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HomeMy WebLinkAbout14136-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. Certificate Of Occupancy No ..... ~ 3 .~.5.25 ...... Date ....... .J .~B.e. . ] 7 .................. ]9~.~. THIS CERTIFIES that the building ...... pB.e.-: .f ~ ~J, ~ y..d,~ e. ~ ~..i,rl g ......... ' House ~vo. Street Ham/et County Tax Map Ho. ]000 Section .... .12.5. .... Block ........ 1 ....... Lot .... ~ ...1.7. ........ Subdivision... L ~ ~.~ 1. ~.t,~ ~ ~ ~.. ~ ~ ~.t ...... Filed Map No..7. ~ 7 9...Lot No ...... 8. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..J.u~l. ~r..~ .0. ...........19.8.5. pnrsuant to which Building Permit No ........ ] .~ J.3.6. Z. ....... dated ....... 5. C)_y.. ] ~ ............. 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 ......... .. -: .. . r~g~ .................................................... The certificate is issued to ...... GLASTOR LTD. of the aforesaid building. Suffolk County Department of Health Approval $ 5 -S 0- ~ 0 2 UNDERWRITERS CERTIFICATE NO. ~ ? 5 3 9 4 9 Building Inspector Rev. 1/81 I~OB~ 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) Ne '14136 Z D~te ~ Permission is hereby granted to: ............. ....... ......................... ...... ,£.~=..~....,~/..7 .................................. .... ~? ........... ~.~..~ ~' ...~.~. ....... .//..~,.~..~, ~ 7 * ~o ..... ~..~..~..~.~.....,.~.~.....~.~ ~...../,~.~.~. ..................................... .............. ~ .............. ~.~ .......... ~,~ .............................................................................~ ............. Z~/~-~ ~/. ~ County Tax Map No. 1000 Section .... ./.~'~....~... ...... Block ....(~.../.. ........... Lot NoC~..O....~.....'.../..'~... .... · ~ Zo l~.~.S..Tand pursuant to application dated ................ ..~.. ................................ , approved by the Building Inspector· Fee $...'ZT.,.~.../.... ~. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD '1 III ~1, I Im~ I~11 Building Department J J JJ ~ '~' ' ~" J )1 Town Ha, I I1~ V~ 765- ~802 ~u~u~l~ APPLICATION FOR CERTIFICATE OF OCCUPANCY , ~~~ /~~ Instructions I z~G ~G~ A. This application must be filled in typewriter OR ink, and submitted ~ ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final su~ey of property with accurate location of all buildings, property lines, ~reets, and unu~al na~ral or topographic fea~res. 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 Unde~riters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a ce~ificate o~ 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 $ :[5 o 0 0 3. Copy of certificate of occupancy $1.00 5. Updated C~.~ $15.0 0 Date .............. New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property. ~ .~..(. ~ ..... ~-,~'.-..~., ,~./.d..C.. L,~, .~ ........ ,~., ,~,~, ,~.. ,~,'. House No. Street Ham/et Owner or Owners of Property ...... ~ ......................................Z~ ~..~.., County Tax Map No. 1000 Section .../.. ~. ~',. ..... Block ...4~./, ........ Lot.. ~ r/ P Subdivision .~..~., ?../--.~..~. ~ ~ , L.~.'.<~. r'~ ~ /~. ~?~ ..~. ............... Fded Map No.~. ......... Lot No ........... Permit No ........... Date of Permit .......... Applicant .................................. 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 all applicable codes and regulations. ? ..~. Rev. 10-10-78 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ..,e ~r,~ :U, ].~ ~ppllc.tlo,,No.o,,/ile ~/~N 753949 THIS CERTIFIES THAT only the el~ trical equipment ~ described below and int~duc~ by the applicant ~amed on the able application number in the premises of in the following locatlon; ~Basement ~ 1st Fl. ~ 2nd FL Section BIoc~ Lot June 5, 198~ and fout,d to be in compliance with the requirements of this Board. 21 DRYERS 32 SERVICE DISCONNECT SWITCHES NCA CENT FLUORESCENT 29 . FURNACE MG^~:ORS H.P. FULU~RE APPLINAo~CE FEAED:.IGS ~O. OF S OTHER APPARATUS: RANGES I COOKING DECKS OVENS DISH WASHERS 1 12,1. 1 I~2 SPECIALREC'PT MEC/O KS ' IUNITHEATERS BELL UNIT HEATERS MULTI-OUTLE NO OF FEET ~ETER EQUIP. E R V X 1 ~,w.~. 1/0 C ~otors: 1-3/ ~p , 3~G. F.I. 2,~Smoke D¢,t;e~)rs ~ 1-Jactzzzi EXHAUST FANS DIMMERS NO, OF HI tEG AWG OF HI-LEG NO, OF NEUTRALS 1 OF NEUTRAL 1/0 Alex~de~ G, tktbb~vd Lic. GENEI~AL certificate must not be altered in an), manner; return to the office of the Board if incorrect. Inspectors may be identified by 'lis COPY OF C ' BE ALTERED IN ANY MANNER. COMMEIqTS ~ ) P'I ELD *~NS~;~CTiON I. FOUNDATION : FOUNDATION (2nd) ROUGH FRAME & PLUMBING I~SULATION FER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND Iii INS~JI~TION~ FRAMING [ ~'~INAL REMARKS: .. (~,. DATE 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-180:2 ~xamined .... f. 1 .9~.. Permit No, / 4~/.~d¢;~ (tpproved .d~/~.../ ..... . ......... Disapproved a/c ~ ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,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. e. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of tiffs 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 ~ 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, Oxdinances 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 necesT~7, i~y~~...~ .......... (Signature o~fpplicant, or name, ifa corporation) (Mailing address of apphcant) State whether applicant is owner, lessee, agent, architect, eno~neer, general contractor, electrician, plumber or builder. ................................................................................. (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 ..... (.a..c/.m. ¢ Plumber's License No ......................... Electrician's License No ................. Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. I goo /4 House Number Street Hamlet County Tax Map No. 1000 Section .... /...~.,..~. ...... Block ..... .O../ ......... Lot....~. ~./..? ......... Subdivision . . A .~.~.~.e..~..../c. ~...~ p.*. fie/ ........ [-~2~'~.~Filed Map NoT... .... 7 ~,~.. ~. ...... © Lot ............... (Name) 2. State existing use and ~ccupancy ~f premises and intended use and ~ccupancy ~f pr~p~sed c~nstructi~n: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy .... t~.. .~. ...... /... ?x....'Z.: . ,f../. '. q..c~_~ ................. New Building ..... A, Idition .......... Alteration .......... Demolition ............. Other Work ............... ......... Fee ~. Number of d~ 5. }f dwelling units .......... If garage, number of cars .... ................................ 6. If business, commercial or mixed occupancy, specify n~re and extent c 7. Dimensions of existing structures, if any: Front .... c).NKc'Sk5 ...... Rear Height ............... Number of Stories ...... .~. ........ Dimehsions of same structure with alterations or additions: Front ... Depth ................... [... Height ....... '.~. ~.iii ....... -8. Dimensions of entire new construction: Front ....... Rem ..-l=h .......~ .......... U-.-b.,. Stones ........... ~ .... 9. Sizeoflot: Front ...... J...OZ°.._,~ ......... Rear ..... / ........ 10. Date of Purchase ..... ], .~.~.C/Z/'... .................. Name of Fonm 11. Zone or use district in whicn premises are situated ................. 12. Does proposed construction.viOlate any zoning law, ordinance or regula; ......"' '/. .~. .S , .......... ,..~.~.. Will excbss 13. Will lot be regraded fill 14. Name of Owner of premises~..C.[.¢,ri~.¢..ff. .~.,~,.~.'. Address/,/~o....~..~. Name' of Architect ......... .... ~..~ .......... Address ....... Name of Contractor.../'.~./. ~..~. r.<..5/5/ ....... Address ff...2'... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or propos property lines. Give street and block number or description according to dee, interior or corner lot. [~ '3- 3¥ STATE OF NEW YORK, COUNTY OF ................ (to be paid on filing this applicatl6n) elling units on each floor ................ f each t.~,.p.~:~f use ................ ,...y:7... ..... Depth . ~'gT.. ...... ............ Rear ................. umber of Stories ....... : ............ ~'..r .... ~.~.. ...... Dept~h .MT'.~. ........ ...... Depth,....~..~ . 'Owner . .,3('~/..,~--,~e... ion .' ...... ...................... removed fl;om premises: ~ No ? r. hone No. ..... ,. .... ,.. phone No ..... ~<. ........ 1, and, indicate all set-back dimensions from and show street names and indicate whether ................................................ being duly s (Name of individual .signing contract) above named. ~ ~orn, deposes and says that he is the applicant 7ficer, etc.) *ned the said work and to make and file this best of his knowledge and belief; and that the vith. He is the ' i ~ . (Contractor, agent, corporate o of said owner or owners, and is d¢ly authorized to perform or have perfo application; that all statements cor~tained in this application are true to the work will be performed in the manner set forth in the application filed there Sworn to before me this ............ , " ........... Notary Public,' ' '~ ' ' ~' '~'~" ~'0~' '0' ' i ', --:' ' V. N0. 47071178. Su,~{lllll 5~/ pplicant) i '~rm Expires I~larck ~l~l~l~ii SURVEY FOR S''"'m~ COUNTY DEPARTMENT OF HEALTH SERVIC[$ GLASTAR LTD. FOR ~ .... . LOT NO.8 "LAUREL ESTATES EAST, SECT, I" Singi~.~,'..fi.~ ;.;~;d¢,~ce b::.y AT LAUREL DATE: FEB. 23,1955 q..~/'~' ~f~"~,,,,. TOWN OF SOUTHOLD SCALE. ,%50' DATE/--"~ HSRERNO.,,-~"~t)' [O~ SUFFOLK COUNTY, NEW YORK NO. 85q85 ~.~ APPROVED ....... *U~UTH~,ZEO ALTERATION OR ADDITION TO mis , SURVEY ISA VIO~.ATIOR OFSECTION 7209 Of: THE NGUARANTEES INOtC~TED HEREON SHALL RUN (~NLY ~ HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT mE PERSON FOR WHOM THE SUR~EY IS PREPARED ~" ~[c'7 ~ ~ -- .~ 0 O / IU____ ~ 400 OSTRANDER AVENUE NOTE: I~= MONUI~ENT ~3= STAKE[~~ ALDEN W. YOUNG~ PROFESSIONAL ENGINEER SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF AND LAND SURVEYOR NY.S. UCEHSE NO. 12845 SUFFOLK COUNTY ON APR. 4, 1985 AS FILE NO. 7870 HOWARD W. YOUNG~ LAND SURVEYOR ~T~E LOC~TIGN OF W~L(W)~PTfC TANK{ST)& CESSPOOLS(C~') ~N HEJ~EO~ N.Y.S. LICENSE N0.45895 6RANDIS & SONS ~NC. 1046 SINGLE FAMILY DWELLING ONLY, ., ~d~FO][~ COUNTY HF. JL~TH DEPARTM~T · JUN 10 The sewage dispoeal and water sul~l~ faoilitiea for this location have been ·tnspected b~ this de~rtment a~d found Chief of g~ne~l Engineer~2 Services HE~ DEPARTMENT*DATA F~ APPRO~ TO C~STRUCT ~F~T~MAP~T~OOO SECT~ ~5 ~K~LOT · OTHER THAN THOEE SHOWN HEREON, SURVEY FOR G LASTAR LTD. LOT NO.8 "LAUREL ESTATES EAST, SECT. I" AT LAUREL TO~N OF SOUTHOLD SUFFOLK COUNTY, NEW YORK su,vE, ~ A V,OCA~,ON O~ SEC~O, ?ZO~ O~ APR. 14,1986 MAR. 18,1986 APR.;50,1985 DATE: FEB. 23,1985 SCALE: 1"=50' NO. 85'183 GUARANTEED TO: USLIFE TtTLE $OUTHOL~ PANY OF N.Y. YOUNG a YOUNG RIVERHEAD~ NEW YORK AL~DEN ~V. YOUNG, PROFESSIONAL ENGINEER ANO LAND SURVEYOR N.Y.S. UCENSE NO. 1284.5 HOWARD W. YOUNG, LAND SURVEYOR N.Y.S. LICENSE N0.45893