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Home My WebLink About8781-zFO~M NO. & TOWN OF $OUTHOLD BUH.DING DEPARTME~NT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..L.'~.'2~. ..... Date ............. l~ee .... ~0 ..... , 19..~.6 THIS CERTIFIES that the building located at ...l~a~ .D~z &. ]~. ~ff~e~tv~ Map No. Dowmmv~zw. Block No ........... Lot No...~ ....~'~;ahog~- · .N,~.,. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..............~...~, 19.. 76 pursuant to which Building Permit No.. dated ............Au~..I, .... , 19. ?6, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is PrL.V~. ome. fo, mil¥. dwe.l.~f~g ........................................ The certificate is issued to . .Oas., .&. Imel~l~..¢o~oram ...... 0w~m~s ........~ ..... (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval ~ee.-.~-~.~6 ..................... UNDERWRITERS CERTIFICATE No. P.®md~n_~ .................................... HOUSE NUMBER ..... 9~0 .... Street .. i~eW '~(~'olk- 'A~ ...................... .......................... ..... ..................................... uilding Inspector IgO~3~ NO. 4 TOWN OF SOIJTHOLD BUll.DING DEPARTMENT Town Clerk'~ Ot~ice $outhold, N. Y. Certificate Of Occupancy No. ZT~..~ ...... Date ............ AUg ..... 22 .... , 19.7.?. THIS CERTIFIES that the building located at .N. ,$:Av.q..~ .D.a. 0la..D.~ ....... Street Map No..D.o.~.m. ~yl,e*/. Block No ........... Lot No. 3 ..... ~utchogue...12:,)(~ ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ Aug.. 3.., 19. ~g~ pursuant to which Building Permit No. 87~.~2[.. dated ........... .Aug..¢ ..... , 19..7.6., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate ts ~ued is ?r.i.v.,~.e..one..f.~. ~ly.. ~.w.e.11 ~t~.g. ~i.~b. ~.t.~o..n ....................... The certificate is issued to .. Ja~ea & .Ilaelc~a...~orc.o. rar~ ....... ¥~ers ........... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .D.e.e.. ~. 7.. fi.??.6. .................... UNDERWRITERS CERTIFICATE No. pp.rqd, i.n.g .................................... Suffolk HOUSE NUMBER..952~.. · N~.~. Street ..... A~ra ........ C1Atchogue .............. 90 Dean Drive .....· .n Building Inspector[ FORM NO. ~ TOWel OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH*OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8781 Z Permission is hereby granted to: ~/e__ d . ce,~eoT~,~ ~ -Do OJ N_~ V~ ~ Lt~ L0-r ~ ' nt premises located et ............................................................................................................................ pursuant to application dated ....................................................... , 19 ........ , and approved by the Building Inspector. Fee ....................... Building, Inspector FOEI~ NO. $ TOWH OF $OUTHOLD 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: 1. Final survey of property with accurate location of all buildings,, property lines, streets, aha unusual natural or topographic features. 2 Final approval of Health Dept. of water supply and sewerage disposalm(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 s~te 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 lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condihon 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-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1 00 ................ New Building --Addition ................ Old or Pre-existing Building ..... I ........... Vacant Land .............. Location Of Property ...... .~..~..~...~.....~)~..~.~....~'.....~....~....~..~.~-~ .~....'~..,~..~h.....~....~.....~..!. ............. Owner Or Owners Of Property ...... ..,~.........C~....O...~....C..~...,~.....,~,..~..~. ........................................................................ Subdivision ................................................................ Lot No ............. Block No ............. House No ............ Permit No .... ~..?..~.LZ.. Date Of Permit ...~./.~.l.~..~.Applicant ...~..:..~...~ Health Dept. Approval .... ~'"'7 "/ ..................... Labor Dept. Approval ................................................ Underwriters Approval .....~...:..~...~..~..~...°.~.. .................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fin~ Certific!te ........... ~ ................. Fee Submitted $ ..... .~.~ .......... i Construction on above described building and permit meets all applicableI codes and regulations. Sworn to before me this ....... ,,~,.... dayof ..... ~..,(T~,....~. ...... Z.~..... (sta ~p Notary Public ........~~ County FOBM NO. 6 TOWN OF $OUTHOLD 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 triplicate to the Building Inspector with the follow~ng; 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 d~sposal--(S-9 form or equal). 3. Approval of electrical installation from Board of F,re 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 Baard 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 o~ 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 inspectton 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 3. Copy of certificate of occupancy $1.00 $5.00 New Building ~f Old or Pre-existing Building Vacant Land Location Of Property ...~/...~... .....'~'": ~'"~'""~"~'"~'T'[~'~'~'""~'""-r~ x .. _ ._ ____ ...... ~'~'~';'Jl .....4~'~'~ ...... ~'~'/'~ ~ ~'ner Or ~ners Of Prope.y ........ ~...:....~.f~.~..~.~..~.~.:. ................; .............................................. Su~ivision ................................................................ Lot No ............. Block No ............. House No ............. , i Permit No .~.~..~.~..~ Date Of Permit ...~/.~/?~Applicant~...(~./.~.~..~..~..~,.~.~.....~].~C. I ~alth Dept. Approval ....... ~.~....~ ......................... Labor ~pt. Approval ............. t.:.. .............................. Unde~riters Approval ............... Planning Board ~pr al ........................................ , Request For Tempora~ Ce~iflcate ........................................ Final Ce~ificate .......................................... Fee Submitted $ ~ ~ 0 ~ Construction on above described building and permit meets all applicable ~c~s and regulati~s. · ....... ~phcant ....... ...... . .............................. Sworn to before me this -- /~~ ~ (sto~p or seal ~ [~ ~ c~ ~ .........o, ............ ~D, N. Y. ~/~/z~ . I ~/~/ ~p.~u.~..-~ ....... ~ .......... Exam,n~ ................ ~.' ........ 19...~.~ ...... : ......................... ' ............................................................. ..................... o. This a~ cat on m~t ~ c~pleteiy fill~ in by ~ewriter or in ink and s~mi~ in triplicate ~ ~e Bu~i~ Insp~tor, with 3 ~ of plans, accurate p ~ plan ~ ~le. F~ acco~i~ to Kh~ule. · emises relationship to ~joining prem Ms or pub c stree~ b, Plot plan showin~ I~?on o~.~ot ~n~ of ~u,?ng~_~.~.... ~ % ...... he diagram which is ~ of this opplication.~ ar~s, and giw~ a detan~ ae~npt~on aT I~UT otpr~e~ c The wo~ c~ered ~ th s a~ cati~ may n~ d. Upon appeal of this a~lication, ~e Building Ins~tor will issue a Building Permit to the ~licant. Such shall ~ kept ~ the premiss ~ailable for ins~ti~ ~m~h~t the ~rk. · No building shall be ~cupi~ or uMd in ~ole or in pa~ for any pu~me whoever until a Ce~ificate of ~cupancy shall have ~en gmnt~ ~ the Bui ding Ins~tor. TION IS HEREBY ~DE to the Building Depaffment for ~e issuance of a Building Pe~it pu~ont APPLICA ................ ~,-.. R,,ildin~ Zone Ordinance at the /~n aT i~hons ~or ?~e cons~ru~ion of bu ~mOs, ndd ~lonS The opplicont agr~s To comply wlTn admit autkoriz~ i~o~ ~ p~mi~s .......... (;~ddress at applicom~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. /~'j..~ ~. ~..~ .~. ................ Name of owner of premises ...~......~,~.J~..~.-.G.J.~. ~l .'~' ....... If applicant is a corporate, signature of duly authorized officer. -,-, .,. ~.;.,~. .... ... ,¥. .............. (Name and tit e of corp~6rate officer) Builder's License No ..................................................... Z~ ,,~ . . Plumber's License No. ~ .............. Electrician's License No~..~..~..u..~.~. ................ Other Trade's License No ............................................... ,, Location of land on which proposed work will be done. Mop Ix~7~.:,,~..~....~.,z.~.l~,> .......... Lot No~,~ ....................... Street and Numbe~ ~.~..~.-.'~'.-~ ........ ;.~47. t~,u.....,x.}.,4..~.~'~..- --- ;~' C. ~ ~ ~ Y~ ~'/J - I9~nici~b~'~' State existing use and bccupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ............................................................................................................................... / /-- /-'j -' "- -- / ' / .'.A~,.~/.*~. -~. -~...-~. ~.~.~c'; ................................. b. Intended use and occupancy ..... ~/. ............ -.~.--,-."--~,~,' ............. :/,4~e~ ~- -- ~. /., ~, ~. 3. Nature of work (check which applicable): New Building' ../~C........ Addition Alteration Repair .................. Removal .................. Demolitior .................... Other Work .................................................. (Description) 4. Estimated Cost ~...x 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, specify nature and extent of each ~pe 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 ............................ Denth Height ............................ Number of Stories ................................ 8. Dimensions of entire n~ construction: Front .......... ,~.~.....~ ............. Rear ...... :.~.~(.& ......... Depth .~..~...~ ....... Z y Number of Stories ~ Z ' Height ........ ~ ......................... ~ o Rear /~ ~ Depth ....~.~.~) ................. 9. Size of lot: Front .................................... :': ................................................ 10. Date of Purchase ........... ~..~ ......................... ~ ........... Name of Former Owner ...... .~';~:~..:!Z ................................ 1 1. Zone or use district in which premises are situated ..................................................................................................... 12 Does proposed construction violate any zoning law, ordinance or regulation: ...~.J~ ............................................. 13. Will lot be regraded ....~ ................ Will excess fill be removed from premises: ( ) Yes ( ~No , ~. ~ ~C O ~ ~ V . Add;e~ ..... Phone No ....................... 14. Name of ~ner or pram sas ......................................................... Name of Architect ................................................. Addre~ ................................ Phone No ....................... Nome of Contractor .......................................................... A~ress ............... ........................ PLOT DIAG~M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from prope~y lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ETATE OF NEW ]~'~R.K~/~z- , I S S cOUnTY DF ................................................................................................ being duly sworn, deposes and soys that he is the opplicam (Name of individual signing contrac~ above named. He is the /~ ~ ................................................................................................. .......................................... ~ontractor, agent, co,°rate officer, etc.) of said owner or owners, and is duly authorized to ~erform or have performed the said work and to ~ke and file this application; that all statements contained in tKis applicction are true to the best of his knowledge and belief; thor the work will be performed in the manner set fo~h Jn the application filed therewith. Sworn t~ me this -- , ........... ..... e .................................. -' f: Nota~ rub ~t..~ .............. (Signature of applicant) ~m,ssia~ [xpir~s ~nrch 30, dnoutho,~-~rJ cl'~.r~h~n ar ~.~ Yten fo Ihls .~.r'm, |ccr vFotc~lor -. '"'°4/f'f'O/- R' LOT LOT ~ SUFFOLK COUNTY DEP~RTiiENT OF SERVICES FOIl ~PPROYAL OF LOT ~ REFERENCE ' ,MAP OF' DOWNS~ FILED AUG. II, f t OUARANTI~D JAMES COR ~OUT HOLD LAND SURVtEY FOR JAMES CORCORAN I~T CUTCHO~UE TOWN OF $ou'r/HOL D SUFFOLK COUNTY, N. ¥. SCALE: I"" 40' MARCH 5) 197'6 All d;slances to wells and cesspools are by lace;hen from house owners and Reid observ,~hons, since most welts and cess- pools are not ws~ble these d~menslons canna' be cerhfied. Unauthorized alteration or addd~on to th~s survey ~s a wolahon a/ section 7209 of the New York State Educahon Law Copies cf ~'ms ~ur~,~'/ mop ~ot bearing the la~d surveyor's ~n~e~ ~eal er e,~,~e,c-d ,col shall not be cons~dorod to be a vchd copy Cu~ . .' ~f c .... :a ~g-s ~r~cetcd hereon shell run only to the ~c~..~, Cot ~.t~o~ th~ su~'~ey ~s prepared, and o~ h~s b~h~f to the IHJe company, governmenla[ agency end lend,no ~n:! ~uhon h~led hereon, and 1o the assignees of the lending mshluhon. Guarantees or cerhficahons are not transferable to add~honal tnshtuhons ~ subsequent owners. LOT* 4 SUBVIE¥ FOB ,%AMIES ~ME_IDA M. CORCO AN AT CUTCHOGUE TO~N' OF $OUTHOL D SUFFOLK COUNTY~ N. Y, AUG. I~$, 19 76 E)EC. 9', 19 ?'6 AppROVED,AS;NOTED i