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Home My WebLink About14910-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Z.l. 5..4.2.7 ......... Date November 26 19 86 THIS CERTIFIES that the building ........ .R.e.n. 9y.a.~. ~..o.n' .a..n.d. ?.1..tg?.a.~..ig.n' ......... Location of Property 1090 First St. New Suffolk -~- ....................... 's'de3i ....................... h t /ei ......................... 30 County Tax Map No. 1000 Section 117 .Block 07 .Lot .......... : ...... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .M.a.y..1.9. .......... 1,9.8.6. pursuant to which Building Permit No... 1.4.9.10g ............ dated ...M.ay.. 2. .3 ................... 19 .8.6., 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 ......... ~enov~tion and alteration to existing one family dwelling. The ce~ificate is issued to . .Al Lane--AMJAD Associates ................... ..................... of the aforesaid building. Suffolk County Department of Health Approval .......... .N/?. ............................ UNDERWRITERS CERTIFICATE NO .................. .Pp~d..i.n[t. ....................... PLUMBERS CERTIFICATE June 19, 1986 Rev. 1/81 Building Inspector FOruM NO. J 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) 1491O Z County Tax Mop No. 1000 Section ........ /.../..~. ...... Block ...... ..~..'~. ....... Lot No ...... ~ ............ pursuant ,o application dated ....... ~.~../...C~ .................. , 19.~..~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Permit No. Building Owner ~/~O--/~/~ /~-5~9~A~ - (please print) Plumber ~f~/~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. County Sworn to before me this / day of 19~ Notary Public, ~-<~t'~/~o ~-~' .umber's signature) ~-ary Public M~Y LOU NOT~J~¥ ~ S1:AT~ OF NEW ~o. 5~1000~8 - SUFFOLE ~SlON ~:~J~ES M~RCH 30. IK~.! FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- :1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in typewriter OR ink, and submitted ~ ~~.?~uilding Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property 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 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. 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5.Updated C.O. $15.00 $15.00 NewCons truction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ................................................................... House No. Street Ham/et Owner or Owners of Property ....~....~...o~... ..... i~/~.~'.~.~. .... ~ ............. County Tax Map No. 1000 Section / ! ~7 Block ..... ~. Lot ~30 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 $ ............................. Construction on above described building and permit meets all appl~able codes and regulations. Applicant ...... .~_____~..~ ........................... Rev. 10-10-78 7rd-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [~ ]~~ROUGH PLBG. I'/]~IDATION 2ND [ ] INSULATION [~FRAMING [ ] FINAL REMARKS: 765-18~2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST []/ROUGH PLBG. ,/ [ ] FOUNDATION 2ND [//J INSULATION [ ] FRAMING [ ] FINAL DATE INSPECTOR 7GS-XSOZ BUILDING DEPT. INSPECTION [ ] FOUNDATION :I, ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ '1 INSULATION FRAMING ~.~] FINAL REMARKS,'~~~ ' ~ DATE /////~/~ INSPECTOR FIELD It~S~'ECTION IDATE !! CO~,~T~ FOUNDATION (1st) FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING STATE ENERGY CODE Ye ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined.· .~....~., 19~. Approved ....~2.~ .~...~., 19~. Permit No.. }..1~..~! .0...~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERM IT BLDG. DEPT. TOWN 0F,SOUTHOLD , 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 buddings, 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. .............. (Signature of applicant, or name, if a corporation) ............... · .... . .L :. . :: ..... .... /.?/.t,' f . . .4( :/. . . . ...... · tma±l±ng address of appl±cant)'build~r. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or Name of owner of premises ..... 4~..Z:...~.~.~..~. - /fi..4/..OTy./~.....~..4.5.<,C.//sv,.Tc=S~ (as on the tax roll or latest (i;e'd') ............... If applicant is a corporation, signature of duly authorized officer. Builder's License No ~ ~ ~." Plumber's License No. Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done .... [~Q.. A:~$ ~ ff~=/ House Number Stree~ ............................................... ~ ~ Hamlet County Tax Map No. I000 Section .... ~ ......... Block ..... ~.~ ......... Lot ~c> Subdivision ................ (~a~) ................ Filed Map No ............... Lot ............... State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~~ .... ~/3.~... b. Intlnded ?se and occupancy .... ffg~'~.~C .... ~g~' · · ~/~::44~ ........ 3. Natur~ of work (check which applicable): New Building Addi+i ....... Repair .... R ' ' ' · · ~ ~ ...... - .......... ~areranon ..~. ..... ...... emovai .............. Demolition .............. Other Work ........... 4. Estimated Cost Gd~'Z?.~o. ,L~? (Description) · · ........................ Fee tto be paid on filing this application) 5. !~f dwelling, nu.mber~of dwelling units, ..... ./ ......... Number of dwelling units on each floor .... tz garage, numt>er oi cars ....... /. ............................................................... ,. If business, commercial or mixed occupancy, specify nature and extent of each type of use ......... '~;. '> ....... 'z Dimensions of existing structures, if any: Front 3.~,~-. ....... Rear ... 3.d, ........ Depth ...~'~./.c ....... Height ............... Number of Stories ..... ~ .................... Dimensions of same structure with alterations or additions' Front ~-~, ~'- ....... l{~r' ''~ ~, .............. Depth .... ~ ~,/.c?. ............. Height ................... i i i Number of Stories ~ ........ :. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height .............. ._Number of Stories ..... ~:~... Size of lot: Front ~.o. Rear ~6: ~)' ............... ¢.' ': .....'~'; ............... t~ept~ ... ~,;,. ~... :' ) ....... Date of Purchase . ~.._. ~v~. ................... Name of Foru~er Owner ./..c '.x. ~ ].. ¥.z: Y./i ~. ~ c. ~. ~ ....... · Zone or use district in which premises are situated... 3~e75//..)~:~t Does proposed construction violate any zoning law, ordinance or regulation: .. ~.~;? ......... ' ................. Will lot be regraded .~?. W .... ........................... iii excess rill be remov d fro remises' Name 6f Owner of premises .. e~-fi.Z....~t'7.~.'~ a~ .... ~ ,5~'~ ~ ~n~.p · Yes Name of Architect .~eq/~'~ ~./.t' .C/~,~.' ~: ...... 's'~'_~_~_° ~ '.~; ,,.,_~':~,~;...rnone No.. ~..~'.:.~'.~..977.~.' .... ' .............. ~um~ss ,..<,-.~i~..t;/.. 2.~//.~.q~r j/Phone No. fi4C.,.. ' Name of Contractor .~.~../d..~.4(c~..c~. ~ .~.~ ...... Address .~g..'~.<.. Yz~ ~, 'J//"*"'?'~Phone No.. ~'~.~. 7 .~:~.g? ~.. ;. ~[s this property located within 1.00 feet of a tidal ~eti~./~"~e~' e.~7.. ~o ..... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from ~perty lines. Give street and block number or description according to deed, and show street names and indicate whether :erior or comer lot. ATE OF NEW YORK, ,UNTY OF S.S ............................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) ~ve named. is the (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~lication; that all statements contained in this application are true to the best of his knowledge and belief; and that the rk will be performed in the manner set forth in the application filed therewith. om to before me this ........... · /''~ .... day of 7/7'7ce~ , 19 .~'~. tary Public ........ ~..~... ~_. ~..'0~ County ' '., .........:! ........... ~ ~,~-~ 7 (~Signature of applicant) SURVEY FOR AMJAD ASSOCIATES AT NEW' SUFFOLK TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. I000 - 117 - 07 ]0 SCALE I "= 20' ,JAN. 2;5, 1986 CERTIFIED TO: FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK TITLE NO. 121 S 2554 HARTFORD FUNDING AMJAD ASSOCIATES. [~ '-'~" ' '~ N.Y.I. LIC. NO. 4till Prepared in a~o~ w~ ,,~.,0,,, for ~le w~ . ~r~ by I I (~OaO ' ' for ~ u. ~ ~ ~ y~ S~ ~d ! SOUTHOLD~ N. Y. 119TI 86 - 114 '