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HomeMy WebLinkAbout8773-z· q)RM NO. 4 TO~V~q' OF SOUTHOLD BU~.~G DEPAR'I~t'RNT Town Clerk's Office Southold, lq. Y. Certificete Of Occupancy No....Z.9.2..2.6.... Date .S~-p.tember.... 25 .......... , 19..78 THIS CERTIFIES that the building located at2.~..0.©. .P.l..n.e..Ne..c.k..R.o..a.d. ..... Street Map No ............. Block No ...........Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...A.~g~a$ .... ~. ....... , 19.7~ pursuant to which Building Permit No....8.7.7.~.Z. dated ...Augam~c... 2 ........, 19..7.6, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which tbi.~ certificate is ~ued is ........... .~ .ZV.A..~.E..q .~...F..~..Z.Ly. ~..~!~L....~..C..~. ~H...~. ~..~.~p~ ............ The certificate is issued to ...... G..ep.r.g.e..&..G..e.r..~.d. ~.n.e..3.c.h.w..e.b. .................... (owner, :~lex~l~ta~s~) of the aforesaid building. N/R Suffolk County Department of Health Approval ........... ......................... UNDERWRITERS CERTIFICATE No ......... N3.7.3~.~3. ........................... HOUSE NUMBER .. 230.0 ....... Street .........P.$D.e..I~ .R.Q.a.d. ................ Southold, N.Y. .... .............. Building Inspector lllX)lu~ No. ~ TOWN OF SOUTHOLD ~JILDIN~ ~A~TMENT 'IX~VN CLERK'S OFFICE ~OUTHOLD, I~. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT'ON'THE PD, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 8773 Z Dot, ..... ~...?.... ......... , ,9.,~O/ PermissiOn is hereby granted to: ,~.'/ ~'/A. ........ ............... ~._:~, ........ ~ . _~~ ................................................................................................................... ~ ~ ~,. ~=~ ~ ....... ~......~...~...~ ................................. Building Inspector. ulld:ng nspector l~OEl~ NO. 8 TO~N O~ $O~TSOL~ Building Department Town Clerics Office Southold, H. Y. 11971 APPLIGATION FOR CERTIFICATE OF OGGUPANC~Y Instructions ' A. This application must be filled in typewriter OR ink, and submitted in~ o 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.F~nal approval of Health Dept. of water supply and sewerage d~sposal--(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 budding. 5.Submit Planning Board approval of completed site plan requirernehts where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or b~bddings 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 ~nd condition of buildings. 3. Date of any housing code or safety inspechon of buddings or premises, or other pertinent formation required to prepare a certificate. C. Fees: 1. Cert~hcate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of cert~hcate of occupancy $1.00 New Building .................... Old or Pre-existing Building ..................... Vacant Land ............................ Location Of Property .~...~...~...~.~.....~/..~..~.~.Z~.~.'~....~..~.~./~.~.~.....~.~...~...~...~...~..A~..~...z/~.~/ Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No..~...Z..?.....~... Date Of Permit ...~/'~./7.~..Applicant ..~..~...~....~....~..~........~...~.....Z~...~.,~. Health Dept. Approval ............................................ Labor Dept. Approval .! .............................................. ov Underwriters Approval .~..-~.~. ............... Planning Board Appr al ........................................ Request For Temporary Certificate ........................................ Final Certificate .......~. ............................ Fee Submitted $ ......~..t ........................... / Construction on obove described building on eets <31 OhS. Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or seal) / IS/JAP OF LAND S~I~VEYED ~0~ George Schwab, 2300 Pine .,.~ex.ml,,ed,., January 26, 1978 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY [~ [DH[ 8..=, JOHN STREET, NEW YORK. NEW YORK 10038 V.,e January 30, 1978 ~,p,,.a.nNo. onfz, 917521 N 373643 THIS CERTIFIES THAT only the electrical equipment o~ described below and introduced by the appllcan£ n~rned on ~ho above appllcatio~ r~umber in the premises of Neck Rd., Southold, L.T. ~-~ £nd FI. - - - ~ectlort BloCk Lot -- and found to be ~n cotnplianee uith the rvq~lrvments of tlti~ Board. FIXTURE ' ECEPTACL~SI SW TCHES FIXTURES ,,J, RANGES __IcOOKIN~ DEC__KS ~' S[RVICE DISCONNECT' ~ OF J. ' ' ' '" S - ~, R ' '-' V ''~ ~" i' OTHER APPARATUS. anelbo~.rc[/s :J.-oc~r, 125amp, 1-G.P.I. 1-Smoke Detector UNITHEAFERS MULTI-OUTLET ~r ~ P NO OF FEET EXHAUST FANS DIMMERS WigGins Lane Greenport, L~I-_ 11944 Lic.1049 E must ~of Be ~ltered m o.y monner~ return fo the off~ce Examined Approved Disapproved a/c ...................................... T. .................................................... (Building rnsifec~r~ -~ ~''''' ~ APPLICATION FOR BUILDING PERMIT Date ...~....~..~,,,~,,.....~....., 'l~.Z~... INSTRUCTIONS a. This application must be completely ~fdled m by typewriter at ~n ink and submttted in triplicate to the Building Inspector, with 3 sets of plans, accarate plat'plan to scale. Fee according to schedule. ', b. Plot plan showing location of lot 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 approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit 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 Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New Yqrk, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buildir~ code, housing code, al3cl regulations, and to admit authorized inspectors on premises and ir~ buildings for necessary/[~-ections. ~' /x/'// ( dr s o a 'c State whether applicant Js owner, le?ee, agent, architect, eng , ge a contractor, mectrJc'~;~, plumber or builder. ............................ Name of owner of premises ...~..~.~/~..:.....~..~.~.~..../~...~.~..~.~.~.~...~..~.~....~..~..~.~.~.~.~.~...~.~ applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No.~.~.~F,J~,~.~..~....'~...~/V~ 1. Location of land on which proposed w~;~rk will be dppe. Map No..: .../. ......... ~ .............. v ..... Lot No.,....., ................. Street and Number "~"~'"'~'"" "~' '~'"~'""'~' "~'" '~'""~' '~'"~"'"'"'c~"~'"'~'~"~'~" '~"~'""~i""ii'' ~ ''''~' Mu'nic 2. State existing use and occupancy of premises and intended use and occupancy of proposed constru.ction: a. Exisiting use and occupancy ..... ~.~'~--"~...-~,~,~......~-~'~//~.,~,~..,~G~,~,~./..~..~.~---- -, .................... b. Intended use and occupancy ....~./K~5'-'-~. .... ~.~;~. .dl~.....~.~O .... ~.~ ~1..~. ...... 3. Nature of work (check which applicable): New Building.. ................. Addition ......~ .......Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cast .........{t~.,~.~ ................................. 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 ............................................................................................................................................. 6. If business, commercial or mixed occupancy, spgcify n~_ature and extent of each _type of use ........................... 7. Dimensions of existing structures, if any: Front .....Z'..~..... .............. Rear ...... ~ ................... Depth ........ ~. ......... '7 Height ....~... ............... Number of Stories ...... ff. ............................................................................ -~ .............. ; ...... Dimensions of s,a.m~_structure with alteratiOn/S or additions: Front ..... ~6Z~.C. Rear .4~....~..../.......~.. non*h ~..'7 25 Heiaht ~ ~ Number of Stores 8. Dimensions of entire new construction: Front ..... ~.......5. .................. Rear ........ ~.[. ............ Depth ...f~....(. .............. Height ~.. '7 Number of Star es /" ....................... ;;;S;"[;'"Z ................................. ~-)~'"~ ............ ~ ..... r ............. ~'- 0 0 , 9. Size of lot: Front ......... - ,..~,, ,, .,--~,--~z/'~': .............................. Rear ....... ~..~.: ..................... Depth .~'...~ .................. 10. Date of Purchase ..... '.,..~..:'.~,,-Z~.;,4..../..~..~.Z~.~...~......Name of Former Owner 1 1. Zone or use district in which premises are situated ...................................................... ~-~/~ .......................... ::"...: ..... ~ n law ordinance or re u at on /...v...,:r... 12. Does proposed construction violate any ZOrtJ g , ' g : ............................... ;~,-'; ............. 13. Will lot be regraded ....~....~/~'...~- Will excess fill be removed frorn_Eremises: (/~)~es ~ No _~,,~ 14. Name of Owner of premise~~'..-~:,.~.~.~-- ~'---- -- ~"-" -" Address ....~....~...~.~.. ..... Phone No./~.~..~Z'. ~. Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly oil 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'W YORK, _ ~ S S COUNTY OF ....... ~i]l~,~O~.......f ' ............................ I~I[~I~-.,~...E~I~ ...................... being duly sworn, deposes and says t~t he is the applicam (Name of individual signing contracf) above named. 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 ~ke and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set fo~h in the application filed therewith. / Nota~ Public, . ............................. ~t~O~.. Coun~ '~"'"'" ............. ;'"';;':'"'~-'7:'"";7" ........................... ~ · -- . , ~ ~ / t~gnature Ot appncan~ ~oun} ~o. 5~-812585~, Sul[nlk ~ ~ Te~m Exoires March 30. t~