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Home My WebLink About13764-zNO. $ TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Offdce Southold, N. 1'. Certificate Of Occupancy THIS CERTIFIES that the building located at 3..2.8.0.0..~.a.~.n..R..o.a.d. .......... Street Map No ............. Block No ...........Lot No .................................. conforms substantially to the .~ ' -- ' ' ~ _ - . ~ PRIOR TO CI~RTIFICATE OF OCCUPANCY dated ........ Apr.l.t.. 2.3 ..., 19~. pursuant to which~ No..Z9.1.38. dated ........Jultr.... ~.~ ..... , 19.7.8., was issued, and conforms %o all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate/s ~sued ~ ....... Co,mmv. clod, .l~a-~ ~,ding. ......................................... · Grabie Appli~ces Inc. ~e ce~icate is issued ~ ...................................................... (owner, ~~ of ~e ~oresaid bu~d~g. S~olk County Dep~tmen~ o~ Heal~ Approv~ ....... ~.~g ............ No ~.e-~isting ~ERWRITERS CERTIFICA~ ............................................. ' ... .._~ttimg~, . ...ork . . Bmldm~ 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 in duplicate 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 featu res. 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 propertv 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 $15.00 C.//,~) ateC~.~.~. /,~,,, .............. New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ./.~,~..~)......~.~./.~.'..'..~?..~.?~ ....................... · .~.~.. ~..~.~..c~. ~.. House No. ~ ~tre~t t Ham/et Owner or Owners of Property....~/.. ,~.~ .~..~..~/..~.~.~. i; i...~..~..~..~..~. · .~., .~.~ ...... CountyTa Map o. lOOOSection ......... BIoc .... .q ......... ........... Subdivision ....................... .~. ........ Filed Map No....~¢ ..... Lot~No .............. Permit No.t~,q.~,~..~,,,. Dateof Permit ~...r~.l~.r~,..Applicant ~..~~ J// ................. Health Dept. Approval ........................ Labor Dept, Approval ........................ Underwriters Approval .~O.z,~(~ ,%~, %" ........... Planning Board Approva{ Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .~ ....................... on tr c,,o. on . ow.,, ~ ~ ~ A..,i~.t ~ [U~. ~~ ........................ '"' Rev. 10-10-78 Southold, N.Y. 11971 (516) 765-1938 March 20, 1985 Victor Lessard Executive Administrator Building Department Town of Southold Southold, NY 11971 Re: The North Fork Clothing Company located at Mattituck Dear Mr. Lessard: The Planning Board has made a review and field inspected the premises for the above mentioned site. It was the consensus of the Board that this would not need a formal site plan review since it is a pre-existing building which is non- conforming, and no site improvements could be made at this time. If any physical changes are made subsequent to this, however, it may need formal site plan consideration and should be reviewed by the Planning Board. If you have any questions, please don't hesitate to contact our office. ~y yours~. ~ A _ _ BENNETT ORLOWSKI,JRo, CHAIRMAN SOUTHOLD TOWN PLANNING BOARD By Diane M ~chultze, Secretary wIELD INSFECTION COMMENTS FOUNDATION 'OUNDATION (2nd) ROUGH FRAME & ?LUMBING INSULATION FERN. STATE ENERGY ~DE FINAL ADDITIONAL COMMENTS: Southold, N.Y. 11971 (516) 765-1938 March 20, 1985 Victor Lessard Executive Administrator Building Department Town of $outhold Southold, NY 11971 Re: The North Fork Clothing Company located at Mattituck Dear Mr. Lessard: The Planning Board has made a review and field inspected the premises for the above mentioned site. It was the consensus of the Board that this would not need a formal site plan review since it is a pre-existing building which is non- conforming, and no site improvements could be made at this time° If ~ny physical changes are made subsequent to this~ however, it may n~ed formal site plan consideration and should be reviewed by the Planning Board. If you have any questions~ please don't hesitate to contact our office. ~V~ry truly yours~. ~ · BENNETT ORLOWSKI~JR., CHAR A SOUTHOLD TOWN PLANNING BOARD By Diane M ~chultze, Secretary Memorandum from... BUILDING INSPECTORS OFFICE TOWN OF SOUTHOLD TOWN 14ALL, [lOX 72§, §OUTlblOLD, N.Y. 11971 765-1802 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 1003~ THIS CERTIFIES THAT only the electrical ecluipment as described below and introduced by the applicant named on tke above application number in the premises of ~orth Fork Clothing Co., 12900 F~in Roa~, MattituGk, ~ in the following location; [] Basement ~ 1st FI. [] 2nd FI. Section Block Lot ~r~h 28 t 1955 and found to be in compliance with the requirements of this Board. OUTLETSFIXTURE SWITCHES FIXTURES RANGES OVENS EXHAUST FANS FLUORESCENT VAPO~ 21 4 4 4 17 DRYERS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT OTHER APPARATUS: ~leutric roo~ heaters: ~-1.5~w., S E R V I C E NO OFpERCC.~COND,OF ~C~/~(~ND NO OF HI-L~O A W.O. NO OF NEUTRALS] A W.O. OF HI-LEO I OF NEUTRAL John A. Rollins 10 Todd Court South H~O~ington, NY 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 I~1 ~ iNCR. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL,: 765-1803 .xamined .~-'-~ .~..~..., 19 ~..-/~--- ,pproved .~.~..~..., 19~.ff..~ermit No..l .~ .2d~ Received ........... ,19... ~isapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tins application must be completely filled in by Wpewriter 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 ~ 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 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 all 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 iall 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 ailding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances 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 mit authorized inspectors on premises and in building for necessa~, ,-,,. ................... (Signature--6f applicant, or name, if a corporation) (Mailing address of applicant) :ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................... dr5' b~' ~/'Sq ~ ......... tO'~ ~ ...... , ..... ~ .... ~ ~ "" ' - Loo $V (as on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~' Plumber's License No,/d)'./a41~l ..~-...'-T .......... -... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000Section . II~ Block [[. Lot l~ 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 . . R/~.~...(e4~l~.-.- ............ .~. ............................. b. Intended use and occupancy ............ 3. Nature of work (check which apphcable): New Building .......... Repair ............ Remgvai .............. Demolition .............. Other Work~[v~/,~ .'-1 Ar-wt.. ~'T. 4. Estimated Cost .-':..~!~ ................... Fee .... /~..t ........... ; ~'~ (to be paid on filing this application) 5. If dwelling, number of dweiling~units ............... Number of dwelling units on each floor....-xL'~--. ........... If garage, number of cars . .'.~. i.: ............................................. t')' ~,? m [.;,t~: ~,'~' "_2." 6. If business, commercial or mixeld occupancy, specif,~re and extent of each type of use 3.'~/~!L/~4 .~ ...... 7. Dimensions of existing structures, if any: Front ~ .',~. '.2' ...... Rear .............. Depth. ~ ..... ~ ...... Height ............... Number of Stories .~'1~. ............................................ ~ ..... Dimensions of same structure ~vith alterations or additions: Front ................. Rear .................. Depth 'Height ................... . .............. Number of Stories ...................... 8. Dimensions of entire new construction: Front ... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Sizeoflot: Front . .I.,~,~ .... : ............ Rear ...................... Depth ...................... 10. Date of Purchase (BiI. ~ .... i ................... Name of Former Owner ................ ...... ....... 11. Zone or use district in which p~emises are situated ........................ 12. Does proposed construction viqlate any zoning law, ordinance or regulation: ....................... , ......... 13. Will 10t be regraded ........ ~' ' l~,t,~ .~ ~.~ ......... u. Will excess fill be removed from premisesk, Yes No 14./~ Name of Owner of premises '~0~! I~. l/{J?.J ...... ~ddress ................... Phone No.Q~..'~. }.~ ......... / Name of Architect ......... .................. Address ................... Phone No ........ ........ ~ Name of Contractor ........ i .................. Address ................... Phone No .... i~" ......... Locate clearly and distinctly all buildings, whether existing or proposed, and~ indicate all' set-back dimensi6ns ~rom 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, I 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 ddly 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 man~er set forth in the application filed therewith. Sworn to before me this £cC ...day6f. 19. Notary Public, ~ '~.~.~... Coun HELEN ~ DE VOE (Signature Of applic~t) EE: BY: 4OTI~ .BUILDING DEPARTMENT AT '65-1802 9 AM TO 4 PM FOR THE )LLOWING INSPECTIONS: FOUNDATION - ~O RE~UI~ED FOR POLIRED CONCRETE ROUGH 4 F~MING & PLUMBING INSULATION FINAL..- COh~Tf:UCTiON BE CiO~API..ET'E FHE ~E~UI'R~tE~ O,F ~E ~ Y