The URL can be used to link to this page

Home My WebLink About8752-zIvOKM NO. · TO~N OF SOUTHOLD BUILDING DEPARTMENT Tow~ Clerk's Office $outhold, 1~, Y, Certificate Of Occupency__ No. Z~4)2 ...... _ Date ................ Dee .... 3 ...., 19. THIS CERTIFIES that the building located at . B.l~ldg~, ~]~ ................ Street Map No.sylore,t .gstBl°ck No .......... Lot No... 'f3 ..... C~];~bgu~ ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ ,T. uly...~), 1976. pursuant to which Building Permit No.. dated ............. July .... k~619 76" was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occllpancy for which this certificate is issued is Prl. v&te ~>ne. faml~y'd~ell~g ........................................ The certificate is issued to .. Frederick & 'RO~' ' ' l~a'Se'l~ ' ' ~' '0~hbYd .... .', ......... ~owner, ~essee or ~enan~) of the aforesaid building. Suffolk County Department of Health Approval 'No~''~ 30 "~ 976" by 'R;' ¥~lla' '" UNDERWRITERS CERTIFICATE No. ]130~0 ..... 0e~' '18" '$976 ................ HOUSE NUMBER ...... ~8~' · · Street .. ~?idl~' 'L~h~ ...... ......... Building Inspector [ FORH NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 8752 Z Permission is hereby granted to: F~.~ce~L.~o~e..Homes...Ine ..... ~.C..~.~ed~rAek & Rose Nase~ ............. .~.0,~...992....I~t~.]~ ....... C~tchogue at premises located at ...~/~o.~,...1..~......~J-~/'~,~iil.~..~ta.{;e~ ................................................................. '~ ~'-~ ........................................ ~. ........................................................................................................................ pu~(d~,ant to application dated ...[: .................... ~u,'L~r.....20...' ......... 19'/J~...., and approved by the FORM NO. 6 TOWN OF SOUTHOLD ~ Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This apphcation must be filled ~n typewriter OR ink, and submitted in DUPLICATE to the Building Inspector w,th 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 reqmrements 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 cond,tion of buildings. 3. Date of any housing code or safety inspechon of buildings or premises, or other pertinent in- formation required to prepare a cert,ficate. 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 12/1/76 New Building X Addition Old or Pre-existing Building , Vacant Land Location Of PropertyW/s/0 Bridge Lane~ 514.23' N/0 Rouee 27~. Cu+chogue, N.Y. Owner Or Owners Of Property ....... ..~...~..~..J;..?..~.....a..~...~.....~..o...s.~....~..a...s.~.~. .......... ! .............................................. Subdivision ..... .,~..~.,,],.,°.,~...e.~...~..s.t~.t..e..,~. ...................... Lot No...]:..~.. ...... Block No ............. House No....5.,8..,'~,5. 7/26/76 l~ances Rose Homes~ Inc. for Permit No 8752 Z Date Of Permit .................... Applicant ........................................................'" ~F"&"'R'"]~'~ .... Health Dept. Approval .]:..~../...~..0../..?.~ ..... .~..T.~..0.~..]:..~..2..Labor Dept. Approval .I.....~...~.. ................................... Underwriters Approval .~.~..0..8..]:..~..0.......~...0./.!.8./.?..~.. ..... Planning Board ApproVal ..... ,~/~ ........................... Request For Temporary Certificate ...................~ ............. Final Certificate ......~...e.~ .............................. Fee Submitted $ ~.....0..0.. .......................... I Construction on above described building Applicant .~...~.~ Sworn ~o before me thJLs ........... .D. day of ..... Notary Pubhc ....... Count/ ,, THE NEW YORK 8OARD OF FIRE UND Future Appliance Feeders: 1-316, 1-2~12, l-2~l~, awg. 1-Smoke Detector Fcur Potn~ Elan~ric Inc. 350 Lake Ave. Nes~onset, N.Y. 11767 I,i~. 307E Pt, r~. ce,t*f,~a,~ mu3 .,or oe al~e,~ ,n a~y ~',~' return ~ 'w~.., ~.,-~- ~ ~ BUILDING DEPARTMENT TOWN ~ERK'S OFFICE .... ~ ~U~D, N. Y. ~ .... ..... , ....................... .................... ' ' (~il~ I~r) / *PPLIC*TIOH FOR .UtLDIHG PE~IT a. T~is Q~licQtion ~ust be comp{eteiV filled iff by ~pewriter o~ iff ink Qnd submit~ in triplicate to the Bui~ing~ Insp~tor, with 3 set~ of plQns, Qccumte pl~ plan to ~Qle. P~ Qcco~ing to b. Plat plan sh~ing I~Qtio~ of lot ~nd of buildings o~ premises, reIQtionship to ~joi~iflg premises ~re~s, ~nd giving ~ det~il~ description of I~yout ofpr~e~ must be drown on.f~e di~grem which is ~ of this QppiicQtion. '~ ~. The work co~ered by t~is Q~licQtio~ moy ~ be commenced before issuence of Building Per, it. d. Upon ~pp~vQl of this QpplicQtien, t~e Building Inspectar will issue ~ Building Permit tothe QpplicQnt. s~ll be kept on t~e premises QYailQble for insp~tio~ throu~h~t the wor~. e. No ~uilding s~ll be ~cupied or used iff w~ole or in pa~ for Qny pu~ose w~ever u~tll Q ~e~ificote of ~cupancy ~11 ~ve been granted by the Building APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to tha,'~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or ~ Regulations, for the construction of buildings, additions or alteratio~ The applicant agrees to comply with all applicable laws, ordinance: admit authorized inspectors on premises and in buildings for nece~ s, or for removal or demolition, as herein described. building code, housing code, and regulations, and to iry inspac.ti~ns, n e, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....]~..~..~..~...~...~....~....~..~......1~..~ .......................................................................................... If ap~or~ duly authorized off Jcer. ......... .,. ......... Builder's License 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.: ~..~...1~..~....~...~. ........... Lot No...~...~. ................ of Street and Number ......... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................. b. Intended use and occupancy 3. Nature of work (check which applicable): New Building-. ................. Addition .................. Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work ................................................ . (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 ............1. ................................................................................................................................ 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 56' Rear .....~..~..~. ................. Depth 30' Height ..Z~ ............. Number of Stories 9. Size of lot: Front ].50' Rear ]1~0' Depth 3?0' 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ......~.O. ............................................. 13. Will lot be regraded ~eS excess fill be remove fA~r~p~'~.(~ )m~Y~e (X) No ............................ ' sWill 14. Name of Owner of premises ll~'~l'~'~k & ROSe il&se~" Address ..~..~.~..~.~Phone No....................... Name of Architect .............................................................. Address~0...~..~l~. ........ Phsne No ....................... Nome of Contractor ....~/..?..l~....?..?..~?.?~....~.~.e..?.~....!..~.?.:. Address .q.~..~...~..~...~.~.~..t......I~... Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back 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. STATE OF NE'v~k [ S S Y F ............................ f' Rose Hones z e. ................................................................................................. ~e,ng duly sworn, deposes and says that he is the applicam (Name of individual signing contracf) above named. il er-C ate Officer 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 application are true to the best of his knowledge and belief; and tk, a~ the work will be performed in the manner set forth in the applicatio~12,er~,v~j[~b Sworn to before me this ........... Noto~ Public,. ....................... ~.. ~ ...[~ ~ ................. ~.Z~.(l~...~: ~ ....................... Lo'z' /4 'i i i SCAt.~:, t00" = I" TO THIS SURVEY IS A VIOLATfON OF SECTION 72C9 CF THE N~W YORK STAII~ EDUCATION LAW COPIES OF THIS SURVL¥ HAP NOT BEAIUi~ THE LAKD SU;VEY~.R'S ~F' O r-&L OR SUPPLY AND SEWAGE MS FOR T~'~lffi CC~NFORM TO THE SUFFOU~ CO. FOR ~PROVAL OF ~N~UC~ON ONLY No~ ~E WA~R ~ .... ,, , I~' , , ?.MENT OF INTENT ~UFF. CO_HEALTH D_IE:PT. APPROVAL J H* S. N~O. ot TU o¥ U~A~I~N LAW, II A VALI0 r~ COP~, ARANT~S INBICAT[D HLR:ON SHALL R~ PREPARED, AND O'N H S LHALF TO THE ~fjIpp. GO, DE. PT, OF' H~,ALTH ~,ERVIC.~ I ~'TATE:MIrNT OF' IN~T FOR APPROVAL OF ~Ng~U~ON ONLY ~OT ~E WA~ SUPPLY AND O~CE WILL ~F~M ~ H. 8. REF. NO.: ..... ST~ND~ OF SUFFOLK ~. D~ OF H~LTH. SHRVI~B. SCALE: /00'_ = /" __ L,o? /4 /'"'l rO TPIS SURVEY IS A VIOLATIQ~ S~CTION 72~9 OF TH~ ~W YORK 1UTiON GUARANT~E$ AgE NOT T~NSFE~ ~O ADplTIONAL INSD~U~ION5 OR ,OF H~L~. SERVIa. , .~ i AS NOteD, ....... - '1 ,--Hr - ZL.__.. __~ZZT_ZZT~TC_~C;..LZZj, 7-0 /Y~O I