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Home My WebLink About7282-zreNO. 4 TOWN OF SOUTHOLD BUII.r~lNG DEPARTMENT Town Cle~k'~ $omhold, N. Y. Certificate Of Occupancy No..a6728 ..... Date ..............0CZ....3 ...... ,19..7.~ THIS CEI~TIFIES th~ the bugding located at . .Hickqry. Ave ............. Street Map No. 6o.o. Se. ,~y. l~ck No ........... Lot No..~9-. 62 .... 3.~Utl~lCl.. ~,~, ..... conforms substantially to the Application for Building Permit heretofore filed in thi~ office dated ............¥~... 2.~.., 19.7~-. pursuant to which BuiMing Permit No. dated ............. .F-.~If.. ~-.~., 197.I+. ., wa~ issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is ~sued i.~ . Pr. ira fa. one..faml.ty, d~e i 1 ing. ~ i tk add i.tior~ ..................... The certificate is Lssued to .. Frankly~. ~a~ser. ~ .Wif~ .... Ownar$ ................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .~ ~R, .............................. UNDNEWEITNES CERTIFZCATE No. I~.~2.t88 ..... Feb..6...1.97~- .................. HOUSe. NUMB~.E ...... .?.?~' .... Street ..... ~;tPXqr3r. A~re ........................ Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N', Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP. EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7282 Z Date ............................. ~. .........~,9 ...... 19~1~... Permission is hereby granted to: at premises located at ...~.~lL.~l~....~(~l~'QIk~-.J~,~'..Jit~.t4tJ ................................................... ......... ::*~ ........ , ............................ ~Le~.e;17..~...P.;L~e...AYe ............... ~o.u.tJ~QI~L ................................... pursuant to application dated ............................. ~]r.....~)l~ ......... , 1~....., and approved by the B,uilding Inspector. Fee ~..~.. ~..~. ............. ~D, N. Y. Examined ..... ~Z.~.~.., 19..?Z Application No..'~..~..~...(/~ .... ,, ..... ....... · .................. Approved ................................... ~...., No. Disapproved a/c ...........~~ APPLICATION FOR BUILDING PERMIT ~ .................. . a. This application must be completely filled in by typewriter o~. in ink and submitted in triplicate to the Buildlng~ Inspector, with 3 sete of plato, accurate plot plan to ecale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjo:mng premises or public streets areas, and giving o detalleddescriptJon of layout ofpmperty must be drawn on the diagram which is part of this applicotion.,.~ 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 C~unty~:g~cYork, and other applic.able Laws, Ordinances or Regulations, for the construction of buildings, additions or altera, t~s, or 'fgr removal or demolit~on, as herein described. The applicant agrees to comply with .all applicable laws, ordinances, bulldl~l code, hou ng code, and regulations, and to admit auth°rized inspect°rs on Prem'ses and ir~ bulldings f°r r~d~'~es~-a'-,,,,~,i~ (Signature of' appli or name, if a corporation) of applicont) '. oL State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · ....~.. ~...~c ' . .. . .................................... ,. ..... I{ oppllcont is o corporate, signature of duly authori~'ed officer. Builder's /ic~se No ..................................................... Plumber's License No ................................................. El~trlcion'~ License No ............................................. Other Trade's License No ............................................... Location of land on whic.h praposed work will be done. Map No.: ..I.J..~./~ ........................... Lot No. 6%~...,.~.1.,/~ MunicippIIty State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ........ .~...~.l~,~'~'~.e,-g~ .............. ~ ............................................................................ ~ature of work (check which applicable): New Building ...:; .............. Addition ....~... .......... Alteration Repair .................. Removal .................. Demolition .................... Other Work ....................................... .~~ (Description) 4, Estimated Cost'l(....'"~.,.t..O...(~)..~...! .................. ~..... ............ Fe~.J.s~.:.0..~. ............................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ....~ ..................... Number of dwelling units on each flooF 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 ........ .a..~..~.~...~ ...... Depth .......~.1~,;.~.-.'~ , _1_ Height ...... ~L~...~T:t' ...... Number of Stories ....... ~...~ ....................................... ~ ......................................... Dimensions of same structure with alterations or additions: Front ...~..~....~ ..................... Rear ....~...~..~.~-~f. ......... · ' , ...... ~....~..'. ...... Numb,er of Stories ...~.~., ..................... Depth ......... l....~.~..~ .......... Height 8. Dimensions of entire new construction: Front .&~'~Jt....~.O~......~':~f.:... Rear ~'g~.~...b~..~.~.7..:. Depth~..~.....B. nd....~.~J', Height ....~.~...~...~.:.... Number of Stories ......... .I...~ ..................................................................................................... t ! ! 9. Size of lot: Front ..... .~_.~....~..~.O .................................... Rear ...l~Tt~.O. ........................... Depth u.~.~.~.Q ................. 10. Date of Purchase ..I...,~..l.~..I.~.t~ ............. ~ ................... Name of Fprmer Owner P,~.Xp,..~..v~'.....~...~j,~. ................ 11. Zone or use district in'~hich premises are situated ...... ~..~.~S.C~.~.l..q~... ...............................................................~ 1:~. Does proposed construction violate any zoning law, ordinance or regulation: ....'~G ............................................. 13, ' Will lot be regraded ..~...¢~ ................... Will excess fill be removed from premises: (~' Yes ( ) No 14. Name of Owner of premises ...~'..~L.~.~.~...~.K%~'..~...~.. ......... Address .),.. N0. ']~.Z.I.~...~. Name of Architect ................... ~ ................................... Address ................................ Phone No.....-~... ............... Name of COntractor .~.~e,~ ........ .~L~.l~kO.~.C) .............Address .O..g~PJ~..t...~...~. Phone No. PLOT DIAGRAM Locate cleaHy and distinctly all buildings, whether existing or propased, and indicate all set-bock dimensions from property lines. Give street and block number or description according to deed, and sh°w street names and Indicate whether interior or comer lot. STATE OF NE-'gV ~ORK .... -' ~ ¢ c COUNTY OF .... :5'.V.~.~....~~'~ ....... ~.-..~..~..~. !.~..~,.% .~ ....~.: .......t~.....°x.....V~,J..~..~.. · .......................... being duly (Nar~e of individual signing contracf) above named, sworn, deposes and says that he is the applicant He is 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 make and file this application; that all statements contained in this applicotion~j3r~-4,rue to the bes~Lof his knowledge and belief; and thoz the work will be performed in the manner set forth in the c~icatJor) filed therew~h Swam to before me this . / ~ / - ~ · · ......... ........ ........................... . _ Notary Public, ....... ~.......~..~..~.......A,...../~... ........ County ............ ~.~y/.~...~.i... ,~,~_.~.o.p..~'_~_tat~e o/New York_ ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS S~; BUREAU OF ELECTRICI~'~ ~ 85 JOHN STREET, NETM YORK, NEV~J ~ORK 1OO3~ N 1 42188 THI~ CE~IFIES THAT ~y ~ ~t~ ~uip~nt ~ ~c~ ~ ~ int~ by t~ ~ppl~t ~ on t~ a~ ~pl~at~n numar in t~ p~m~es O~ :. ~.hlln Wanser, n/s Hickory Ave, 200' e/o Cedar Ave., Southold, L.I. ;.thefoll~winglocation; [] e--m~n~ [] ;,n. [] ;.d Ft. Outside s~,;o. BIoc~ Lo* ~VaSeramlnedon Pebruary 4S 1974 and foun~ to be in cornpliance tvlth the requirernents of this BOard. RXTURE FIXTURES RANGES ~)VENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHSS FLUORESCENT 2 DRYERS PJTUEE I~EDER$ TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMEES SYSTEMS NO. OF FEET SERVICE DISCONNECT S E R V I C OTHER M'PARATUS: OF CC. COND. 3 HO. OF HI-LEG OF HI-LEG OF NEUTRAL 5 John M. Ladema~] 1200 Harbor Lane Cutchogue, New York 11935 m MANA~a FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FORM NO. 6 TOWN OF SOUTHOLD Building Deporl'ment 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 $5.00 3. Copy of certificate of occupancy $1.00 Date New Building ................ Addition ~ ............ Old or Pre-existing Building ................ Vacant Land .............. ,ocot,on Of Property Owner Or Ownersf) ~Of Property ............. ~ .................................... ~..(~ .~.~.~.t~ .......... ~'~' m~'~' IIL~ }~j~l~ .................. LOt No ............. B lock No ............. House No ............. Subdivision Health Dept. Approval ........... ..~.. ............................ Labor Dept. Approval ..............~ .............................. Underwriters Approval .............................................. Planning Board Approval .......... ~ ........................ Request For Temporary Certificate ........................................ Final Certificate ........ ~ ........................... Fee Submitted $ ..~.~.~,O...O. ...................... Construction on above described buildin~p~rmi~ll ?p~ 'p~ble codes and regulations. Applicant ... ,~.. ~..~...~Z~.../~m.....~ .~. ~ ..................... Sworn to before me this ..... /...~....... day of ...~....../..~.?.~ (stamp or seal)~'~D/'~7 otary Pub ,c ..... Jo. 52[-8[61785 Suffolk Count~,