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Home My WebLink About14182-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..~.z.~.e.~. 7 .......... rote .'!~. I.Y. ).9, ....................... ~9 .s.c. THIS CERTIFIES that the building.. ~)R~. t~. 5.1y..c~well.i.tlg. with. a.ctditians ..... ; and alterations .' Location of Property ...495. ~{aPl~..La~. ....................... .Qrie~t,. Naw .¥oak House No. Street Hamle~ County Tax Map No. 1000 Section ...C}I. ? ...... Block ...0.2 .......... Lot . D~I3.1 ..... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated July 22 ~ 1985 pursuant to which Building Permit ...................... ........................ No 14182Z dated . . ?..ug.u.s.~...1.,. '; 198. .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 ......... The certificate is issued to Laurie S. Reeves (owner, .tofi?~'2~X ' ' of the aforesaid building. Suffolk County Department of Health Approval N./.A ............................. UNDERWRITERS CERTIFICATE NO.. N756984 Rev. 1/81 FO~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTNOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 14182 Z Permissi°n Is hereby granted t°: .~C~/'~/~--~ ~ ...~....~..C~..~ :::::::::::::::::::::::::::::::::::::::::::::::::::: ........ ~.~ ........ ~....~ ........ ~ ...~... ~o ~ ~ z~- ~ ..~.., ........... ~,...~~...~....z~......~.~....~~ ................... ................... ~.~.~...[~......~.~Z~ ............................................................................... / County Tax Map No. 1000 Section ..... .~...~., .~.. ....... Block ..... ~.~. ........Lot No...~..~....~..:./. .... pursuant to application doted ........ ~..~.....cc~.. ........ ~..-~/. .............. , ,9..~and approve~ by the Building Inspector. Rev. 6/30~80 FIELD IMSPEO~ION FOUNDATION (~st) ~"OUNDATION (2nd) COMMENTS ROUGH FRAME & PLUMBING INSUL^TION PER N. Y. ,~IA~E ENERGY G,ODE ! , FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ma,=.=.-=- 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 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- t/on required to prepare a certificate. (~ertificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O. $15.00 Date . New Building .... ~, ...... Old or Pre-existing Building ............ Vacant Land ............. House No. Street Ham/et County Tax Map No. I000 Section 01r~ Block ~.~. Lot ~ 0.'.~%; Subdivision ................................. Filed 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. 10-10-78 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. iFOUNDATION 2ND[ ] INSULATION / FRAMING [ ] FINAL REMARKS: f THE NEW YORK BOARD OF FIRE UNDERWRITERS 1~00773 BUREAU OF ELECTRICITY ~j~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ..to July 1,1986 4pp,,,..,io. No.o..fil~ $$6929/8S N756984 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on tile above application number in the premises of F,d Reeves, 495 Maple Lane, Orient~ N.Y. inthefollowinglocation; ~ Basement ~ I.,tFI. [] 2nd FL Section Block Lot .~, ~x.,.i,,ed o,, June 2 6,19 8 6 and found to be in compliance o'ith the re,tuiren,ents qf this Board. FIXTURE OUTLETS RECEPTACLES SWITCHES 19 17 FIXTURES FLUORESCENT 9 FUTURE APPLIANCE FEEDERS RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS TIME CLOCKS UNIT HEATERS MULTI-OUTLET NO. OF FEET DIMMERS SERVICE DISCONNECT S E R V I C E OTHER APPARATUS: G.F.C.I.-2 Arthur Ruroede Main Road Iic,#2S34E Orinet, N.Y., 11957 ,,' G~N~AL MANAORI! This certificate must not be altered in any manner~ return to the office of the Board if incqrrect. Inspectors may be identified by their credentials, COPY Fo~ B~I~DING DEPARTMENT. THIS COPY OF CERTIF 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined...~, ..~. .... ~...., 19~.'~ )isapproved a/c ........ ~__~__j_.....j' ............ ~,~ ...... .-, ( uilding nspector) APPLICATION FOR BUILDING PERMIT Rece±ved ........... ,19... INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building lu~pector, with 3 ets 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 ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. c. The work covered by tiffs 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 hall 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 'hall have been granted,by the Bnilding Inspector. APPLICATION iS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. :he applicant agrees to comply with all applicable laws, ordinances, buildiffg cqde, housing code, and regulations, and to .dmit authorized inspectors on premises and in building for necessary inspections., ..... ................ (Signature of applicant, or name, if a corporation) ...... ~q/.~r:~C~. ~:.. 03~ ~.d'.'/....: ............ (Mailing address of applicant) grate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. hame of owner of premises .... ~-.1).14).l??../¢.'... ~.¢...A..3.(.~g/./.~...~... ?.~j/.3.'u.6' .......................... (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ......... ??. ~. ........... ~ I~-I.C..~5 c/~5'~'/~/ ~ Plumber's License No ......................... Electrician's License No. ~ . . . .P~?~-~0~. '.? ...... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. .................. ~.~'.~ ..... /.~[3P/.~.. Lqt0 ~- .................. (9. ~/~ .~. '.77 ..................... House Number Street Hamlet County Tax Map No. 1000 Section ..... ?.? .......... Block ..... ~ .......... Lot....~.?../ ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ... ()./[JCl . .~¢~/'4 '(-f... ~. i, QC,Zl~./.4J.~. .................................... b. Intended use and occupancy 3. Nature 0fwotk"(~heck'~hi6h, ~pplicable): NewI Building .......... A~dition .......... Alteration ',)~.. :.. Repair .~ ~,~. ~l~ ' Ren~oval ........ i ...... Demolition ...~ .......... Other Work ............. ~ ~ ' ~ [ ,~ ~ (Description) : 4. EstimatedCost. I ~q ~O I).O.O . F~ ~r,~'l~ '.' ' [ '~'/1'~ (to be paid on filing this application) 5. ilfdw~lling, number of dwelling units ..... ~.AJ..~- ..... Numberofdv~ellingunitsoneachfloor....~.~..~.-- If garhge, number of cars .... i ........... 4~.~ ................. ' ' ' 6. If business, commercial or mixed occupancy specify 8ature 3nd extent t ,f each type of use ..... x.~ ..... , ....... 7. Danei~slons of existing structures, ff any: Front... ~ .q ~. Rea~ ....~.~ '.T/'. .... Depth ... ,~..~. ~ v. .... · · 0~ . I . TWO ....... m ght ...... Number of Sto s .................. !, F" Dimensions of same structure ~ith alterations or additions: Front . ~ Rear . ....... ,'... ...... ::/, .......................... Depth ..... .~,,~ ((~.C /~,,.~.~..t~ ...... 'umber of Stories .... ~.O. ............ Dimensions of entire new construction: Front .... ~.~. ....... Rear ............... Depth ............... .... ,~, ................. N,.rnb~r o~ ~,to ............................................................ 9. Size df lot: Front ..... .~.8'~......... ....... Rear ...... D.~.¢ .......... Depth ...... f,.q.,,~ ........... 10. Date of Purchase ..... [.0. ;./.~[:-ff.~.. ............ Name of Forme Owner . .%%1 .~g?V.. ~.'~%"F-.,~E&'~ ...... 11. Zone or use district in which piemises are situated .... ,~ ................................................ 1,2. Does Proposed cpnstruction violate, any zoning law, ordinance or regula ion: .... /xJD.. ........................ 13. Will lot be'regr~ded ....... )~. ~ ................. Will excess fill be removed from premises: Yes (~) 14. Name of Owner of premises .~l~bg~.l.~;. ~.q~/~.~.. Address /~.~?~ ~ ,co . , -~ .!r'~..O/* $~9.. Phone No. ~ ~..~.~r/0.1[~.. Name of Architect ........ N..0d.~. .............. Address .................. Phone No ................ Name of Contiactor ........ i .................. Address .................. Phone No ................ :' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or propo~ ;d, and, indicate all set-back dimensions from property lines. Give street and block number or description according to dee~ and show street names and indicate whether interior oi- corner lot. STATE OF NEW YORK, COUNTY OF...',~.q .~.~ d~.-.... ' S.S (Name of individual sigg~ng contract) above named· ' He is the of said owner or owners, and is duly authorized to perform or have perfm application; that all statements contained in this application are true to the work will be performed in the mann er set forth in the application filed therex Sworn to before me this t/ \ / \ \ I ?orn, deposes and says that he is the applicant ricer, etc.) med the said work and to make and file this best of his knowledge and belief; and that the dth. Notary Public, .... ~ ................. County , ........... .......... [~'"I~I~N:Ii0~_ ~ ~ 0~-~//~-- . (S,gnature of applicant) TF rJ