The URL can be used to link to this page

Home My WebLink About7474-zTOWN OF $OUTHOLD BU~.nlNG DEPARTM~IT Town Cl~rk% O~i~ Southold, N. Y. Certificate Of Occupancy No. 2;6%'31 ...... Date ..............lttaT'...~ ....... ,19.7..~. THIS CERTIFIES that the bui]~i-~ located atO~ancl, .Ave .............. ' Street Map No..xx ........ Block No...xx ..... Lot No. zx~ ...)~a.~t~.tuak.. ~I.oX, ....... conforms substantially to the Application for BuildJn~ Permit heretofafe filed in dated .............AU~...l~, 19. ?~. pursuant to which Bui]~n~ Permit No... ~.~.7.~ dated ..........A~..1~ ..... , 197~., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which tht~ certificate is issued is. Priw.~. sw~Ln~ .P9~1 .w~.th. ~ce~.~gry~. .......................... The certificate is issued te. 0.~&ver. ~emmott ....... l~wne~ ......................... (owner, lessee ~r t~mmt) of the aforese/d buildi.~. Su~olk County Department o! Health Approve/ ....N. :.R: ............................ UNDERWRITERS CERTIFICATE No. N.~*(~7 .... Sept.. 26.. l ~7.~ ............... HOUSE NUMBER .... ~OO ..... Street ..... {}r.~D4. A~r~ .......................... FOB~ NO. ~ TOWN OF $OUTHOLD 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? ?474 Z Date .......................... A~,/~,/~ ~ ....... $~..., 19..'~. Permission is hereby granted to: ..... :~ (~ ..~.~r~h.. S;L~1 ............. ' ........................ - ~o ...~...r.~.~.~.a..~;L..~.~;~.. ~.~. j.7.~ ~...~i...~ a ~2... ~l~.. ~e ~a e...~, at.sa ~ ~ ................ at premises located at .~/~...(i:~azl/1...~.e .................................................................. ~ ........................ ................................................................... ~.e.,~.~..f..~.~ ....... ~,.~.,. ....................................................... pursuant to application dated ............................. J~g......1..3 .......... , 19~...., and approved by the Building Inspector. ~O~]~l ~eed ~ndez~F~l;e~ oertl~'a&te ~'or C/O Fee $.'1.,~-..~G. ........... AFPUCATIOH FOR BUILDING PIRMIT e. No building .h~ll be oeeupled or uged In whole or In I~rt for iny purbu~ whltm~r until · CmMfim~ of (kx~u~n~y d~ll hM ~ gran~d by th~ Building Insbe,,,tor. APPLICATION IS HEREBY MADE to th~ Building Debertmmmt for th~ Imulnse of · Bulldin~ Ib~mlt pursuant to the Building Zon~ Ordinance of the Town of Southold, Suffolk County, New York, and other NWdkmble I.m~, O~lin~mom or Regulmtiom, for the eon~m,.,tion of bulldlngl. Idditlorll or II~lratlonl, or for rlmovll or demolition. Ii bemin bel~'l~ld. 1"hi IIwMk~ltt ~ ~ gx~tply with Ill IIR~k~bll lewl~ ordlrmnms, building cod,. housing code. and mgul~ions, and to ~dmit ~utherlz~l Im~ m~ I~ led la bulldln~ for ~ ~ (Sl,e~tum of, f~plle~t, o~ n~rm, ig~eorpor~tioe) / ~}~50 ¥ott~'&nl ~m®rl&l ~l~y. ..]~lb~ll;L& ,...~...~., ............................................... (Addrlll of ~ppliclnt} State whether applicant is owner, t~, agent, amhttact, engineer, g~nerd contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. {Name and title of corporate officer) Builder's Licen~ No .......... , .................................. , ............ Plumber's License No ......................................................... Electrician's License No .................................................. . Other Trade's License No ................................................... . 1. Location of land on which proposed work will be done. Map No ...................... ~..-..,*.:c?.:..,..~.r,.~., ~No,.~, ....................... Street and Number .......~..~..O...O.....~..~..A...~..d.....A..?..e..~...~..e. ............................................................... .l~...t..~.~.l;..l~i~ .................... ~ ~'~.'l ;, ,,:, Municipality 2. State existing use and occupancy of premises and intended use and occupancy of prol~ ~onstn{ction: a. Existing use and c,o~pancy ...........1....~...~}...t..!.~.....r_~.."..l..d...q.~...q.~. .............................................................................. b. Intended use and oceupancy ..........J~l~.YkllR~R&..{.{ll~,l, ........................................................................................ ut-WOrk (check which apolicable): New Building ....................... Addition ..................... R~pair .................... ~. . .. Removal .......... ... ... ......... Demolition ........................ Other Work (Description) Estimated Cost .~.~.9.O..O.. ..... Fee ....~d,5, .................................................................................... · ' .......................... {to be paid on filing this application) If dwelling, number of dwelling units .................Number of dwelling units on each floor ......................................... If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occuoancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front ....5,1,':~.! ...... Rear ...5~,5.! ............. Depth ..,,~0 ............................ 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 ...... :~!. ............ Rear ..... ,,~ .................. Depth ....~,~J.! ...................... Height ................................................. Number of Stories ......................................................................................... I O0~ n,,~r A/13.68t 9. Size of lot: Front .......... ~.~.R .................................................................. Depth ........ g~. ..................................... 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 1~." Does proposed construcb6~'~ ~t~ J ~;vio ate any zon'ng law, ordinance or regulat on: 13. Will lot be regraded .............................. Will excess fill be removed from premises: [ ] Yes [ ] No (Address) (Phone No.) Name of Architect ....~[e~.~i..~L~.e~....~.~`..g.~;c~*-~.~5fL.1~.~..~.ea...~.~#~#~.e~.....4~...~.~6 (Address) (Phone No.) Name of ContraCtor ..~J~'.~&~A.'J~.~.~'-..~.~.fl[-.,g.et:R~.~*~t.~.~-.-y.~.~.R..~Ma...~aa'~'~''''''~'''~6 (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all bu drags, whether ex st'ng or proposed, and nd cate all set-back d'mens'ons from property lines· Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. STATE OF NEW YORK, ) SS COUNTY OF .,~u~:t.e.].~r ................................ ) ........................... .~'~,~,~.~Jll...s[.a...~.T.~.[I).~ .................................. being duly sworn, deposes and says that he is the applicant above named. ,~ (~raltne qf~indlvidual signing contract} ~ m / ~ : ~,; He is the ........................................................................... .C,.9.-B..~,a/-?.~-?-~ .......................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and t6 make and file this application; that ell atatements contained in this application are true to the be~'~f ~his knowled~eian$ b~lief( and that the work will be~ performsd in the mannsr C~ROL G~RROLI. set forth in the application filed therewiJJ~. _ · ... /'~/ ~ : '~ / ~, '; . I~0TAI~Y PUBLIC, State 0t New r ~.. da of ~19 ~7~ No. 52-4501567 ................ /.. .......... ~ y ........ ~.,.-->n~9.-. .................. ~7~- (~ualified in Suft~k C0u~nty__ i~iOn arch FORM NO. $ TOWH 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: ]. 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 ]957), Non-conforming uses, or buildings and "pre-existing" land uses: ]. 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: ]. 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 ~ ...~..1 .?. ~ ~ Addition New Building ................................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..c~.~.~..~.~.¥.~......~.."i~...x~..4'.~ ....... ..~T.~./..-~..~.L~./.~.. ....................................................................... Owner Or Owners Of Property ....................................................................................................................... Subdivision .............. ~ ............................................ Lot No. -- Block No. ,....~'~. ...... House No~. ,~.,.~.¢?. Permit No..~..~...~'...~..'~.- ...... Date Of Permit/~/~/~...Applicant ~/~..~,I~..~.....~ .... Health ~pt. Approval ...... ~ ............................. Labor ~t. Approval ..... ~ ................................. Unde~riters Approval .............................................. Planning B~rd Approval ..... ~ ........................ Request For Tempomw C~ficate ........................................ Fin~ Ce~ifJcate ~ ................................... F, ~bmi,ed $ ....:~...; ..................... Construction on above described building and ~ermit me, ets all applicable codes and regulations. Applicant ~..~//..~..-..... ;~.~':...~.~.'....~.../~.. ....... . . .~.: .~'.. ~. J: ../...' ........................ t l I t i~. THE NEW YORK BOARD OF FIRE ~UNDERWRITERS tab * BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW yO~K ~,~ 8eptember 26R 1~?# ~p~,o~o.o~/,~ 75 ~: ; N 184647 THIS CE~IFIES THAT in the following location; [] Basement [] let FI. w=..,mi~do. Sdptember 23, 197~ i 1 RXTURRS [] 2~ n. Outside s~. and found to be in compliance with the ~uirements of th~ B~rd. ~NGES ~NS ~ W~ERS ~HAUST FANS DRYERS FURNACE MOTORS FUTURE APIqJANCE FEEDERS TIh~CLOCKS UNIT HEATE$ MU4.TI-OUTLET DIMMERS SYSIIAtS SERVICE DISCONNECT S E OTHER APPARATUS: Panelboamd/s: lOFI R V ' . I A. W. G, NO. OF H~-LEG A.W. G, 1-2ekt 12~amp (Swimming Pool) Th~s certtfflcate oovers compliance at the date of lnepeotlon only, Beoause of unusual environments: It ts'advilable to have frequent test and/or repairs made by a qualified person, Joseph D. Hazzoni 227 Waverly Ave. Medford, L.I.11763 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST N~/M, ALTERED IN ~ MANNER. ' Of ../ /VOTE: · -' MONUMENT THE LOCATION OF WELLS ][ND CE$spOOE~ ......... I FROM FIELD OBSERVATIONS REVISIONS YOUNG & YOUNG .~_~ DEC. ~0, 1975 400 OSTRANDER AVENUE, RIVERHEAD~'Q~.W,~: ALDEN W. YOUNG SURVEY FOR: ATLANTIC HOMES OF SUFFOLK INC. .~-."c~-.,~/9 ' '~ AT M AT T ITU C K RIVERHEAD SAVINGS BANK TOWN OF SOUTHOLD SUFFOLK CO., N.Y. SCALE: I" : 50' I DATE: AuG. 28,1973 73-841