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Home My WebLink About7387-zNO. ,I TOWN OF SOUTHOLD BUILBING DEPARTM~,NT Town Clerk's Office $outbold, N. Y. Certifi te Of Occupency ............ Date ............................ , THIS CERTIFIES that the bui]din~ located at / I..E'E ~JP,~ ,~__~,r~...~ ............................ t Map No....~..~. ?..~... Block No. -- ...Lot No...~.7. ............................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ~' ~JUL'( 1977.. pursuant to which g erml~ ~o ......... ...................... , Buildin P .--- dated ~"JUL '1' , 1~.~' was issued, and conforms to all of the require. ments of the applicable provisions of the law. The occupancy for which tht~ certificate is issuedis ,A ~lqE Frei'4 tcN' ~E LL The certificate is issued to ~UPl L -F/~ l-~ ~ (owner, lessee or tenant) of the a~oresaid building. Suffolk County Department of Health ap~ro,~, .......... .) .............. ~ ......... UNDERWRITERS CERTIFICATE No. "~. t,t HOUSE NUMBER la~---5 Street k~-£ ~/A~ ~'k:~/K .. .~Ou T Building Inspector ~ ~ APIJMCATION FOR BUILDI'~IG FEIIMIT '~'',~.%~ ~.1' ¥, ...................... INST~IONS a. ~is ~licati~ m~t ~ completely fill~ in ~ ~writer ~ in ink a~ s~mi~ in tripl~e to ~e Buildi~ .r~s, and fivi~ a d~all~ d~ripti~ of I~uf of~ must ~ drawn on the diagram which is ~ ~ this aDli~tim. ~. ~ cover~ by th~ a~lic~on ~y ~ ~ c~ ~for~,i.~f~J~g Pemit. e. No buildi~ shall be ~cupi~ or ~ in whole or in pa~ for any pu~e whoever until a Ce~ific~ ~ ~c~n~ ~all have ~en gmnt~ by the Building Insp~tor. APPLI~TION IS HEREBY ~DE to the BuJ~J~ ~ment ~r ~e i,~e of a Buildi~ Pe~it ~nt to t~ Building Zone Ordinate of the T~n of ~t~l~ ~ffolk Count, New Yo~, and other applic~le ~, 0~1~, or Regulatiom, for the co~t~ti~ of buildi~s, ~ti~or al~s, or for m~al or de~liti~, ~ ~i~ ~ri~. ~e applicant agre~ to c~ply with all ~lic~e I~i~, building c~, h~si~ c~e, a~ ~lah~s, a~ to admit authoriz~ in~ecto~ ~ premiss a~ in juildi~r n~,a~ inactions. .... ....... ................... . ~-. ~g~Um~ of ~plicant,, or ~me, if a co,mt on) . __..-.~-~-.~ ...........~ ~..~] ........ ~....~.....~ ............ .l.y~.~..~ State whe~er applicant is o~er, Ieee, agent, ~-~; ~ ~ ~ e~~Z~ ~,~*~mctor, d~trician, plumber or builder. ..... ~......~ ............................ ~.~.....~.~.~.~...~.~, ............................................................................. ~m, o~ ~,r o~ p,~,, .~.~.~....~.~.~.~.~.....~....~.. ~ ........................................................... If ~t ~ ~o~omte, signature of duly a~oriz~ of Rcer. (Name and t~tle or co~oraFe office~l Plumber's License No ............................. ;: ................ :.~ Electrician's License No ............................................. Other Tmde's License No ............................................... Location of land on which proposed work will be clone Map No.: ...~..-, ............ ~; ........... ~. Lot No · ..~....~. '.;.~.. · '_ ~ . r .~', .... '.g':.~".~..~,";'" Street and Number .~.l~.~.l~.....~lk~J~.~..,~. ................ ~'J'~....~?...~..l~.i.~..~.. ,....; ............................. : .......... Municipality State existing use and occupancy of pmm~se~ ~]r~.~ i~t~e~de~. ~r~e/~ncy of proposed construction: a. Exisiting use and occupancy ...................................................................................... ; ......................................... b. Intended use and occupancy .....~.....~...~........F..~....~...~..~..~........~.....~'..~.~.~..~...~. ................................................... 3: Nature'of work (check which aPplic~able): New Buitding ;.~: .... Addition .................. Alteration ................ ; Repair .................. Removal .................. Demolition .................... Other Work ...................................................... (Description) ' ' 4. Estimated Cost ........... .~ ......................................... Fee .............................................. J . : (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 ........ /.......~...?...~. i ......................................... 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 ......... 7 ......... · 8. Dimensions of e~tire new construction: Front ......... ~..~.. ............. Rear ...~...~ ............. Depth .~.~...~.~... ........ ........ ':': ........... ........... o*.**.: ............. whether interior or corner lot. 1 1. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....~Jl~ ............................................ 13. Will lot be regraded ............................. Will excess fill 'be removed from premises: ( ) Yes (;X~ No 14. Name of Owner of premisest~l~/~'~l~.t~....~...~..~..~. ........... Address J~llll¥~.....-~...~ Phone No. ~..,..~...~. ~ Name of Architect .............................................................. Address ................................ Phone No ..................... ~. ~:~ ' Name of Contractor F~.?...~.l;t~.~....~e..~.~.~.....lld.~,... Address .~,~e.~.~l~e.k~J~ ....... Phone No../~....~..'.~....~... i:/ PLOT DIAGRAM Locate clearly, and distinctly all buildings, whether existing or proposed, and indicate a set-beck 'dimensions from property lines. GiVe street and block number or description accardin to deed, and show street names and indicate STATE OF NEW YORK, [cc above named. (Contractor, agent, corporate-officer, etc.) of said owner or owners; and is duly authorized to perform or have performed the said'~vork and to make end file this application; that ali stateme~s~g~bi~his al~b[jcla~el~'~.re taa~',the best of his knowledge and belief; and that the wo~k will I~;l~erformed in the manner set f6rth in'the application filed therewith Swam to before me this ' . (Signature of al~'plicant) TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL CONtPLETION OF THE WORK AUTHORIZED) N? 7387 Z Permission is hereby granted to: Founder. a .~..Izm ....A~.~,..~aLter.. ~ ..l~atrLe Sa Coutt~ .......... aottt, l~u.l~ .....~ ............................................ at premises located at ...[,~.te..~. ....... ~ti't~T~.~...~g~.~. .................................................................... ..................................................... ~..e.~..~r.~v.~ ......... ...~.~ut&.~.~ .......................... : ...... pursuant to application dated .........................ethiC. ....... J~ ........... , 19.~..., and approved by the Building Inspector. BUilding Inspector FORM NO. 6 TOWN OF $OUTHOLD Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions/ A. This application must be filled in typewriter OR ink, and subrrJitted 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 lin~s, streets,~and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or e~ual). 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-ex'st'ng 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 occupency $1.00 Date ..... New Building ......~... ..... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ...~..~...T........,~...~....T....~.J~..~'....~....~.Q ....... /.-.).G,.I~..,~ ................................................... Owner Or Owners Of Property .~..0..~..~'~..~.:~'...~...~...~.......~....~....~¢....I-i~......S~.. ......................................................... Subdivision ...L~...~.~..~,.,,~..~...o. ...... J~.~-.t~,~.,~ .............. Lot No..~.,r7. ..... Block No ............. House No./...~....~...-- Perm t No...~...'~....~....'7.. ..... Date Of Permit~/~..~..~.~...~..Applicant .~..~...~....~'.~..~.~...../(-~../~.....~.~...~.~.~.~ ..... Health Dept. Approval ..O....~':..~-..~..~v,..~..~'..?..~.. ............. Labor Dept. Approval Underwriters Approval ~..~...~...0..~..~..~ ........................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ....~ ............................ Fee Submitted $ ........~.. ........................ Construction on above described building and permit meets all applicable codes and regulations. Sworn to be{ore me this ~}'~'"~'~'~~ · ................ day of ............................................ Notary Public .................................... County (stamp or seal) 9 07 THE NEW YORK BOARD OF FIRE' UNDERWRITERS BUREAU O~ ELECTR!G.~I~ff l-- ~,ab 85 JOHN STREET. NEW YORK, NEll"YORK ~o~.. ~. ~7~ ~,~0,~.~o.o.~,~ ~0~0.' -~ '- N 189415 THIS CE~IFIES THAT ~, C~tts, ~eward ~lve, 3outhold, int~efollo~ingl~at~fl; ~ S~ement ~ lstFl. ~ ;nd Fl. Outside ~tion S~k ~t RXTU~ RX~ RA~ ~NS EXHA~T FANS OUTLETS SWITCHES FLUORESCENT 23 ~1 29 23 TIME g~)CKs MULTI. OUTLET DIMMERS SYSTEMS SERV~ DISCONNEC'r S E R · V- i; C OTHER APPARATUS: 1 2/0 1 2/O EPurnaoe/at 011, 1-1/Shp 2-1/12hp l~otor/s! 1-1 1/2bp Charles M. Hall Box ~17 ~outhold, L.I. 11971 WA L T L- X LOT · /AAF oF- ¢ ~ATR !C lax SOUTI.IOLb b NOT/--: FRO~L-XTY COL!TT':5 5CA L & - 50'= 1" ./ 4'/,.~.~ APPI~YEJ:) AS NOTED DATE:, /~L~ (~ 7K NOTIFY BUILDING DEPARTMENT t I 765-2660 9AM TO 4PM FOP, REQ~I[-'- kD iNSPECTIONS: 1, BEFORE BACKFILLING POUNDA. lION OR START FRA~vlNG ~.. BEFORE COVERING PIP~;LIN~- 3. FINAL WHEN JOB COMPLETED NOT RESPONSIBLE FOR DESIGN OR CON- STRUCTION ERRORS