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Home My WebLink About6746-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..~.723.0. ..... Date ............. Sel~...10 ..... , 19. ~.6 THIS CERTIFIES that the building located at ...K..x~.~.s.e...ll.o.a.~. ............ Street Map No... ~ ....... Block No....x~X. ...... Lot No .... ~ .... .!~. ~.t.i..t..l~k.....N.,.Y. ? ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. July. 22, 19.73. pursuant to which Building Permit No. ~71~,. dated .......... .July... 2~., 19.72, 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~va.~$...o~1..f.~t...~X .d..v.~.l.~,:~[. Y.i.~;h. ~ .a.d.d.i.~..~.o.~. .................. The certificate is issued to ...~.~.1.1.~..~.. ~..t~..1~.. 0.1'9..1~. e~' ..... . .(~..e.r.l~ ................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N $11~ ................................ UNDERWRITERS CERTIFICATE No..][~21~ ..... lion...~...¶~ .............. HOUSE NUMBER ..... 37.~. ..... Street .. K?a.~.~.~..R..o.~.~. ....... .~..~i.~..~.~.k. ........ Building Insp~tor FO,B3( NO, ~B TOWN OF SO4~THOLD BUILDIN~ DEPARTML~IT TOWN CLERK'S oPlqcE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT O1'4 THE Pl~EMISES UNTIL FULL CC~pLE'I'ION OF THE WORK ^UTHORIZED) 6746 Z Permission is hereby granted to: .~L ~,l,~,e~..~=.~....~er~.ea .................. .................... ,~,.t.~;Ll~u~.....~. ............................... ~o ~.~l~Cl..~l~..ac~dt~:~nr~..~n ..~$~t frog.. A~ ~r~.., ............................................................. at premises located at ...~.3....Jf~s..~Oa~....~.9.~[~ .................................................................. .............................................. ~t,t &~,u~k ......... 3l ..~.. ......................................................................... pursuant* to application dated ...................... ~U~.~ ....... 2.~ ........... , 19..~._~.., and approved by the Building Inspector. .. J FORM NO. ~ TOWN OF $OUTHOLD Building Department 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: 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), 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 // Date .....~./..~. ,.~...~...~.. ~ .~. · ..................... New Building .................... Old or Pre-existing EL~Hding ..... ~ .................. ~yacant Land ............................ Location Of Property ~- .-.~..7~ ~_, .j ..~..-~-~/.....~,..~....~,..~ t. ~./ .~.~...~)..- ~ Subdivision ................................................................ Lot No(/ ............. Block No ............. Hou~se No.~..~..~...~. Permit No. ~...~....'.~...~......'2".... Date Of Permit ..7 ./.,"?..'~../Z,.~...Applicant ..~...~.~ Health ~pt. Approval ............................................ Labor I~pt. Approval ................................................ Underwriters Approval .......... ...t:~... .............................. Planning Bo~rd Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ........ ~ .......................... Fee Submitted $ .........~.~..:...0..?.. ......... ~ t ~ "[,~z~/"~_,,R Construction on above described building anc~permit meets all appligable codes and regulations. Applicant' .i~....~........~~i ................................ Sworn to ,before me this _ . ~/ o~.~ ~.~ ~ ~ ....: .... ' ,' .....~ ~y~ (stamp or seal) ~, ~/ HE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK. NEW YORK 10038 THIS CERTIFIES THAT ~r. & Mrs. W. Orenler, n/side Kruss Rd., 295' e/o Old Jule Rd., Mattituck~ L. I. in the followlng locatlon; ~ Basement [~ lst FI. [] 2nd FI. out;side Section Block Lot was examined on ~ovember 1~I ].973 .nd found to be in compllance wlth the requirernents of thls Eoard. RXTURE FIXTURES RANGES OVENS DISHWASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 4 DRYERS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET E R V I C NO. OF CC. COreD. A.W.G. t40. OF HI-I.~G A.W.G, NO. OF NEUTRALS A.W.G. OTHER APPARATUS: W'arne~~ Eleet~i~ 194 Woodlawn Ave. St.James, L.I. 117[~0 Per COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NoT BE ALTERED IN ANY MANNER. _ . .......................... ................ ~s~u~s *. This e~i~tion mu~ 3 ~ of b. Plot pl~ showing I~tion of lot ~nd of bui~d~ on premiss, relationship giving ~ e. T~ ~ ~red ~ t~s ~lJ~tion m~y not ~ ~m~nmd ~m i~u~ of Buildi~ ~rmit. d. U~n l~ovel of ~his ~li~tion, t~ premi~ ~eileble for ins~ion throu~out ~he wo~. e. No ~ildi~ s~ll ~an~ by the Building Ins~or. / - ~PPLICATI~ IS HEREBY MADE to the Building ~pan~nt for t~ issuanm of a Buildi~ ~it ~t to ~ Bulldi~ Z~ ur~an~ of building, ~dit~s o~inan~s, building ..... ~i;.;.~.g;;i; ~.~ ......... (Addm~ of a~li~n/) .State w/I,l,l~ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ., ~;1~;' of owner If applicant is a corpor~m, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................................................... Plumber's License No ......................................................... Electrician's License No ..................................................... Other Trade's License No ................................................... 1. Location of land on which proposed work will be done~ MaD No .............................................. Lot No .................... - ::: .......................... Streetand Number .... ~ ~':" :' .................. ' ........ ""~uniciPality 37_5' 2.State existing use and occupancy of p,,r~emises and intended use and. occ, upancY of proposed construction: a. Fxistir~l use and O~Ul~nCy .............................................................................. b. Intended use and o~upancy .... ~ .......... :.~ ..............................~ .............................................................. 3. - NatO~ §f'~vork (check which applicable): New Building ....................... Addition ..................... AlteYation ............... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) 4. Estimated COst ...,....,~.~./~..~X ............................. Fee . ./...~......~ O_~a, , . . · ,A (to be paid on filing this application) : 5. If dwelling, number of dwelling Units.~/.-~. Number of dwelling units on each floor ......................................... If garage, 6umber of cars ...~.. .............. ~ ........ .u. ................................................................................. ~ ........................ 6. If business, commercial or mixed occuoancv, specify' nature and extent of each type of use .' .............................. 7. DimensionS of ex,sting structures, if any: Front ..... ~..'~.....; ..... Rear ..... ..-]...~. ............... Depth ..'~..f. ........................ Height ................ /..~. ...................................... .Nufl~ber of Stor es ......... ./. .................................................................. Dimensions of same structure with alterations or additions: Front ......... ~..~.. ........... Rear ......... .7..~. .................... Depth .....,i....~..~..'. .......................... Height ....~...~.~.. ........................... Number of Stories ...... /. ................................ · o r . · ......../e ........ Rear ......... /...7..[..~.......,. Depth. ?,...0.' 8. D~mens~ons of ent.re new construction: Front /..~' Height ............. /..(e. .............................. Number of Stories ..F...../. .............................................. ' .................... 9. Size of lot. Front ......... J.~.~ ..................... Rear ........ L.O..O.. ........................ Depth ...L.~.~.. ..................................... 10. Date of Purchase ......... ./.~.~.~.~ ...... ., ........ Name of Former Owner .~..~J~...~ .......................... 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 re,reded ................ ._..,...~.~...: ..... WilJ~excas~,fill be removed from prer~i~es. :~ ]~) [ ] No-- 14. Name of Owner of premises .~,~,~.~v~....~...:..~.../~~.~.....~....~..~..~" (Address) · (Phone No.) Name of Architect .......................................... : ....................................................................... {Addr.~) .............. iPho~ NoJ - ' Name of Contractor .................................................................................................................... (Address) i~l~'i~:i' ............. PLOT DIAG RAM Locate c~.l~rly and. distinctly all buildings, wh.eth?r existing or proposed, and indicate all sat-back dimen$iom from property lines. Uive street and block number or descr pt on according to deed, and show street names and tnd cate wheth- er interior or corner lot. ............... ~'~:~-~'~-'~_ .'~:~' ~..~,~...~-..~-..~-.,.~ ....... being duly sworn, deposes and says that he is the applicant above named. {N~tme o£ individual signing contract/ ................. He is the .............................~..~....~...~...~.... .... . . (Contractor, agent, corporate o£17cer, 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 apldi~afion are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the applii:~fion filed therewith. .. . TERRI LEE ELAK ....... ............. , / _ .S'c ~,L ~: 40; I" MON; E]