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Home My WebLink About8776-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.. Z8907 ..... Date ... ,Ianuary..1.2 ...........,19...7.8 THIS CERTIFIES that the building located at . 5.1.1 ~. F~:Lu Ad, .......... Street Map No ............. Block No ...........Lot No .................................. conforms substantially to the Application for Building Permit heretofore fried in this office 8776z dated ... Au~tst .....3 ....., 19..76 pursuant to which Building Permit No. 87777~. dated ... Au~%tst ..... 3 ......,. 1~76., was issued, m~d conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .... &wimmi~g. Pool. ~.th. ¥.e-c® ....................................... The certificate is issued to ...... ~Ioh~/{:~ ...................................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ..... I~R ........................... UNDERWRITERS CERTifICATE No ..... .~3.e.S. 7~....A~?.~..~..S:..??.e .......... HOUSE NUMBER ., .5] ] ~ ..... Street ... Ma~n. Road ............................ ......................................... Southald t. !~®w. y_o~lr .... ] ~9~.l ....... Building Inspector FOB3g NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PEPJ~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 'N? 8776 Z Date .............................. ~LL~g~S~.......,~., 19.~A.. Permission is hereby granted to: ................ ~,2a.~t i.tuck .......................................... to ....k~!~...~.e.E..-~.~!.v.~.Le....~.~.~.~.~..~..;,~..~~,..~.L~h..f.emce...~....e~.~e~-~.~zT.~ ................... at premises located at ....~,/~...~i~O...~Q~1- ......................................................................................... ................................................. ~th~ ....... I';.,~.- ........................................................................... pursuant to application dated .................. ~,,.~.......~ ....................... , 19..~6>., and approved by the Building Inspector. Fee $.. ~.~.*....C~.. .......... Building Inspector FO~.M NO. 6 TOWN OF SOUTHOLD Building Depaffment Town Clerks Office Southold, bi. Y. 11971 APPMGATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to 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. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of F~re Underwr,ters. 4. Commercial buildings, Industrml 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 1957), Non-conforming uses, or buddings and "pm-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 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-exist~ng dwelhng or land use $5.00~ 3. Copy of certificate of occupancy $1.00 Date ....... .... New Building J Old or Pre-existing Building V~cant Land Property ..... .................. ...... .,,~;../.... :,,x.. .................... Location Of Owner Or Owners Of Property .~..~.~'.4~.......~.../..../~. ........................... : .............................................. Subdivision ................. 1.2.;;::....J~ ................................. Lot No...~ .... Block Ho......-z~...._House Permit No. ,~.2..-2..i~. .... Date Of Permit~./.?./../.~.~.....Applicant ,../~i../~.~.~.¢/.~.~.....~..¢.'..~.i.~.~.X../~'....~.... / 1 H, alth Dept. Approval .......... (¢.~../...,...~ .................... Labor Dept. Approval ........... ................................ Underwriters Approval ../~.......~...-~."...~.....Z. ..... ,7_ ............ Planning Board ApprOVal .....~/./.,~..~.~.. ...................... Request For Temporary Certificate .............................. r.:.'. ..... Final Certificate Fee Submitted $ .. ,~,,, .............................~ d~ ' ?~pp~ i an er regulations, Construction on above described uildin, g ADp ,cant .......~~ .......................... Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or seal) ,, 12/16/77-tiTHE NEW K BOARD OF FIRE UNDERWRITER , ' ='l,--' BUREAU OF ELECTRICITY DUPLICATE OF N299120 -', _ - ,, - 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,D.~. August 18, 1976'~:.- .~..t,..t.on",o.o.fte871964 ~?* onty the el~t~at equipment ~ d~cdb~ b.t~ ~d ~nt~uc~ by the .ppHca.t .a~d on t~ ~ob~ appllca~io~ John King, n/s ~in Rd~ ,Southold, L.I. ~t~ ~, DRYERS J FURNACE MOTORS ' [ FuTuRE APPLIANCE FEEDERS ~,PECIA[REC'PT, TIMECLOCKS I-BEL 1 0 '1 40 ' SERVICE DISCONNECT [ NO. OF METER OF CC COND OVENS DISH WASHERS I EXHAUST FAN UNIT HEATERS MULTI-OUTLET [ DIMMER~ ,Panels: 1-2, lOOamps; ' - ':;,? ,- ~'~----: -- "':', "SWIMMING POOL"~This~certtficate co,ers compliance, a~ thee ~a~' of -inspection o~ . Bedause of unusual environments~it lis advisable to ,have frequent casts ~nd/or repairs made by a qual%fied person: ' Town HarborLLane -' ' :-:-,'~ ,--- , ~ - " Southold, L.I. 11971 '. , lit-J! 282 ' ' GENEmAL/~.N~(~EI~ '[.~ _t, ~,, , - ~ _ '~ --,--, CU~ ' · ~, = '-Ii - - ~ '~ :,~ :~ i{~ ' - -~ ce~,f,cate must not be altered in any manner, return to the office of the Board if incorrect, Inspectors may be idenhfie~ th~ credenhal SkinnB 'Dip "Pools Inc. A HALLMARK DISTRIBUTOR Westphalia Road, Mattttuck 298-5010--298-4445 Dear Ed~ In the essenc{ o£ ttme I am sending both the check and the U. %:riters certificate..., in hopes that it will help ~you expedite the completion of this cert. of occ ...... My bookkeeper i~ off for the winter and honestlylI, don't know where the hell she has the application with the permi~ number on it. My thanks £sor your help and apologies for having put'you through~ addltional work ..... $. 74 '£$ ',~. TOWN OF SOUT,OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE MUTHOLD, N. Y. Applicofion No. ~' ~ ? ..~ . ~ Examined Approved .......................... ~.. .......... , 19..7....~.. Permit No. ~ ~ ~] ? ~-~ Disapproved o/c ~ ~ ..................... APPLICATION FOR BUILDING PERMIT ~.~ Date . , INSTRUCTIONS a. This application m~st b~ completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot 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 opplication,.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 6r 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 York, and other applicable Laws, Ordinances or 4 Regulations, for the construction of buildings, additions or alterations, o,,,J~'Feqnoval or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, ~j~ing.cp/de, hOUsi~cede,/e~d regulations, and to-~ admit authorized inspectors on premises and ir~ buildings for neces: ~'.17 inj~ions. // /// ...... ( ........ - (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, gener~lectrician, plumber or builder. of o~r ' ' Nome emises ...... : ......... i ........................................... If ap h ~c~zed office~, d- ~'~e fo corporate officer] Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ......... ~-.....~........~.. ............ 1. Location of land on which pr~gosed work wi~ be dene. Map No.! .~ ................... ; ........ ~Lot No. ........................ Street and Number ..... r...'~'~.~./.:....~.......~..~.~....;,* ......... ~.~..~....~/./.~... ............................................. Municipality 2. State existing use and occupancy of prem,~ an~ intended use and occupancy of proposed construction: a. Exisiting use and occupancy ....... ~,.¢,~--------~..Z.....q'....~......~(..~...., ....... ~../¢w~ ............................................... -- b. Intended use and occupancy .................................... .~..~.-..~'..UZ....u:D.......Z~...~..T...'~:... ............................................. 3 Nature of work (check which applicable): New Bui,ding . ................. Addition ....Q .........,~¢rayon ..:/Z~l.._.~. Repair .................. Removal .................. Demolitiar .................. Other Work ~.~.~"/~,l.../.~t~'~'.~....~-., ~..,~'"'~ , ~ ~~ ~ ~~ (Desc;i~i~ .......... 4. Estimated Cos~ ........~ ...................................... Fee ............ /....~ ...................................................................... (to be p~id on filing this application) 5. I~ dwe]iing, number of dwelling units ............................ Number of dwelling unffs on e~ch floor ........................... If garage, number of cars ........................ ~ ................................................................................. ~ ............................. 6. If business, commercial or mixed occupancy, specify nature and extent of each ~pe of usff ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ De~th .................... Height ........................ Numar of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rea~ ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ............ ,r,/.~.. .......... ~.... Rear ........ ~.~.-- ........... D~pth .. ......... --~1. ............ Height .................... Number of Stories ...................................................................................... ~ .............................. 9. Size of lot: Front ........... ~.Z..~ ................................ 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: ........................................................ Will lot be regraded ...... ~.~.....~ ..... Will excess fill be removed from premi~e~: ((~Yes ( ) No 13. ~4. Name of Owner of premises ...~.....~ .................... Addross ~l~g~. ........... Chon~No.~.~ ~ome of Architect .................... ~ ........ ~...J ..................... Addross ................................ ~hono ~o ....................... -- . ......... , ................... ......................... PkOT DIAGRA~ koc~te cloorly nnd distinctly o~1 buildin~s~ whethor existinfi or proposed, ~nd indicate oll set-~qk dimensions from ~rop~rty lines. Give street ~nd block number or doscri occordino to deed, ~nd show street fl~mes ond indicate whether interior or c:orner lot. ...... n,..being duly sworn, deposes and soys that he is the applicar, ning -- above named. ~-/' He is the .................................................................................... ~~ ...................................... (Contractor, agent, corporate officec,/~fc.) of said owner or owners, and is duly authorized to oerform or have,~:i0rmed the said,~j~rk~to make and file this application; that oil statements contained in t~is applicction c/~ true to th~'"best of~ kn~led~e and belief a?,d that the work will be performed in the manner set forth in the appJ4/cation ,f, i4'ed tRerewith// Sworn to before me this / ...._ . _v.zc~_~'"~' ......... day of ....... ~ ............... , 19.~.~. L//~/'~ ~_LtZABETH kNN N~~ tlOTARY pUBLiC. State ol ~ 'to No. 52.8125850, Sutf~k TeTra Expires M~ch 30, 19.~.~