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Home My WebLink About7346-zFO~ ~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's OIEice $outhold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . .S/S..I~idd.],.e .Ro~d ........ Street Map No. x~ ......... Block No .... .~x ....Lot No. ~xX~ .P. ec.onic.. ]~,¥., ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............... ~..un..~... ,~ ~9. ?.~. pursuant to which Building Permit No. ~..h-~[4.. dated ........ .J. un®...20 ....., 197~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .... Fr.i.v~te. ~cces,ory..swim~il~ .pool .wi,th. ~"enc®. & .aecassor~.s.. The certificate is issued to ,.. LOlXls..&, Ar~,a. ~lter. a ....v~ers ............. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval l~,t~, ............................... UNDERWRITERS CERTIFICATE No. N..~.~8~0. .... .Q~t.. ~ .... J.9?l.~ ............. HOUSE NUMBER ..... ~ .~. ~.0... Street ..... ~I~..c~d..l.e..~(~I... (.C.~..7.) .............. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7346 Z Date ..................... ,]":~u~.....2O ................ , 1 gr~.j~ ..... Permission is hereby granted to: ~J,~;~'L~:...~,!~..J.).g.g:$~...~.~CL.....~/..q...~.9.~..~...~..A~ '~:L't-~:: .~: ....... 2. Sg,..~.a~...L~ ................................................ ............ g.~..o.!.~,.o.~;~ .............................................. at premises located at ~,'/~;~-"~'fi~e'",['t~.'~'""~(](~]~"~') ..................................................................... ..................................................... ~.~.comi~.... ~..~. ............................................................................... pursuant to application doted ........... ! ............. .~DI~,~,~......'J.C~ .......... ~., 19.~1'..., and approved Dy the Building Inspector. Fee $..~.~,120 ........... Building Insp~/e~tor t ............. FORM NO. 8 TOWH O!~ SOUTHOLD Building Depnetment 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: I. Final survey of praperty with accurate location of all buildings, property lines, streets, an6 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, Industria~ 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 $5.00 3. Copy of certificate of occupancy $1.00 p?. Date ~./. ........ ~/.~..~.. New ~ildi~g~'~ ..... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..................................................................................................................................... ' Owner Or Owners Of Property .. ../...;~'...:.. ./.-" .... Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit Dote Of Permit ............. .................................................................. Health Dept. Approval ................................. i .......... Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fin~ Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permit meets all applicable codes and regulations. Sworn to before me .......... l ..... day of ...... Notary Public ........ Applicant ......................................................................................................... County (stamp or seal) :V, ACH/£J~OW/£Z ~ / ,/ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRIcrr~., ~ '., ~ ~ ' 85 JOHN STREET, NEW YORK. NEW-~ .IO038 3, 197, :q..'. N 185810 THIS CERTSFIES THAT only the ~trlc~ eq~iltm~t ~ describ~d b~o~ a~]j~troduc~d by. the ~ ~w~ed ~n tJw ~ apRlica~ion number fA tAe premises o~ .L,OUXS WaJ.1;s~'eo ~[o~t~e ~TA, e/o Caz'z'ox ,'~d.~. FeGor~,o~. L,.To inthefollowin~loeotlon;~ 8~.,,,.,.[] z... [] =nd ~. out,tide ~eetion 8loek ~ ~o.~i~o. Sept~ember, 30. 197q and found to be ln corapl~nce with the requirements of thiz ~oard. OTHER APPARATUS: Panelboard/s: 1-2ci~'. 70amps. EXHAUST FANS A~t,~ WATTS (Swimsning Pool) ~his oertifioate oovers compliance at the date of in~pe~ion only. Beaauae o~ ~nus~l envir~mem~ ~t is advisable ~o ~ave ~requent ~est and/or ~epal~s made b~ a qualified person, Olenn R. B~ad le7, Ho~ton Ave. ~ Hattlt~uok, L.I. 11952 11 COPY FOR THIS COPY OF NOT BE ALTERED IN ANY MANNER.. · ~ FOII, M NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN C;LERK'$ OFFICE ..~..,~ SOUTHOLD, N. Y. E×am ned, ..... ................ ]9 ...... ~ Pe~mff ~o ..................................... Approved .~ ............:.[ ...... ~ ...... , ?( 7 ~ z/6 7~ Disapproved a/c ~~,.~...~:~.:.~.~ ...... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ in ink and submitted in triplicate to the Building Inspector, with 3 sets 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 port 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 part 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 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, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) 250 COx [Lane,, Cu'l:ehoi~ue, (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................... L~.$..~ r~.e.. ~ ......................................................................................................................................................... Nome of owner of premises ~{.~.u.i,t~, .~nz/. ~'~.nn.a...~.~,],.i;~m.-v$. ................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and tide 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. Map No,: ......... ~.~[) ......................... Lot No ......................... Street and Number .C.~.~2.Z.~i~..~:~.b.~d.-.~`~ert~...~d~`~.~`~$~ ...................................... Municipality 2. 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 ........ f.~.~y.~,lp..~.,t;~.~...~:.t.~f,...1. ......................................................................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................... Other Work Swt~l~tt~aJ (Description) / 4, Estimated Cost ...........' ................................................. tee .......................................................................... (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 of entire new construction: Front 3')' Rear ............................ Depth Height .................... Number of Storie~ ...................................................................................................................... 9. Size of lot: Front ......... !.!!.0.'~ ...................................... Rear I00.~ Depth .....l..O...0. 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ A 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... .N...o. ............................................. 13. Will lot be regraded . ....... .N,.o. ............... Will excess fill be removed from premises: ~; ) Yes ( ) No L. t,, A, ~,;'aZt;or~ Address!:.e..c...o..n...l,.o..~...N..,.Z.*..,.* 14. Name of Owner of premises .................................................... Phone No Neme of Architect .............................................................. Address ................................ Phone No ....................... f, kinny ~'ool~ ~ Inc. r . . Addresst.:.~..e..n...o.~.u..~.*.~l:.l:Phone No ....................... Name of ~onTroctor ............................................................ 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 t c S COUNTY OF ....?.~,~.'.d.~..~. ........... f-,. G~or,~.o Ahle~'~ bein duly sworn, deposes and says that he is the applicant (Name of individual signing contract') above named. ~ut 1der He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of sold owner or owners, and is duly authorized to perform or have performed the said work and to make and file this appUcation; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be perform,e~ in the manner set forth in the application filed therewith. Sworn to before me this [ / g c c ~ ' .............. ....... ...... t . C_J Notory Pub,c .ty ..................... .............. .............................. ~ (Sig(l:Jature of applicant) No. 52.0344963 ~ Commission Expires March 30, 1~-~-- TRA~£D ~y ~ DAT-,ZT~ LOUI,9 d. ~ ANhlA H. YVALTE,P$