The URL can be used to link to this page

Home My WebLink About14095-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No....g.~4~-)-.7. ....... Date ......... .D.e.c..e.m).e.r...2.6 ........... 19.8..5 THIS CERTIFIES that the building ....... a.dcli1:£.Qn ............................... Lar~ti~n ~fPr~n~rt~ 1865 Westphalia Rd. Mattituck House No. Street Hamlet County Tax Map No. 1000 Section .... [.4.~. .... Block ........ ~ ...... Lot .... .4 ............ Subdivision ........... X ................... Filed Map No .... .Z ....Lot No ....... .X ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .~..une. 2.5 ......... 19 B.5 pursuant to which Building Permit No. 14095Z dated ..... ~u Sy..2 ............... 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 ......... .... Addi.t. ion..~q .e~,i,~t; ilng .q)~.e:xf.~..m.i.l.y..dW.e.i..1.~.n.~.. .......................... The certificate is issued to EDWARD NOLAN (own~~ of the aforesaid building. Suffolk County Department of Health Approval .................. .~../~. .................... UNDERWRITERS CERTIFICATE NO ........................ .N .'7 .0. 6. .l ~ ,.~. ................. Building Inspector Rev. 1/81 FO~ NO. 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OI; THE WORK AUTHORIZED) NB 14095 Z Permission is hereby granted to: ....... ~L..b.d..~,.k,~...~ .................... ~. ...... ,,.~.....~, .~;'.~... ~../.L.. ~ ~.. ~,..1 ............................................... ..i)~...q;~..~./c....~.:?t.:...:.l.!.~. ...~:.:..=... ,o C~>~.,~r...~.....~..~l.&~C~...g:~..~~t...~...~.~.~~ ..... ~~,..,....~.....~...~ ............................ ~ ................................................... ~ ~% ~ ~ ~ . .. ................ ................. ....~......~.~.~¢., ... ....~.,~. .. ................................................................................................ . ... c~.~ ~.~ ~.~ N.. ~ s.~,,.. ...... L~-.J .......... ~,~ ...... .~.~ .......... ~o, No ..... ~[ ................ pursuant to application dat~ ....... ~..[~. .................. , 19.~..~ on~ approv~ by the Building Inspector. Fee $ ........................ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG. DEPT. , OUT, OLO Instructions A, This application must be filled in Wpewriter OR ink, and submitted mm 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. B. 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 /.~//..~ /~ i-~- _Date ...~ ~..~. ~ ........ New Building ............. Old or Pre-existing Building ,~ ...... Vacant Land ............. Location of Property./¢~'/.~...~. ......... .~,..~...~c~.' .~./.~.?..~/..,~, ..... : ................. House No. Street Hamlet Owner or Owners of Property .... ~..,. ........................................... County Tax Map No. 1000 Section ./.. ,~./. ....... Block . ..~. ~ .......... Lot.,. ~ ......... Subdivision ................................. Filed Map No ........... Lot No .............. Perm it N o./.~.~. ~.. ,~..~. D ate of Perm it ?/~..~/~,~ .,~.App l icant .. ~.:. ~.~,~..~.~-~.'~...~)~'...~.~ ,~'~,~'.///~C Health Dept, Approval ....~..'.~. :.., ............ Labor Dept. Approval ........................ Underwriters Approval .~//.~/~'.~,..1~. 70 ~ [/.~,..Planning Board Approval ...................... /.- Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ...... ~ F_~.c~....~..~...~.~.~. q-~ Construction on above described building and permit meets all applicable c~ns. C, 0 ,:4t~' Iq I/--~ Applicant ........ s .............. Rev. I0'I0-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000771 SUREAU OF ELECTRICITY 8~ JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT Otdy tke e~ctrical equlpm~nt ~ ~scribed bel~ a~d ~tr~ueed by t~e uppJica~t nam~ on the abbve application nu tuber in t~ premises of ~w~ No~n, W/S Westplmkia ~d~ 1500' t~/O ~ 48 ~. ~, ~t:~ituck~ in the following location; ~ Basement ~ ls~ Fl. ~ 2nd Fl. Section Block Lot was examined on a~%~, 1~ ~ ~)~ and found ~o be in co.tpl~nce wlth the requlrements oJ thls Board. FIXTURE 1RECEPTACLE'~ I SWITCHES OUTLETS 3 DRYERS FIXTURES RANGES ~ COOKING DECKS OVENS DISH WASHERS EXHAUST FANS R R I C NO OF HI-LEG AW.G. OP HI-tEG ~und Elactric Co. P. O. Box 143 ~xatt/tuck, N,Y. 11952 LlCo 242 Th~s certificate must not b,e altered in any manner; return'to the office of the Board if incorrect. Inspectors may be identified by their credent[aJs, coPY~FOR BblI..DING DEPARTMENT. THIS COPY OF CER'[q FICAT~,MU~; N~'i'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 BLDG, DEPT. TOWN OF 8OUTHOLI~ CERTIFICATION Building Permit No~2~ -- z (please print) (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plumber' s signature~ Sworn to befor~e me this ~ m 19~__ ( ///"' Notary Public Notary Public, ~C°unty~-~' ' VERON/C/I'F. C/DONE ~1~,/ NOTARY PUBUC ~TATE OF NEW O~IlFIED /N 8UFFOLK COUN~ COMM/SS/ON EXPIRE~ MARCH ~0, FIELD INSF~CT~N FOUNDATION FOUNDATION (2nd) 2. ROUGH FRAME & FLUMBING INSULATION FER N. STATE ENERGY CODE FINAL COMMENTS ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined . .~ .~ ?~......, 19'~~'/... Approved ...~.'~...., 19~. Permit No.I..~.~. .~.~. · .~-~.. Disapproved a/c ..................................... ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BLDG, DEPT. TOWN OF SOUTHOLD Received ........... ,19... Date .................. ,19 .~. T~ 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 building for necessary inspections. ,,~ l admit authorized inspectors on premises and in ..... ~....i ~¢.~ ~""~-~'~i '~'' ~)O .... ~.~. .... ~.~.Q (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................. ,~.. O./.~ ~... ............................................. Name of owner of premises ...... ~...~..../~..O..~...~./7.' ............... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate ~fficer) Builder's License No ...... .,~.~.~. ................ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done..~.~.fi....~.~?. ~..T.-..6~..~..~.~../.,~....~:)D.' ............... .... ~. ~ 0. . .~. . . . .................. ~ r. r ,.,,z. .,q. ~ x. ./.~. . ~ /R ..... . /~. /9. ~ / /T. .o. ~. /~. . . . ~,~. .. .... House Number Street Hamlet County Tax Map No. 1000 Section ..... t..~.l ......... Block ......... ( ........ ~ot ~ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancypf proposed construction: ' .................. a. Existing use and occupancy .... /.. ~--.~ .A~.../.Z:. ...... .p~...~.~...~./. ............... b. Intended use and occupancy ............................ l~'~. ,,. ,t'.,:... ~J~;~ ................... 3. Nature of work (check which ~pplicable): New Building ..... ' ..... ddition. .~..... ..... ·. Alteration ....... Repay01.~ .~ ~ ..... Removal .............. Demolition .............. Other Work ............... (Description) 4. Estimate~t CO~t ............ ~ .O.O..o....D...~ ........... Fee .................................... ~ ~' (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of d, ~elling units on each floor ................ If garage, number of cars ... ~ .................................................................... 6. If business, commercial or mi~ed occupancy, specify nature and extent >feach type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Ret .............. Depth ............... Height ............... Nnmber of Stories ........................................................ Dimensions of same structure jwith alterations or additions: Front ............... Rear .................. D.epth .................. ~... Height ...................... Number of Stories ...................... 8. Dxmensions of entire new construction: Front ............. Rem ............... Depth .............. Height ............... Number of Stories ........................................................ 9. Size of lot: Front ......... ~ ............ Rear ...................... Depth ..................... 10. Date of Purchase ........ r ................... Name of Form~ r Owner ............................. 11. Zone or use district in which ~remises are situated ............. 12. Does'proposed construction violate any zoning law, ordinance or r 13. Will lot be regraded ....... i .................... Will excess fill 14. Name of Owner of premises . i .................. Address ... Name of Architect ' Address ..... Name of Contractor...~5~...e~. i .................. Address PLOT DIAGRAM Locate clearly and distinctly ~ll buildings, whether existing or property lines. Give street and bloc i number or description accordin interior or corner lot. ~ [ removed from premises: Yes No .......... Phone No ................ .......... Phone No ................ ......... Phone No. p~.ct.~ .~..W.q...~... and, indicate all set-back dknensions from . and show street names and indicate whether STATE OF NEW Y(~,..t~a~ ~' S S ...... ~/~ .... being duly s (Name of individual sig~ing contract) above named. He is the .............................. (Contractor, agent, of said owner or owners, ~d is d~ly authorized to perform or have application; that all statements contained ~ this application are true to work w~l be perfo'~ed in the m~ner set forth in the application filed Swom to before me this ~oses and says that he is the applicant the said work and to make and file this best of his knowledge and belief; and that the