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Home My WebLink About14221-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin8 Inspector Town Haft Southold, N.Y. CertiFicate Occupancy November .10 198..6 NO..g. 1..5.0.7.7. ......... Date ............................... , . Addition THIS CERTIFIES that the bulldog ........................................... . .... i . Location of Pto ... ~O00 West halla Road Mattltuck '' .' County Tax Map No. I000 Section 114 .... Block .0.7 l,~t 12.2 Subdivision ....... Filed Map No Lot No conforms substantially to the Application for Building Permit heretofore ~ed in this office dated .............~..u.ly. 1.7 .. 19..8.Spursuant to which Building Permit No ................... 1422..1.g dated..... ~-.Auqust ...... 29. .. ............. 19 .1~ 2, 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 ......... ~9Aq~.r.u.c.t. ~ .a.d..d.i.t.o.n. to an existing one family dwelling. The certificate is issued to .R. UT.I:t L. SATTERLY (owner, ~.ee.or-tena~J of the aforesaid building. Suffolk County Department of Health Approval. ........ .N/.A. .......................... .. . . N756056 UNDERWRrEERS CERTIFiCAT~ NO .......................................... ... .. ... Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. N_o BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14221 Z Data ..... ~ .............. ..~... · 19....~...'""' Permission is hereby granted to: .... ""*'; ...... ~ ............. z""""~ ........................... ............. ~o ................... ~ ..,Owm ~. ~..l ......................... County Tax Mop No. lO00 Section ............ .~, ......... Block .......... 3 ........ Lot No ......................... pursuant to application dated ...... ...~......~.]-...'~. ..................... , 19.~..~..~ and approved by the Building Inspector. Fee $..~.... ............... Rev. 6/30/80 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 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 pZt)perty 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. 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 5. Updated C.O. $15.00 Date . ..~..a..O..~*~...~., .z~.. , ./..~o ./,~..~(~ NewC°nstruction ...... Old or Pre-existing Building ............ Vacant Land ............. House No, Street Ham/et Owner or Owners of Property ......... : .................................... County Tax Map No. 1000 Section .... ~/./.~. ....... Block ..... ~.'7 ...... Lot.../..~',; .."~. ..... Subdivision /Y//~/oX. ~, ,A.cr,~. ,/~.~' Filed Map No. ,Lot No. Permit No./5/;a; .~. Date of Permit ~//.?/.~.~.~..Applicant ...................... ~ ..... Health Dept. Approval .... .Labor Dept. Approval ......... - ............. Underwriters Approval . . . .O. .......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Subm tted $ ,~b'. ~- Construction on above described building andpermit me~'s-a~ap, plicable cpd~nd regulation% Applicant ...] .... ~.~ .......... Rev. lO.lO-7a THE NEW YORK BOARD OF FIRE UNDERWRITERS . 100077~. BUREAU OF ELECTRiCiTY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,.,e 25, fi, e ?es/se N756055 THIS CERTIFIES THAT only the alee trical equipment as d~scribed below and introduced by the applicant named on the above application number in the premises of James Le~sard, e/s Westphalia Road (1000' n/o Rte 48), Mat~ituck,N.Y in th. foliotrlng /ac. tion; [] Basement ~] ist Itl. [] ~nd f'l. garage Section Btoch Lot was examined o~TL~r~ 19, 1986 and found to be in compliance u'ith the requirements of this Board. FIXTURES RANGES :IX)KING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETsFIXTURE SWITCHES fN¢~,NO~SCeN! ~LUORE~.~'N~ v*.o. 9 12 7 DRYERS MOTORS FUTURE APPLIANCE ~EDERS TIMECLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTRMS NO. OF FEET SERVICE DISCONNECT S R R V t C OTHER APPARATUS: Panelboards: l~30ir., 100amps 1-G.F.C.I. NO OF CC COND pER ,e' o~ %Jc§~Ll A W, O, NO, OF NEUTRALS A, W G, NO O~ HI-LEG OF HI-LEG OF NEUTRAL Ruland Electric Co. P. O. Box 143 Mattituck,N.¥. 11952 Lic#242E This certificate must ~at be attered in any manner; return to the office of the Board if incorrect. Inspectors may be identifie~L~by-~heir, ~OPY FOR BUILDING DEPARTMENT. THiS cOPY OF CERT I= CAT~E ~UST NOT BE AILTERED IN ANY MANNER FIELD INSPEr~TION I. FOUNDATION ( 1 st } FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING iNSULATION PER N. STATE ENERGY CpDE COMMENIS FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 \e~,U~.~". TEL.: 765-1803 ixamin · .~.~.., 19~. .4./'>' tpprove~kS~lT..~.~.., 19.2/.~. Permit No./..~.~?..°~/. ~ )isapproved a/c ..................................... (Building Inspector) APPLICATION FOR Bi,..JlLOI[qG PE~{t¥i'i) Received ........... ,19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~ts o~f 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 appll- ~tion. ¢. 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 s)mll 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 sl dl 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 uilding 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, building code, housing code, and regulations, and to clmit authorized inspectors on premises and in building for necessary inspectio~/~. ~.' ~· i~i'g'j~r-e' ~ applicant, or ~e~ 'i; ~'c;~;;a~i~)' ' ' 7., (Mailing address of applicant) Irate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. qameorownerofpremises ....'~O/t.4..k.: Zg'lWte"IZ.t--[ t-~7, O-{o ~tl.~.C:.q....~.:..~..~..~..~.t.~'? ....... (as on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) 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 .................................................. House Number Street Hamlet County Tax Map No. 1000 Section . 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 ........... I~.. ~,q~T.w. .... . .~..t75.1.I¢..e~.~- ............................. b. Intended use and occupancy ....... ~, co~'T-- .~ S. o¢.¢~ ~,[~?~i~ m' ... 3. Nature of work (check which apphcable): New Building .......... ition ...... Alteration .......... Repair .............. Removal .............. Demolition . , Other Work ' ' (Description) 4 Estimated Cost Fee ! ~' i (to be paid on filing this application) 5. If dwelling, number of dwellin~ units ....... Number of dwelling units on each floor .... ~ ............ If gargge, number of cars .... i .....]~ ] ] ] ] 6. If business, commercial or mixed occupancy, specify nature and extent 9f each type of use .......... / ........... 7. Dimensions of existing structuies, if any: Front...,~.. ~.: ........ Rear ....~'./. '. .......Depth s~..'; ,~s;2.t. .... Height ............... Nuinber of Stories .... : i~..~.~.~". ......... ] .................................... Dimensions of same structure With alterations or additions: Front .... i ............. Rear .................. Depth ..... 2. kt ...........i... Height ................. ' ' . .... ..... Number of Stones ................. 8. Dimensions of entire new construction: Front . .~ ~., ...... " . Rear~ ............... Depth ............. Height ...... I.q ./t ...... Num,ber of Stones ....... I ............ ~ .................................... 9. Size of lot: Front ... ............ Rear .... ./0~.~/: .~.~..'..i ....... Depth~??~. ~5~.t. ..~..,~.~.~...0..r .... 10. Date of Purchase ...... /.~.5~. ................. Name of Forme~ Owner ../~..o..wM..Z:..~.~.r/.~. t~..~.~.. ? ..... 11. 'Zonel or use district in which premises are situated ...... "/~f~7,5'! ~...T:'~-¢ .............................. 12. Does~propos. e.d construction wolate any zomng law, ordinance or regulation: ... ~/..~. ......................... 13. Will lot be regraded ... &]~.T'. ~...AJ~.r~..~'_'_'_'_'_'_'_'~?~ .~4.. ...... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .-~: .~..~..~..Q ....... Address . .2q. qo..~?.p~..~y~..t~yr.. :~.. Phone No...~.~.~77.~'.&..&r .... Name of Architect ......... .................. Address ....... ............ Phone No ................ Name of Contractor .......................... Address ....... ! ............ Phone No ................ PLOT DIAGRAM Locate clearly and d~st~nctly all buildmgs, whether existing or proposed, an& indicate all set-back dnnens~ons from property lines. Give street and block number or description according to deed and show street names and indicate whether interior or corner lot. ! STATE OF NEW YORK, COUNTY OF..~. · ~-. .... S.S ................................................. being duly s ~orn, deposes and says that he is the applicant (Name of individual signing contract) above named· He is the. .................................................. ~ .................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d¢ly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to th~ best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed thereMth. Sworn to before me this 19 ~.~ ........ ....... day0f ....... .~ ......... Notary Public, ~.. ~. ~L~ ./--..~ .~. ......... (Signature of applicant) f ~CUPANCY OR WITHOUT CERTIFICATE OF OCCUPANCy APPROVED AS NOTED FEE: ~-'"~ ' ~"OTIFY BU1LFHG ~,EPA~TMENT AT ~,5-1802 ~ ~"¢~ '~'O 4 ?~ ~R THE 3. INSU~TIOH · ~. ~(NAL CO*;STRUCT{ON MUST ~ COMPL~E FOR C.O. ~LL CONSTRUCT~ON SHALL MEET rile REQUiP~MENTS OF THE N.Y :~TATE CONSTRUCTION & ENERGY CODES. NOT ~SPONStBLE FOR "~gN OR CON.RUCTiOn' ~RORS f OCSUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY APP~OVED AS NOTED '~tFY BUILD~"'G ~EP&~T~ENT AT ;-, i802 9 Ab¢'~ ~'O 4 ~tQ ~R THE OUNDAT~ON -~NO ~OU~RED · oR POURED CONC~ ~% COM~L~E FOR ¢**L, ;O~STRUCT~N SHALL MEET -f~ ~eQU1P~MENTS OF THE N.Y STATE COr~STRUCTtON & ~ERGY CODES, NOT ~S~NS~L~ ~SIGN OR CO~m~ ' '" ~ORS