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Home My WebLink About7424-zTOWN OF SOUTHOLD BUff.BIN(; DEPARTME. NT Town Clerk's Office Southold, BI. Y. Certificate Of Occupancy BIo. ~T~10~jt. ..... Date ............/Jept...~ ....... , 19. THIS CERTIFIES that the building located at., .~hl]~m. D~$,e~.. '!' Street Map No. B&~®¥. lioo~ck No ........... Lot No...1.8 ..... 8~tttholdi .............. conforms substantially to the Application for Building Permit heretofore t~led in this office dated ..........Jtal/...16.., 19.7~. pursuant to which Building Permit No.. dated ............ Ju.l~.....~.~., 19.. ~ was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which ~ certificate is issued is . Pr&,e&te .~a~g. t~oo].. ~rlth. &eeem~t*ym. &. f®~ ................. ) ~~The certificate is issued to . .Grqory..P. ov~v ·.. lb, m®l, ............................. ,. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... ~,R, ...... /. .................... UNDERWRITERS CERTIFICATE No..]i..1'.~1~78 ...... AII~.. 23...1.9'~;b, ............ HOUSE NUMBER . .$1~?.~. ....... Street ... ~tl~Ll~.m. DI'&Ve..,. ..................... TOWN OF SOUTHOLD BUILMNG I)EI~ARTMm4'r CLERIC'S ol~qCE SOU*KHOLD, K Y. (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7424 Z Permission is hereby granted to: Sk&n~..~i~..Pe~s..~M....~C.-Glmiox~y-- Po~ex, .................. C~&t,~o&~m~ ........................................ at pmmMs ~med ~t ..~mt..~.....L .~...~.....~v..:~o~Ls..~t~ ................................................ pursuant to appl{cationdated ........................... ~]:~. ....... t6 ....... 19.r~.., and approved by the Bui~lJrlg In~ector. APPUCATION FOR BUILDING PERMIT INS I KUCTIC)IqS in~.toT~r, iS~a,~c.~.~ion_~m_~_e~. ,y?l!ed !n by .typ~_writer or..in ink and submitted in triplicate to the Building. -,--- , ..... ~ ~., v, p.,,~ ~ ~.m pmn m ~cam. Pet aoccadl to uJe v b Pi ~ ., ng ~ . ~ · ot plan showtng location of lot 'and of buildings on premises, relationship to ~djoir~ing premises or public streets o~ I~ areas, and giving a detoiled description of layout ofproperty must be drown on the diogram which is I~rt of this ~10plication. c. The work covered by thia a~!icgtion ~.3y not be c .o[13F3~edbefgre issuance of Bu Id ng Permit. d. Upon approval of this ~PPli~ation, the Building Insp~tOr will ia a BUilding i~ermit to the opplicant. Such permit~b~ shall be kept on the premises owiloble for inspection throughout the work. shalle' haveN° buildingbeen grantedShall bybe the°CCupiedBuilding°r usedlnspector.in whole or in I~rt for any purpose whotever until a Certificate of Occupancy .,a luwr! U[ ..~X~JTrlOla, ;:)UTTOIK ~.OUFITy, I~IOW YOLK, a~a omer applicable Laws, Ordinances or admit author zed in,hectors on ,,remises ~ .'- ~-..'t~'--'--°rz-a-lr~--n~-es' outi.alng...c~e, J,z)usmg caoe, and ee~Ulatmns, and to Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. zP =c ..... ....... ......... ., ........................................... (Signature of applicant, or name, if o corpomt on) (Address of applicant) State whether applicant is owner, lessee, agent, arctdt~ee~engineer, general contractor, electrician, plumber or builder. ................... ]Bt~.,L~t o;r. .............................................................................................................................................................. Name of owner of premises ..~"lA~t~'...~",w~S: ....................................... If applicant is a corporate, signature of duly authorized officer. Location of land on which propos~__d, lWOrk will be done. Map No.: ............ /~ ............... No ......................... Street and Number ..~kJL~t.!~..~Kt,t. ILe. e,..~.O.~;JlLe],4e..~ii.W..~ ................. i ................. i....i...i ...... : ........ - Municlpahty State existing use and occupancy of promises and intended use and occupancy of p~ construction: a. Exisiting use and occupancy ..~'~'~ .................................................................................................... b. Intended use and occupancy - ~'.. ,,.13aILL .~.1 .('/'/--' ~'~ % " ' 3. Na~ur~'~f~work (check which applicable): New Building.. ................. Addition .................. Alteration ........... Repair .................. Removal .................. Demolition .................... Other Work ,.az~,~.:l,~.,~te~.;L.~r ......... :~: ...... c;rO (Description) 4. Estimated Cost ............................................................ Fee ./.~.......~ ....................... ~ ........................................... (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: Fra~t ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... 3~ ........... ~i ..... Rear ....~.~J~ ................. Depth ...S0. ............... Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ..~,~.~.~.~l.J, ........................................ Rear ............. .]'.~.0..e..~.. ................. Depth ..~.~.*..~?.. ............... 10~ Date of Purchase ..~ ........ :~...::.~. ................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are sit~uated ..... ~ ............................................................................................. 12. Does proposed construction violate any zoning law, ordihance or regulation: .... .~..~. ............................................... 13. Will lot be regraded ...... lee ................. will excess ~'ill be removed f:cl;~n premises: ( ) Yes (~) No 14. Name of Owner of premises(~tl~a~l~e~.1..~.e.We't": ............ L,,.. Address ~ea~,ls&:/,a ............. Phone No. ...................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ~.k:l.~l~3r...~l, lL~.e.ell.ae....[.l&{~, ....... Address .C..~.~.9.~.~%.q.9. .......... Phone No. ...................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beak dimensions from property lines. Give street and block number or description according to deed, end show street names and indicate whether interior or corner lot. STATE OF NEW YORK, i S S COUNTY OF ~[a~.~e.l, lc ...............f ' ................... ~ele~e~.~/~,3.el~, ......... .................................... be ng duly sw~r?, depo,ses.and says that he is the applicom (Name of individual signing contract)'''~) , " ; ' ~ ...... : above named. He is the'. ....... ]~t~.Zd®~ ........................................................ (Contractor, age, t, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make end file th s application; that all statements contained in this application arq true to, the best of his knowledge end belief; end that the work will be performed/l¥~ the mann~£~et :fo'bib rib fl~d appllccition filed therewith. Swam to before me this / / ,~ .............. z....7. ....... ................ . Notary Public~ ,,~,~'~~ .............. Count7 .......................... ~ .................................................. ~c'~ ~ ~'~t'/ ~-~ ' (Signa~re of applicant) FOlt~ NO. 6 TOWN OF SOUTHOLD 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 end 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 Newi~K~ing~]~J~'~-.,,A~n Old or Pre ex st n Bu dn O ner Or O ners Of Property Health Dept. Approval ....... .~....'.....T~... ....................... Labor Dept. Approval ................................................ Request For Temporary Certificate ....... ~. ........ :. ...... : .... Final Certificate ........ .~....;; ............... Fee Submitted $ 5 ~ Constructiononabovedescribedbuildingandper~meetsallappl'.j~ble~nd.~/j~,~ ~1~-~ regulations. Sworn to before me this · THE NEW YORK BOARD OF FIRE UNDERWRITERS P.-k BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~,,.e ^u~u~t 23, 1974 ~ppl,~,~n~o. onS, l~ ?~l~ N 178478 THIS CERTIFIES THAT only the electrical equipment as described below and introduced b~ the ~ppl~cant nartzed on the above application number in the premises of Ore~orW, Power· Ships Drive, ~out,~old, I,.I. in the fotlowing location; [~ Basement [] lst FI. [] £nd Fi, outside s~ctlo, slo~ ~ot was examined on ~ Ll ~aS t 19 , 19 711 and found to be in compliance with the requirements of this Board. FIXTURE r ~R .~ FIXTURES OUTLETS ECEPTACLES SWITC S INCANOESC T FLUORESCENT ~VEA~RR¥ DRYERS FURNACE MOTORS FUTURE APFUANCE FEEDERS AMT K.W. OIL H.P. GAS H.P. A~T. NO. A.W.O. RANGES SPECIAL REC'PT. 1 2O ICOOKING DECKS OVENS DISH WASHERS TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET SERVICE DISCONNECT NO. OF S E R V I C EXHAUST FANS DIMMERS A.W.G. NO. OF HI-LEG A.W.G, NO. OF NEUTRALS A.W.G OF CC. COND. OF HI.LEG OF NEUTRAL (Swimmin~ Pool) This certificate covers compliance at the date of inspection r~nl¥. Because of unusual environr~ents it is advisable to have frequent test and/or repairs made by a qualified person. ~,letm R. Bradley· .~{orto~~, RVO. · ~attituck, L.~. 1195~ GENERAL MANAGER Per ,. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER.