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Home My WebLink About7010-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.z~990 ....... Date ............. ~ullr .... 8 ....., 19~.. THIS CERTIFIES that the building located at P..She. ~.r.®e. tloa~[ ........... Street Map No. Nassau. F&~d/lock No ........... Lot No. 2.1.A/. 21~ ..... C~lt,~hOg~# ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Nov...30.., 19.?1/'. pursuant to which Building Permit No.. dated ......... ~ov .... 30' ., 19~., was issued, and conforms to all of the require- ments of the applicable prowsions of the law. The occupancy for which this certificate is issued is 'PX%v&te' '~e .fam/~..¥. elw~lling, wi~h. &ddl.~$o~ ...................... The certificate is issued to .Edw~x'd. Hob.de, ..... 0wr~e~. ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. ,~.,Ho ............................. UNDERWRITEBS CERTIFICATE No.. l~S~. ~../.~.~/..~..~ ..... ~./.~..~../ HOUSE NUMBER 't~3~' ........ Street .... Pin~ .Tre~ .Road ..................... Building Inspector FORM 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) No. 7010 Z Permission is hereby granted to: ........... Catalao~aa....: .......................................... to .JauJ_q.~..~,..a~LaJ. i;.i.a~..o~z..~z~.~&..ciwe41.1 ~v~ ............................................................... at premises located at ..... ~P.~:~...~.~...~Zl~!:t ....... ~..~,~.~1~,.~...~.~,:/,'t$1~ ....................................... ....................................... F~.~...,.~h~.....:n._ z...kload .............. .(Jutcho&'tle .......................................... pursuant to application dated .........................]~'~ .......... ~0. ........ , 19..~.~.., and approved by the Building Inspector. Fee St ~,.(~) ............. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.]< BUREAU OF ELECTRICITY -- 85 JOHN STREET, NEW YORK, NEW YORK IOO3E D.,. ~,,,e 5. ~7,, App,,.,,o.,o.o.,,,. :,~0~9~ N 163129 THIS CERTIFIES THAT only the electrical ~qu~r~ent as d~scri~ blow and introduced by th~ applicant named on th~ abo~ application number in th~ premis~s of Edward Robedee, e/side Pine Tree Rd., 1000' e/o Billard Rd. CUtcho~ue~ in the following location; I ~ Basement ~ls~ FI. [] 2nd Fl. Section Block Lot wa~erarninedon .~ay 30~, ~..~7~ and found to be in cornpliance with ~he r~quirernen~s of this Board. FIXTURE / A I I RXTURES OUTLETS rRECEPT CLES SWITCHES INCANDESCENT FLUORESCENT M,~n' ~,/~ I~ ~ DRYERS I r-URNACE MOTORS FUTURE A~FUANCE FEEDEES ~T. ~.w. o,~ ,.p. oas ,.p. ~r ~o ~.w.o. I OTHER APPARATUS: DIMMERS FOI~M NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Sou~hold, 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: 1. Final survey of property with accurate location of oil buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerege 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 Plenning 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" lend uses: ]. Aocurote survey of property showing oil property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner os to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent formation required to prepare o certificate. C. Fees: ]. Certificete of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date ...... ,,T.u :1, 3'....$. ~... ],~.7. 4 ............. New Building ................ Addition ..... ~ ........Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ~`~$~?~'~~b~?~[~ ............................................................. Owner Or Owners Of Property ..l~-~wa,~cl...~,~b~cl.m.a ................................................................................... 21A-24 Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No..7.0.].0~. ....... Date Of Permit ].]./..~0/.'/..3. Applicant .~.ee~l'.g~....A.~l.~,.e.~.~....~..~.]...~.~.~.,....[..~..¢.,.. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval 7.,1,.0.],.~.~..-...~.l.~.~.....5.,..l..9..7..4....Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ....X.. .................................... Fee Submitted $ .....~......~. ................ Construction on above described building and permit meets all applicable codes and regulations. App,,cant ............................................ ~.0.,~.~.~.,.~??.!!?~.."..'"..~.: ................ ........... ~..doyof~..~ ....... (.~...~..~ .... 's,a.Uorseo,~ ~ ~0 o,ory Pub,,c ..... .U. ......... ............... coL,y TOWN OF SOUTHOLD BUILDING DEI~ARTMENT TOWN a. ERK'S OFFICE SOUTHOLD, N. Y. Kxamined ............................ ........... ¢~ ~¢ 9..~....~.. / Approved ........................................ , 1 . Permit No. --- Disapproved a/c ........................................................................ ................................................ ::::::::::::::::::::::::::::::::::: ................ Application No..~... .......................... INSTRUCTIONS Date.. ~..~. ~....'...~.....~... .................... , a. This application must be completely filled in by typewriter oC, in ink and submitted in triplicate to the Building Inspector, with 3 set~ 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 ofpraperty must be drawn on the diagram which is part of this applicat,on. 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 shall be kept an the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pa rt 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 ~uild!n.g. Zon,e O .rdinance of the Town of Southol,d., Suffolk County, New York, and other applicable Laws, Ordinances or egulotl.o, ns, tor the construction of buildings, add,tions or alterations, or for removal or demolition, as here n described The apphcont agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on promises and in buildings for necessary Inspections. g o app ,can, or name, it a corporation) State whether applicant is owner, lessee, a ent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..~.~,..~~...'~.~ ............................................................ If app icant is a corpora e, signature of duly authorized officer. - - (4qame and title of corporate-officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. ? I. Location of land on which pj~l~eed ]~ork wJII be done. ~l, ap t ]No ......................... Street and Number ...... ,~..~G~..~T.~F~.....~ .......... .............................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...~~~ ............................................................................ ' ........... b. Intei~ded use and occupancy ..... ~ ................................................................................... Natur of work (check which applicable): N~w Buif~ing' ..~: ............. Addition ........ Alte tion Repair .................. Removal .................. Demolition..? ...... ,..:,.!. Other Work ...................................................... 4. Estimated Cost ........ ~./.,,~...~...¢LgZ~..~ .............. Fee ~.~,._~,.~._ (Description) ' (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 structu~s, 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 ent re new construct on' Front ~r_/~ rd R~n. ~ r Height ..... ~. ............ Number of Stories ........................................... ~ ........................................................... 9. Size of i,ot: Front ..... ~'-¢_~. ..... Reor..~/~... ........................ De~th~ ......... 10. Date of Purchase ........................................ Name of Former Owner -~ 11. Zone or use district in which premises are situc~ted ~.:....~ ............................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .,,~.~ ....................... ./ ............... 13.; Will lot ~be regraded ....~ ............. Will excess fill be removed from premises: ( ) Yes ( ~)/No 14. Name ofOwner of premise~s .:/,~_...~....4~~4~ddress~..~Fr~...~.~. Phone No ....................... Name of Architect ..~?~~, .~.j] ................. Address...~.~l")~~one No ....................... Name of Contracto~~ ............ Address ~.~.. Phone No. ~'~...~./...~. 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 comer lot. ................................... ~c.~. ............ ~ ........................................ being duly sworn, deposes and says that he is the applican~ (Name of ~'ndividual signing contract) 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 apP cation are tru,e,_to~the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application ~ therewith Swom to befog'me this -- , '~ ' ........... .., · Notary Public, ..~I~E,~_,~,~..~.~... I / ....... ~;?~z....~.... ~-.....~<~. ~ ............... ~/ JUD~?H T. BOKEN ~h~gC~'(Signa~re of app cant) Notary Public, State of New York No. 52-0344963 Suffolk Count~' Cornrniss/on EXpires March 30, G