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Home My WebLink About6228-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No..Z. 52..~. ..... Date ............ .,T..~. ..... 3 ..... , 19. ?~ THIS CERTIFIES that the building located at . 6/S.. Ol, ange .lloa5 ....... Street Map No~l,...~. rb.o.r..Hq~k No ........... Lot No. ]3 .... .~.~l.th~!~....N.~y: ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... 0o~obel*..27 19.72 pursuant to which Building Permit No. 62287,.. dated .......... 0.c.t .... .~? .... , 1972.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. P. riYate, or~e. la,lily. ~,welllng ..................................... The certificate is issued to . Rene · Gendron ...... t~aex, ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .Apr&l. 90 .. ¶ ~.3.. bT .R,. ~illa... UNDERWRITERS CERTIFICATE No .................................................. HOUSE NUMBER: .~'5 ........ Street.. {~gO. ~O~i .................................. // .... Building Inspector / ~OE.~ NO. ~ 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? 6228 Z Permission is hereby granted to: .......... ~...~.z,. ~ ......................................... ............... ~m~ s~o~'.~ ........................................... to ..... .~.i;l~...ne~...one..£m~t..~,~mllJ. ng ......................................... ~ ..................................... at premises located at ..... Z~l~...S.~ ....... ~IllP,~..~IIOZ'...NuI~I~.8..~I~I ............................................ ............................. ~.~...G~..~o&& ........... aa~tlm3~ ................................................................ pursuant to application dated ...................... ...~...~. ......... .~.~?. ........... , 19.~..~.., and approved by the Building Inspector. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, .. Disapproved ........................................................................................................................ ' '/"~'~i~':~"~ln ......... ...................... ~'" "Jl~ ns~to;} ........................ AFFLI~ATIOH FO[ IUIL~IN[ Fl[MIT ' Dat~ 0o~oBe~ 2~ i~ ~ I NSTRU~IONS ~. This ,pplic,tion must ~ completely filled in by W~writer or in ink nad submitted in triplicete to the Building Inspect 3 sets of plans, ~ccurete plot plan to so8le. Fee ~coording to sohedule. b. Plot plen showing Ioo8tion of lot nad of buildings on premises, relationship to adjoining premises or publio streets or 8re~s, 8nd giving ~ detailed desoription of I8yout of pro~rty must be drnwn on diagram whieh is p,rt of this ~ppli~tion. ~. The wo~ ~vered by this ~ppliontion m,y not ~ commen~d before issu8nae of Building Permit. d. U~n ~pprov,I of this 8pplicefion, the Building Ins~otor will issue ~ Building Permit to the ~pplionnt. Suah ~rmit sh~ll be kept the premises ~veil,ble for ins~ction throughout the work. ~ e. No building shell ~ occupied or used in whole or in psrt for ,ny purpose whatever until 8 gertificete of Oceupenoy sh~ll have grnn~ by the Building Ins~ctor. 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, Suffoll~ 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 buildings for necessary inspections. Rene Gendron (Signature of applicant, or name, if a corporation) ............. ~ ~.~ J. ]. g.~ .~ ......................... ...................... .~ (Address of applicant) ~=~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build Name of owner of premises ~,e['~..C~.e~d,~.e~_. ......................................................................................... ~....: ................. If applicant is a corporate, signature of duly authorized officer. ~ (Name and title of corporate of~.r) ~ .~.~ 1. Location of land on which proposed work will be done. Map No.: ..~..°.~.?:..~....~'J~cflJo.~i.°..~.e..s. ................... .1..,~ ........... Street and Number ..... IS.../.~.....~.~g~..~.~..~,~'.,.~g~b.c~L~ .......................................................................... 2. Slate existing Use nnd °~-ul~m¢~/of premi~ ~hd j,J~'~d~d u~ ~d o&:upancy ~f iJroposecl construction: a. Existing use and occupency .,..;..~.~.(L~,rk'~,,~]..¢~.... ................................................. : .............................................. b. Intended use and occupancy. ,~,:,..;..:CI~,.e,.2~...~P-~J,;Li~t~ ................................ J~l' ..........[ J ' ' ' ' ' [J ...... ~ ......... ~ IX~t~re of work (check which applicable): New Building ....................... Addition ..................... Alteration ....... v~.-, Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) Fee ............. /~ ~ ................................................................................. ~ 4. Estimated Cost ............... n~.,.~q~0....~.. ......... (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 ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of usa ..................................... 7. 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 ......................... Rear ............................ Depth ................................. Height ................................................. Number of Stories ......................................................................................... 9. Size of lot: Front ...................................... Rear .......................................... Depth .................................................. Height .................................................... Number of Stories ...................................................................................... 10. Date of Purchasa ..................................... Name of Former Owner ............................................................................ 11. Zone or usa district in which premisas are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................................................ 13. Will lot be recjraded .................................. Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premisas ....................................................................................................................................... (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 sat-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. STATE OF NEW YORK., COUNTY OF .......'.~....%~...~.....~..~..%~... .................... .............. ~....~....~~ ....................... . being duly sworn, deposes and says that he is the applicant above named. (Name o/individual signing contract) He is the ......................... ~:...t~i~n~ .................................................................................................................... {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 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. TERRI LEE ELAK NOTARY PUBLIC, State of New York ................................... o V r ...... ~...N..c~., .......................... Notary Public, ..,~...~~ ....... County ..... ~.............~,,,,~.-:.~'~..-..~., .-~.-~ ................... (Signature of applicant) ~15 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT 0. Porfeti, w/side Grange Rd., 600' n/o Main Bayview Rd., Southold,~. I. in t&e foflowln~ location; ~J Basemen! L~. Ist Ft. ..~e,,~i~,, June 21, 1973 FIXTURES ~-- 2nd FI. outside and.~ound ~o be in compliance with the requirements qf rhis Bo.rd. RANGES COOKING DECKS ERS 18 15 FURNACE MOTORS. FUTURE APPUANCE FEEDERS IIMECLOCKS MULTI-OUTLE1 SYSTEMS DIMMERS SERVICE DISCONNECT *Furnaces: Oil 1-1/8hp, 1-1/15bP S E V I C George Zimlinghaus, ~ Park Place, GmERiL M&NAGER Pa~chogue, L.I. 11772 · r~ .- D . Pe? This certificate must not be altered in any manner; return to the office of the ~ard if inc~r~t. Inspe~ors may be identified by meir c'edentia~. FOUM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerics Office Southold, N. ¥. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildings or new use: I. 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 dispasal--(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 inspection of buildings or premises, or other pertinent in- . formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or Isnd use $5.00 3. Copy of certifica'ce of occupancy $1.00 Date ..~...~.. ~'.. ~. ~..~.. ~ .~. .................... New Building ...... ~. .......... Old ar Pre-existing Building ............................ Vacant Land ..... ~ .................. Location Of Pr ert ~..:~,~, ~ ~ ~ ~....r. ~ Su iv,sion ........ ..... House .o ............. Permit No. ~...2:..~..?...~.. ..... Date Of Permit/.~,~..~.]....-T.Z..~..Applicant .... ..~.~~ .................... Health Dept. Approval O..ff'..~.~..~...-;.~.,~.. ...................... Labor Dept. Approval ..... ..~..~.Z.TT.; .......... ;p .... Underwriters Approval .............................................. Planning Board Approval "'--~. ~. Request For Temporary Certificate ......~..?;~';~~ ...... Final Certificate ~ ....................................... Fee Submitted $ .~. ............................... Construction on above described building an~,d permit meets all applicable codes and regulations. Sworn to before me this /~-~'~ ................ day of .....~.....~.. ........ .~.. ....... (Stamp or seal) ~ Notary Public .................................... County /~ ,~. RoAD '~_ot 15 .EW$~ONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG NO~MARD W, YOUNG SURVEY FOR.' RENE GENDRON LOT NO. 15,"SOUTH HARBOR HOME SUFFOLK CO., N.Y. , ,~~~BY ~ '~' ' ,1~.1..Y l4,/9~4 ,4~ FILE IVO. 4096. __~_-~---- ~ ~ .~ou.~._, ...,... ~ ~.£',.,q~t,4. ir, ro'~'-r~erlu ~o THIS SURVEY IS ~ VlOLA$ION OF ~OW 135 11846 SUFFOLK COU~TY HEALTH DEPARTMENT APR $0 1973 ~ .,~ / ~) The sewage disposal and water supply facilities for this location have been inspected by this deper~n_t ~d_~n~,~ to be satis£actory. ,% ~ ~,~. Chief of General Engineering Services ROAD now or formerly B. ~ Sfepnoski NOTE~ ~OI¥1SIONMAPFII.~O IN rH£ OFFICE OF rH~ CL.~BK OFSLIFFOAK ~o/~l/ry ON aEV,S,O~S YOUNG & YOUNG MAN.~,O, 197~, 400 OSTRANDER AVENUE, RIVERH£AD, NEW YO~K SURVEY FOR: RENE GEN DRON ~ LOT NO. 13,"SOUTH HARBOR HOM~.~.~;~ SUFFOLK CO., N.Y. ~~ SCALE: I" = 40' DATE: 0CT. 25,1972 ~52 DI£TZGEN 135 ll846