The URL can be used to link to this page

Home My WebLink About13799-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy 5685 Date July 30 9~5 THIS CERTIFIES that the building ...... .a.qqe..8 .sp.~.;y. g.a.r.a.g.e.. ...................... ~l 5 Pine St. Location of Property ... 2~.Q .............. yp.u.~g.8..A.¥ .e: .................. Ma...tt .... ituck.... House No. Street Hamlet County Tax Map No. 1000 Section ..... .~.~.!...Block .......... .0.q...Lot .... 0.~.q .......... Subdivision ......... ~2 ..................... Filed Map No .... .x .... Lot No .... .x. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated Hatch 22 193.~. pursuant to which Building Permit No. dated March 26 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 ......... Accessory garage. Dg!SIEL H. WALOSKI The certificate is issued to ..................... ~o'~n~,:~J ...................... of the aforesaid building. Suffolk County Department of Health Approval 3T/A NT0f1260 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev. 1/81 FO~ NO. S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALl. SOUTHOLD, No Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 ~3799 Z Date ........................... , 19. .. Permission is hereby granted to: ..~.y.;.... ..... 7 .................................. ~ ..... ·, ~ .................................. E,' ................ D'"'"";":;'""i~": ........... 2 .............. at premises ~ocated at ~.~..~.:...~.Y...."Z.4.~.....V..~..~......m.~-' County Tax Map No. 1000 Section ..... J..t../. ........ Block ...... ~..! .......... Lot No....0....~.....I ........ pursuant to application doted .... .....~.~..,..~.'~ ........... , 19.~..~.'~, and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Flu ilding Department Town Hall ,~;~uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG. DEPT. TOWN OF SOUTHOLD Instructions in duplicate ~- . A. This application must be filled in typewriter OR ink, and subm tted ,. r',V~,~ ' *':~:O~, ~.he Building Inspec~ tot 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/coperty 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 $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 '~'/'/~''z-//~/~"~-- Date ................. New Building ~ . Old or Pre-existing Building Vacant Land Location of Property,. ,~, ,? ~(:~,~ C//5'--~)p .'._~. ,~ ,~,, . ,~,. ,,'~., .'.'~. ,~--~.cL Mouse No. Street Ham/et Owner or Owners of Property ....................... ~/~.f ................................. County Tax Map No. 1000 Section ........ /..~.~ .... Block ....... ~. / ..... Lot ..... ~ .~. 1 ..... 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 $ ,C, onstr, uction on above described building and pe, r~it me~s all applicable codes and regulations. ._~,~. ~(~ Ct ~ Applicant ./~'1' .".-~..-,~r .¢¢Y-'~c. · . .~.: :'. ........................... Rev. 10-10~78 / ~ ' L/ FIELD INSFECTION FOUNDATION {1st) FOUNDATION (2nd) ROUGH FRAME & FLUMBING INSULATION FERN. Y. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: ,. __z"~' THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000663 BUREAU OF ELECTRICITY k~-I 85 JOHN STREET, NEW YORK, NEW YORK 10038 .ate auly ~3,198s ~p. iicatio,,No.o,¢ile 3438~.4'/85 N70:].260 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the pretnises of Waloski, Daniel~ 280 Youngs Ave., Mattituek, N.Y. in tbe followlng location; [] Basement [] 1st Fl. [] 2nd FI. garage Sectio. BIocl~ Lot wasexamined°nJllly 15,1985 andfot~ndtobeincompliancewiththerequiretnen.~softhisBoard. FIXTURE FIXTURES RANGES OVENS EXHAUST OUTLETS FLUORESCENT 4 1 3 4 DRYERS FURNACE FUTURE APPLIANCE FEEDER~ TIME CLOCKS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET DIMMERS SERVICE DISCONNECT OTHER APPARATUS: S E R V I C E NO A~ W G, ' NO OF HI-LEG A. W, G OF CC CONO OF HI-LEG Glenn R. Bradley BOX 382 Matt:i.tuck, N.Y.., 11948 lio. %1227 [his certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors PY FOR B ENT. THII GENERAL MANAGER Per-- 11 may be ~dentifled by their credentials. NEB. 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL · $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined . .'..~ Odq .c~. ~..¢.., 19~b.~. ..~ .9~...~...~. ?-.., 198.~. Permit No. l .~?.~ ~..-~.. Approved Disapproved a/c ..................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BLDG. DEPT TOWN OF SOUTHOLD Rece±ved ........... ,19... Date ................ a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets 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 or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 shall 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 shall 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 Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessaryj~fpecti~,r~" ·/t¢?~.. ~<~ .~..~:.< .--~.' ................. · .~.q.&,.x.~.~.~../. ~.~..~.'l~?~.~.,.:q..~... I/Y. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................... ..... : ..................................................... Name of owner of premises ...... [:*~ ~.~,.~.,...(. ..................................................... (as on 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 ........ .~.0.0, ............. Plumber's License No ......................... Electrician's License No ....................... Other Trade s License No ...................... Location of lmzd on which proposed work will be done .................................................. ..,..q2~:.....'q.~ .~.. :..--7:~.. ~ .L?~ .~..e .... ~ ~cY. ................ 09.a.'Ofr:.~..e.(cs. ................. House Number Street Hamlet County Tax Map No. 1000 Section \~ \ Block Lb \ Lot O~\ 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 .......... (L~./~.a-.~.. ¢ ............................................ b. Intended use and occupancy ./...d .4,.L...¢df.~5(. :}~. ................................................... 3..Nature of work (check which applicable): New Building .... ~.'... Addition .......... Alteration .......... Repa/r Removal Demolition Other Work '~ 5 ~ ' ~/- : (Description) 4. Estimated Cost ......... ~.~ (27.q) ~..o.? ................. Fee ...................................... : *" (to be paid on filing this application) 5. If dw61ling, number of dwellin~ 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. Danens~ons of emstmg structures, ~f any: Front ............... Rear .............. Depth ............... ' Height Number of Stories Dimensions of same structure v~th alterations or additions: Front ................. Rear .................. Depth ' Height Number of Stories 8. Dimensions of entire new construction: Front .... /.V. '. ....... Rear ..... .Y ......... Depth . .2-..~..'... ! ~ t Number of Stories Height ...................................................................... 9. Sizeoflot: Front /OO. Rear .t.o¢) Depth ./.~,c) 10 Date of Purchase : Name of Fenner Owner one~oruse ; ' ' 1 1. Z district in which premises are s~tuated .............. 12. ocs proposed constructmn w01ate any zoning law, ordinance or regulation: ~c.) ................. 13. Will lot be regraded ...... .'~.?. .................. Will excess fill be removed from premises: Yes 14. Name of Owner of premises tfl~g,~.c/'. .Z)...gJ¢.[.o.~,&~... Addr~-)/~/.~.~..~.'l,i.lt.~qI..~.'/p.e[.c-.. Phone No.~..~.F.'.c/r~.~ 5.' ..... Name of Architect ........ . ............ . ...... Address ................... Phone No ................ PLOT DIAGRAM 'Locate clearly and distinctly al buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and blocl 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 ........................... . ..................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. I 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 co~tained 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 ........... .~. ~ .... ./..day Of .... ..~~ ...... , 19 .~..~.'''' r, lo 470Y878, Stlff0lk C0unt~ lerrn £xl)~res h[arch 30. ]9~_? I