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Home My WebLink About7286-zFO~M NO. 4 TOWN OF $OUTHOLD B[rfr.DING DEPARTMENT , Town Clerk's ORice Sou~hol/, N. Y. Certific te Of Occupancy No..Z.6..2.0J ...... Date ........... 1/or, .... 18. '. .... , 19.~. THIS CERTIFIES that the building locate?i!at . Sudd..P.~ct .Roai ......... Street Map No. ¥.i.1.1..o~...P.t~. Block No ........... Lot!No. 1.~... lt°Ui;h~ld.. ~I .~. .......... conforms substantially to the Appllc~ation for B g Peo'Mt heretofore fried in this office dated . l~y. ,~0... 19.7~. ~ ........... , pursuant t~ which Building Permit No. ~86Z.. dated ........ Eay... 30 ..... , 19~.., was issued, and conforms to an of the mants of the applicable iirovisions of the law. Th~ occupancy for which this certificate is issued is .?r~,v~s..oas. i~$11,~ .~l~allia~.../~i/ ................................... The certificate is issued to .J..o.h~....i[~'~... ....... .0~.e.l~ ............................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ,.. Sellt.. 12.. 19~.lt.. b~..1t,..V, ill&.. UNDERWRITERS CERTIFICATE No..Ill 8~338 ...... l~apt.. 2~...1.ff~ ............ HOUSE NUMBER. ~90 ......... Street ... ~udd. icad. 2oeit ..................... 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) N? 7286 Z Permission is hereby granted to: at premises located at ..~O~-..J..~ ......... ~,~l~..~O~lat~.~a~e ......................................................... ................................... ~..2m~L..~ ......... .qaatlaoad .............................................................. pursuant to application dated ................... ~, ............ ~ ............ , 1~....., .and approved by the Building Inspector. Fee $.9.'J.t.~l~ ........... TO~N OF $OUTH~OLD BU~r~IN~ Town Clerk'~ Office $outhold, N. Y. Certificate Of Occupancy No..Z61i6 ..... Date .. ............ ~ept. ~8-.., 19. THIS CERTIFIES that the building located at: ]B~d. -Po~l-.Pu~l. .......... Street Map NO~ll.l. ow. P'b.. Block No ........... Lot No.l~ .... 8olithold...I~ ,Y,.. ........ conforms substantially to the Application for Building Permit heretofore ~ed ~ thi.~ office dated ........ ~' 'li~y" '30" 19.~1~ pursuant to which Building permit No..728~. dated ........... Na~ · '30 .... , 19..~, 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 . Priv&~' ~ .£ma~ly. 4~ell~ ....................................... The certificate is issued to . Jol~n~Za~a ....... 0~llel~.. (owner, lessee or tenant ) of the aforesaid buil~ipg. Suffolk County Department of Health Approval .. ~el~t...17.. 1.9~...b~'. Re UNDERWRITERS CERTIFICATE No... ~el~l~ ................................. HOUSE NUMBER ....~0 ....... Street . ~tcl~l. l~.o~d, l~oa~ ....................... · ' Z~'~ s' neeS. w 't,e~ .lri~han. ~iak ........................................... Disapp~ed a 'c .................................................................................... · ~ - (Building .In,tar) ~3~ IPPLIClTI~ FOR BUILDIHG PE~IT~ b. Plot plan s~owinG J~ation off lot and of buildi~s on premises, ~lationship to adjoining premiss or public struts ox areas, and giving a detail~ d~ripti~ of I~out ofpr~e~ must c. The wo~ c~er~ by this a~lication may n~ be comme~ before issuance of Building Permit. d. Upon a~al of this appl~ation, ~e Buildi~ Inserat will i~ue a Building Permit to the ~plicant. Such permit shall be kept on the premises available for in~ti~ t~r~ e. No building s~all ~ ~cupi~ or u~ in whole or in~ for any pu~ose whoever unt ~ uN ~ HbK~Y ~D~ to the ~udamg ~ment ~or the i~uance o~ ~ ~u~d ~ P~ pu~uant to the Building Z~e O~inance of the T~n of~uthold, Su~olk Count, Now York, and ~her a~licable ~, O~inanc~ or Regulations, for the co~tru~ion of buildings, ad~iti~s or alterations, ~e applicant agrees to comply with all a~licable I~s, or~inancK, bud~inG c~, admit authorized ins~o~ ~ p~mi~s a~ i~ buil~In~ ~or n~es~ i~i~s. Co.ell Const~ction Corp (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Builder Nome of owner of premises ~1'O~1~ 8zala If applicant is a corporate, signature of duly authorized officer. ~ (Name and title of corporate officer) Builder's License No ..................................................... Electrician's License No..0..9.t~..~.~ ........................... Other Trade's License No ............................................... Location of land on which proposed work will be done. Mop No.: ~.~.]....~..O...~....?..O....~...~.. .......... Lot No....1.~.. ................. Street and Number ...B~dcl..~.OZlcl..~.ontl ............ ~.C~J,~b.O,]J~ ............................................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy .......... ~'~,(~.~. ........................................................................................................ use ond occupancy ............ ....... b. Intended 3. Nature of work (check which applicable): New Building ...~ ........ Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................... Other Work ...................................................... (Description) 4. Estimated Cast ................................. ~ ............ ,.~ .......... 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 ..~W.e. .................................................................................................................................... 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 ...... ~0,~ .................... Rear ....... 6 .0~..~. ........... Depth ...~..'.~/~..'.3 Height .................... Number of Stories ...e.~l ....................................... ~..~ .............................................................. 9. Size of lot: Front ....................................................... Rear ................... : ...................... Depth ................................ 10. Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district Jn which premises are situated .~.n...,~l,~-.~. ................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ~ ............................................. 13~ Will lot be regraded ....~.~. ................ Will excess fill be removed:fram premiss: ( ) Yes (~) No 14. Name of Owner of premises ...... .~.~....l~.....t~...~.~..~ ..................... Address....L....;.~ ..................... Phone No. ...................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ..... ..C.~.e....~:......C..e.~.s..~.,!~...,~...~..?.~.. ...... Address ~outho~d Pho~ No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and 4ndic~' all set-back dimensions from property line[ Give street and block number or description according to deed, and sh°w street names and indicate whether interior or cam .~lot~---~-'~ -- STATE OF NEW_YOJ~_. COUNTY OF'. ~.~...o.'..J~... ............ t' ~'~ ..................... -,.~Z.j,,...~l't~s..~o,~,,lle~'l .................................... being duly sworn, deposes and soys that he is the applicant (l~an?e of individual signing contract~ above named[' ' He is the ................................... i ....... ..~..d~....]:~...e..~. .................................................................................................................... (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 applicationi that oil statements contained in this application ore true to the best of his knowledge and belief; and that the work wdl be performed in the manner set forth in the application filed therewith. Swam to before me this ................ of ...................... .............. . Notary Public,. ................................................... County ... gr~ature ~f ~]pl~li~')' ........................... FORM NO. 6 TOWN OF SOUTHOLD 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 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-ex'st'rig land uses: 1. Accurate survey of property showing ali 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 .............. Location Of Property ...~...z~/)../) ~,q/~ ~..~..~/~. ~ej'~ Owner Or Owners Of Property .~..(.x'.f,~. ,.~'~-,4Z-4 ................................ Subdivision ..~..C.&..C..~.?......~/.~/...~....~'.. .......................... Lot No../.~... Block No....--:~. ....... House No ............ PermitNo~'I'~F'~z Date Of Perm t .~..:~.°-7~A,-,, cant Heath De i'"'~,""i~" .~.: ,,~,-',7~ '"'[*-';~'~'~'~. T ~ ~. ...... .~..,~r...~=..../. ......... P- PP .............................. Laoor uepr. ^pprovm ....... ~.~r..,:_:..:. .......................... Underwriters Approval ......................... i..~, ........... Planning Board Approval ...~..:~,. ....................... Request For Temporary Certificate ....... ~ ............................ Final Certificate .............................. Fee Submitted $ .~.,: ~. ................... Construction on above described building and/~r?it Teets/~l ,~g~licab/J,~codes an~/~ulations. Sworn to before me this ~ ~ (stamp or seal) MURI£L BRUSH NOTARY PUBLIC, State of New York NO. ~2.452202b - S'Jff~ Counf~/. I N / = AqO,q~kl'tCt'l'P , THE NEW YORK BOARD OF FIRE UNDERWRITERS [~ &W BUREAU OF ELE~"rRIC~ ·, 85 .JOHN STREET, NEW YORK, NEW YORK THIS CE~IFIES THAT 3zala~Budd'8 Pond Rd.,~th house on ~t~t,8outhold,L.~. ~ ~,,~ 5eptembe~ 19,197~ ~fou~m~in~mp~w~th~r~uirementsofth~. RXTURE ~TUR~ ~ ~ ~ I OVENS raSH W~ ~HAUST FANS Box 215 3outhold,L,I, 11971 COPY FOR BUILDING DEPARTMEHT. THIS~CQPY OF CERTIFICATE MUST'NOT'BE ALTERED IN J