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Home My WebLink About6727-zFOB, M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z5.979 ...... Date ............. Jnn~.. 27. ..... , 19. ~.~. THIS CERTIFIES that the building located at .. t~eebe..Dr:[~ ............ Street Map No..Eooae. ¢o~eBlock No ........... Lot No.. ~.~... C~tchogu~.. ~ ,~.. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... July- ·-12., 19. '?3 pursuant to which Building Permit No.. $72~ dated .............. July.--l& 19 '?3', 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 .. Private..one..£amily .dwelll_ug. ~ith- ~n. addition ................. The certificate is issued to .Wezley .J...$1~lek ~ of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) .N .R.. ............................... UNDERWRITERS CERTIFICATE No...E. ].~380...F~ .8...1.9~ ................ HOUSE NUMBER .... 2~7.~ ..... Street ... ~,~abe..Drl~ ......................... Building Inspector FOuv,~ 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) 6727 Z Permission is hereby granted to: .~e~le~..~/mehlck..j~ ................................... ............. · Be~be...~ ........................................... -" .................... ,.C..u. ~.o...~... ...................................... to ...~.~.Z.~...~.~..~.~.~.o.~...o..~...~.x.~..,..t..~...d..,..e.~ ............................................................. at premises located at ..... ~,e~l~...l~. ...... .l~lO0~..CO~e ........................ ~ ................................................ ...................................... ~#.e. ba..l~£~e ............ Cutohog~....#,,¥, ............................................... pursuant to application doted ........................~IA,],~ ....... 9t~ ......... , 19~13..., and approved by the Bu,ding Inspector. Fee $.~ ,~.& ~ ........... · ~ v Building InspecT'or-- THE NEW YORK BOARD OF FIRE UNDERWRITERS ~¥ BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 pp,,c.t,o. No...,,,e N 158380 THIS CERTIFIES THAT Wesley Simehick~ I:'eede~., 2 ~ouses so~zth Fawn Lane, Cutchogue, L.I. in the /ollowing location; [] Bazement ~ 1st FI. tvas examined on i,'~ay (', 1~974 [] 2nd FI. Section Block Lot and found to be in compliance with the requirements of this Board. RANGES SPECIAL EEC'; RXTURE FIXTURES 5 7 ~ 5 DRyERs FURNACE MOTORS FUTURE APPLIANCE FEEDERS S E ICOOKING DECKS OVENS I DISH WASHERS TIME CLOCKS B~LL UNIT HEATERS MULTI-OUTLET R V I C A' W' G' NO. OF HI'LEG A' W' G' NO. OF NEUTRAl OF CC. COND. Of HI-I~G NO. OF NO. OF CC COl,ID PER ~' SERVICE DISCONNECT OTHER APPARATUS: EXHAUST FANS DIMMERS OF NEUTRAL Wesley Sinc~iek Beebe br. Cutcho~e, ~ew York lle3h GENERAL M~AGER COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FO~ NO. $ TOWN OF $OUTHOLD Building Delmr~ment Town Clerk~ 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: 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 Cede 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 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 3, Copy of certificate of occupancy $1.00 $5.00 Dote ...~../,,~...~.... g..~.,../.~....7...~.. ...... New Building .................... Old or Pre-existing Building ....... ..~...... ............. Vacant Land ............................ Location Of Property ............................. /~....~.~....~...~.....~......~....~..: ........ .~..~..?'.~..~.....~...~....~..~../....~..~.~..'. ............ Owner Or Owners Of Property ..... .~..~..~.~)~.~....,.~f.'.....?..~..~...~.~....~...~...~......~..../...~..(~.~.~. ............ Subdivision ........... .~.~.~.~..~.~....(~'~.~...~... ............ Lot No......~..Z Block No.......~:T...... House No..~..~..~'.s~- Permit No. ~...~..~....~. Date Of Permit ...?.j./..~/~.,,~Applicant .~...~...,~..L....~....~.....~.......~./.~(..C'.~../...~....~.. Health Dept. Approval ................. ...~..:.../~.: ............. Labor Dept. Approval ............../~...'....~...: ...................... Underwriters Approval ................... ~ .......................... Planning Board Approval ...... ...~...:..~...*.: ................... Request For Temporary Certificate .......... [~ ............................ Final Certificate ............. ~ .................... Fee Submitted $ ....'~-..'..'..~....~. ................... Construction ~.....~~~ on above described building d ermit eets I appl' hie c ,',s an regulations. pphcant .. Sworn to before me this - /~' · ..~-..~..*.'... day of -.~-,~, · ./..c~.. ~ .~.. .......... (stamp or seal) // ANNA W. JACOBS ~/ Notary Public in State of New York No, 52-7057150 Residing in Suffolk County Commission Expires March 30, 1~ Disapproved a/c ............................................................. __ / APPLIC:ATION FOP,, BUILDIN~ P/ERMIT Date.Z ...... ............. INSTRUCTIONS o. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building~ Inspector, with 3 sere 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 streets or areas, and giving a detailed description of layout ofproperty 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 approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in port for any purpose whatever until a Certificate of Occupancy shall have been granted by the B~4ilding 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, buildin code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary ins ~ections. licant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................ ............................................................................................................................................ Name of owner of premises..~...~...~...L....~..Z......~.'......~./..../~.....~./~.../.~'...././~.. ............................................................................... 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 ............................................. Other Trode's License No ............................................... Location of land on whi~,h proposed work will be done. Map No.: ~.. Street and Number .].~..~l'~..~....~.~,...../2,.,.,.~t..~..~... ....................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy /~..~...~.../.~..~.~....~..~.. b. Intended use and occupancy ..../~...~..~'..~...~.~.~-..~.. ....... ...~..Z...E..~...~ ............................................... f 3. Nature of work (check which applicable): New Building .................. Addition .............. Alteration .................. Repair .................. Removal .................. Demolition .................... Other Work ...................................................... 4. x~/7 /"/ / ~ ~ (Description) Estimated Cost ...........~.,.~..~..~...:..~...,r.. .................... Fee ....:.. ................................................................................... (to be paid on filing this application) If dwelling, number of dwel ng un ts /. 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 ..~.,~..~.~...~..~/A(.:. Rear ...~..~.../~..~...~../.../~..:. Depth ....~.6:...E...~: Height ..../..~;..E..Z:~ ..... Number of Stories ............... ~.Z~.~.. ..................................... Dimensions of same structure with alterations or additions: Front ..~..~..~..Z...'...~._/.~..'. ...... Rear .~.-~ .~../.'....~.//¢¢'...'.. Depth ..... .~..~....~ ......... Height ........ LC...E...~.:....Number of Stories ........... ~..,~.4~.. ......... 8. Dimensions of entire new construction: Front ........ ~-~...E./.-:: .......... Rear ...... ~..~.: .~'...Z.-~.'..... Depth .....~.....~....~./--'..:.. Height ..J..~../~..~..~'/,4/~lumber of Stories ................ /. .................................................... ~..2.~.;~_~.:..~.~ 9. Size of lot: Front .......... /..~..~...~....~.~ ......................... Rear ...... /..~..~.....~...~..' ................ Depth ~.~.Y..,~.~.-..~..~..~...~/./?~. 10. Date of Purchase ....~..(,f(./~.Y..../....~./.k¢..~..~ ............... Name of Former OwnerE~.Je/~..~...~....~...(~../../~...T.~...C..~..~... 11. Zone or use district in which premises are situated ................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ~...~.. ................. ~ ...................... 13. Will lot be regradecl .....~..~. .............. Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ~..~..~..~. ~..~...~.'....~/..~...~.~/~'.~. Address C~.~..~.~.~.~...¢¢~E,~.~.~..'~hone No. 7.~..~.:..~.~.~...~.. Name of Architect ../~.~.~..,/.~....r~l..~../~...L/~....~'.~ .~.. ........... Address .~/..~'~..~ .~.~...~/~/..'~.- Phone No. ~..~...7.T..~..[~.~...-' Name of Contractor ..~./..~I[~..~.~..~.....C¢2.~L~..,/~.. .......... Address~.~.A¢-~.¢...~.~..¢..~ .~.'..'~Phone No. ~..~..~.%~...~.~- PLOT DIAGRAM Locate clearly and distinctly all buildings, whether exitting 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 indicc~e whether infesdor or comer lot. ~03.84 T iSTATE OF NEW~YORIC J S S CO~JNTX OF ..~'.~:..~..LJ..~. ....... ~' · ~ ...~...~...~..~..~...~.......~.,.....~/...l~...C'.~...J.l~.../~.. ............. being duly sworn, deposes and says that he is the oppliconI (Name of individual signing controcf) above named,!: -- ;.. He s 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 meke and file this a oil statements contained ir{ this application are true to the best of his knowledge and belief; and ~ thor the work ~ in the manner set forth in the application filed therewith. Swam to b Notary d . I I o