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HomeMy WebLinkAbout13899-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13880 Date September 25 19 85 THIS CERTIFIES that the building ...... .A.c.c.e.s..s.o.r.x ............................... Location of Property 36980 C.R. 48 Peconic County Tax Map No. 1000 Section ....0.6.9 ...... Block 04 .Lot P/O 8 Subdivision ...... .X. ....................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .A.p..r.i.1..1..5 .......,19.8.5. pursuant to which Building Permit No....1.3.8.9. 9..Z ............ dated ....M.a.y...1..; ................ 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 ......... ..... rT.-..A, qc..e.s.s.o..ry. Utility Building --- The certificate is issued to TAPLIN, CHARLES E. ..................... ...................... of the aforesaid building. Suffolk County Department of Health Approval .... .N/.A. .................................. UNDERWRITERS CERTIFICATE NO. N7 0 4 5 5 8 Building Inspector Re~. 1/81 FOR~ NO. ~ 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) 13899 Z Permission is hereby granted to: ...~...~....7..~: ............................................... ..£~/....~,...~....i_/..~... ..... . ...................................................................... '""':. .......... .................. at premises located at ...~....~......~......~..Q. ............ .~...~....-~......./~....~... ......... .~.......~...~~. County Tax Map No. 1000 Section ....~....~.,...~.. ...... Block ...... ~ ........... Lot No../~...~....~....~.......~'~'~/ pursuant to application dated .... ~ .......... ~....~.... ........... 19~..~..,~nd approved by the Building Inspector. Building Insl~ctor Rev. 6/30/80 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,, ,?co' ~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--(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. Su bm it Plann lng Boa rd approval of comp leted site p lan 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 requ ired to p reoare 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 O0 Date ~ew ~u[Idin~ ~ ~ or ~re-oxistin~ ~uildin~ Vacant Land Hou~ No. ~/eet Hamlet --'""5'i ¢¢ ...... .... .¢ ........ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No./.~.~. ?.?.',~. Date of Permit /~'.?.~/Y ..... ~pplicant...~.~,~ .~.~..~'.,./..~?(~ .......... Health Dept. Approval ..... /~. ~zYC~...~././ ..... Labor Dept. Approval ..... ~¢zYf~- ............ Underwriters Approval ./~.. ~.~..~ .~. ~. ..... Planning Board Approval ... z~.~.~'..(~, .......... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ /~ Construction on above described building and permit meets all app)icable codes and regulations. 0.-0 ~ ~ '~:'~0 Applicant ....... ~..."¢~ .............................. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~- 88 JOHN STREET, HEW YORK, NEW YORK 10038 Date AD$~3 ].~ ~ ~9~5 Applicatlon No. on file ~J~/85 T.,s CE.T,F,ES T.^T V#43~V~ N704558 only the electrical equipment as described below and i~troduced by the applicant named on the above application number in the premises of in the following location; [] Basement [] 1st FI. [] 2nd ~l. C~rllgO Sectlo~j~9 Block 4 Lot was examined on A~A~*~kcY~ 8 t ~9~ and found to be in compliance with the requirements of this Board. OUTLETSFIXTURE SWITCHES FIXTURES RANGES OVENS DISH WASHERS EXHAUST FAN FLUORESCENT 5 ~ 3 5 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS [JNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: S R R V I C RCC~ A.W,G r No. OF HI-LEG A. WG NO al~E CONg. OF CC, COND* OF HI-LEG NO. OF NEUTRALS OF NEUTRAL .arle~ E. :~aplin 30~0 Cr48, P 0 Box Peconic, }rg 11.958 Per- ~d~ certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be idenfifi dentials. FIELD INSFECTION FOUNDATION COMMENTS FOUNDATION 2. (2nd) ROUGH FRAME & FLUMBING INSULATION FER N. STATE ENERGY %ODE FINAL ADDITIONAL COMMENTS FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1803 Examined . .~. ,~.[ .... , 19~.~- Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ....... .PI ........ , 19 ... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~ts 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 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 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 Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the milding 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 dmit authorized inspectors on premises and in building for necessary inspectiggs. ~ ~ ~ ~ ....... .................... (Signature of applica~f, or name, if a corporation) ..... )q.¢co ./'q.<'/?. .......... (Mailing address of applicant) ;tate whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ..... . .(~..~..~.~.~ ................................................................................ [ams of owner of premises. ~.Z~ .r-~/~,r'....~..-..~ ~(. ~. ~ ~ .~. Z.~ .~.~ .......... (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officer. ............................................. (Name and ti{le of corporate officer) Builder's License No. Plumber's L~cense No. .~ ........... Electrician's License No ..... Other Trade's License No .... Location of land on which proposed work will be done .................................................. .................................................... ~.z.~ ................... House Num bet Street Hamlet ,o00 .......... ............. .... 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 ...................................................... b. Intended use and occupancy .... :~....'~..' .7(~F.ctc~.~..~. td./.~/.~./~F~ ........................... 3. Nature of work (check which applicable): New Building .... ~... Addition .......... Alteration ......... Repair .............. Removal .............. Demolition .............. Other Work .............. 4. Estimated Cost · · · .~ ............... Fee ................................. ~ *-~ (to be paid on filing this application) 5. If dwelling, number of dwellinlg units ............... Number of dwelling units on each floor... If garage, number of cars ...; .................................................................... 6. If business., commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ... '. .......... Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................. ! .... Height .............. / ....... Number of Stories ' 7 ~ 8. Dimensions of entire new construction: Front ....... ~.~. ..... Rear ...... SO.~.... i ~e;'t~' i i ~.' i i i. Height ..... /..~f. ...... NUmber 9f Stories / ~" S-~' ~ 9. Size of lot: Front ........ W....~..../~e-~ .... Rear .......... /. ....... Depth .. ~.~.q 10. Date of Purchase ......... ~ ................... Name of Former Owner 11.. Zon~ or use district in which ~rem~ses are situated .................................................. 12. Does proposed construction violate any zoning law ordinance or regulation: ........ '.~...C~ ........ 13. Will lot be regraded ....... I~.:../~,.(2. ~ .......... Will excess fill be removed' from premises: Yes 14. Name of Owner of premis~es, .t ,~,~ c./ed'. Ac.,. z~.?,t~. ~.:q. Address .'?.~..q.~.~¢'~,~,.~ .... Phone No...'7. 4'.-C/.~./.~. .... Name of Architect . ~J.~,, './~c...~r~.,..~.,~./,~... Address . 4~.Z'. ~.ff .~.~.qo.~/.,¥,._.... Phone No.. 7.~ .~../..~./(.... Name of Contractor ....&.~. '/.,%r.. t~-~...~./t.'.,? . . Address ffFqg' ,~eo~/c Phone No '74F /,P'/? · PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and bloc number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. l S.S ............................ '. · · being duly sworn, deposes and says that he is the applicant (Name of indxwdual s~g~ing contract) above named. He is the ...................... i .................................................................... (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 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 ............ day of .... ~ ........... 19 ~.-q7 Notary Public, ..... ~..~'. .......... County HELEN K. DE VOE ', '~ .................................... N ' ' (Sig ppli t) 0TARY PtJBLIC. State 01New,Y0r~ nature of a can No, ~1707878, Sulf01k Cottony feun/Xl]}res Marcfl 30, ~UF'F. CO.,HF. AL21'H I . $'UFF, CO. DE~F~r. OF ,' 765-1802 9 AM TO 4 P~ FOR THE FOLLOWING INSPECTIONS: 1. FouNDAXION -~TWO REQUIRED FOR POURED CONCRETE 2. ROUGH ~ FRAMING & PLUMBING 3. INCUI A~N 4. FINM- - CQN'S'T'R JCT ON MUST BE Cr~w~n. ?mF FOR C. O. ALL CONc-"~ ~C~'ION SHALL MEET THE REO~m~FMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. N~T RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS.