HomeMy WebLinkAbout14268-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Buildin§ Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
Z-16075
No ..................
August 19, 1987
Date .................................
THIS CERTIFIES that the building ....~ .W.I.I~?..ZF.~..~.99k .~.. ....................
LocationofProperty 185 Hummel Avenue Southold, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 63 ...Block 2 .Lot 13
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
September 12, 1985 pursuant to which Building Permit No. 14268 Z
dated September 12, 1985
............................ 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 .........
SWIMMING POOL WIT~ FENCE
The certificate is issued to .. PETER J. GRATTAN, JR.
................... ?o';~;,'$;~e$¥7:/~;~l~l~xx ...................
of the aforesaid building.
Suffolk County Department of Health Approval bl / A
UNDERWRITERS CERTIFICATE NO. bi 771353
N/A
PLUMBERS CERTIFICATION DATED:
Rev, 1/tll
l~UU NO. B
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N-° 14268 Z
Date ................. [..' ......................... , i9.
Permission is hereby granted to:
........... ~ ....... ~..~:~.~. .......................
.......... /..~......~.~..1......~.~_~, ......................
............. ~.~.~.~.~ ....... .~.:~ .......................
,o ........... ..c...~.t.~ ........... ~.~..~.~:!~,~.....~.1. ...... ~.:...%.... ....... .~.~ ....................
County Tax M,p No. Iaaa stcti.n ~ '~ mo~k ~' Lot No. /~
pursuant to application dot~ ~//~)- 19...~.,?ond opprow'~J by the
Building inspector.
Fee ~ ........................
Building Inspector
Rev. 6/30/80
THE NEW YORK BOARD OF FIRE UNDERWRITERS
...EAU oF E-=CT.IC,T¥
Se~tem~' ~e. l~eJ°"" ST.E~T..~w ~o....~ ~~
,.,, ' ~,,~..,o.~o.~.~,,~ N 77~353
THIS CERTIFIES THAT
only the electrical equipment ~.~scrlbed below and ~ntr~uced by t~ ~pJlcat~t ~med on the above application number in the premises of
Peter ~ratt~ Jr. ~1 I~1 Avenue, ~ld~ N.Y '
~side
in thefollo~ng location; ~ ~,ement ~ Ist Fl. ~ 2nd Fl. Section Block Lot
~s exatnlned on SO~)~ ~ ~ ~9~ and found to be in compllar~ce u'it h the roqt~irements of thls Board.
SWITCHES
FIXTURES
DRYERS FURNACE MOTORS FUTURE
SERVICE DISCONNECT
RANGES
NO OF CC COND
~~~~__COQKING DECKS OVENS DISH WASHERS
TIME CLOCKS UNIT HEATERS ! MULTI-OUTLET
NO OF FEET
C
EXHAUST FANS
DIMMERS
AWG,
OF NEUTRAL
APPARATUS:
1-G.~.C.~.
IS?_.~inm~ This certificate covers oompliano9 at the d~te of inspection only.
Because of unustm] onvironnents it is advisable to ha',.'o fr~tuent test/and or repairs
mede by a qualified person.
penelope Gratt an
201 ~{~lmel A~nue
SOuthold, N.Y. 10971 OENER~i:iMANAOER
Per
this certificate most i be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by thek credenflals.
co~ ~o~su~L~l~o o~e,aT~. TInS COPY OF CEeT~:C~T~
~'i~LD I~$SI'ECTI 0N COMMENTS
~OUNDATION (1st)
~OUNDATION
(2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
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 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 $25.00 -- BUSINESS $50.00 ACCESSORY $I0.00
2. Certificate of occupancy on pre*existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $]0.00
5.Updated C.O. $ 50.00 Date .... ./ ....
New C.~ons tructio.~., f. Old or Pre-existing Building ............ Vacant Land .........
Location of Property ............................. . . .
House No. Street /Yam/et
Owner or Owners of Property ............................................................
County Tax Map No. 1000 Section ............... Block ............... Lot ................
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No./'..~.~.~;:i .Z'~. 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 buildin ndg. a'~permit~eets all a
Applican .~~....~~
Rev. 10,10-78
~-:i~J ~ j :, FOR~ NO. 6
i,iI TOW~ TownOF SOUTHOLDH,ii
- ~?. Building Department
Southeld, N.Y. 11971
APPLICATION FO~ CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted I ~ to the Building Inspec-
tor with the following; for new buildings or new use:
1. Final sur~ey 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 e{ectrical 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,
§.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 featu res,
2.Sworn statement of owner or previous owner as to u se, occupancy and condition of bu tidings,
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: Additions $25.00
1. Certiflcate of occupancy New Dwelling $25.00, Acc&ssory,~I0.00 Business $50.00
2. Certificate of occupancy on pre-existing dwelling $ 50.00
3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00
4.Vacant Land C.O. $ 20.00
5.Updated C.O. $ 50.00 Dat .?.~..'~./.~.~.Z .....
? ,
NewC_°nstruction ...... Old or Pre-existing Buildin,~ ............ Vacant Land .............
Location of Property .~.. ,o/. ...... .~. ~2~..'.~.?..~.~ .....................
Owner or Owners of Property ..~:/~~ .......................
County Tax Map No 1000 Sect on ....... .if' ..... Block ............... Lot ................
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No.. / . . ate 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 a~ all_/~.d~.regu~/tions.____
R~v. 10-10-78
P~c.. 2~2~113
TOVJN OF SOUTHOLD
OFFICF~ OF BUILDING IN$1?ECTOR
P.O. BOX 728
TOWN HALL
SOUTIIOLD, N.Y. 11971
TEL. 765-1802
To Whom This May Concern,
We are unable to complete your Certificate
of Occupancy because ,of the following reasons.
An application for Certificate of Occupancy
is not on file.
No Underwriters Certificate on file.
The check is(outdated/~ot o~ fi!e~)~ ~--~
No Health Dept. Approval on file.
No final inspection has been made.
Please contact our office on this matter.
Thank you for your cooperation.
Building Permit I~ _k L_~ _~ _~. ~__ Z
Building Dept.
***/~/ No Plumber solder Certificate on file.
( all permits involving plumbing being
issued after April 1,1984 )
Occupancy or use is unlawful without a Certificate of
Occupancy. Please clear up this matter so that legal action
does not have to be taken.
Thank you for your prompt attention.
'FORM NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
, .7 ' ,' TOWN HALL
SOUTHOLD, N.Y. 11971
\ TEL.: 765-1803
×amined .... .?.. . ., 19 .?
Approved ....... i9 rPe, it
BLDG, DEPT.
TOWN OF SOUTHOLI)
Received ........... ,19...
Disapproved a/c .....................................
.. ' ' (Building Inspector)
APPLICATIOhl FOR BUILDI~IG PERI',]IT
INSTRUCTIONS
a. Tins 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 tins 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 g 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 Oldinance of the Town of Southold, Suffolk CounW, 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
admit authorized inspectors on premises and .in building for necessary inspections.
(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.
Name of owner of premises . .F~.. ~ ..~.~:~.....J.~...~...r .~.~..~'~. ~..~..~... ~.:... ~v~ ~.~.,_. ~.~Yr. .................... ·
(as on the ta~oll or, test deed)
If applicant is a corporation, signature of duly authorized officer.
Other Trade's License No ...................... ~
1. Location of land on which proposed work will be done ................. .~ ...............................
...... ......... ......... .................
House Number Street Hamlet
County Tax Map No. 1000 Section ..... ~..~. ........ Block ..... .~. .......... Lot .... ~.~. ...........
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
2. State existing use and occupancy of premises and intended us~nd occupancy of p/oposed construction:
a. Existing use and occupancy ........... '~/./~. · ~...1~..~~ ~. ¢,,:~.~.. (. Z .........
b. Intended use and occupancy .......... ~ ~"~ ' --' '.~. ~.".~..//~:¢'O~'. i'i~'. .... \'~.' ::'i'll..: '.' .' i'i ........
(Name and title of corp'orate officer)
Builder's License No ..........................
Plumber's License No .........................
Electrician's License No .......................
3. Nature of work (check which applicable): New Building ..... 'i.. '.. 'Addition .......... Alterati~oit~ ..........
, Repair .............. Removal .............. Demolition .............. Oth~ Work~].~.~,~ ......
~ I~- q2k~ ~,,~ i Id ,, ,,- ~'Zt~_,-~,_~.'~L~¢~,' (Descriptio. n)
' ~.14: Estimated Cost ...... :~...~Q..~.,.q.o. ................ Fee/?. ,.otTD.:,O.O.
[ .i;.; .... ~ :. ' (to be paid on filing th~s application)
L-~..,-qf;~ellmgi numlJer,of dwelling units ............... Number of dwelling units on each floor ................
If garage', number of cars
6. If business, commercial or mixed bccupancy specify nature and extent of each type of use .....................
7. Dimensions of existing structures, if any: Front,.. '.'i ......:... Rear .............. Depth ..............
Height ............... Number of Stories ........................................................
Dimensions of same structure with alterations or additions: Front ................. Rear.. ................
Depth ..................... i. Height ...................... Number of Stories ......................
8 D .... Rear Depth
'- lmenslons of entire new constru~tton: Front
He~-ght Number of S~o~es; ·
9. Size of lot: Front ............ 1 ........... Rear ...................... Depth ......................
10 Dat~ of Purchas~ I Name of Former Owner
1 1 Zone d' ' ' h' h p m' itu t d
. or use xstnct~nw ~c re lsesares ae .....................................................
i
,., 12. Does proposed, construction violate any zoning law, ord nanceorregulatlon: ................................
~ 1'3.Will lot be regraded ...... i,,., j .................. Will excess fill be removed from premises: ~- Yes No
14. Name of Owner of premises ~.d~. ~ ~¢hCK' .. Address ................... Phone No.q~...t~.q..~.
Name of Architect ........... ~ ................ Address ................... Phone No ................
Name of Contractor ......... ;i ................ Address ................... Phone No ........... ~ .....
!
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed and, indicate all set-back dimensions 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,{~ //~¢/ SS
couN2'Y'jo.,F · ;~ ~,ASt:~;g/'~j~ ,,·
a " ant
i~a~(/o'f in dividu{~I/,~i~nifig contract)
above namecI, ~'
He is the ........... .~..".'~....~.. ....................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly,i authorized to perform or have performed the said work and to make and file this
application; that all statements contaihed in this application are true to the best of his knowledge and belief; and that the
work will be ~erformed in the manner iset forth in the application filed therewith.
Sworn to before me this
................. day of. ?. ......19
, ...............................
NOTARY PUlit, J~ 8'~ete M New York
14o. ~S22~, Su~olk Com~. ure of applicant)
Ter~ Expires March 30, 19-~