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Home My WebLink About13994-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z.14891 Date .S.e~.%:..18. ............. 19 86 THIS CERTIFIES that the building ........ .I.n.g .~9.u.n.d.. pp. ql. ........................ Location of Property .... ~-.4.15. ~.o.z;t .h..P.a.r..~.s.h. ,D..r: .... Southold House No. Street Hamlet County Tax Map No. 1000 Section . .7.1. ........ Block . 01 ...Lot 14 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore f'ded in this office dated June, 3 ,19 .85. pursuant to which Building Permit No. 13994. Z dated ....J.u.n.e...3 .................. 19..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 ......... ... ~r~g.rp.u.n.d..pool and fence to code. The certificate is issued to ...N..A.N.C.Y.E...&..M.~. CK RADMIN (owner, l~g,~K~[ of the aforesaid building. Suffolk County Department of Health Approval N/A ~699521 UNDERWRITERS CERTIFICATE NO ................................................ Rev. 1/81 TOWN OF SOUTHOLD 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 13994 Z Permission is hereby gronted to: , · . . / 20 .....~........~.~.....v...~ ........ I.....~. ............... ~-~ ....... ...... ...................................... ';';';":'~'"~ ......... :'"';;"~'2'"; ........... ~ ...... 4~';";; ................. at premises located at ...I...'~.(...~... ....... J~.~._.l.~...~.~.~.....~.r~.... ...... .~~.~..,..~ .............. County Tax Map No, 1000 Section ...... ..~...l ........... Block ..... ..~..,.1 .......... Lot No ........ L..L~, ........... pursuon, 'o application dated ......... ......~...~....~T:....'~, ............. , 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 765- :[802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ~ 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 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. Bo 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-exist{ng dwelling $15.00 3. Copy of certificate of occupancy $1.00 5 · Updated C. O. $15.0 0 Date .... ~F' ' ' ...... Newcons%puc%±on ...... Old or Pre-existin~ 8uildin~ ............ Vacant Land ............. House No. Street ...~ Hamlet Owner or Owners of ~roperty .... ~, ......................... County Tax Map No. 1000 Section ............ Block ............. Lot ............. Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept. Approval ........................ Labor Dept, Approval ........................ . rs App i d App Unde~rite royal · · Plann ng Boar royal .................. Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ...... ~: ~ ................. Construction on above described building and permit meets all applicable codes and regu at OhS Applicant. . .............. Rev. 10-10-78 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1502 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ Ism. ms.~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, property 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 property 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: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacan~ Land C.O./ $ 20.00 ~ 5.Updated C.O. $ 50.00 Date. .,.o.../.! .......... NewC°ns%r'ucti°n .../... Old or Pre-existing Building ............ Vacant Land ... / Locat on of Property /C//,% .......... . .~.0...~.....~.C. id..~...~. ~F.. Housa No. Street Ham/et Owner or Owners of Property ... (9~. (3. ~.. ~L/'~..~.../~..~L,C-~,~-,.. ).~. ....... County Tax Map No. 1000Section ... C'~-7 / Block .~).,/ .... Lot... /~/. Subdivision ................................. Filed Map No ........... Lot No .............. Health Dept. Approval ........................ Labor Dept. Approval .................. ; ..... Underwriters Approval ........................ Planning Board Approval .... Request for Temporary Certificate ..................... Final Certificate ....................... F S b itted$ [0. Be U m ............................ Construction on above described building and perxnit meets all applicable codes and regulations.. ~ ...... Rev. 10-~0-78 FIELD INS~ECT'%ON DATE COMMENTS , FOU~DA~O~ ~ /J~ ,. FOUNDATION (2nd) ~ ROUGH FRAME & , , PLUMBING '-- ,,_ INSULATION FERN. Y. STATE ENERGY ~ODE ADDITIONAL COMMENTS: FIELD INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ~ODE ADDITIONAL COMMENTS: ~-~ ' , "1~ ~ -~ * ' '' --~ . 1000174 THE NEW YORK BOARD OF FIRE UNDERWRITERS O~, 85 JOHN STREET, NEW YORK, NEW yORK 1OO38 / ~ · ~J ~ THIS CERTIFIES THAT only the electrical equipment as ~scrlbed below and introduced by the applicant named on the able application number in the premises of was examined on J~Y ~ t Z ~85 and found to be in compliance wi~h the requirements of this Board. OUTLETsFIXTURE SWITCHES FIXTURES RANGES .~OOKING DECKS OVENS EXHAUST FANS FLUORESCENT 4 DRYERS OTHER APPARATUS: ~a~el~rds J.-ti~i.r, 125 ia'ap SYSTEMS E R V I C E NO ~C,~COND, A. W O , NO. OF HI-LEO / A W, G NO O~ NEUTRALS OI~E OF CC COND. OF HI-LEg [~t~OL 'ft~T~ C~IFZC~I~ COV~ O2~ ~ ~ ~ OF ~NSoECT3DN C~LY. ~SS OF UNUSUAL A~V~s 1T ~S ADVZSAB?_~ TO HAV~ FREQL~T 'i~W~' A~/OR Rk~A1R ~%DE BY A QUALIFTFn ~. OF NEUTRAL EECO El~ctri¢.Corp. (Cliff Cornell) 325 Wil]ow Po~nt Rd ~outhold, N Y 11971 Lic 2816 This certificate must not be altered in any manner; OOPY to the office Board if incorrect. Inspecto Per_ 11 may be 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING REMARKS: FINAL DATE_ ......... INSPECTOR "- ~- 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined ....... .'~ ...., t9~..~-"' Approved. ~...~=.. [, 19 '~fi' Permit No. 1. ~ ~.% Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT 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 Y6rk, 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, bull ,~.g'-qode~de, and regulations, and to admit authorized inspectors on premises and in building for necessary ins~c~.t ~l~,~z___}.~ (Si~ant, or name, if a corporation) P 0 Box 244, St. Jaraes~ N.Y. 11780 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Agent for owner Nan~. Radmin ................. Name of owner of premises ....................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Builder's License No... ~.89. Irl;[ ................ . "~ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done.. ........... ~/.$ .... North .Perish .Lane, .flout;hold ................................................ ltouse Number Street Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ................... S bdi i i Filed Map No. Lot ..... U vson ..................................... ' ....................... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of pr°p°sed c°nstructi°n: a. Existing use and occupancy 1 family, res.idence 17 X 35 pool " ' b. Intended use and occupancy ..................................... · ............................. 3. Nature of work (check which applicable): New Buildtng Repair ~(~'S~' ' ' Reme~ai 4. Estimated Cost ............... Alteration · ?.o.0~ .....Addition. ,- ................... ............. Demolition ............. Other Work ............... (Description) ................. Fee '" (to be paid on filing this application) 10. I1. 12. 13. 14. property lines. Give street and block interior or corner lot. 5. If dwelling, number of dwelling ~ ~nits ......... Number of dwelling units on each floor ................ If garage number of cars ..... 6. It' business, commercial or mixe( occupancy, specify nature and extent of each type of use ..................... 7. · DimensiOns of existing structure~, if any: Front... ~.~. ......... Rear .............. Depth ~. ........... Height ............... Number of Stories ..... ] .................................................. Rear Dimensions of same structure with alterations or additions: Front ................................... N mber of Stories Depth .................... ~.. Height .... .................. u ...................... 8. Dimensions of entire new constrUction: Front .... .~.~. · ...... Rear ............... Depth . .)..-~. .......... Height: ............... Number of Stories ........................................................ ' ! 9.0 Depth I .~..~ Size of lot: Front ~ J ~'-~'.. ' Rear ................... Date of Purchase ........... l .................. Name of Former Owner ............................. Zone or use district in which pr{mises are situated 7 ........ . ............................................. Does proposed construction viollate any zoning law, ordinance or regulation: . 3~. o ........................... Will lot be regraded ......... i ................... Will excess fill be removed from premises: ~ No Name of Owner of premises lq. '.i .&-.co I .~. ....... Address tq...f~¢,.~,h.L. % ...... Phone No ................ Name of Architect .~.: .¢'.~...~. ~ .et. ?... Address )~(5~o.~. P~.~E.. ~- . Phone No. OY.~.-.'~.~ ! ~ ..... Name of Contractor . .l~.~.qo,~aO.. i~..~, o/.~. i ....... AddreSs i~.l. 6'~. ~,T~.~. lc.~ .*t-,o/~3'hone No. ¢-.~.*:-IgB.~.9 ..... PLOT DIAG~ Locate cle~ly ~d dist~ctly ~1 bufld~gs, whether existing or proposed, ~d~ indicate ~1 set-back d~ensions from aumb~r or description accord~g to deed, ~d show street nines and indicate whether STATE OF NEW YORK, OUNTY OF .~9.~,-~.'.1~.~.l ~. i S.S ........ ,~.:~.h ~.~-.... xC~¢S.~ Il ~ ................ being duly sworn, deposes and. says that he is the applicant (Name of individual sighing contract) , ' above named. tteis the... ....~. .~e-~°-'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 ~e 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. Sw0m t° bef°re me'this i Notary Pubhc, . .... ............ County NOTARY PU~L[~.. :,tale of New York Qualifie~ in S,ffulk County , . No, 52.4648993 4-- qon Expires March 30, 19 (Signature of applicant) TITLE NO. SURVEY FOR N~N¢Y BAYVI EW TOWN OF SOUTHOLD SUFFOLK COUNTY, SCA~E' 1"'40' OCT, 3f, 19'80 S£PT. 23,1984 N~IFY BUILDING DEPARTMENT AT ~5-1802 9 AM TO 4 PM F~-THE FOLLOWING INSPECTIONS: - TWO REQUIRED CONCRETE ~ & PLUMBqNG MUST C.O. SHALL. t~I~ET :NTS OF THE N.Y. & ENFRGY RESPONSIBLE FOR, ERRO~ · ,'0 J$C ,~5, DATUM. SURV£Y BAY'VIE~W , TOWN OF SOUTHOL. D SUFFOLK COUNTY~ SCA L. N07'£I ,~ ~MONUM£NT