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Home My WebLink About13800-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ...A.d..d .i.t.i.q .~ .s ................................... Location of Property ....6.6.6.0.. ~.e.w...8.u.f.f.o..1.k..R.o..a.d .... New Suffolk House No. Street Hamlet County Tax Map No. 1000 Section 117 .... Block 04 .Lot 32 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated March 22, 1985 ........................ pursuant to which Building Permit No. 13800 Z dated ...M.a.r.c.h...2.6. ,...I .9.8.5. ......... 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 ......... Afl.~ ;~p.n.. [:p..e.x..i.s.t.i.n.g..qn.e...~.a.m..i..ly..d.w..e.l.l.l.n.g.. ...................... The certificate is issued to Dan & Nancy Lyon ..................... io'~de~', )~7**~'S ~rXt~}~ X X X' ................. of the aforesaid building. Suffolk County Department of Health Approval .... lq./A .................................. UNDERWRITERS CERTIFICATE NO ............ .N.6.9. 3. .9.6.7..1~..a 7. 30, 1985 PLUMBERS CERTIFICATION DATED: N/A -/ i,g p ........... Rev. 1/81 FOB~ 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) N9 13800 Z Permission is hereby granted to: ....... .....~.~.~...no...~..I .............................................. ~ ...~..~..~.o nt premises located at ......... .~...~....w.~mm/./ww~...~, .......... ~'7' County Tox Mop No. ]000 Section ........ l./..,7. ...... Block ...... .~...~.. ...... Lot No ......C)....~......'~...... pur, uo,, ,o app,,~,,on d~,~ ....... .)~.C~....~.~. ............ . ,9.~.~ ond oppro~ by ,he Building Inspector, Fee $...~.'~....'.....*~... ..... Building Inspector Rev. 6130/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, propertv lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions ~ 1. Certificate of occupancy New Dwelling. S25.00, Accessory~.$~0.O0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50-. O0 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .... .J.u.l~r. 9~..1~..~/. ......... NewConst~'ucf,ion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ....~.~.~.. ~.e.~..~.u~$p.l~. Av.e..~..~.eM..s.u~..~.o.~. ~..~.,.'~., ........................ House No. Street Ham/et ])an & N~ng~ .L~r. qn. Owner or Owners of Property ...................................................... County Tax Map No. 1000 Section .... 1.1.7. ........ Block , b~ Lot. 32 Subdivision ................................. Filed Map No ........... Lot No .............. [ 20o z ' Permit No ........... Date of Permit ..... Applicant ............... Health Dept. Approval .......... ,'~ ............ Labor Dept. Approval ...... ~.. ................. Underwriters Approval . .)~ ................... ~ ~'~.~' ~7 Planning Board Approval ..... .~, ............... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted ............................. Construction on above described building and permit meets all applicable codes and regulations. Applicant. ~.~ ~ .......................... Rev. 10-10-78 FIELD INSPECTION FOUNDATION FOUNDATION 2. ROUGH FRAME & PLUMBING 3. INSULATION PER STATE ENERGY qODE 4. FINAL (2nd) N. Y. COMMENTS: 765-1802 BUILDING DEPT. /~ ~INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH F~LBG. FOUNDATION 2ND [ ] INSULATION FRAMING R£MARKS:~'/~ .oo]-o93 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ , ES JOHN STREET, NEW YORK, NEW YORK 10038 ,.re May 30, 1985- 331086/85 on ,le N 693947 THIS CERTIFIES THAT only the electrical equipment ~ described below and introduc~ by t~ applicant named on the above application number ~n the premises of ~ ~on, ,~ N~ ~ffolk Road, New ~ffolk, Southold, N.Y. in tae following location; ~ Basement ~ 1st FI. ~ 2nd Fl. Section Block Lot ~,nm~do. ~ 23, 1985 ' andfoundtobelncompliancewitkther~quirementsoftkisBoard. FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST OUTLETS SWITCHES FLUORESCENT VAPOR 1 5 2 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTI.OUTLE1 DIMMERS SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R i~ RCC~ AWO NO O E COND OF CC, COND OTHER APPARATUS: I C E NO OF HI LEG A W, G NO OF NEUTRALS A, W G OF HI-LEG OF NEUTRAL Gary Doroski 425 Monsell Lane Cutchogue, N.Y. 11935 This certificate must not be altered in any manner; return to the office of the Board if i=ncorrect. Inspectors , COPY FOR /lENT. THIS COPY I GENERAL MANAGER: Per ;L may be identified by frhelr credentials. iD IN ANY MANNER. ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved....~...~...~.~., 19i(. Permit No./. .~..~. ?..~..-~, ...................... ...... (Building Inspector) APPLICATION FOR BUILDING PERMIT ~ 2 Z 1985 1! BLDG. DEPT. TO't,'¢~ O~ S-O-UT~OLO .. , Date .................. , 19... INSTRUCTIONS 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 necessary,inspections. ' .../:.~../.~.'.'P.. ~:~ :~....,'7..~ .<, .............. (Signature of applicant, or name, if a corporation) '.7..o...¢o. ~., t.o...z. :... ~..x.~..~.o..6.~.~.,, .~, ..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... ~°.~."C.~..4¢.T.o. ~ .................................................................. Name of owner of premises ..... ~..~/.~... /7~..~.. ..................................................... (as on the tax roll or latest deed) If agRlica~t is a corporation, sig4c~tture of duly authorized officer. ..... ~Builder's License No ..... ~ .............. Plumber's LicenseNo ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ....... . ./~4./~./....~..6~.(~..~/.~...,~. :~. '.O~W. ~7: .~.¢-- .......... .... tko, ~ .o. . ............... .x/. ~u. .~. ~(Z-.;Y~. . .~. q.~. ............. .~1/~ . 7.~. :~./?./. & ............. Itouse Number Street Hamlet County Tax Map No. 1000 Section .../{.7. ............ Block ....~...~. .......... 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 0,~./.~ ~,4,~7/.~. t/(. ~ ¢. b. Intended use and occupancy ........ ~. fi(/.-~.~/./t:/~./.D..~. ............................................. 10. 11. 12. "13. 14. Nature of work (check which applicable): New Building ..... ' ..... Addition. ~ ..... Alteration Repair .............. Re,oval .............. Demolition .............. Other Work ............... , i (Description) Estimated Cost .................... Fee ...................................... ! ~" (to be paid on filing this application) If dwelling, number of dwellin~ units .............. Number of dwelling units on each floor ................ If garage, number of cars . . ............................ If business commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structures, if any Front Rear . Depth Height ...... , ......... Number of Stories ........................................................ 'Dimensions o'i~ s'ame*structure with alterations or additions: Front ................. Rear .................. Depth .................. L · · · Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front ............... Rear ............... Depth ............... · Height ...... . ......... Number of Stories ........... Size of lot: Front .... /z2~.z, ............ R;~; i i i i/'.'~i,'~'/.': i i .......~);~i~ ~.~.' ~ ~/~'.'~/i~'.'~[%' 2~.'~-~ i Date of Purchase ' Name of Former Owner Zone or use district in which premises are situated Does proposed construction viplate any zoning law ordinance or regulation: ................................ Will lot be regraded ....... i .................... Will excess fill be removed from premises: Yes No ¢ fO fp ~ Ph N Nam o wner o remises. ~ .................. Address ................... one o ................ Name of Architect ! Address . Phone No ................ Name of Contractor ....... ! .................. Address ................... Phone No ................ PLOT DIAGRAM I~ocate clearly and distinctly all buildings, whether existing or proposed, an& indicate all set-back dimensions from property lines. Give street and bloc or description according to deed, and show street names and indicate whether interior of corner lot. STATE OF NEW YORK, ' S.S COUNTY OF ................. ............................ i .................... being duty sworn, deposes and says that he is the applicant (Name of individual si hing contract) above named. He is the .................... ~ .................................................................... 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 conlained 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 /em!~x~res March 30. LIC, LAN'P SU~"v',CY025 HAP. coo-,,7 ~.: TtTLE C0. NO.- 82-5Z' ~9099. LAND ,.-,LJ~ WE/.~ ~25 fi' 4. F""' .... ALL ~,'~ THE .......... STATE COb STIL'Ci!-ON CODES. DESIGN O2 CONSYRuc~I~ I-