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Home My WebLink About14092-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z14183 Date January 27 198..6. THIS CERTIFIES that the building .... 0..n .e..f.a..m.i.l.y....d.w.e, 1..1 .i.n.g.: .................... Location of Property 1728 R,0,W,. off Arshamomaque Ave. Southold House No, Street Ham/et County Tax Map No. 1000 Section .q~ 6 ........ Block . .C22. ........... Lot . .0.~..~ ............ Subdivision .B.e.i..x.e.d. qn...E.s.~a..~.e.s ............ Filed Map No..~.4..7.2...Lot No. 6 conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. ~9p. i3_..1.2 ........ , 19.85 pursuant to which Building Permit No...3 .~.0.9. 2..Z ............. dated ..... J.u. 1. y..1 ................. 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 ......... · ..Q~.[.amily dwelling The certificate is issued to HARRIET FREEDMAN ..................... ...................... of the aforesaid building· Suffolk County Department of Health Approval 85 o S 0 o 78 UNDERWRITERS CERTIFICATE NO ........... [1.7.2.8. 6..8 .6 ............................... Plumbers Certificate Jan. 24~ 1986 Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEFARTMEHT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT (THIS PEP, MIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NB 14092 Z Permission is hereby granted to: .... ,~...c .~.~~:~...~..: ............. ..... z.~....z~r..~...6......z?~ ......................... .... .~.~.~...,...~u:.~.....ff.z.Z~. ,o ..~~...o~....~~...~Gz~..~. ....... Y~ ......................... ...~.~,..,.~,,~..~~~.~~.~ ................................ et premises I~oted ot ........................................................................................................................................ ~z~ ,.~~..~~ ............... .~ ......... ~z.~X ............................................ c~ ,~ uo~ ~o. ~ooo s~,~o~ ...~ .......... ~k ..... O~ ......... lot uo...~ ........... 8uild~n~ Building I~tor Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate 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 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 $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 New Building .. ~.. ........ Old or Pre-existing Building ............ Vacant Land ............. House No. Street /Hamlet Owner or Owners of Property ~-. ~.,~¢..~. e~~ ............. County Tax Map No. 1000 Section ...O. ~.G ...... Block ...Q .~ ....... Lot..~. .......... PermitNo. l~O~ateofPermit 5 . ~S.Applicant ~...~J[V..~ ........... Health Dept, Approval aST~g .T.'l/~ {SC...Labor Dept. Approval ....... Unde~riters Approval ~.?~S~.. ;. ~ ~l ~lanning Board Approval .... Request for Temporary Certificate ..................... Final Certificate .. ~ .................. Fee Submitted $...,-~ ,, .O..~. ................... Construction on above described building and permit meets all applicable codes and regulations. Applicant .C_~ Ni~.~-~.'~7~ .~.o)..~,..~. ~.~.O..~..7. ],¢.~.\..~).~.~,~ Rev, 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~(~{~5~70~ ~ I~UREAU OF ELECTRICITY ~ly the el~trical equipment ~ ~scrib~ bel~ o~ i~duced by the ~l~nt na~ed on ~he able application numar in the p~emi~ of was examined on and found to be in compliance with the require.refits of this Board. FIXTURE f ~ i SWITCHES FIXTURES OUTLETS SCEPTACLE~' 74 6O 7,'~ DRYERS FURNACE MOTORS FUTURE APPLIANCE PEEDERS RANGES OVENS ,DISH WASHERS i EXHAUST FANS TIME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: Smoke Dete~tok s S E E V I C E '~ 2/0 ~," 2/0 Sal Pra%o~ Electrician Wi~gins Lane . Gre~nporl:~ N~Y.~ 3,1944 P~r~ This certificate must not be altered [n ony manner;, return to the office of the Board [f incorrect. Inspectors may be identified by their credephols. gDPY FflR R.~III DIIgR DI~PARTMI~N'I'_ THIg~CDPY DF CERTIFICATE MU~T NOT BE ALTERED IN ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Building Permit NO. {qOq~ (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. Sworn to before me this Notary Public, County Notary Public ~I~-LD ~NSPECTION FOUNDATION FOUNDATION ( 2n~ ) ROUGH FRAME & PLUMBING iNSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS. 'FORM NO. 1. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ,~OUTHOLD, N,Y. 11971 TEL,: 765-1802 Examined ' '" , ~, Approved.. "'/'' '"1 .~..PermitNo. -. Disapproved a/c ......... T ............................ (Building Inspector) APPLICATION FOR BUILDING PERMIT BLDG. DFP£. TOWN OF SOUTgOLD Received ........... Date .~.~.!U ltd- 19 INSTRUCTIONS sets of plans, accurate plot plan - ' b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public str or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this at 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 peJ sliall 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 Occup~ 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 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance Regulations, for the constractinn of buildings, additions or alterations, or for removal or demolition, as herein descrf The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, an. admit authorized inspectors on premises and in building for necessary inspections. .... .W..A..~..o.,..&~...x~c¢.. B 7~ .~. ~ .~..~.. ......... (Signature of applicant, or name, if a corporation) ..... ~..~ ~c~&,. ~ .~-/.. %...U.'171.9.... (Mailing address of appli~l~nt) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or buil ' , A...¢-q44..Ix~.x .]..~..~>T~..O.~?-,~ ......... : .......... LLL ............... ; ...... :'~ ......... ..... . ......... Name of owner ofprem~ses · · .---.,.-- - (as on the tax roll or latest deed ~'hlicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. g~_.,.~..k} 0..~. c, Il Electrician's License No. f! .... Other Trade's License No · · -k will be done .... · proposed .............. land on which ............................ I Location of , · '- Ilouse Number . .. .. Street . Hamlet ' ' ' - '" :' : .z. ' 1000 S ...... · County Tax Map No. ection .... · .... Block ......... Lot .... Subdivision. 7ESC0X ~-.~-1 G-~TA'Y ~-?° (F~'C~c~'?) Filed M aP N°' J '~' '-/'~' ' ' ' Lot ~, ...... · fiqame) 2. Stale existing use and occupancy ofprem~ses and intended use and occupancy of proposed construction: .; .... Existing use and occupancy ................. ,:' b Intended use and occupancy ' '1 F ' ,~,' Addition Alteration 0 work (check which appl}cable): New Building ........................ ~'" 3 Nature of ' Other Work · D mohtion · pair Removal .............. e ........................... R · '~' ........ (Description) 4. Estimated Cost ........ .w .... ,, ....................... .~ (to be paid on filing this application) i . .~..~. Number of dwelling units on each floor ---' of dwelling umts ' · $ ' ' ' numbbr ......... · If dwelh~lg-, If garage number&carS ...... I.'Vl~t~ .............................................. 2 .......... ' commercial or mixed ~canp.a.ncy specify .n~atu~r~e and exte_.nt of each~?rp~e of use ..... bi. ~ ......... 6 If business ' Depth ~./.~ · ' if any Front $'~Z t~. Kear Dimensions of existing structures .......................... 7 Number of fio es 'Height ~ .......... ,,., k,/A. .. ' ; Height ......... ~e/(/~ ...... ' '" . . 'i . i . 8, Dilnenslons o! entire new cortstT~uv-- ............ ~Z ' Number of Stories . . ~ .-['.~q21. ........................ : ............... Height ...... .:2'q : -~%7, .~.. ~ ,~.~/. 9. Size of lot: Front ...... 1 .c~..., .......... Rear .... '. . .o.~. ~ ..... Depth ................ ._ _ I ............ Name of Former Owner ........................... 10. Date ot~urcnase ........... ~ · · . · . -- 11. Zone or use district in which premises are s~.tuated .... .' ~.%k~?..~..~'/.g~.~. ...... A~ ..................... 12. Does proposed constructioD violate any zomng law, or.dlnance or regulati°n: ...... ~ ....................... ........ · -~-~ C>~L.¥ ~X ~-¢~.~.~,~Xtt>~,Willexcessfillbqr..e~_~ovedfrompremises: Yes 13. will lei De regrauuu · · . ..... ~.~.. ~.>~ ~ 14. Name of Owner of premises ~.P~], -~- .g~f4~'.~:. g-~-E'~'~ddress ~v_~c~ '~,~.,~k~.. {.hone .N.O.,~ ;. ~"..-~e of Architect .ka/,~ ~-Q .,%~.Cp~tT~$~ .~'..~: Address F,~J~*d~,4.0'. 3.~. · Phone f'~o.-~,.~. 7--~.~ ....... '~" ' L'-2t -ec.-x-~2r~ ~,,~,~=~ ............. Phone No .............. Name of Contractor 1470.."I'. ¢=F7 .,~-~ .-.~ · ..-~--- ....................... . PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and. indicate all set-back dimensions fr property lin'es. G~¥e street and block?umber or description according to deed, and show street names and indicate whet interior or corner lot. i o ® o STATE OF NEW~,YOR~, S.S COUNTY OF..~.'VP~-<. ·~-rc- ..... . .cv~..,~,. 1~.~' b ing dly deposes and says that he is the appli~ ............... · . .... . e u sworn, (Name of individual signing contract) above named· lie is the ........... ~e offi r, otc ) . ' ! (Contractor, agent, corpora ce · ' '' d to perform or have p+rfo d the .s ,.d .rk and t,o,m,.ak~ and, sldul~ authorize rme a we o O in this li e true tc~ the b st ofh~s r~nowie 'r owne~ ~u,~ · ~ . age an · anti annlication; that all statements comau,~,~ . rr ....... · .~_ -'. ............... et forth m the appl cat Sworn to before me this ...... ,19 ... N ta~ public,' c -'he~b--ta~e~?'~'~''' C'~nty. c ~ ' Qualified in, SuffolR Cg.~.P, , ' * ' ' ' ' Term expires March < i BEAC!-~ =.:" ~Okl':;'iEt'J~. __ . GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORI~TO THE STANDARDS OF THE SUFFOLK COUNTY DEPT, OF HEALTH SERVICES -- FOR APPROVAL OF CONSTRUCTION ONLY APPROVED: DIST. SECT. BL~K OWNERS ADDEESS: ' DEED; LAS ~{ TEST HOLE STAMP SEAL