The URL can be used to link to this page

Home My WebLink About14013-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate O[ Occupancy No. 7.1430.9 Date March 24 198..6. THIS CERTIFIES that the building ...... .A.d.d..i .t.i.o.n. ................................ Location~¢Pmn~rtv 270 Dogwood Lane East Marion House No. Street Hamlet County Tax Map No. 1000 Section . .0..3.8 ....... Block 0 5 .Lot 0 0 . 3 Subdivision .... .G.a?.d:%~.e?.s...~.a~..~..s~..~ .s.e.c..Filed Map No. 50 8 3 .Lot No. '1 78 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .M..a. y ...... .2.8 ......19.8.5. pursuant to which Building Permit No ....... 1. .4 9.1.3. g. ........ dated ........ ~.u.n.e....6 ............ 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 ......... ..... '~TT.-.-.'~ .b.d.d.J:.~..i9.n. .o..n. ?.x.i..s.~.i.n.q.p.w.o..1.1.i.n.~. 7.-.'~T .-7 ........................ The certificate is issued to ............... .U~.I.C.H. t' .G.E.Q .R.G.E..~...E~.A..N.O.R. ................ (owner, of the aforesaid building. Suffolk County Department of Health Approval ...... .N./.R. ................................ UNDERWRITERS CERTIFICATE NO. N7 4 0 0 4 8 Rev. 1/81 Building Inspector FOB. I~ NO. B TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Yo BUILDING PERMIT (THIS PERN[IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-~ 14013 Z Permission is hereby granted to: ..... !a~..~....~~ ...... ~ ............... at premises I~ated at ...~.~. ....... ~.~.~,..~.....~....~~ ...... County Tax Mop No. 1000 Section ..... ..~.....~...,,~. ....... Block ...... ..O....~..~. ....... Lot No .......~.. ............... pursuon, ,o application doted ........... ...~.~...~..~ ................ , 19..~..~., end approved by the Building Inspector. Fee $.,.~....!.~. .... Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY TOWN, OF ~OUT~OLD 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. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings end 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 pZbperty 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. Certificate of occupancy on pre-existing dwelling $15.00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 Date.. /~.-/~. '.c~/ j.~.~. New Building ~ Old or Pre-existing Building Vacant Land . o.o ........... ' Owner or Owners o~ Property ......................................................... County Tax Map No. 1000 Section ..... O.~ ~J ..... Block .... 0.~ ....... Lot .... ~ ......... Su~ivi,io. .......... ~cgtr~c~.~ ~/ ~}.~ .~.~ 4~ u~p ~o..~.~...~ot ~o. ..~2~ ..... ~ermit No. /~ ~.[~ ~. Dato of ~armit ......... ~/&/~Applicant~..~a'~ ............. ~t /~ e~ ~) Health Dopt. Approual ........................ Labor De~t. Approval ........................ Hnde~rimrs A~roval ........... ~lannin~ ~oard Approval ...................... ~equ~st for Temoorer~ Cortificate ..................... [ina~ Certificate ....................... Fos Submitted $ ..... ~ ~ ................... Construction on above described building and permit meets all applicable codes and regu lations. .......... C~ d¢~ i ~-I Applicant 4~. ,.. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 8S JOHN STREET, NEW YORK, NEW YORK 10038 only the el~trlcal eq~ip~e~t as described below a~ in~duced by the applicant na~ned on lhe above application number in the premlses of in the followit~g location; ~ Basement ~ Ist Fl, ~ 2nd FI. Section Block Lot was examined on ~/i&,[~7~g ~[ ~) ~ ~[' ~) ~'~ and found to be in con*pllance with the requirements of this Board. FIXTURE FIXTURES RANGES , OVENS OUTLETS SWITCHEE EXHAUST FANS INCANDESCENT FLUORESCENT 7 7 7 DRYERS SYSTEMS OTHER APPARATUS: E R NO O E COND' OF CC, COND, V I C NO, OF HI-LEG AW.G. OF HI-LEO NO OF NEUTRALS AWG, OF NEUTRAL BOX 215 · .. Per- , . ~ TENT, TH XO ~ ' ' , - ,: ;T ~ANYMANNER. P1AP OF P~..P..EP,,TY a- GEO. _bi.:. E ¢ ELEANO'~ ULtCH ~T E'A~T' ,/ // ,,' ~'I~ON PIPE .' ' ~ITLE ~.NO. 695t05~t9, ' '~ ..... 0 ~me~ ~o o~ ~ ,I A~C- 1~,00 LAN E" TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 T~om This May C~ncern, ~are un~ble~to complete your~ertificate ~.~O~cu~ lllcause ~of.~. -~.. .. . the~ll~ing reasons. '~/ An ~,~l~~lflcate Of OOOupanOyX - is not '~. ~file. ~/.--/ The chec~ is (outdated/not ow.. file.)_ ~_-/ No HealtI .Dept. Approval on file. / No fina~ inspection has been made. P~ Ple ~/contact our office on this matter. Thank you for your cooperation. Building Pe.rmit # / ~ ~ ~3 Z Building Dept. ***/~No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) F1ELD~NS~i~CTION FOUNDATION (1st) COMMENTS FOUNDATION (gnd) 2. ROUGH FRAME & FLUMBING INSULATION FER N. STATE ENERGY qODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 'r sOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received 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 In. specter. 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. . .7.o~..~ec..v~.~:..~. 0.4 e.c..WT~, n. ~ ...... (Signature of applicant, or name, if a corporation) .3 :l~..~,ob. o.~.t....C< ~.., .~o.~ch o .t.4_;... (Mailing address of Oapplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......... b ~.,.\~ ~c ............................................................................ N~e orowner orpremises..~e_.o. CO&..em.a,.. ""C._,t.,eo~noc LC~.~e..~.. ................. (as on the tax roll or latest deed) If appl~;ant is a corporation, signature of duly authorized officer· .c.Tdd, ..... ~ (Name and title of corporate officer) Builder's License No ....... [ .[7.[ ................ Plumber's License No .... /.~. ,.~YL,.k~ ...... Electrician's License No ......(,~.¥.~. ............ Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ~'. %.~ .~. ' .... 2.-!0. .................... .0. oa~0.c~o¢..L, .~.o..~. ............... G2 ~,c, ~.,% ............ House Number kJStreet Hamlet County Tax Map No. 1000 Section 8e'(~ Block ~ Lot Subdivision..c~..O?.~S~C.'.i.. (~Na~me)..~.~.~..~.<) .*-.~.~.~iled Map No....~3..~..~ ...... Lot .... ~.9.~. ...... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... GT~t~-...~f'c~; .~<4.. 4k,kle~ · r. '" ~ ,..,,~.t~.~' "(' .... , .......... .................. b. Intended use and occupancy .... 0.~¢.~...~t, kI33tX ~:~);,.,,~',~; .g31[ .~..7 92J..1. ~.%) ............ 3. Nature of work (check whlch Opphcable): New Building .......... 'Addition .......... Alteration .......... ' Repair .............. Removal .............. Demolition .............. Other Work ............... ~. (Description) 4 Estimated Cost .~.,~/ ~.dYD Fee ~ ~ (to be paid on filing this application) 5. If dwelling, number of dweliin~ units ...... J ........ Number of dwelling units on each floor .............. If garage, number of cars ... i .................................................................. 6. If business, commercial or mixed occupancy, specify n~a?ur, e and extent of each type of use ............ ~ ..... 7. Dimensions of existing structures, if any: Front....,5 ~. . Rear .~..2_. ' . . Depth .3..O ....... Height /. ~. / Nu'mber of Stories / Dimensions of same structure With alterations or additions: Front ....... ~, .~ .. Rear .. .~.'.. ....... Depth. ....... . ,~.c/.. ~ ...... ~.... Height. ..... l .ti~ ............. t , ~ Number of, Stories~ .... ( ....~_:~. ) ...... 8. Dnnenslons of enBre new constrnctmn: Front ..... {i~...o3..~.. Rear....;1~...z?J/..... Depth .......... Height ..... /. ~ .~ ......Nu~nber of Stories ...... / .....................................i ..~ ' 9, Size of lot: Front ............... Rear ................... De ............... 10 Date of Purchase : Name of Former Owner 1 1, Zone or use district in which premises are situated .................................................... 12. Does proposed construction w~late any zoning law, ordinance or regulation: ............................... 13. Will lot be regraded ...... ^~ ........ ....., .........Will excess fill be removed fromnremises: Yes . No 14. Name of Owner of premises (,.~f~ .~[~¢,~ Address¢ ,~b~ Lft~l.~c0~?t~oo ........... ne No . Name of Architect ~ ..... ' ........ ^ ...... ~. Address ................... Phone No ................ Locate clearly and distinctly property lines. Give street and bloc interior or corner lot. STA'rE OF NEB( YO~, K,, COUNTY OF..~o~. {~D.\3.~x.. .... (Name of individual sig above named. He is the ..... .C, .Cg.[~ .C'~. '.~..~Tq~ PLOT DIAGRAM all buildings, whether existing or proposed, and. indicate all set-back dimensions from < number or description according to deed, and show street names and indicate whether S.S .................... being duly sworn, deposes and says that he is the applicant ting contract) (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d01y 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 .... t~.~. ~ ........ day ~f.....~f~.....~. ......... ,19..~.~-- Notary Public .................... County No. Term Expires March ~, 19 (Signature of applicant)