The URL can be used to link to this page

Home My WebLink About5610-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z.6. 8.7.9. ...... Date ........... THIS CERTIFIES that the building located at E/.8. Al~h?.s. L$~e ......... Street Map No.. ~ ........ Block No...X~. ....... Lot No. XXX...CBt;eh.o.g~...N. :.Y., ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... Sept · 18 ... , 19.~+. pursuant to wkich Building Permit No...?~+~ dated ..... l~ept~ .o~9-- .3.., 19~., was issued, a,~d conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private..one. f.a~ily .dwelling. with. addition. &. Atty.,..$~$~Ag~ .10ool The certificate is issued to . .Fr...a~c....B.e.s.t...~..W.i..f.e....0j~..er.s ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval lq :R.: ............................. UNDERWRITERS CERTIFICATE No. N.2.$.2.2.0.7.-.M.a.r...~...~.~?~.. (p.o.o.1...N.EJ.~.~7.~....Ma.r 20 HOUSE NUMBER .... ~..00 .... Street ...A~..W~..h.'.S...L..a~.. .... .O.u..t.e.h.o.g~..e ........... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5610 Z Permission is hereby granted to: ............. ~..~,_.~..~.t ..~..~lf.~. .......................... ,o ~a~ ,a ~.~...~.~.~....~... ~.~ .............................................. ~ ........ Building Inspector. Fee $....~j[j~.l~ .......... pursuant ~to application doted ............................. Jtj~:....~e ........... , l~.~J.., and approved by the THE NEW YORK BOARD OF FIRE UNDERWRITERS ': . ~ BUREAU OF ELECTRICITY r rl~ :, ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038" ~).t, Ms~'eh 6, 't975 .~pplicatio.]V,..o..rile 727590" , N212207 THIS CE~IFIES THAT o~y t~ el~tdcal equip~nt ~ ~cdb~ ~ a~ int~c~ by t~ applicant M~d on the ab~ appllcatio~ number in t~e premises of Fran,~a Bee~, ~Alvahs La. R~. 25' ~ 27A, Cutchoque. L,I.. examinedon ' ~arch' 3, 19 75 .~o.~d to bain co,~pliance with the requirements of this Board. · ~ fiXTURE ! ' FIXTURES ' RANGES COOKING DECKS · OVENS DISHWASHERS ~ [~ DRYERS FURNACE MOTORS [ mTURE A~UANCE ~EDERs SPECIALREC PT. TIMECLOCKS BELL JUNITHEATERS MULTI-OUTLET ~ I I I I' OTHER A~A~A~US: EXHAUST FANS DIMMERS OF NEUTRAL Glenn R. Bvadley Horton Ave. Matt It uck., L.I. 13,952 11.00 AMOUNT PLEAEE REMIT BY CHECK OR MONEY ORDER TO THE ORDER OF'THE NEW YORK BOARD OF FIRE-UNDERWRITERS AS CASH SENT BY, MAIL WILL BE .~ RISK. OF SENDER.~ \ Per- D THIS IS YOUR BILL FOR SERVICE RENDERED AND IS NOT A CERTIFICATE OF COMPLIANCE· THIS BILL PAYABLE AT THE NEW YORK OFFICE, 85 JOHN ET I~EET NEW YORK, N. Y, 10038 ~"' FOKM NO. 6 TOWN OF SOUTHOLD ~ Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This apphcation must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: ]. 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 installations, 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 19§7), 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 inspectmn of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: ]. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3 Copy of certificate of occupancy $1.00 New Building ................ Addition ~'~ Old or Pre-existing Building ..... ../~....... Vacant Land · o¢ot,on Of Property ...... ...... ................................................................... Owner Or Owners Of Property ...... ..~..r~./..~......~J'.....7~....~z....G~..(;...~..~.. ......................................................... Subdivision -:~y:~..4 ..................................... ,~...~ ....... Lot No ............. Block No ............. House No..~..?~ Permit No ..... Date Of Permit .... Applicant .,..~.x'.~<;~...~...~5.~......'~....~...!..¥...~.. .............. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......... ~ ..................... Fee Submitted $ .....~..'.....~.....~. ................. Construction on above described building(/~. ~r, permit meets all~-applic,aJ:~ cod~s and regulations. Applicant ....... co.. I, Mrs. Frank Best, will have the following items completed on my building permit # 5610Z, dated November 3, 1971, within 30 days of this date: Mois'~.u~e-proof floor in downstairs bathroom· Ail trim- doors & windows & baseboards,etc. Ail doors hung and hardware installed. call for reinspection. (Mrs~ Frank Bes0 ~onstance M. Best Subscribed to and sworn to before me this L/7~ day of~, 1976 NAa Publio, Suffol NOTARY PLJB~ lC, S',"te of F~ew Yorl, No 52 81£555~], Suflc, l~ Cr. unty Term Exp,res M~rch 30, 19._~ ,~ L~ ^/~ ~ TOWN OF SOUTHOLD '' BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~UTHOLD, N. Y. x m, ed Pemit ~o ~. ~. ~ ~ .... Z ................................................................. ~ ............................... ~ ......... ~ - ~at~_..~.~.~ a. This application must be completely filled in by typewriter or in ink and submitted 'in duplicate to the Building ~'~ inspector. ~' 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 ofproperty must be drawn on the diagram which is part of this application. 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 issue a Building Permit to the applicant. Such permit Z; shall be kept on the premises available for inspection throughout the progress of the work. ~ e. No building shall be occupied or used in whole or in part for any purp '~l~~~L~pancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o 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 alteration~%.or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinance, bj~ilding code, housing cede, and regulations. / / V .................... ,~ ~ --~ //. ~/(S-F~'~ture of applicant, or~ame, if a corporation) ......... ............... (Address of applicant) State whether applicant is owner, lessee, agent, q~chitect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .....['..~..~...~.....~:'........~......-~.....~.-.-.~' ~r 'w .................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which pr~gse~brk~ll~ done.,gMaPj,=~/~r~_.~_4~ Z~ s~ ~,~N/°~:~'~"~'~'"'"ii"~'~ .....~.. ................. Street and Number ........... ~~..~....-~r~..~..~..~,~- ........ ~,,~..~...,~....~..f~.~.~ ......................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ...... ~..............~..i .......................................................................................... b. Intended use and occupancy .............. .~. ~......~....~......C~.....~..~ .............. 3. Nature of work (check which applicable): New Building ....~ ............. Addition .......~... ........ Alteration .....~.~ ........... Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................................. :..:.. 4. Estimated Cost .......... --"/.~..~..~...~. ............................ Fee ..~....~ ......................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... ~ ......... Number of dwelling units on each floor ............................ If garage, number of cars ............................................. ~ ............................................................................................... If business, commemial 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 of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... ~/..~.Z.../. ............. Rear ....... /..~...~./. .......... Depth ....~. .................. Height .................... Number of Stories ........ ~ .................................. 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ............................................. : .......... l~,omue o_f F~rlgner Owner ........................................................ 11. Zone or use district in which premises ore. situated ....~,~. ............................................................... ~' 12. Does proposed construction violate,_~. /. ,~.~ J ~/qany zo,n.ing .law,~] ~i/~/°r/:lJrl'ance or regulation?.,~ ~[ /f .._.._~ 13. Name of Owner of premises ~.:.~Address ...... ~.....: ...... Phone No ..................... Name of Architect ...................................................... Address ............ :.:....: ........................ Phone No ..................... Name of Contractor ...... ~.~ ................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE-~/~Y(~P~,~,~ ~ c ............... ~,~.-N.,~'~.,~.N.~.~'......~.~.....,~.E.~.T.. ................ being duly sworn, deposes and says thot he is the applicant (Name of individual signing application) 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 contained in this application gz~ true to the best of h s knowledge and belief; and tshwa~ tJ~owb~rfkorewilml eb~hPi~rformed in th,e manner set forth in the ap,~'c~o~ filed therewith.,~ ELIZABETN ANN/NEVILLE NOTARY PUBLIC, State of New york No. 52-8125850, Suffolk Term Expires March 30, 19~b