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HomeMy WebLinkAbout7455-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. .76.809. . . . . Date . . . . . . . . . . . Aee*. . . . . :12 . . . 19.75. THIS CERTIFIES that the building located at g/g. begne tt•La • • . . . . . . . . . Street Map NoYrzirviev.PkBIock No. . . . . . . . . . .Lot No. .32. . . . .5outholA . I . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . . AUg. . .I. . ., 194p1 f . pursuant to which Building Permit No. 745%. . dated . . . . . . . . . . . . *Ug. . 4. . . ., 19 94 ., 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 . Private• swimwing -pool •vith• -fence A. acaesoorys. . . . . . . . . . . . . . . . . The certificate is issued to Fr. & .ylr* .&dw. •gkeesee• • • • • • • biers• • • • • • • • • • • • • • • . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval 1j.R.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . X$82996 . . . 00t . . 17r .1994. . . . . . . . . . . . . . . HOUSE NUMBER . . .625 . . . . . . . Street . . Sennett• La. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ./. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector FORNI NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISE COMPLETION OF THE WORK AUTHORIZED) 7455 Z Date ............. UNTIL FULL Permission is hereby granted to: : Sk$.:.~..~...k;Z.p...~.9.9.!~....~.~m.~./.q...~.a.~t...§~.~.ea & wt~e ......... 250...~x..J~a~ ........................ i .................r Cuteho~ to .~bL~i~1~..~..~p~.i.Ya~..`~m~L1~&~.p.~...~&th~en~..~..a~eas.~3:~.s[ ....................... ot premises Iocoted at .~...~..3~......~.a..~.~..~a~g ......... i ......................................................... .......................................... ~.e~m~.t.t..~,~ ............ '..&~.ut~l~ ........... ; ........................................... pursuant to application dated ............................... ~J~.....~.....i....., i9~.~.,;., and approved by the Building Inspector. ~ NOTi~ ~ader~riters certifieat~ :requi~e~ fer c/o FORM NO. 6 TOWN OF $OUTHOLD , Building Deportment i Town Clerks Office $outhold, N. Y. 11971 APPLICATION FOR CERTIFICATE oF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and sbbmitted in DUPLICATE to the Building Inspector with the following; for new buildings or new rise: 1. Final survey of property with accurate location of all bui dings, 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 Uhderwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance from rife Architect or Engineer responsible for the building. .5. Submit Planning Board approval of completed site plar~ 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, bccupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildihgs or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: l. 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 Dote .,~..~ ~ ,/~**.~F~..../.,I.~ .[.,~ .7~ New B~lilding ................ Addition ................ Old or Pre-existing B'~ilding ................ Vacant Land .............. Location Of Property .~).~..~.~ ..L~.~.~.I~..[~.....~.O..6<.T./.~.~.~.......I~O.~.~I,...[.L~.~.r).i ............................ Owner Or Owners Of Property ............................................. . .......................... ...(~ ................................ Subdivision . .~.~.[I~.V.J.~...IA)......0,..~....~....~..~..~.~...J. ...... Lot No...~..~.... Block No. House No ............. Permit No..g.,c/.~,~,.~,~r... Date Of Permit .................... Applicant .................................................................. Health Dept. Approval ............................................ Lobar Dept. Approval ................................................ Underwriters Approval ..]~'..J..~...)~...~..~..~ .................... Planning BOard Approval ........................................ Request For Temporary Certificate ........................................ Fin~ Certificate ...... ~ ............................. Fee Cubmit~ed ¢ ~. 0 0 Construction on above described building and permit meets all applicable codes and regulations. (stomp or Sworn to before me this .... ..L( ....... day ...... Notar~Public ....~...C.;-~..~..'~.~..~;....~..... County ANTHONY AB/~TE Notary Pubhc, State of~ New York No. b2-0000850 Qualif,ed in Su/iolk'Counb/ ?~ ("omrmss~)n Expires Ma!ch 30 ] 9 J zo 0 .,c .0~<0 rnom - Y TOWN OP SOIUTMOLD /j/4/yti o`Zya hr� sItILDING DLPARTMBJT � TOWN CNRIC'S ,0PPr5 SOUTWOLD, N. Y. 75—d) 4� f wZe c�et Examined .. �....�............... 19.7..1- Application No. .2.4..5- Approved ............................I............ 19..I. Permit No. ..f... :J .Z_../7 `Y 7S Nd Co. Disapproved a/c .... .... .............. � .................................. ......................................... �',G1i ................................... .... ...... ................... 0\ (Buil dg Inspector) APPLICATION FOR aU1LDING PERMIT Date .....Aa"!s...l........................ 19.1i..... INSTRUCTIONS a. This application must be completely filled in ri Inspector, with 3 seta of lane p Y sy typewriter or. in ink and submitted in triplicate to the Building sP plans, accurate plat plan to stole. Ftre ac4ordinp to schedule. Z b. Plot plan showing location of iof 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 part of this application. c. The work covered by this.application may not be comMenced,before issuance of.Building Permit. � d. Upon,approvol of this application, the Building Inspector will issue o Building Permit to the applicant. Such permit `l 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 Occupancyr shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to that 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 removol h demolition, as heroin described. The applicant agrees to comply with all applicable lows, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. .l3lima..W1)...AA X4.,6...NVA............................................ (Signature of applicant, or name, if a corporation) .2.59.gsa..4Aq....Cns 11I RX ......................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...............ftuder................................................................................................................................................................. Name of owner of premises . T...6c.. SAI...$i1RfIF..41..S�Ff..Rrrf.4...................................................................................... If applicant is a corporate, signature of duly authorized officer. .............C'..flr.RS..At iltrllet ......................................... (Name and title of corporate officer) Builder's License No. ..................................... .............. Plumber's License No. ................................................ Electrician's License No. ............................................ g Other Trade's License No. .............................................. 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No......i�2................ Street and Number ..Elaa *1V.ra..L&iati...BAILMAkOld........................................................................................ Munldpality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ....Aws.7.11tit......................................................................................... ................ b. Intended use and occupancy ....dww131.at..asd•..awlanf.as..#0w1............................................................. NY �i 3. Nature of work (check which applicable): New Building• .................. Addition .................. Alteration :............... . Repair .................. Removal .................. Demolition.................... Other Work ... l.......:.... . O b (Description) 4. Estimated Cost ...........................i................................Fee .. . . ............... aid.................th.is...........atio..................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................Number of dwelling units on each floor'............................ Ifgarage, 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 some structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................Number of Stories ................................ 8. Dimensions of entire new construction: Front ...........36 ................... Rear .......36................ Depth ....1P................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ......................L35............................ Rear ........135........................... Depth ..........160............... 10. Date of Purchase ........:.....:.........................................Name of Former Owner ........................................................ 11. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded ......N®................. Will excess fill be removed from premises: ( ) Yes (z ) No 14. Name of Owner of premises EdmarA...G-Doxai...SktamawAddress 0.watkA141............. Phone No. ...................... Nameof Architect .............................................................. Address ................................ Phone No. ...................... Name of Contractor Fg..immy.11hp.NA?k4.r.,I ae....... Address NtOl .«ui......... Phone No. ...................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock 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. SEE ATTAC RED . . . . . . . . STATE OF NEW yORK, t S S COUNTY OF ..... YA19m1 :..........f ...............:.d.0exxx..uxsxx..............................................being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .....................EIX11sAAi........................................................................................................................................... .. (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 application are true to the best of his knowledge and belief; and thaT the work will be performed in the MaInner set forth ih A's dpplitaitioh''filed therewith. Sworn to before me this ............../:. y oaf .....jJ... y.. ... 19.�.Y y Notary Public,P-yW0'-' (.�..,�:. .... ... ............ County ......(........1. (Z&............................... gnature of applicant) JUDIN T. SOKEN Notary Public, Slate of New York No.52-0344963 Suffolk Count 60i- March 30, 19 THE NEW YORK BOARD OF FIRE UNDERWRITERS ek BUREAU OF ELECTRICITY _ 11 F 85 JOHN STREET, NEW YORK, NEW PORK 10038, .. Dat,3eptember l7, 1974 Application No.onfile7530618 N O 1O2996 THIS CERTIFIES THAT ESE d.7 C7 only the electrical equipment as described below and introduced by the icant named on the above plication number in thepremises of Edward 9krezee, Benetts Lane, Custer, Clearview, Southold, L.I. in thefollowing location; © Basement 91 Ist Ft. ❑ Ynd Ff. outside. Section Block Lot was examined on September 12 , 1974 and found to be in compliance with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT1 FLUORESCENT I A I AMT. I K.W. "T. K.W. AMT. K.W. "T. K.W. "T. H.P. DRYERS FURNACE MOTORS FUTURE APPLIANCE RIDERS ISPECIAL R1C'PTj TIME CLOCKS I RELI I UNIT HEATERS MULTI.OUTLET DIMMERS SYSTEMS AMT. K.W. OIL H.P. GAS N.P. MT. NO. A.W.G. AMT. AMP. AML. AMPS, TRANS. AMT. H.P. NO.OF FEET ff WATTS 1 20 SERVICE DISCONNECT NO'OF 5 E R V �r C E AMT. AMP. TYPE METER 10 tW 1 S SM' S/3 S,e 4W NO,OF CC.COND. A.W.G. NO.OF HI-UG A.W.G. NO.OF NEUTRALS A.W.O. EOUIP. FER B OF CC.COND. OF MI-LEG OF NEUTRAL OTHER AFPARATUS: (Swimming Pool) This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have frequent test and/or repairs made by a qualified person. Glenn A. Bradley, H Horton Ave . , Y Mattituck, L.I. 11952 GENERAL �M(ANAGGR 11 Per COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICAT!-MUST-NOT BE ALTERED IN ANY MANNER.