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Home My WebLink About13696-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z. ] .3.2.q3. .......... Date .... F.o.b.,. 7 ...................... 19 .(35 THIS CERTIFIES that the building . O..n.% .q a..r. ~a. r. ~ g.e.. ~ a.d..c~ ~ la..~ n d.'.b.a t h ........... 4100 Fine Neck Rd .~..4.~.9.a.k~gp.d..D~ ....... S.auth~.ld Location of Property I~s'e N'o: ' ' Street Hamlet County Tax Map No. 1000 Section . 9.7.q ....... Block .... ?.3. ......... Lot...0.q I ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..F.e..b ....5. ........... , 198 5. pursuant to which Building Permit No... ~. 3. .6 9.6. Z. ........... dated ..... F...e .b.... 5. ................ 198. 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 ......... ...0.n.c...c.a.r.. ¢.a.r.a. ~?..a.n..d, .d?.n...a.n.d...bm~.~ ........................................ The certificate is issue d to ........ P..~ .U.L.. ~. ~.U. ~ .~ ~ ~E../~ ~ ti.U.S. ~ .E ~q ......................... (owner,~e~.~ ~ X X of the aforesaid building. Suffolk County Department of Health Approval ..... .N/.~. ................................. UNDERWRITERS CERTIFICATE NO ............. ?.e.n..d ~.n.6 ............................ Rev. 1/81 Building Inspector IPOu'M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERJ~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 ~3696 Z Permission is hereby granted to: , ..~ .~ , ot premise, located at ..~.....~./.'/.;~...~'-...~ ~'~, , County Tax Map No. 1000 Section r..~..~....(~1. ......... Block ..... ./.~. .......... Lot No..(~:~.../.. ........... pursuant to application dated ..~~.....~..i ............ , 1~.~.i and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD 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--(S-9 form or equal). 3. Approva~ of electrica~ 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~t~perty 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: 1. Certificate of occupancy $5,00 2. (~rfificate of occupancy on pre-existing dwelling $15.0 0 3. Copy ,oR certificate of occupancy $1.00 ~ Date ....... New Building , ..~,, ........ OI,d~or Pre-existing Building ............ Vacant Land .... .. ....... House No. _~ l ~tre~t Ham/et ....................... County Tax Map No. 10~ Section ............... Block ..=~. .......... Lot .............. Subdiws~on ...... . ........................ ~...Fded Ma o ........... Lot N~ .............. Permit No. ate of Perm . .Applicant/ . .......... Unde~riters Approval ......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate Fee Submitted $. Construction on above described building a_nd permit meets all appl~able ~odes and regulations. ' . ................... Rev. 10-10-78 [ooo7~ THE NEW YORK BOARD OF FiRE UNDERWRITERS EUREAU OF ELECTRICITY ~3~ F~b~rM 1S~ 198~S JOHN STREET, NEW YORK, NEW ~.~ ~,~.,~,.~o.o.~,~ ai4~/a~ , N 678473 THI~ CERTIFIES THAT only the electrical equipment ~ described below and introduced by the applicant named on the able appl~cat[o~ num~r m the premises of P~ul A~ssen, 45 ~od ~ive, S~thold, N.Y. in tbe following Iocationj. . ~ Base,~e,tt_~.~ lst FI. ~ 2nd FL Section Block Lot . . ~ ~'~D~ ~ &~OO and~ound to be i~ compliance with the require,tents of this Board. FIXTURE OUTLETS DRYERS 7 SWITCHES 10 FIXTURES RANGES :OOKING ORCKS FLUORESCENT DISH WASHERS EXHAUST FANS 1-~G.F.C.I. 1-~moke Detector. E C A W, O NO' OF NEUTRALS A W, g OF HI-LEG O~ NEUTRAL ~1 Prato Elc~trlc~ Wiggin~ Lane Greenport, N.Y 119~ Lie. 104~9 This certifier, return to the office of the Board if iocor~ct. Inspector~ may be identified by their credentials. COPY ~OR BUILDING DEPARTMENT. THIS COP¥OFCERTiFICATE ~U~T NOT BE AJ~/ERED iN ANY MANNER. FIELD %NSPECTI(~' ,FOO__ND~TIp_N.__ {~st} FOUNDATION ROUGH FRAME & PLUMBING (2nd) INSULATION PER N. Y. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: , (516) 765-2713 M. DAWSON PLUMBING & HEATING P.O. BOX 1207 SOUTHOLD, NEW YORK 11971 February 5, 1985 To Whom ii may concern: I installed the plumbing and healing in ihe new baih and den of Paul Asmussen's home. The insiallalion was done in 0ctober o£ 1981. To ihe besi of my know]edge, all work was done according ko Town Code. Very ~ruly y~ Michael Da~son 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved...~..~. · .~. .... 1 ..q~. P~it No. Disapproved a/c APPLICATION FOR BUILDING PERMIT Received ........... ,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 premiseg and in building for necessary inspections. -- .......... ................... ~ (Signature of applicant, or name, if a corporation) 5_4. .......... {/ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ¢ ago ................................................................................ Name of owner of premises . tO~../...vT. ~.rx ~ .,~ ¢ ..... ,e4,l'.~ ~.,37. Se, n ................... . ................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Plumber's License No. ~t..D~t tag. $.e.a .......... Other Trade's License No ...................... ~t'r/]/57~ County Tax Map No. 1000 Section . ...ff. ~.~. ......... Block .... /.? ............ Lot ..... ./ ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:/) , icable): New Building ..... ' ..... Addition .......... Alteration ~. ....... ............ Demolition .............. Other Work ............. (Description) .................... Fee..~.~....~ff-.... ...................... (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 . . .... ' ' ' ' :: ........... 7. Dimensions of existing structures, ff any: Front .... ,2/. ........ Rear ...~./ .......... ~ ~. '~' Height .... /~. / ....... Number of Stories ..... /. ................................................. Dimensions of same structure ~v~th alterations or additions: Front .. ~,~,,,~ g ......... Rear .................. Depth ................... i. · · Height ...................... Number of Stories ...................... 8, Dimensions of entire new cons/ruction: Front ~'~ ~ Rear Depth Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...~.~.,.~.~/..i ............ Rear ...................... Depth .../~.7~ .~.?. ............ 10, Date of Purchase .... .~,~. ?~./. ................ Name of Former Owner ............................. 11, Zone or use district in wliich i)remises are situated .... /...~"%.nn.,.'/g ................ ~ ...................... 12. Does proposed construction vi01ate any zoning law, ordinance or re~ulation: .~.~ ............................ 13. Will 10t be regraded . .,/I~..... i .................... Will excess fill be removed from premises: Yes ~ 14. Name of Owner of premists' .~q~.~: ..4& *t.t~,*i.e.,. Address. ff~.. ~.~ ~?Fc*~, .~.t',. Phone No../t~,n, r~ ........ Name of Architect .... /_~,,,lf~. l,/'¢~.t.)f~ .......... Address . .~.~.~. ~.e~d....'.~... Phone No.. ~7.. ~..~..~x~.~..~. Name of Contractor ..... -~n~, ............... Address ................... Phone No ................ PLOT DIAGRAM Locate. clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and bloc} number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applicant m i (Na e of individual sigrdng contract) above named. He is the ..................... , ................................................................... ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duty 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 manner set forth in the application filed therewith. Sworn to before me this ........... .'fl ........... day of......7/k ./~..\ .......... 19 .~)- -.s / ~ .~1 ~ t/. Notary Public ....... ~ i. ~f:.. ~L),~ .~<~--. County H~LEN/<. DE VO~ ............. NOTARY PUBliC, Stak~ o~ New 8o 4707878, &dt,?lk 00ury~, (Signat~of applicant) o b 0 ~UNtC~ ~. 0