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Home My WebLink About14284-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z 7.1.5.5 3..5. Date , De.c em.b e r. 23. ., 19 ..8.6 THIS CERTIFIES that the building Deck addition . Location of Property ..... 1.4.5.5. ~ .~.a.y.. ~.v.e.n.u..e...: ............ ~..a .t,t.i.t..u .c.k.,..N..ey..Y..o.r.k... House No. Street Hamle~ County Tax Map No. lO00 Section .... J 63 ..... Block ..... ,5 .........Lot ....... .5 ......... Subdivision ............................... Filed ]Map No ......... Lot No .......... .... conforms substantially to the Application for Building Permit heretofore filed in this office dated bug.u.s.t.. ~.3. ~ ..........19..8. ~ursuant to which Building Permit No... I.4 .2.8.4. z. ............ dated ....s&p. t..e .m.b.q r...I .6., .......... 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 ......... Deck addition to existin o..n.e f.a..m.ily..d.w.el. 1..i.n~.. .... '.. ROBERT LUHRS The certificate is issued to ................. r ......................................... (owner,/~ ~ X X of the aforesaid building. Suffolk County Department of Health Approval ....................... .~ [.~. .............. . N/A UNDERWRITERS CERTIFICATE NO ................................................. . Building Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.. .Z-.]5536 .... Date D.e.c.e.m.ber..23, 19 86 THIS CERTIFIES that the building T w o C a r A c c e s s o r y b u i 1 d i n g . .1.45.5. :.Ba.y. Avenue Mattituck New York Location of Property .............................. .. . . .. .. ..' .......... . .. . . House No. Street Hamlet County Tax Map No. 1000Section ....143 .... Block .. 5 L 5 · Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fded in this office dated ,~ug.txa g. 23., ......... ,19..~l ~ursuant to which Building Permit No .... .1.4.2.8.4. .z ........... dated ....s.e.p.c..e .~.b.e.r...I.6 ............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 ......... T~@ car 9ccessory..b.uil. d..ip~, a..s .a.p.~.l.i.ed..f.or. The certificate is issued to .... ROBERT LLrHRS ................. i x x × ................. of the aforesaid building. N/A Suffolk County Department of Health Approval ..................................... ..... UNDERWRITERS CERTIFICATE NO N 7 6 4 ] 5 3 . Building Inspector Re~. 1/81 FOB~ NO. 0 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) No_ 14284 Z Permission is hereby granted to: '~..~.~....~.,....~: ....... .."~.~ ..x.....~..~....~ .................................................... ..~. ~..~.~......~.:.~..,......u,~...q,~ ........... ,o .......... ~..~..~' ...................... ~ .............. "t'-~ ...... ~~~ ........ at premises located at ..~..~..~..~......~.~..~.* ........ ...~...~.,~. ......................... · I ~ L ~ County Tax Map No. 1000 Sectfjen~'..~..~.....~. ...... Block ...................... o, No ....................... pursuant to application dated ~~..~.......'~....~ ............... , 19..~..~..'~, and approved by the Building Inspector. Fee $....I. .................. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Bu ilding Department Town Hall $outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in Wpewriter OR ink, and submitted ~' ~!ll~ 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~Coperty 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 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 New Building ~ .... Old or Pre-existing Building $15.00 Date.../'.~. ~'..~.1.-"...~5~. ........ ............ Vacant Land ............. Location of Property ............................. L .'r?~.. ~ House No. Street Ham/et Owner or Owners of Property ................................. County Tax Map No. 1000 Section...J~Y.~ ...... .. Block ....~ ..... .. . Lot~,~ ...... .. .. .. Subdivision ................................. Filed Map No ........... Lot No ..... '...'..'.... Permit No.'.~.~... Date of Permit ¢/6/.~...Applicant... ~...~...~..~./... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... A Request for Temporary Certificate ..................... FinaJ Certificate ...... Fee Submitted $ ...... .~.,...<~.. ................ Construction on above described building and permit,r~ t/ts al~j;~able coj;Jes and regulations. Rev. 10-10-78 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,%uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions in duplicate ~ A. This application must be filled in typewriter OR ink, and submitted,, ,'V, ?o's. he 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-iS-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 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 preoare a certificate. C. Fees: 1, Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date.....~C,~.~/ .... I..~...- ....... ..~..~. New Building ' Old or Pre-existing Building ............ Vacant Land ............. Location of Property ................................................................... House No. Street Ham/et Owner or Owners of ProperW .................................................. County Tax Map No. 1000 Section ............... Block ............... Lot ................ 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 meet,5~ll ap ~ca~j~odes~d regulations. Apphcant ................................... . Rev. 10-10-78 THE NEW YORK BOARD oF FIRE UNDERWRITERS LLJUU~ BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW 'YORK 10038 ~tl august: 14, i9~6 397~15/~ N 764~53 THIS CERTI~IE~ THAT only the eletrical equipment ~ ~scribed below and intr~uced by t~ applicant named on the above application number in the premises of in the followlng location; ~ ~.,~,t ~ ~t ~'t. ~ ~nd ~ar~e s~tio, m~ rot ~s exutnined o~ ~ O~ ~ ~ and found to be in complla~lce u'ith the requlre.te~ts ~f this Board. FIXTURES RANGES COOKING DECKS OVENS FANS FIXTURE SWITCHES OUTLETS FLUORESCENT 3 ~ 2 3 DRYERS FURNACE MOTORS TIMECLOCES ,INIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO, OF FEET SERVICE OISCONNECT S V I C E R OF HI LEG NO OF NEUTRALS Gooda~e ~lectr~cal Go~. 735~ aaa~ GENERAL MANAGER certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THiS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 FOR CERTIFICATE OF OCCUPANCY instructions vriter OR ink, and submitted illllllllE~ to the Building Inspec- S or new use: ~te location of all buildings, property lines, streets, and unusual ar supply and sewerage disposal--(S~9 form or equal). 3 Board of Fire Underwriters. dings, Multiple Residences and similar buildings and installa- e from the Architect or Engineer responsible for the building. 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 $1 5.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 .'~. ~.~. Date../..~.: ........ New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property .... ~..~--~, ............ ~ky:/~.~.- .............. .. .. Hou~ No, Street Hamlet Owner or Owners of Property .... .............................. . CountyTax Map No. 1000Section . .J.z~....~ ........ Block ..... 5 Lot. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No..I.~..~..~-~..~. Date of Permit . .~/.~.~./,~,~,Applicant. ~ .~.~.... ,~,, ,~,~,",1~, ..... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ............ Request for Temporary Certificate ..................... Final Certificate . '..~....... ........... F s b 'ttd' ee u mi e ~ ............................. Rev. 10-10-78 ]65-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION ;ZND [ ] 'INSULATION [ ] FRAMING ~ FINAL REMARKS:, INSPECTOR I~ELD INSPECTION ~OUNDATION {1st) COMMENTS )UNDATION (2nd) OUGH FRAME & PLUMBING NSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL EOUTHOLD, N.Y. 11971 TEL.: 765-1802 ., 19~ ~ ., 19~.h.'. Permit No. J .q .~.~ .L~..-~. )isapproved a/c ............................... ' ' -~'h ................................ ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19... INSTRUCTIONS a. Tins application must be completely tilled in by typewriter or in ink and submitted to the Building Inspector, with 3 :ts of plans, accurate plot plan to scale2 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- ttion. 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 tail 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 ~all 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 desctibed. he applicant agrees to comply with ail applicable laws, ordinances, building c..9~e, l~usicg, code, and regulations, and to mit authorized inspecto rs on premises and in building for ne c ess ary in speckle/ ////ff. ~'~ (Si~r'e'~ ~pplicant, or name, if a co poration) (Mailing address of applicant) rate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......... . .~...~ .~....~m~...c.,. ..... .~..~.~. ~.-r:?. ~ .................................................. ~ame of owner of premises ...."--~. ~o..~. .... ~..~.h~. .................................................. (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 .................................................. .... ~ .4.., .a-5.. ................... ~'-t ...... .~. ~ ........... .~..~;:~..~..'rs,...,-~,... .................. 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 ....~..~..~m...~.~..,~,~-t.. ,_.~ ~ ~.~ ~..~..t.,, ~ ~ b. Intended use and occupancy . . .'~C.~,_...... ..~ ..~___~. ~~' ' property lines. Give street and bloc interior or corner lot. Rep~r .............. Removal .............. Demolition ...~.. ~ ..... Other Wor~ .............. [ .-. ;;.~ ~-~ .... (to be prod on fihng th~s apphcat~on) 5. ~ If d~tl~units ............... Number of dwelling units on each floor ................ If garage~ number of cars . .. ~ .... ~ ............................................................. 6. If business, commerci~ or mix,ed occupancy, specify ngture and extent of each y~e of use ..................... 7. ~ D~ensions of existing structures, if any: Front .... .~.~ ...... Rear ... ~ ......... Depth ............... . Height . ./.~ .......... Nu.mber of Stories .......................................... D~ensions of same structure ~ith alterations or additions: Front ~ ~ ~ ..... ~ ~;ar..~ ........... Dep~ ..... ~ ~ ......... ;... HeiSt ..... [.~ .............. Number of Stories ...................... · ' .8. D~ensions of entire new con~tmction: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ......................................................... 9. Size of lot: Front ......... ~ ............ Rear ...................... Depth ...................... 10. Date' of Purchase ......... + ................... Name of Fomer Owner ............................. 11. ~. Zon0 or use district in which Eremises are situated ..................................................... 12. Does propo~d construction viblate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ....... f .................... Will excess fill be removed from premises: Y~ No of premises .B~.~..~%. .... Address . ~*~ ~ ~ ...... Phone No. 14. Nme of Owner Nme of Architect . ' ...... ....... r ............ Address ................... Phone No ................ Nme of Contractor ~~q .~ ...... Address ~*~ .......... Phone No.Z~.~ ~.. PLOT DIAGRAM Locate cle~ly ~d distinctly ~1 bufld~gs, whether existing or proposed, ~d, indicate ~1 set-back d~ensions from number or description accord~g to deed, and show street nines and indicate whether STATE OF NEW YORK, S.S COUNTY OF ................ ................................................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ~ ' : of said owner or owners, and is dhly authorized to perform or have performed the said work and to maks:and file this application; that all statements coqtamed m th~s apphcat~on are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........... ~. · .&~. · ....... day9f...~ ............. Notary Pu;blic,...~.. . .~..~...~ .~.. ...... County ..... ,....: ....... ~ ~ (S~gnature of applicant) ; i OCCUPANCY OR USE IS UNI.AWRJL WITHOUT CEETIROATE OF OCCUPANCY APi~ROVED AS NOTED NO'~;¥ BUILDING D ~RTMENT 765 1807 9 AM TO ~ ~M ~R THE FG: OW = ;~ ~qSPEC3~ r ~iR POUI~E~ CONniE 2 ROUGH FRAMING & 3. INSULATION 4. FINAL CO~STRU~ON 8E COMPETE FO~ C,O. ALL CONSTRUCTION ~ALL ME THE REQUIP~MENTS DF THE N.Y STATE CONS~Rt;~ r~C~' ! APPROVE~D AS NOTED '~OTIFY BUILDING D'7~ARTMENT AT' 765d~02 9 A~ T~ ~ ~M ~R THE ~OLLC',?IN(~ nNSpECTIO~S: 1 FOU~~i~3~';::3~ TWO~EOUIRED FO~. PCIUFL.O CON~ETE 2 ROUGH ~RAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MUST 8~ COMPLETE FOR ALL CONSTRUCTION SHALL ME~ ~HE REQUI~MENTS OF THE N.Y STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR D~SIG~ OR CO~TR[~y'~"~ ~ C! OCCUPANCY OR USE-IS UN~WFUL WITHOUT CERTIRC~TE OF OCCUPANCY