The URL can be used to link to this page

Home My WebLink About8772-zNO. · TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk'~ Office Southold, N. Y. Certificste Of Occupsncy No. Z7.9{~c) ....... Date ............. ~[il~.. ~OV...1~., lg. 2.7. THIS CERTIFIES that the building located at W/.S. Nassau P.o~r~t .lioac~ .. Street l~ap No. ~aas,. P.~,. Block No ........... Lot No. 8.7.... C~tcha~ue.. 1~ .~f, ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............... Aug...2 19.76. pursuant to which Building Permit No.87.72Z... dated .........Aug...~. ...... , 19.7.6, was issued, and conforms to aU of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is . Pr£vate..one. J~am~.~Ly .dwe_!.~ :Lng. ~f~.th. add~.t~on ...................... The certificate is issued to .~/a~..te~'. & -Leu.~.se .Uh~. .... 0~ner~ ..................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .N ,R~ .............................. UNDERWRITERS CERTIFICATE No..$360.7.~? ...... .0.c.t~ ,..~.~.. 197..7. .............. HOUSE NUMBER ...98~0 ...... Street .. l~assnu · · l~o.$nt. Re&d .... Cute. h~gue~... ' Building Inspector / TOWN ,OF SOUTHOLD BUILDING DEPART/v(ENT TOWN CLERK'S OFFICE SOUTH'OLD, I~. Y. BUILDING P.ER~IT (THIS PERMIT MOST B~ KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8772 Z Date ............................... /k~q~.t, ....... 2, 19.....~.6 Permission is hereby granted to: ..... ~'~er-'~t~L ................................................... ............ ~a~sa'~..t~o~_~t...Hcract. ......... 5~.t~l~gue ~o ~:~'~"~t~.'~ x'6n'"~'"~'~'~i~'"a~'~:1'~' ............................................................... _ ~ ¥ - Buirding I~or- J lvOEM 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 ltriplicate 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 topographm 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, Mulhple Residences and similar buildings and installations, a cerhficote 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 hnes, 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 inspechon 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 cert,ficate of occupancy $1.00 Date .~....~ ...~...£~,.. "~'~'"~"7 New Building .................... Old or Pre-existing Building ..... ,....../.... ........... ¥olcont Land ............................ Location Of Property ~ (~:;" Owner Or Owners Of Property J Subdivision ..~....~..~..'. ~.~..~.. ....... ..~....?../.....'~.....~.... ....... Lot No..~...~ ....Block Nd....~. House Permit No. ~..~/~....~...~.... Date Of Permit Z~..~.l~.~....~..i..~..;~k~pp~icon, .....~....~..~~.'!'.~./...~....~.......~...~...'~.....~.. Health Dept. Approval ........... ~...".~.; ................. Labor Dept. Approval ..~ ........,..~.¢./..~. ......................... Underwriters Approval .~..~.~.~...~. ............ .~.././~./~..~Planning Board Approvbl .......,~..)..~.~,.:. ..................... Request For Temporary Certificate ........................................ F~nal Certificat~ , Fee Submitted $ .......,~..!..; ................... Construction on above described building and pjermit meets all applicable codes and regulations. Sworn to before me this/ (stamp or seal) (~ ,~r, ................ dayof ........ ......................... I - Notary Public ............. /. ..................... County ~' 'THE ' NEW,' "YORK BOARD OF FIRE UNDERWRITERS ,r-,m " BUREAU OF ELECTRICITY -., ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~ THIS CERTIFIES THAT ' ~ ~ o~ly the electrical equipment as dcscr~beE beto~ and i~troduced by t~ appllc~t ~m~d on the abo~ application number in the premises of ',"" ' ' ~alte~ Uhl, Nassau Pt. Rd., Cutchogue, h.I. -. ~., o,,~,od o~ Oct ~;r 17, 19 7 7 andfound to bo in compll.nce ~ith lhe requirements of thcs hoard. OUTLETS SWITCHES ,NCANO~SCENT FtUORESCENT , DRYERS ' , FURNACE MOTORS - ~TURE APPLIANCE FEEDERS , ...[.. · . ,, , ~ERVICE DISCONNECT' NO. OF, S c [ 200 C~ t" I OTHER APPARATUS. '~' ~Zec. ~oom ~e~e~s: Z-Z.~ ~W ~ 1-GFCI ' .2-Smoke Detectors RANGES ~, , '~' ~,, sP~C~t R~C'PT E R EXHAUST FANS ' DIMMERS PEE ~ OF CC COND OF NEUTRAL 1 3/0 ',, -, , .... ~, Peter Bogovic '~ Li'c. 137E ' ' Om*,At ~.a~E~ i~ ' - ' -'- ' ' ' ~- ' ' Per D ~ /./ l- This cedificafe muzt not be altered in ~ny monner; rCvrn to the off,ce of fhe ~ard if tncorrech Inspedors m~y be idenhfmd ~f~ir c~dentmls. & ^ TOWN OF SOUTHOLD .~ t~ IUILDING DEPARTMEMT 9/.,~/?~, a.~.. "~'""7";**~. / "" SOU'mOLD, N. Y. ,of,J~ ,~ ;~. .....'-' ......... , / , p. ation .......... ........... .... ..... ...... ...... ....... L~ . ' ' (Building Inspe~tq~) ~--~-z~ -- ~ *- ~ .. APPLICATION FOR BUILDING PER~IT ~' Thi* application mu~t be ¢ornpletely Tilled in by typewriter o~ in ink onc~bmitted Inspector, with $ ~t~ of plan,, ocoura~ plan to ~cala. Fee ~.ng~t~. sche~oej: ~ b. Plot plan showing location of lot and of building* on premi*es, relationship to adjoining premise, or public *treets areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which i$ part of this application. .~ The~work covered by thi, application may not be comm, enced be~C~re, ssuance of Bui cling Permit d. Upon' opprova of th s app cation, the BUl dng nspectcor w~l issue a ~udta~mg PermltZto the~apphcont. Such perm t ~hall be kept on the premises available Tar 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 I$ HEREBY MADE to the Bulldit~g Department. ~or the issuance of a Bmldmg Permit pursuant to the Building Zone Ordinance of the Town al Southalcl, Suffolk County, New York, and other t~:flicoble Laws, Ordinances or Regulation,, for the con*truction of building*, additions or alterations, or for removal or demolition, as herei.n described. The applicant ogrees to comply with all applicable laws, ordinances, building code, housing cade, and regulation, and to admit authorized inspectors on premises and ir~ buildings for necessary inspections. (Signature of applicant, or name, if a corporation} (Address of State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of ...~1~..&,..~1~,111..1~ .......... : ................... ........................................................................... off icer. Builder's License No...:~,2~:g:~ ............................ t Plumber's License No. ~}~. ....................................... Electrician's License No. -3~ ................................... Other Trade's License No...; ...............~ ........................ .... ~ ·, 1. Location of land on which proposed work will be done. Map No.: ....~,K~. ...........................~ Lot No~,...~{~.: ............... Street and Number ..~tk~lll~..~l~..~j..~.~....a~...~..e.~......~'.....e~.~,t..~.?.....: ................................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy ~f I~i'0posed~cOn~tmc¢ion: a. Exisiting use and occupancy ....~.¢t~ ........................................................................................................... b. Intended use and occupancy ....~[e~lAea~. ......................................................................................................... 3. Nature of work (check which applicable): New Building.. ................. Addition ..... "-.Z .......Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) 4. Estimated Cost ..................... ~'I~m00D,~D0 ................... Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling unitsl:.?..t!..~...(.~.). ......... Number of dwelling units on each floor .~,a~i,.~..3,..~ ....... If garage, number af 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 same structure with alterations or additions: Front ................. ~ ............ Rea~ ....................... Depth ................ ~ ....... Height ............................Number of Stories ................................ 8. Dimensions of entire new construction: Front ....~,.~..! .......................... Rear ...~.t. .................. Depth ...~.t ................ Height ......... 2(~ ...... Number of Stories ...................................................................................................................... 9. Size of lot: Front .................... .1DD .............................. Rear .......................... ~ .......... Depth .............. ~ ........... 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 law, ordinance or regulation: ............ ~ ....................................... 13. Will lot be regraded' . ................. ~.... Will excess fill be removed from premises: ( ) Yes (~[~) No 14. Nome of Owner of premises ../~[~L~IL'..~.Z~t:LII. e...~[~, ........... Address .~i~l~ ................ Phone No ....................... Name of Architect .............................................................. Address ................................Phone No ....................... Name of Contractor ..[~re~'..~.~5.~..~.~..C,e~ ..... Address .~ .............. Phone No...~l~)~,c~... 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. /,~,, No. S2-8300210 ~ua )fled in Hassau & Suffo)k ~erm Expires M~rc~ 30, STATE OF NEW YORK, COUNTY OF ............. ~s~ ....... ~ "'" . ................ ~.~e.~ ............................. ~ ....... ~ .......... . ...... being duly sworn, deposes and says that he is the applicam (Name of i~ividuat signing'~b~r~ above named. He is the Co~ff~..~.~ ........ . .................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hag~c P~rfoFmed the said work and to make and file this application; that all statements contained in this application are true.t~ be~to the bee : his knowledge and belief; and that the work will be performed in the manner set fodh in the appliaatiohJ~~ Swor.,o e'ore .' ' / ...... ......... .......... , ........... ......................................................... // ~~~~ ~,_._~}~HA~L ~. PAVON~ .............. (Signature of applicant) ~of.~ Public, St.fe of New Y,otk AND -LVA LTE P-., ~ Lou ,sE TOWN UNI UNAUTHORIZED ALTEI~ATION OR AODITION TO THIS SURVEY IS A VIOLATION O~ SECTION 720~ OF THE NEW YORK SI'A'EE EDUCATION LAW COPIES OF THIS SURVEY MAP NOT BEARING APPROVED AS NOTED DATE: FEE~," - NO~I~Y ~.~JILDING DEPARTMENT AT ~.~.&¢,~ ~,AM TO 4PM FOR REQUIR-