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Home My WebLink About5901-zFOB~ NO. 4 TOWN OF SOUTHOLD BUILBING DEPARTMENT Town Clerk's Office Soutbold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the bugdlng located at. 1~0~[ ~...~e:~,~. ,..~1~eet Map No.~ .......... Block No. ~ ....... ~t No.. ~ ...... ~tSt~.. ],~, .... co~orms subst~ti~ly to ~e Applica~on for B~ding Pe~it heretofore f~ ~ ~ office dated ............ ~...~., 19 ~. p~su~t to w~ch B~l~g Pe~t No. ~1~.. dated ............. ~...~.., 19.~., was issued, ~d co~o~s to ~ of ~e req~ ments of ~e appUcable pro~ions of ~e law. The occup~cy for w~ch ~ ce~icate ~ ~sued ~ ~$~. ~. ~. ~V~.~I ....................................... ~e ce~ificate is issued to . ~Oleph.. ~ l~ .... ~o~ .......................... (owner, lessee or ten~t) of ~e ~ores&d b~g. S~olk Co~ty Dep~ment of He~ Approv~ . J~...~...~ ·-by. ~,.~'~' · U~I~RS CERTIFICA~ No~..q~ ..... Teb..~ .... $~ .............. HOUSE ~ER ... ~ ....... S~t .... ~ .~ .~. ~. (. ~s~l. ~) Building inspector ~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. CertifiCate Of Occupancy No. Z.~.0?.Q ...... Date ............... &~l[... 26..., lg.~.. THIS CERTIFIES that the building located at R. 0...~. OSf..ELS..We~l~h~l~ S~et Map No. ~ ......... Block No... ;~ .....Lot No.~....l~.~.~.~.%u..ck...N..,.~.~.. ( .~.:[.n.o. ~,. conforms substantially to the Application for Building Permit heretofore filed in this office dated ......l~y.. 2.~ ....... , 1972. pursuant to which Building Permit No .... ~901z dated ............1~. [.. 2~...., 19.7.2.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is p.r.~,v. ~.t.e..9.n.e..f..a.n~.~.y...d.w.e. 1..1.$.n.g ........................................ The certificate is issued to ...J.o.$ep.h... ]~.o..A¥~[g~l~ ....... ~.~m.e.r .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . ~ .u.J..y.. J.6... J.9.73 .... b.y..R. :. ¥.~.1.1.~. UNDERWRITERS CERTIFICATE No. N.~.~r~ ..... F~b...]3.. 19.7~ ............... HOUSE NUMBER.. ~9 ......... Street .... P~.t .]~oa~l .~. 2~2. (Laster..Bd) ........ Building Inspect~ FORM NO. 6 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 DUPLICATE to the Building Inspector with the following; for new buildings or new use: l. 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 ar 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}, Nan-conforming uses, or buildings and "pre-existing" land uses: l. 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 land use $5.00 3. Copy of certificate of occupancy $1.00 New Build ng Addit. i~on Old or Pre existing Building Vacant Lond oco, o. ............................... Owne, Or Owne, Of Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No..'~'...~...~.~.Z Date Of Permit ....~.....~--.~..'~.Applicant .~..~.....~...~.......4z.....~....~.~....~...~..~/ Health Dept. Approval ...2/.(.~./....7.~... .................... Labor Dept. Approval ................ .~...:...,~... ................... Underwriters Approval ....~...../...~..~...~...~...~ .................... Planning Board Approval ......... ..~....~....~...: ................. Request For Temporary Certificate ........ .~ ......................... Final Certificate .......................................... Fee Submitted $ ....~...~ ...................... Sworn to_~efore me this ~.~...'2daypub,,c of.~/v~/'"~'""/'2Z'~' Notary ..... ,~,~,,;~r,~. ;. .......... County NOTARY pUBLIO, Stale oF Haw Yor~ ~e~ ~pir.s Narch ~O, 1~7~ ~ ~ Construction on above described building and permit meets all applicable codes and regulations. .................. ............................ (stamp or seal)~ ~'~ 70 THE NEW YORK BOARD OF FIRE UNDERWRITERS '~]" BUREAU OF ELECTRICITY~ ~'~ ~5 JOHN STREET. NEW YORK, NEW YORK,10038 · ,,,,,,~ ,.,,,~,,.. ~,1~7~ ,.,.,,.t,o..,,...o..f,,. ,9,,8,,. N ,~43499 THIS CEI~rlFIE$ THAT in th~ Jollowing loe~ t I ~,t FI. [] 2nd Fl. Section Block Lot was examined on and~ou~l to bo in ¢Ompllance with the reqBirements of this Board. RANGES K.W. 10.3 SK:ClAL EEC'PT, R TIMECLOCKS ] BIU. r~PNU~XEI$ IMULT~OUTLET '"" f'"'~. J,.~"$' ~ ' 1 I "" V I C E EXHAUSY* FANS DIMMERS OF CC. COND. 3/0 NO. O~ HI4EG 1/o 1-l,Okv. 2-1.25tm. 1-.75kv.--- FOruM NO, 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5901 Z Permission is hereby granted to: .... ,T~ ee~e ..R.~. · .~'~a~c~ .................................. ...... · 1.8-3~ · .. ¢~e~.ae~ · .A~e ................................... ...... · ~eme ......... ~'~'""'$e~6~ ......................... to ... J~.lL13.~,..z~e~..oz~e...£a,m.LL~...c~e~,~,g .................................................................................. at premises located at ...... £^~et~..~ea¢~...~ .............. ~j/~'"~*~'L'~t~:~L~'"~.O~ .................................. ............................................................. I~tat.~:LL-ae~ ......... ~..~ .......................................................... pursuant to application dated .........................~&~ ....... ~..~. ........... 19'/~ ..... and approved by the Building Inspector. Fee $..~e~O .......... Building I flslSector / TOWN OF SOUTHOLD ~ ~/ Zi~c~,,,/,~, ~ ~ ~ ~ BUILDING DEPARTMENT . TOWN CLERK'S OFFICE ~' Examined ....... ~..~.~ ....... , 19.~..~ Application No..~.~.~..~./. .............. Approved ........................................ ~ 'k , 19..~..'... Pemit No ..... ~..~..~..~..~././~, ~'V-~~ Disapproved a/c~ .................................................. . ............. ~ .............. : Z/ -- .,, ~-' .... Z '- / r~ ~-- ,' - '~ ~ m ~" 1 ~vc .~ ............ ~,...~..~..~..~..~ ....................... ~.~.m...~4~,*, /~ ~t '~ - ~ -' '~ i , J ~(~ (Buildi~ Inspector) ~i~'~*/ . ~ ~ APPLICATION FOR BUILDING PERMIT -~ .z;~-~ --'~-~ ~, ~ ~ '~ ~-~ ~ - n~,. ............ ~y. >r ,~7~ a. This application must be completely filled in by ~pewriter or in ink and sub~n 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 gMng a detailed description of layout ofproper~ 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 qpp[oval of this application, the Building Inspector will issue a Building Permit to the ~licant. Such permit~t shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be ~cupied or used in whole or in part for any purpose whatever until a Ce~ificate of ~cupancy ~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY ~DE to the Building Department for the issuance of a Building Permit pumuant 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 ~11 applicable laws, ordinances, building c~e, housing c~e, and regulations. ,: ........................................ '-- '"--'~':~U ~ '~ ':~' ri ',,~j, ~~'~' ~b ~// Z~'(~gnature~ ~ of(~ ~"appl~nt'- or name,,/~c~if a corporation) :- ~ ~ ~ ~.,: .......................... '~xa~;;;; oi';~i~;;;ii ......... , .................. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................... t.~.e.~ ........ ~......~:~.,:~ ......... .Cc~:.:.a.~.z?.:h ............................................................. Name of owner of premises ..... ~g~.~:~....(~.~ ...... /~.~ ........................................................................................ If applicant is a corporate, signature of duly authorized of Hcer. ~_ ~ ~ .................. i~;;;";~Zii~'i;";f'L;:;';;~;';~ii;;;~ ......... ~ ~ ~ ~ 1. Location of aM on wh ch proposed.~ .,/ ,-~ ~ ~ N~ ,.w°rk w ~ be done Map No .... Lot No, .........,.............. s,,,, ............. ................ -.'"'"'""-".'"'"'-' Municipali~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed con,ruction: a. Exisiting use and ~c,pancy ............. ~.....,~.~ ............................................................................... b. Intended use and occupancy ............. J...~ ............. ~ ............................................................................................. 3. N'ature of work (check which applicable): New Building ....~.. ........... Addition .................. AlteratiOn .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) .......................... :. ............ 4. Estimated Cost .....o~.....~..~.~ ................................... Fee ..,~......g......./-¢...O.. ....................................................................... (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 use ............................ 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. D mens OhS of ent re new construct on Front .,~ ~.'~..~.. Rear . .~'.k ..... Dec>th ..'~....~.. I , ' - '"~ ........ ~ ................ Height ~.~...~.~..../.b... Number of Stories ..../. ...... .J..(.~..~. ............................... .~........!..2:.~...~...~_...~....~,,.....~7../~?.:~.c.Z .... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ...~.~...~...~. ....... /.~...~....O. .................... Name of Former Owner .....~.,. ......,~'.~(.~.~./~..~... ....... : ............ 1 1. Zone or use district in which premises are situated ..................................................................................................... proposed construction violate any zoning law, ordinance or regulation? ......... ..,~'.?_.....:......; .......................... 12.13.DOeSName of Owner of pre,m?ses '~/~'~'~'~''''~'''l''~'''~'~'''~'''''''''Address-- -- ,~'.~....~.~.....~..~..~.~.~..~..~:...~.'~!~5__ ,-_. ~ ~--~ No. ~..~.TT..~...~.~? Name of Architect ..J~!.~...,..t~ .~.....C~.. ......................... Address ./.~..0....~.~-.~¢./~.~./~.;,..~.~.~..~..~.~;Phone No...~:~.~/.~...~.'.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-b~ck dimensions fram property lines. Give street and block number or description according to deed, and show street names and indicate whether i~terior or comer lot. STATE OF NE'W YORK, COUNTY OF ................................ ................. ~..~..L..~....~....-~..,..~.'..C.~...~...(..~'.. ................................ being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ....... ~'~,,~,.,7,,...~,,..~....~.~.~.,.,.,~.,.,,~$~,,,,,,~,,,'~::... .............................................................................................. (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 conta.ined in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth Jn the application filed therewith. Sworn to before me this ..... .......... ........ Notary Public, StateofNew York No. 30-3741040 Qualified in Nassau County Term Expires ~exch30, 19 BUILDING DEPARTMENT . ~. , TOWN CLERK'S oFFICE '~. SOUTHOLD, N.Y. ~/~-~/?~ ~ e,~'/,~ ', 19...~.....ZT/ Application No. ~...~....~'...g.~/. .............. Disapproved a~_...~~ ....... ~/7'/- ........ : .................. ~..~...;.....: .............. ~ ..... ~ ........................ U .%.~ , ~ ~~ (s~i~a~ ~,p~tor~ ~ ~ -- ~ ~~ ' ~_ ~ APPLICATION FOR BUILDING PE~IT~ ~ '~ ~ ~-~ ........................ , .......................... , .............. a. This a~licoti~ must be completely fill~ in by ~ewriter or in ink and subm~in d~licate Ins~t~ 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 port of this application. c. The work ~Overed by this application may not be commenced before issuance of Building Permit. d upan.t:lpplloval of this application, the Building Inspector will issue a Building Permit tathe applicant. Such permit~[ shall be kept on the premises available for inspection throughout the prOgress of the work. ' e. No building shall be occupied or used m whole or m part for any purpose whatever until a Certificate of Occupancy~l sha 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 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, '~'T--=~-9~-~---~, ~.~ H ( / /~ /~ ,~' '._ __ .. ..................................... I II ~ 1;IL~:Sr,~ ._~ee.~7 ~ // (Sfgnat · of applj~6nt, or name, if a corporation) ~ .,,.~ ? ~T'~i ....... 'r'~ ,..,'-- ,'- v . State whether opplicant is owner, lessee, ogent, architect, engineer, general contractor, electricion, plumber or builder. ~ome of owner of premises ..... ...... ~.~ ........................................................................................ ................................................................................... and tit,e of corporate officer 1. Location of land on which propped work will be done. Map No.: ...:: ...... :.:..2 ....................... lot No ........................ O,/Z/, ~ s~ r///~ Ko, Street ond ~umber ............. ~ ............... ~ ........... ~ ........ ~ ~ ....... :.~ .................. ..7 ~unk:ipali~/ 2, State existing use and occupancy of premises ond in~ended use and occupancy of proposed construction: a. Exisiting ~ and occupancy ............. ~..~...'.~.......L..~ .............................................................................. b. Intended use and occupancy ............. L.~.....~. ............................ ~. ................................................................ 3. I~rature of work (check which applicable): New Building ............. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................... : ............ 4. Estimated Cost .....c~...?~..~,~, ................................... Fee ...~....~..:...~..O. ....................................................................... (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 use ............................ 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 ofentir~newconstruction' Front ~...~... ..... Rear .'-~...~... Death .....'~....~.. .... .' ..... .......................... )'i':;,;'i:;:" ' ....... Height ~./...~.,~ ........ Number of Stones ....Z ................ .Y- ............................... ~ .................. ~.~...~.."~'....7. ......... ~.e... .... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Dote of Purchase .......... .................... Nome of Former Owner .....~.~ ...... 5.~j.'j.~../~..~... ....... : ............ 11. Zone or use district in which premises are situated ..................................................................... : ............................. ;~ 12. Does proposed construction violate any zoning law, ordinance or regulationP ~ . Name of Owner of pre~?ses ..~.~.~ ~.1.6'--~'/~/. Address ~.....'~. ~"'~Z~.~.'.~.'.'~i'..~.'..'.~.'~'~'3:~"~.~.'i~.'.'.~..~. ? Name of Architect ..,~i.~...~..t~.~.. ............. i.. ......... Address ./..~..0....~¢J~..~.;~..~.~.~, P/~ne No£~...-r/.~...~.. Name of Contractor ~...~.J.~..~!...~.. .....................Address/...~..~....~ .~...'~; ........ '..~..~./. ~e No. ~>~3,~...-:..:~..,~7 PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back 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 NEW- YORK, ! ¢ c COUNTY OF ................................ $~'~ , ................ · ~ ................ ~ ............................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ........................................~ .............................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application ore true to the best of his knowledge end belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ..... ..........1 ...... L.,zl Notary Public. ~'P,l]~? D.~M~ C°unty'~'"t" '~;~'~;;"°'f"~31~l~ii';;;~")' ............................. NotaryPub]ic, StateofNe~ York No. 30~3741040 QT~alified in Na~au County erin Expires MarchS0. 19 ,' ~$H THE INDICATED, Dlt~ENSION CtL SiNK AND WINDOW TO REF. .!~A~ltr~? OF' 0WlIEI~ ~^TM 0 HALL II, I~PORTANT NOTE: TOP S ,DiRFACE ~ous~ SUB~LO0~ i': 0~3 Doo~ ~CE, GEN~RAi~ NOTES , SUPPLEMENT QF TI'IF,, STANDARD "~:~ ~'~ I~W'~"~C> ?_T..;~PL~, N AND PA~T THE~E OF THE WNOLE P~NS'~ND~ N~T~D THEREON., .FOR.~LL ~HI~K~ R~K'~IH THE DEALER OR CONTRACTOR SHNLI V~RIFY ALL D;~Et'!$1OH,t' ~ C~c,-FT ANY' DI~C~EPANC!ES BEFORE I:UDGE A Div Sion o~' ~/i~'/T/--~ Products Con ~010 Ridge Pike Consh011o~ken, Pa, 1942S A RESIDENCE FOR , DATE APPROVED ,-'~.L~'~.',, s~ ':.w~: No. SI~i'FO~ COU~TY ~E~f~T~ DEPA~TIE~NT DATEJUL--- 1 6 t973 ~. ~. ~. ~ ~O~'1~O~ ~AP, OF PROPERTY' ,5.,U P-VEYF P FOP.., J%EPh P~.~:~EL.AI DEl A..VIG~ON AT P1ATTITUCV.. TOW'N OF SOUTHOL , ' ,-,, &~' 4> ¢. ,, 14-' TITLE C4JA I;;;F. AJN T _E_~ .... JULY -'WELL 'x %