The URL can be used to link to this page

Home My WebLink About13931-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..:$7.I.6.4.64. ........ Date. D.ec.e.m.??.r...7...l.~8. ? ........... THIS CERTIFIES that the building CONSTRUCT STORAGE ADDITION ABOVE ATTACHED · 'dSA,/.d ~ ........................................ Location of Property 2105 Camp Mineola Road Mattituck New York House No. Street Hamlet County Tax Map No. 1000 Section 123 .. ·Block 6 .Lot 52 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated May 2, 1985 13931 Z ..................... pursuant to which Building Permit No ...................... dated Hay 9, 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 ......... STORAGE ADDITION ABOVE ATTACHED GARAGE TO EXISTING ONE FAMILY DWELLING Tile certificate is issued to THOMAS & BARBARA MacLEOD ..................... ?o'd,.'~;, '~Y f~xt~i~'~ x .................... of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. N 844 I 28 & N 844 I 29 PLUMBERS CERTIFICATION DATED: N/A Building Inspector Rev. 1/81 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) 13931' Z Permission is hereby granted to:. ~.~.~.Z~....~.~ ~, ~../...:~~...~.~../~/. ........ .............. .................................. ~...~.........~ ~...~. ...... ; .............................................. ................................................................ ~.~....¢.~~ ..................................... Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 i TOWN ~F §OUT~OLO 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: I. 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, §. 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 pzoperty 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 $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00, over 5 years $10.00 4.Vao n a.d C.O. 20.00 5.Upctated C.O. $ 50.00 Date .. ./~../--./{.~/.~.? ....... NewCons truction ...... Old or Pre-existing Building ............Vacant Land ............. Location of Property .............................................. House No. Street Ham/et Owner or Owaers of Property ...... g.~..4...~....~.....~.r....<r~ .... ¢ .................... County Tax Map No. 1000 Section ............... Block ............. Lot ........... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. 'J.3.~'-~J.?-'' Date of Permit ~..~.~.~.Z ..... 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 meets all applicable codes and regulations. Rev. 10-10o78 FIELD INS[~ECTION FOUNDATION (1st) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION ?ER N. STATE ENERGY ~ODE ADDITIONAL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000663 [~UREAU OF ELECTRICITY THIS CEETIFIES THAT o~y the electrical ~uipment ~ ~scrib~ be~w a~ int~duced by t~ applicant ~med on the above application number in the prem~es of Thamos ~Cloud~ Cemp Mineola Road~ ~ti~uck, ~.Y Section Block Lot examined on and found to be in colnpl ance u, ith the require.~ents qf this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS ~WITCHES FLUORESCENT DRYERS FURNACE MOTORS TIME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE S E R V I C OTHER APPARATUS: Electric Room Heaters: 2-2.01c~ Glenn Bradley ~ 602 Laurel, E.Y. 11948 Lie, 1227 This certificate must not.be altered in any monner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR !BUILDING DEPARTMEHT. THIS COPY OF CERTIFICATE MQST NOT BE ALTERED IN ANY MANNER. 1000663 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~-~t~ BUREAU OF ELECTRICITY 19, Jo.. Date ~pplication No. on file in the following tocatlon; [] Basement [] Ist FI. [] 2nd Fl. Section Block Lot teas examined on NOV~ V. 5 ~ 19~7 and found to be in compliance u, ith the requiretnents o,f th s Board. EIXI'UEE FIXTURES RANGES OUTleTS SWITCHES OVENS EXHAUST DRYERS FURNACE SERVICE DISCONNECT FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET S E R V I PER ,~' OF CC. COND NO. OF HI-LEG C E DIMMERS Glenn Bradley Box 602 Laurel, NY. 11948 Lic, 1227 GENERAL This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their COPY BUILDING RTMENT. THIS COPY OF CERTIFICATE A NOT BE MANNEE. BUILDING DEPT. INSPECTION [ '1 FOUNDATION 'IST ~ '1 ROUGH PI.Be. [ ] FOUNDATION 2ND [ ]INSULATION ( ] FIt4MII~ [ ] FINJU. DATE ~INSPECTOR ~- 7M-~le2 BUILDING DEPT. INSPECTION FOUNDATION SST [ ] ROUGH PI.BG. FOUNDATION 2ND ~/~3NSULATION 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION SST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING FINAL DAT~ 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ., ~OUTHOLD, N.Y. 11971 TEL.: 765-1902 Examined .~..~...~ .... , 19~..~f~ ,pproYed Cn .q ...... 19 e, it No. /.3. . . .Y/7.. Disapproved a/c ..................................... ............................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BLDG. DEPt.. 'I'OWN OF SOUTHOLD Received ........... ,19... Date· ~/..~...~. .......... 19 ..~. a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets 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 applioant. Such permit hall be kept on the premises available for inspection throughout the work. e. No building ghall 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 luilding 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 inspections.~ (Signature of applicant, or name, if a corporation) ........... i~l'aili~i ~fifi~ess of applicant) ! ' ;tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 4ame of owner of premises~5... 0,~1.. ~.k,.~.e. A... ,~..q .e'...~Z~. ~X ............................... (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 .................................................. . . . .k :. . . . . . . ! .z. ....................... House Number Street Hamlet County Tax Map No. 1000 Section . .{c~. 3 .......... Block .... ..~. ........... Lot...5-..~.. ............ 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 ....~ '.~..k~. ...... ................... b. Intended use and occupancy ~~" ~ I~'~.~' ~.0q~...~.~.ff~: ............ 3. Nature of work (check which ~pplicable): New Building ..... ' ..... Addition .......... Alteration . ..~.. ..... Repair ....... :... Removal ....~ ..... Demolition ...... .~ ....... Other Work ............... ~ (~ i ~ (Description) 4. Estimated Cost .. ~..,~...g~., 0-O .. Fee ~ .~..~r ~ ~: ~' (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage, number of cars ... ~ .................................................................... 6. If business, commercial or mix'ed occupancy, specify natur~and extent of each tyne of use .................. 7. Dimensions of.e~isting structures, if any: Front . ~.~..~.': .".. Rear .~J..~. ~' ..... Depth i 1.~ Height ... 1~. ......... Nu!mber of Stories .... [ ~ ...... Dimensions of~sa~n/e.structure with alterations or addi¢ons: Front .... ~.O..~· ....... Rear .,.?.ff. t ,, ....... Depth ...... t. (..6,. ....... ~... Height ..... / ~. .............. Number of Stories .... / .............. 8 Dimension of entir traction: Fro Rear Depth · s e new cons nt..., ......................................... Height Nu'mber of Stories 9. Sizeoflot: Front ......... ; ............ Rear ...................... D~t~t~.~.~.4. j~ ............... 10. Date of Purchase . 1.0:-~ ( .-~ ................... Name of Former Owner ........ ~ .................... 11. Zone or use district in which premises are situated ..................................................... 12. Does'proposed construction viblate any zoning law, ordinance or regulation: ~ ..... 13. Will lot be regraded ...... ~, .~ .~. .................. Will excess fill be removed from premises: Yes 14. Name of Owner of premises . i{~..~.a.c..~, q.~. Address ~lqS~ ..~. ~. ~g. p.[.~,~ Phone No,g~ Name of Architect ........ ~ .................. Address ................... Phone No ................ Name of Contractor ....... i .................. Address .................. . Phone No ................ . i 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. APPIIOVED AS NOTIFY BUILDING D~PARTM~NT 765-1802 9 AM TO ~ PM FO~ TH~ FOLLOWING INSPEC~IONg: 1.~ FOUNDATION ~ T~O , FOR POURED 2.] ROUGH - FRAMIN~ & ¢LUMgiN~ 3.i INSULATION ' 4,1 FINAL . CONS~Odit~N MU~T , BE COMPLETE ¢0¢ ALL CONCt~tJC~lON~ gHALL TBE REQUI~EMEHT~ co~g~. NOT ~g~OHg~LF 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 ..................... ................ (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 conltained in this application are trne to the best of his knowledge and belief; and that the work will be performed in the manfler set forth in the application filed therewith. Sworn to before me this .... . .............. ~. Coun "~ HELEN K. DE VOE NOTARY PUBLIC, State of New Yori( .................. No. 4707878, Buifotk d0uetv (Signature of applicant) i Ternl Expires March 30, 1~'? ~. D. 'FUTFIIL. L. !l ,¸5 LAND '~' ,:.,.'1'