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Home My WebLink About13951-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z13677 Date July 29 1985 No. renovation. THIS CERTIFIES that the building ................................................ Location of Property 5~5~75 Hain Rd. Southold House No. Street Ham/et 61 ~ ~5 County Tax Map No. 1000 Section ............ Block ............... Lot ................. x x x Subdivision ............................... Filed Map No ......... LOt No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Hay 98.5. 395 z ..................... , I . pursuant to which Building Permit No ...................... dated ....... .H?.7. .~. ? ..............19.85, 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 ......... Renovation of existing commercial structure. The certificate is issued to A1T~ HOCKING & WILLIAM P. SCHOTT ..................... io;;,n'e;,~~ ...................... of the aforesaid building. Suffolk County Department of Health Approval N/A PENDING UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 ffOBM NO. ~ 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) No 13951 Z Permission is hereby grarttad to: ............ at premises located at ...~.~...~....~...~...~. .......... ~..~,..J~.~,.,.....~~ ............... County Tax Map No. 1000 Section ....... ..C~...~...I ..... Block ....... ..~.....~ ....... Lot No ....... t....~.~. .......... I~ursuant to application dated ....... ....~..~.[-..~. ....................... ,19..~....~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~lll~ to the Building Inspec- tor with the following; for new buildings or new use: 1, Final survey of property with accurate location of all building§, property lines, streets, and unusual natural or topographic features, 2. Final approva~ of Hea~th 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. 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 prepare a certificate. C. Fees: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1,00 4.Vacant Land C.O. $5.00 ~ / Date .............. New Building ............. Old or Pre-existing B ,uilding ..... i ...... V~clnt La~ ............. Location of Property .~/'~.~. ~ .~.' ......... ' .~d.~.O,. ~..~.....~.: ................... ~..L/~I~ .... House No. Street Ham/et Owner or Owners of Property .......... ~ .......... .~ ............................... County Tax Map No. 1000 Section ...~.,I ......... Block .... ~ ........... Lot... Subdivision ........... i"/~ ................... Filed Map No .... 4~ ..... Lot No, . .~. ......... Per ...... Date of Permit ....................... Health Dept. Approva, .... ~_ ~3 ~ ~') '~' ...............Labor Dept. Approval ...................... UnderwritersApprova, .~.P~/~, .~J.~.~'~ ........... Planning Board Approval ..................... Request for Temporary Certificate ..................... Final Certificate .... ~ .V~. · · ............. Fee Submitted $..~,. ,(~., .................... ~onstruction on above described building and per 'n~e/et~'.all app, l~le/od~nc~/regulations. % ,~c~C~ (O% Applicant ~...~, ,~ ,?~~.., ................. Rev. 10-10-78 FIELD INS])ECTION FOUNDATION {1st) FOUNDATION ROUGH FRAME & ?LUMBING (2nd) INSULATION PER N. STATE ENERGY C~DE FINAL COMMENTS ADDITIONAL COMMENTS: lOO1 5 THE NEW YORK BOARD OF FIRE UNDERWRITERS ,~ BUREAU OF ELECTRICITY 8,5 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT N was examined on Jnly 29 ~ 1985 and fou~td to be in co,~pliance with the requirements of this Board. OUTLETSFIXTURE SWITCHES FIXTURES RANGES OVENS EXHAUST , FLUORESCENT VA~OR 38 26 13 5 31 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E NO. OF CC COND, O R PP ATUS:, ~ R V I C E A W G. OF CC. COND 5 0 0mcm 30 Rec.. NO OF HI-tEG A W, G, OF HI-LEG NO OF NE~iTRAL! OF NEUTRAL 500mcm Clifford D~ Berry P. O. Box 124 Calverton, N.Y., 11931 GENI~I~AI. musf not be eltered in any menner~, refurn fo the off,ce o~ fhe Boerd i{ incorrecf, Inspecfors me¥ be identified COPY 0i 'FORM NO. ,1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 19 .; Examined · · · Approved .' .~ .~.~ .~.~ ., 19~. .~( Permit No..[ h~..~. ! ..'~.~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... a. Tins application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets of plans, accuraie 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 aieas, 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 hail 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 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. ~ /9 ff ~ .... ...... (Signature 64* applicant, or name, if a corporation) -e,~. ~??., .~?. ! ..... ~ v.r~ .~.¢.~., .c.~. ~..~ .......... % ~ u'~o%c% [ ~%~, (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises . ~ IV. ~0.E.....'~ ~. ~ ~ .~'..~.~.. · · · 5....kk).,.\.[. k .~.vy5....~.~.~ .,a / ['---7 .............. (asbh the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No.. [gJ. ~..k~; ~vv~...'~.....~..% .~.9-['~ Plumber's License No...[.(~. [ (~ ..~. ............. Electrician's License No...% .~ .~ ~...~. .......... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ...$.~. ~ .~. s:. ................... .m .~.': lO....~.~>..~.4 ............. . .~. ~..~...~..~\ .4 ............... House Number Street Hamlet County Tax Map No. 1000 Section ...O.(~.\ ........... Block ..... ~ ............. Lot .... 1.$ ............. 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 . .~ .~, ¢,. kck Igl .~. .... ~-O.C~.~ .x2. ~o.~4.5 ...... .' ,'7-)3, .q3.. ............... .].~) ...... b. Intended use and occupancy . ~ .~. [ ;....%. ~.fh.k( .~...c& V..~.....'-~..9 .o. ~ ~. ............. 1..~. ..... 3. Nature of work (check which a )plicable): New Building ..... ' ..... Addition ......... .(Alteration~j). ......... Repair .............. Ren' oval ............. Demolition ............ Other"~' ' -'~ ~ .............. __~ (Description) 4. Estimated Cost ~' .~ ~ .cg. pO. .] Lei ,.~.. O ........ ~ .......................... Fee ................................... (to be paid on filing this application) 5. If dwelling, number of dweilin units .............. Number of dwelling units on each floor ............... If garage, number of cars .... 1 .................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...'~. o.~ r~ .......... 7. Dimensions of existing structuies, if any: Front...~...~.* ......... Rear ..."o~o. ~ ........ Depth .. G.~) ........ Height ...~ ~).~ ......... Number of Stories ..... t .................................................. Dimensions of same structure with alterations or additions: Front . .S. fi r~ -~ ...... Rear ................. Depth ................... ~... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ...~ .~.~ .... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ · :' ' , ..:~) .......... ~.~I ............... Depth ...~k%~...; ........... .~'. Name of Former Owner ¼ .~ .~, .~ · · .'-~.. ·..t~.~..,~ .ch'~ .o. 10 ....... 1 1. Zone or use district in which premises are situated ..... ~ 7.[ .......................................... ,~u 12. Does proposed construchon vmlate any zomng law, ordinance or regulation: . lg.Q ....................... I~ 13. Will lot be regraded ......... ' .............. .:==... Will excess fill be removed from premises: Yes \ ~o~ 14. Name of Owner of premises~4~ .e,~.h,~q.~ ~.~.\J.. Addresst~ .$.o.~m eR .L~ ~.~ Phone No.~ ¢.~-.-.~'.~. N ~ .-~. · o~ C. -~ Name of Architect .'ff..~.... ~*.'~ .-~-..[.~.~* ........ Address C6~,.o9..~.l.~/Iq. I..hi~,[.. Phone No.~3.~....~ .... .~.~) {, Name of Contractor ...C)..~p.! .eg..e~.C~ ............ Address (,.~ ,.~.o.m~e .q ~a~hone No..~ ¢.~.'.~.~ B .~ .. PLOT DIAGRAM Locate~ clearly and distinctly ~1 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, COUNTY OF ......... ........ S.S ............................ i ..................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named· He is the ..................... 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 corttained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manher set forth in the application filed therewith. Sworn to before me this , ........... ....... day ...... .......... ,19 ...... , HELE'Ng'OE'VOE . NOTARY PUBLIC, State 0~ New York ~ /(Signature of applic~t) ,,~o ~p78~8, Su~fotk C0un~y ' Ter0r t~lr0s March 30 FEE: //~/,~-a BY: ~-~./, NOTIFY BUILDING DEPARTP 765-1802 9 AM TO 4 PM FOP- TI,F FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4 FINIAl CONSTRUCTION MUST BE r-~O~FTF FOR C.O. ALL C~ mTmJCTION SHALL MEET ,'1 ~S ~ 't P/ZZE~/,4 -%.. -: ...... ii_., OCCU~^HCY OR S'OLDER USED IN' WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 of 1% LEAD. USE I,~ ~LAW[UL WITtieST CERTIFICATE E PCCUPAN,C¥ 7 pi~A ~5 A~ -F-I£6T ~l..OO/~ pi-AH ~q~e ~":I'-o" IIl ,~d/bT'IAIG ~IL.ING ~udF~N ~ ~C~ dH / T~'c T