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Home My WebLink About5879-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy Exceptions Top ef foundation t~ be f~xe~ THIS CERTIFIES that the building located at ...l)O~r. D~.iTO ........... Street conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... ~&~.....~.0., 19~... pursuant to which Building Permit No. dated ............ .~l.a.~. .... .1.$, 19~r2.., 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 ....l~.!.~.a.~.0..ogt..0..f..a~.~..1.~. d.~.o. 1..1..i~ ...................................... The certificate is issued to .. l~ex'nar~, ]qle~ko. &..~ifo ...... 0~t~:~ ................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .[~Op.t~.. ~t..~-9~...!~. Il,, .rill& .... UNDERWRITERS CERTIFICATE No... ] .l~'~3fi~ ...................................... HOUSE NUMBER. ~.~0~ ....... Street.. ,Do.l.lllt~l". D.~'~.~O ................................ Building Inspector I~RM N~. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5879 Z Permission is hereby granted to: ;X,~l. aaa..]lemm.~..Xa~..4vSg..,,~mmmat.ll~memm & w~e .... .llo~,~ ......... 1,~.,....1.1.~ ........................ to .... ~tl,,l.. ~m~..,m~ ..l'~l.~'...~.~t~l ..................... , ........................................................... at premises located at ....... ~1"~ ........ ~II~"O~'~ .......................................... .......................................... ,~eZmma'.. ~m,l,~e .............. :i, mame]L....I,~l., ............... . .............................. pursuant to application dated .......................... ~ ....... I{~ ......... , 19...~1~, and approved by the Building Inspector. Fee $...~.&.~ ........... F~RM{T INCLUDES A?PROVAL TO REMOVE EXCESS FiLL F~OM ABOVE PREMISES BY P,~C~ R AD I~'~G L~DT / E;i~;'/~ W;,y CONtTRtJCTION ~ CZ:;SPOOL CONSi RUCTION ~ CELLAR CONStRUCtION OTHER FOEM NO. $ TOWN: OF SOUTHOLD Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the BuiJding Inspector 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 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. 13. For existing buildings (prior to April 19,57), Noa-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. New Building ....... X.. .......... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ........... ..~.....~!~.....a~....,l~a-....q.e..~......l:c~...v'...z..e...]:,,......l~... .................................................................. Owner Or Owners Of Property ................ .B...e..:...n.?r~'...d....&.....D..°..]:...°..z'...e..s.....l~...i.e...~...°. ............................................. Subdivision ..... ..]~.....t~'....e..3'.....C..°...l:!..n..~.:.Y...~..a...~.e...s. ...... Lot No.....3,~ ..... Block No ............. House No ............. Permit No....5.8.?.~.Z.. ..... Date Of Permit ...5.../..3:.6.../..7...~..Applicant ....... ~.n...3:..a.....n~.....~...o~...e..s..x...~.n...~.... ................ 015172 Hea~th [~pt. Approva~ ............................................ L~bor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ......... .Y...e..s. .......................... Fee Submitted $ 5.O0 Notary Public ......~~ ...... County Construction on above described building and permit meets all applicable codes and regulations. p,,cant .... me ~enne . zn~oe ~ . . or FO~ NO. 6 TOWN OF SOUTHOLD Building Department Town Clerics Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF O~C:UPANGY 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: 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, N~ultJple 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 1957), Non-conforming uses, or buildings and "pre-existing" land u~es: 1. ~ccurate 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. New Building ....... ..X. .......... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ........... ..D~...~...~t...~.e..~.R.....~... .................................................................. Owner Or Owners Of Property ................ ...B~..~..d.....&...??..~...°~....e..?....~...J:.~,0 ............................................. Subdivision .............................................................. o No ............. Block No ............. House No ............. Permit No. ~87~Z Date Of Permit .5.../.~..~../.?...~..Applicant cj15172 , Health Dept. Approval ............................................ Laoor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ......... ..~..e..s.. ......................... 5.00 Fee Submitted $ .................................... Construction on above described building and permit meets all applicable codes and regulations. AppZicant ........................................................................................ ~, VoPo (stamp or seal) Sworn to before me this ................ day of ............................................ Notary Public .................................... County B.~_~cxo:~, ~ w/s Delmar Dr. , Laurel, L.I. Zob155 ,: ,~.,,/,,::,,,,~,,~o~,.~o,. ~x ~,,.~,.¢,,t ~ ~.~ ~'~. ~ ~,~d ~. & outside ,~ ........ ;,,tined ,,,~ Sept emb er 8, 1972 attd fou,~d to &e i,* compliance .,ith the req,tlrements of this Bo,,rd. _ 15 : , 51 [ 22 ; 16 I I .... LO THEATE S ;MUL J-OUTLET I~, *Furnaces l-l/8, ~< Motors 1- 3Z4hp 1-1/12hpoil Zimlinghaus ~ Park Pl. G EN ~:]~'a/~AHAGER Patchogue, L.I. 11772 J~ Per IIX manner, return to the office of the Board if incorrect. Inspectors may be Ment,f,e~b~ their ~redent,als. Examined ..................... ~ ............. , Approved ~ ~ ~ Disapproved a/c ............................................................................................ APPLICATION FOR BUILDING PERMIT Dat~. ........... ...~..~...~...0. ................ 19..~...~. ...... INSTRUCI'ION$ a. This application must be completely filled in by typewriter or in ink and submitte~icate to the~lina ~nspactor, 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 stree~or areas, and~ giving a detailed descriptiOn of layout of property must be drawn on diagram which is part of this application. c. The work covered by this application may not be commenced before iS~uanca of Building Permit. d. UPOn ~oflrOVal of this application, the Building Inspector wilt issue a Building Permit to the applicant. Such permit ~h~ll be kept o the Ixemi~ available for inspection throughout the work. e. No building shaft be occupied or used in whole or in par~ for any purpose whatever until a Certificate of Occupafley d~all have been ~'m~t~d by the Building Inspector. A .A. PPLICATION-IB HEREBy MADE to the Building Department for. the issuance of a Building Permit pursuant to thlL~luilding Ze~l[ urolnance of the/own of Southold, Buffotk County, New York, and other epplic~ble Laws. Ordinances or R~ ~ltructiprt:ef buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply wi~fl all ep~)iicablelaw~ ordinances, building code. housing code. and regulations, and to admit authorized inspectors on premises and in buildings for neem~Y inspections. (Signature of applicant, or name, if ~ corporation) (Address of applicant) State whether applicant is owner, lessee, agent, amhitect, engineer, general contractor, electrician, plumber or~ builder. ....... ; ........................................................................... .(l.~.e..z'..~....C..~ ~ ~.~.~.. .................... , ............................................ Name of owner of premises ........................... ,/. .......................... .~. ....................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ...~..~...u.~..e..:~...~ig-ot No ........... ~ .............................. Street and Number .............................................................................................................................. : ...................... · /' ~'~ ~'~" Mun=~l~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy ......................... .~. ........ ,,,~; ..................................... , ...................................... ,..., ...... L Intended use and t~unnnPu · e Nature of work (check which applicable): New Building .........~[ ........... Addition ..................... Alteration......'....,,.. Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) 4. Estimated Cost ........... ~. .2:. .0. ~ . .0..9. .0......0. . .0. ............ Fee ........... , ..................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ .3: ....... Number of dwelling units on each floor ............... 6. ....................... If garage, number of cars .......................... .~, ............................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: FYont ....... , ...... , ...... Rear ........................... Depth ................................... Height ........................................................... Nt~mber of Stories ............................................................................. Dimensions of same structure with alterations or additions: Front ........................ ,. Rear ......................................... Depth ............................................. Height ...., .................................... Number of Stories .................... ................. ,.. 8. Dimensions of entire new construction: Front ......~.~.~..8..e.. ...... Rear .......... ~.~..8..e. ...... Depth ...... ~(~ ...................... Height ........... ~.~.. ................................. Number of Stories ..................... ~ ................................................................. 9.~'': Size of lot: Front .,.....~.~. ....................... Rear ............ ~ ....................... Depth ...................... .:L~.~ .................... Height .................................................... Number of Stories ...................................................................................... 10. ' Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ......................... ..~..o. ............................. 13. Will lot be regreded ............... ; ..................... Will excess fill be removed from premises: [ ] Yes [ ] No i4. Name of Owner of premises .............~....A......~..~.e.l'P.._..~.~.a...e..a.. ...................................... ~ ............................................... (Address) (Phone No.) T,~land 1%ales, Inc. aeZden 11~ 117.8.~ 7. 2-2..1.~.?....., .... Name of Architect ....................................................................................... ~ ............................. ~ ......... (Address) (Phone No.) .. ~ _ _ [bland Homesa [nc. ~eZdea, ~iY 1178b~ 732-2~77 ' I~lama OT ~on[reclor ................... , ............................................................................................................................. . (Address) (Phone No.) PLOT DIAG RAM Locate clearlY and distinctly p!l buildings, whether existing or proposed, and indicate all set-back dimension~ from prol ~rty lines: Give street and bilk flUihber or description according to deed, and show street names and indicate wheth- er int rior or cbrner lot. COUNTY OF He is the .......... ;..' ..... ~~ ......................................................................................................................................... ' · / . (Con~ctor, a~t, coyote o~, e~.) of said owner or owners, and ~s du!~ au~hor~~ ~ ~ ' ~z~ to ~rform or have ~rfor~d t~ ~id wo~ and to make a~ file this ap~i~fion; ~ all ~m~n~ contained in this appli~tion are tr~ to t~~wled~ a~ ~lief; and that the wo~ will ~ ~dor~ in ~ ~n~r mt fo~h in the ap~ication filed t~rewi~h. ............. .............. Lot 12 Lotll ;~6;:~ sa.ft. % /J AUG22,1972 Lot 10 YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG SURVEY FOR: ~ BERNARD E NIECKO 6DOLORES LOTNO. II,"LAUREL COUNTRY AT LAUREL TOWN OF $OUTHOLD SUFFOLK CO., N.Y. I" = 401 DATE:MAY 2,197Z HOWARD W. YOUNG joS L. Ot I~ Lot Ii i~ot I0 .Ewsm.s ' YOUNG & YOUNG MAYgt Ig?~. 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK SURVEY FOR: BERNARD F. NIECKO & DOLORES NIECKO LOT NO. I I," LAUI~L COUNTRY ES?~TES" GUARANTEED TO: *. AT L A URE L mvE~l~ ~ ~ 8EIXIRITY TITLE ~ ~ 'tOWN O~' SOUTHOLD ,1 :I 21:,0 1483' II