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descdbed
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and tr
admit authorized inspecto~ on prenfises and in building for necessa~ inspections. ,
...~' ~. ~..~.~ .~.G:~:..
(Signature of applicant, or name, i~a corporation)
..~.~,~../.7...¢
(Mailing address of applicaut) [
State whether apphcanl is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
~,n~ oro~,,,,.,,~,~.,,,i~,.~ . .G h~'O ~q.¢~ .... C,..~.,,,,~,, . ~>..:~ .... ~¢:.~ ......................
(as on thc tax roll or latest deed)
If applicant ~ n corpo~ion, s~gn;Hurc ol'duly atllho~zed officer.
.
Builder's License No ..........................
PILunber's License No .........................
Electrician's License No .......................
Other 'Fradc's License No ......................
...... .~ s~ ....... ~...~:~o ........
] Iou se Num her SI reef Hamlet [
I ' ' .l..~.. t. . Block ....................
County Tax Map No. 000 Sect,on ..........
Subdivision .................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupallcy of premises and intended use and occupancy of proposed construction:
a. Existing usc and occupancy ...C~.
b. Intended use and gccupancy ....
Repair .............. Removal .... .......... Demolition ..... ~ ....Other Work ....
' ' (De cription)
4, Estimated C0st o 9, o,..-T-" Fe~ '
'~ (to b~ paid on filing this application)
5.,, [f ,dw, elling, number of dwelling units ,... .......... . Number elf flwelllng' u~its on each floor. ..............
I¥ garage, number of cars ....................... ,~. ~ ................................
6. , If business, commercial or mixed oc,k;upan0¢>, specify nature and extent of each type ofus~ . .~.~. ~. ~.~, ~ ~ .....
7. D mensons 'existingstrtct res, f~anv' Front ~;~ (o,', ~;~. r ~ q~ Depth . .,~,,~,,
Height ............... Nuln, ber of St l~s .. ,, .............. ~, ' i ' ~''' ''~''" ........
Dimer/sions of same structul-e 'w~th alterat~6hs or additions: r~' ........
Front ,.'~..,~ .... ", ............. ... Rear ..~,?.-.
· ~/. ~, l!eighi Number of Stories
Depth ..... - ........ ., ./,. , ...................... ,
new con~tff, ction: F/bht Rear ' ' ' ....................
8 DimenSions 6fentiie
· . ............... ~ ....~ ........ Depth ...............
Ifeight Number of Stories ' i '
9 Size of lot: Froflt Rear ' ' Depth
10 Dte of ! 'cha ' Name o.~fFonner Owner
. a )ill se. ~, ................. . . , ,., ......... ~, , ..........................
1 1. Zm{e or Use" district in which premises are situated .... ~., .... ,1~, .t~. I-'~. ~ .'[f.~.!] ~ ~.
12. D.oes proposed constn orion violate any zoning aw, ordinance or regulation ...............................
13. ,W, lll lot be regrade~d ....~/. ? ...... ~ ........ ~,: W~ill exce~ss fill be removed from premises: Yes "~
14, .r~,ame of (.?.w..,n?r m premises%~.v.O...t..,,f.~'.fW,. ,~..,Ti, ,4,Afl.ess ,/.M~.v~,~_,_,/~,~aPhone No, i~-,~Ta~.~,,~,'~,
l~anle of ^rcmtect ........................... Address/4tAt'.q. 14. :t. Phone No
Nmne of,Co ~tractor . '. . .':',. " Addressl'~.~-~ /. 1'¥~..~" rn,,,,~ x~,,' .........
' ', ' '!!;; PLOT DIAGRAM
L~ocat.e. clearl,y and d~stmctly all bmldmgs, whether, ex~stmg or propofied, ,and lgdicato all set-back d~mens~ons from
property hnes. Give street and block nmnber or deseriptio~ according'to deed, a~d show ~treet names and indicate whetilet
interior or corner lot,
STATE OF NEW YORK,
COUNTY O1" S,S ,, M~', ,
..... .~,~:~.~...'..(-~. f, .~, ,~Y¢4~,...'""~...':~, . · ~ ...... being duly sworn, depbses and says that he is the applicant
(Name of individual signing contract,)
above nanled.
IIeisthe ,, '~
(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 this
application; that all statemeuts contained in thl~>application are true to the best ofh s knowledge and belief; and that the
work will be perfommd in the manner set forth in the application filed therewith,
Sworn to before me this
............... . . .da, of .4&.¢ ..............
........ ,
fl01hRY POBLI~, State 0t NeW York
No. 4693093, Suffolk Count~
t,q i - ' '
'L:5~ z '
1
765-1802 9 AM TO 4 PM FOR; THE
I~OLLOWING INSPECTIONS:
J. FOUNDATION - TWO RE(~UII~EI~
FOR POURED CONCR/~
~, ROUGH - FRAMING &
~, INSULATION
4. FINAL - CONSTPUCT/ON
BE COMPLETE FOR C, O.
ALL CONSTRUCTION SHAEL
~HE REQUIREMENTS OF T~[
~TATE CONSTRUCTION &
CODES· NOT RESPONSIBC~
OCCUPANCY~~
USE
WITI~i~i E.i~TiFICATE
OF' OCC~JPA_NCY