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Home My WebLink About6711-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certific le Of Occupancy THIS CERTIFIES that the building located at . .0warm&. & .O.~mo .A~rm,.. Street Map No... XX ....... Block No..XX. ...... Lot No. X~... ~0~;]2~.~..N, .Y.* .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... J~10r..6g..., 19.73 pursuant to which Building Permit No. dated ........... JtO~..6! .... , 1973., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issu4d is :. l~:l. vate .o~e .£a~t,l.y ~ ..................................... The' certificate is issued to ... ]~lll]C I)lPh,tlJ. J. pl ................................. (owner, lessee or tenant) of the aforesaid building. S~ffolk County Department of Health Approval .................................... UNDERWRITERS CERTIFICATE No... P.~ ................................. HOUSE NUMBER ... ~). ........ Street ...O~a,t,~l$&. ~; .P,~..0.$$.~..A.~.~.~ .......... .................................................... ........... ............ ]~aii~ '~ ' i~.~;~t;; ...... "~"' FOB, M NO. e, 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) 6711 Z Date ............................ ~..~. ........... .~...., 19.~,~.. Permission is hereby granted to: Oornell Construction Corp. ..A~..C Fran~ DePhillip$ Build an addition on existing dweli~g at premises located at ....Otf~.IIIL..~....QII. II~J~..A~.e ............................................................................. ......................................................... ~.~...o.~...... ~.,~.... ...................................................................... pursuant to application dated ............................. ~...1~..~. ......... .~......., 19..~,~., and approved by the Building Inspector. Fee $ .~5.e.~O ............ TOWN ......... ...... . ......................................... .......... ~ -- ~ ' .............................. '(euil~"l'~ ............... ~'~'~ Date ..................... ~.....'~ ........ , 19.~....~.. a. ~his a~lication must be completelV fill~ in bV ~ewriter o~ in ink and s~mi~ed in triplicate to ~e Buil~n, Ink,tar, with 3 ~ oE plans, accurate pl~ plan to ~ale. ~ee ~oding to ~h~le. b. Plot plan ~ing I~ation oE lot and oE buildings on premises, relationship to ~joining premises or public str areas, an~ givi~ a detaild de~ription o{ I~yo~ o{pr~ must be drawn on tbe diagram which is ~ of this applicati~. c. ~e work c~er~ bV this a~lic~tion may not be comme~ beEore issuance oE Building Permit. d. U~n a~val of this applicati~, the Building Ins~tor will issue a Building Permit to the applicant. Such permit shall ~ ~pt ~ ~ premis~ ~ailable for in~ti~ ~r~h~ the work. e. ~o building ~all be ~cupi~ or u~ in ~ole or in ~rt for any pu~ose whatever until a Ce~ifica~ o~ ~cupanc shall have been g~nt~ by the Building In~ector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ord nancos al Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described The applicant agrees to comply with all applicable lows, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessen/ inspections. ~ ' ~ Clearview Ave Southold ..................... ............................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................ ................................................. Name *f owner of '-mm ses Frank DePhillios · If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No..,~,*....~.0...~..~.~.~...~. .................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ....... ~ ............................ Lot No ......... ~ ........... Street and Number C)~',$..i..~.~.a.....~....0.~..seo Ave 8ou~hold N.Y. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy dwellirJ, g b. Intended use and occupancy same with an addition ,d 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ................. Repair .................. Removal .................. Demolition ............. ( ....... Other Work ..................................................... (Description) 4. Estimated Cost ............................................................ Fee ...~.~.......0g.. ........................................................................... L (to be paid on filing this application) oz~e 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 of entire new construction: Front ........ .~...~. ....................... Rear ...... ~.~ ................. Depth ...~...0. ................ Height .................... Number of Stories ..one. ............................................................................................................ 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. ~Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated ........ ?.~l?...rl:L~q.~ .......................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~g. ............................................. 13. Will lot be regraded ..... J:LO. ................. Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises .~..~..~...Z~......D..e....~..~.]...~.~ ............ Address ....~.9..1~..~.~..9.~.~. ........ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor .....~.0~,,].l...(~O,l~.,~.~.~.Q.~.~.~..g.~Z~dress ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether exit-ting 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 whether interior or corner lot. See sketch attached STATE OF NEW yC~I~,... ~ ¢ c COUNTY OF ........ ...... ~lice Co~.l~ ...... ,n ............................................................................... be' g duly sworn, d~oses and says that he is the applicam (Nome of i~ividual signi~ contrac~ above name. He is the .......... ~..~.~..~.~.~.~.~ ................................................................................................................................ (Contractor, agent, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and file this application; that all statements contain~ in this application are tree to the best of his knowledge and belief; and that the work will be performed in the manner set forth Jn the application filed therewith. Sworn to before me this ~ _ ~ .... ~ ~- ~ .................... ........ .......... ' ...... .... ', ~N~I,~.~O~E~ · (Signature of a~lica~) ~ Cjw°, ~-0344963 Suffolk Coual/ °~alS~l°~ ~XpJ~I March 30, 1~ ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS Off BUREAU OF ELECTRICri:Y ' : ~- AU.?,t.tst 1 ~ 1~7~s JOHN STREET, NEW YORK, NEWyORK io~8 THIS CEEIFIES THAT in the follo~ing ~atio.; ~ B~ement ~ lst FL ~ 2~ FL Outside ~t;on ~ ~exami~on ~ ~ ~7~ andfou~incomplla~ewithther~ui~men~ofth~B~. SERVICE DISCONNECT NO. OF S E RANGES SPECIAL REC'PT R I TiMECLOCKS B~L [UHITHE&TERS MULTKOUTLET V I C OF CC, COND. OF HI-LEG EXHAUST FANS AMT. H.P. DIMMERS Joseph C. Co,nell 750 Clea~vlew Ave. Soutbold, L.I. llP?I D COPY FOuR BUILDING DEPAR?MENT. THIS COPY OF CERTIFICATE MUST IK)T BE ALTERED IN ANY MANNER. FORM NO. 6 TOWN OF SOUTHOLD Building Delm~tmenf Town C:lerk~ Office Southold, H. ¥. 11971 APPUCATION FOR CERTIFICATE OF OGCUPANCY Insfructiona 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 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 1957), No~-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 land use $5.00 3. Copy of certificate of occupancy $1.00 /./'/,,~ ~../. ,,~ ~ Date "~'"'1'"?'"'"'"' '~ '""'"'~" New Building .................... Old or Pre-existing Building .../~/../....~....~.... Vacant Land ............................ Location Of Property '~"~'"~"/~_ _ ~ ~ )f"l%O' 0~ ."~"'~'"'"i'C~": ......................................... Owner Or Owners Of Property .~...~.....h~..~~ ......................................... 76"~-c~- Subdivision ..... ~--,~,,=~...~.~ ......... r. Lo~, No...~... Block No...~ ...... House ,o~.~,.5..~ Permit No...~...7./1.....~.. Date Of Permit .~l~...~....Applicant .....~.....~.....(-~./.~ ......................... Health Dept. Approval ...... '' ~..~...:..~...............~' ........ Labor Dept. Approval ..... .~...~/....-.L~...-- ~'- ............................. Underwr.ers Ap.raval Request For Temporary Certificate ........................................ Final Certificate ....~.. .............................. Fee Submitted $ Construction on above described building and pero~jt meets all aj~plicabJ~ codes a,~l j~gulations. ..................... Sworn ts before me this ~ ~: of ~~ (stamp or seal) ~~ ~ D ' ~DITH r Plre~ March 30.