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HomeMy WebLinkAbout14231-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. g ]-.~.6.8 3 ......... Date ......... qu..ly..2..2.~ ............... 19.8.6. THIS CERTIFIES that the building bathroom addition Location of Property 2.5. O.$~h Drive No. Southold~ N.Y. House No. Stro~t Ham/et County Tax Map No. 1000 Section . ~.7.~ ....... Block .... 0.2. ......... Lot .... 0.1.9. .......... Subdivision ............................... MapNo. 1663 .LotNo. 85,86 & p/0 87 M/o Goose Neck Filed .................... conforms substantially to the Application for Building Permit heretofore fried in this office dated ·. September 4, 19 .8.5. pursuant to which Building Permit No. 14 2 31 Z dated . .S.e.p.t.e..n~..e.r..4.: ............ 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 ......... bathroom addition The certificate is issued to William J. & Clara A. Coleman ..................... ..................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N 7 2. 5 8 91 Plumbers Certification Dated: September 2, 1985 Building Inspector R.~. 1/81 POB3M[ NO. O TO1,VN 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) No 14231' Z Permission is hereby granted to: ..~.~..///~.~. ..... .. . .... 5.~o.r~za~....~....6L~.: ./... .................... to ........ C~.~..=.~.~.cT.....~.~.Z.X-.~..~-~AY.... ~.~ .M...r..7..z c~.~.:. ...................................... ....................................................................................................................... ~,o..~.=~.~.:~ .... ................. ................ County Tax Map No. ,000 Section ....~...7~. ....... Block ......0...~. ........ Lot No..~.'./.:? ........... pursuant to application dated ....... ~...C~..5.(.~.... ....../.. ........... , 19 ....... nd approved by the Building Inspector. ulldlng nspector Rev. 6/30/80 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~.~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the el~tdcaJ eq~ipment ~ described below and introduc~ by t~ appJlcant ~d on the above application number in the premises of Wi~.i~ J. ~ 250 ~ith Drivo ~'th, ~t~ld, ~-,~./o,o~.~o~.ao.; ~ ~., was examined o~ ~0~ 5 ~ ],9~}5 and found to be in compliance with the requireme~ts of this Board. ~;xma~ RX;Oa[S a~N~SS iCOOmNa OaCKS OVSNS 2 ~ 3 2 2~ ~th~ ~tve North ~.i/ l l/>?l rhis certificate must not be eltered in ~ny menneO return to the office of the Boord if incorrect inspectors m~~ )F ~ERTI! ' BE ALTERED IN ANY MANNER. TOWN OF SOUTHOLD OFFICE OF BUILDING INsPEcFoR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 1197~ TEL. 765-1802 C E R T I F I C A'T'I~91~ rtify that the so[der used in the water supply system l~ess than 2/10 'of 1% lead. · Building Permit Not/q ~ ~ / ~ 0w er I (please print) ~ '(pl~-e eon.rains :Sworn to )efore me this Notary Pul~lic, ~Fz/< County: - INSPI CTION [ ] FOUNDATION ~,ST [ GH PLBG. [ca/FOUNDATION ~ND [ ~/~NSULATION [ ~//FRAMIN(I [/] F, NAL REMARKS: ,/ DATE iNSPECTOR EIELD INSPECTION DATE COMMENTS FOUNDATION (1st) FOUNDATION (2nd) .... R0uG. FRAME ~ C FLUBBING INSULATION FER N. Y. STATE ENERGY ~DE. ~ ~· ADDITIONAL COMMENTS: , I 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved....~..~ .r~...~. .... 1~..'Permit No...~.9/..Z:J(.~ Received ........... ,19.. · Disapproved a/c ................ ._~. .............. ~ ~"~ ........................ : .... ' ........ . ~ ~ ~ ' ....... ~ii~i~'I~spector) ,/n, .~ ~ ~ ~ x% /) APPL CAT ON FOR BUILDING PERMIT ~ .... .... ~ ~ ~ ~.*/ INSTRUCTIONS a. T~s a ication must be completely filled in by ~pewfiter or in ink and submitted to the Building Inspector, wi~ 3 ets of plans, accurate plot plan to scale. Fee accoding to schedule. b. Plot plan show~g location of lot and of bulldogs on premises, relationship to adjoining premises or pubic streets )r ~eas, and giv~g a det~led description of layout of property must be drawn on the diagram which is pa~ of this appli- :ation. c. The work covered by t~s application may not be commenced before issu~ce of Building Permit. d. Upon approval of this application, the Building Inspector w~l issued a Build~g Pemit to the appBcant. Such pemit :hall be kept on the premises available for inspection throughout the work. e. No bufld~g shall be occupied or used in whole or in p~ for any purpose whatever until a Ce~ificate of Occup~cy ,hall have been grated by the Build~g Inspector. t APPLICATION IS HEREBY MADE to the Building Dep~tment for the issuance of a B~lding Pemit pursuit to the ~uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d other applicable Laws, Ord~ces or ~egulations, for the construction of build~gs, additions or alterations, or for removal or demolition, as herein described. ~e applicant agrees to comply with a~ applicable Jaws, ordinances, building code, housing code, and regulations, and to ~dmit authorized inspecto~ on premises and ~ build~g for necessa~ i~pecti~ns. ........ (Signature of applicant, or name, if a corporation) (Mating address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............. .................................................................... qme of owner of premises ~.~.t ~. ~ .... C..~.~.~ ................................. (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. 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 . .~. 7..~.,. .g). ?. ...... Block . .~.O-...~..~. ........ Lot...~). ~/.~.,..o..~..~. .... Subdivision. ~..O..t~'..~-'~.../~.~..~.../~ ................ Filed Map No. i~,..~..-:~. ...... Lot ~..~-.~..~.4..~. ?.~..~. ? (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... /~..~. .... (.l~../~.. ~ .~. ~ ! /Y'Fa5 b. lntended use and occupancy ........................ .... ,,,· ¥,~, ~.~; ~,4~,~., ...,....... itl 1/~ ~.. ;.Nature of work (check which applicable): New Building ..... ' ..... Addition ..... Alteration .......... !['!;ii CI[~! ,,J~ gi~ l ~ ' ~ aa .... ~' ....... . Removal, .......... ~' Demolition ~ ...... ~ ~ Other Work (Description) '.:,:. 4.~ .EsQma~ed Cost ~, :~t · · .~ ...... . ........... Fee ............................. ~ ' ' ' ~ (to be paid on filing this application) 5.If dwelling, number of dwelhn~ umts ............... Number of dwelling units on each floor ................ If garage number of cars ] 6.If business commercial or mixed occupancy, specty ~ture and extent 0f each type of use 7. D~mensmns of e~stmg structures, if any Front... ~. Rear ~ ~ ~ Danth Height ... Z~ ......... Number of Sto~es ... ~. ............... ~ .... r ................. -' z .......... 'D~ansions of same structure with alterations or additions: Front ..... .~.~ ........ Rear ... ~ ~ ........... Depth ..... ~ .......... ~... HeiSt ...... /'~' ' V .......... Number of Sto~es ....... [ ....... --' 8.He~g~tDimensi°ns' ~ ...... ofentire[~ ........ newcons[mction:Number~ of StodesFr°nt ........ .... .~...................Rear,~..M.~f.~......~.........~.....,.........Depth ...&G .... ....... ...... 9. Size of lot: Front ...... Z~ ........... Rear ....... l~...~ ....... Depth ...~..~ .............. 10. Date of Purchase ~/.z:~ /,f ~ ....... : ................... Name of Former Owner ............................ 11. Zone or use district in which p~emises are situated ................ 12. ' " .... ~ Does proposed constructmn vml~te any zoning law, ordmance or regulation: . .. ~ ......................... 13. Will lot be regraded ...... ~ ...... ~ ........... Will excess fill ~e removed from premises' /,//' Ye~ No 14. Nme of Owner of premises ~J3.&(~ ~,&~f~.,~Addres~.~ ehone Name of Architect ....... ~.~. ~ .......... Address .................... Phone No ................ Nmne of Contractor ...... ~. ~.6~ ........... Address ..... : .. Phone No. PLO'[' DIAGRAM Locate cleariy and distinctly all buildings, whether existing or proposed, property lines. Give street and bloc interior or corner lot. and, indicate all set-back dimensions from number or description' according to deed, and show street names and indicate whether /ti, 72'~ STATE OF NEW YORK, COUNTY OF ...... , (Signature of applicant)i~ Term'Expires Mirch 30, ........ · ..~.....................~ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) i above named, i ~ He is the ~ I i (Contractor, agent, corporate, officer, etc.) ~ of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements coniained in this application are true to thei best of his knowledge and belief; and that the worl/will be performed in the ~ mantlet set forth in the application filed there, ~ith. Sworn to before me this . !ii' Notary Public, . .~. ['.'...~./:-. ~...t~..... , ...... County t/e-A/7' /ES '/'-0" If copper tubing is used for water distributing system; piping shall be of types K or L only I 3 ' £A5 7- EL E ~/,n ~FEE~---Y · ~-'AT ~oTIFY BUIt.D~NG '765-1802 9 AM-~O 4 PM FOR THE FoLLOWIN~ iNSPECTIONS: 1. FOUNDATION "TWO REQU~ED FOR pOURED coNCRETE 2. ROUGH - FRAMING & pLUMBING 3. iNSULATION 4. FINAL - CON'sTRUCTION MUST BE coMPLETE FOR C, O, ALL cONSTRUCTiON ~MALL r S OF THB N, "THE ~ATE CONSTRUCTION ~oDES, NOT R~fiPONSI~t.B ~StGN OR CQNST~UCTtO~ 3 ~AqtAZ \ ~lAZL..q ~ C~ILMI(.~ - ,2~'¥-I~"©,c, I/~ "5tt,-:,~ 5'>[,',,/6' ~ c:£ CI~0..:£ 5£C T/OAI .~. E'x sT 131:t TtlI~O0 FO£ ,,4D~ I Ilo ~ ~ >'$ / T W z..',,t . .~ o u ? z4 o z ~ ,,,v.,),X