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Home My WebLink About8793-zNO. 4 TOWN OF SOUTHOLD BUH.nINC, DEPARTMI~,NT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. 'Z' '7'5 -I 7"' Date ................ .~.~ .~.... ! J.., lg .~.~.~. THIS CERTIFIES that the building located at t~.r. ~.~..~ j~b..4 ........... Street Map No .... .'7.~.~. · · · Block No .......... Lot No...~-. ~r.~..I.~ ...................... canfor~ ~b~ta~ ~i;a~y to~t~e~/~p~lication for Building Permit heretofore fried in this office dated ............. ~,f~.. ~ ~, 19.7[~ pursuant to which Building Permit No.. ~7.~.~Z- dated ............. ~.... ~,, 19.7~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. ~" ' '~ ~' ~'~," ~,' ~'E"" ' *0~ '1;' ..... f. ~ ,~ t ~.'¥..- -~.1-_-.~.~ .I ~ .~. ................ The certificate is issued to .... .~...v,./~.. ~/.f~. ~.. ~. ~.r.~ ............................. of the aforesaid building. Suffolk County Department of Health Approval ( owner, UNDERWRITERS CERTIFICATE No ..... ~,~ ...~..I. ~ .~ .D .¢~ ........................ HOUSE NUMBER ..... .~ .~ ~ ... Street ...~,,.~ ~_....~e~ .~ .u .~....7-~4~. A .~ ........ ................................................ L ~14.~: ~.~ .................... ........ /, ...... Building Inspector FOIble[ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 8793 Z Dot, ........................ .,...q~.s.~. ......... J.~..., 19..~.~. Permission is hereby granted to: ................. ~!.c. ~.,o..~:.,~ .z. ~....c...z:..o...s..s..$..n. ~ ...... ~.~?...e.~, to ...... i.~:.~..z.~....q.n....~.~.`+.~.~..~..n....~....a...z&.e...z:.~.~.t..~..~....~.~.~.~;:t.s.~J`c~;...~:~.~.~`~.~ .......................... o~ pr~m~,e, [o,:ot~ ~t ..... ~.o..~..s.....~...y.....-...~.~.....~.a...g.~.z:..~....r.~ ........................................................... ........................................... ~L~2..o..n.~..z..a.....C...z:.o....s.~ ......... ~.z:..e...Z. ............ ~ ....................................... AU.? IF~ 19...~.~., and approved by the pursuan~t to application dated .............................. Building .Inspector. Fee $...J.2~.'~...00... ........ FOR~ 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 ~n DUPLICATE to the Building Inspector w~th 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 Underwriters. 4. Commercial buildings, Industrial buildings, Mulhple Residences and similar buildings and installations, a certificate of Code comphance 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-conform~ng 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 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 O0 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 .................... ;._ ......................... ;.~,. .........~ ...... t ........... > :~ ................................... Subdivision ,,3 au Health Dept. Approval ........................ : ................... Labor Dept. Approval ~ X/. '~ Underwriters Approval .............. .~..~'...c...~.. ................... Planning Board Approval Request For Temporary Certificate ........................................ Final Certificate ......................................... Fee Submitted $ .......... ' ~ ................. described budding and permitl me, e~ all app~icable~cod, es and r~gul,at,ons. Co n st ruction on above ~~.~.. I~ . Sworn to before ,n~his Apphcant ........ ~.~..~ .................... ................ day of ...... '+ ..................................... (stamp or seal) ..~/./77 Notary Public .... :6 ......... ~.: ................. County I Cf. ~ ? 5-/7 J,,I ~1-- I II IIIIIIii I I I I I I-I-I-I I i J I I I I I I I I I-I-j 4 4 ~ , 4 ' I , , I-i-~ III tP~F_~F~T f-z. oop~ °~ ,J THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ ak 85 JOHN STREET, NEW YORK. NEW YORK 10038' ri.t,, January 3, 1977 THI,~ CERTIFIES THAT only the eJ~'tr~¢a! ~,qu~pment as described b,,low and introduced {~y the applicant named on the above appf~¢atlon number ~n the premises B.W. Walker, Peconic Bay Blvd., 50' e/o Bruches .Creek, Mattituck~ FIXTURES I RANGES ICOOKING DECKS I OVENS DISH WASHERS i OUT~ETS ,~ ' 1 1.5 DRYERS J FURNACE MOTORS , FUTURE APPLIANCE FEEDERS JSPEClAL REC'PT TIME CLOCKS BELL UNIT HEATERS J MULTI.OUTLET --- , I I SYSTEMS SERVICE DIgCONNECT I NO OF I S E R V I C E PE~ ~ OF CC COND OF HI LEG OF NEU?RA i 12oo CB x 1 ~/0 I I 3/0 OTHER APPARATUS *Speclal receptacles: 1-50~mps., 1-30a~rs. glec.room heaters: l-3.Skw, 2-2.0kw, 2-l. Skw, 3-1.0kw, 2-1.25kw, 1-.?Sk~, 1- · 5kw 1-10 amp. Compactor EXHAUST FANS 2 ~ DIMMERS Cal Electric, 103 Briarwood Lane, Plainview, L.I. 11803 L~c. 1~97 ~, Thts cert~ftcate must not be altered in any manner, return to the off,ce of the Boord ,f incorrect Inspectars may be ,dent,fled by ~e~r credent~a~ TOWN CLERK'S OFFICE lTl~ ~l BUILyG PE~IT INSTRU~IONS a. This a~lication mu~ be c~ple~ly fill~ in by ~pewriter o~ in i~k and s~mi~ed i~ triplicate b. Plot plan showing I~ation of lot and of buildings ~ premises, relationship to adjoining premiss or public streets areas, and givi~ a detail~ description of I~out ofpr~e~ must be drown on the diagram which is ~ of this application.~ ~ c. The work c~ered ~y t~is a~lioQtim may n~ ~e commence~ ~efore issuance of Building Permit. d. Upon approval of this application, ~e Building Ins~tor will issue a Building Permit to the applicant. Such permi~ shall be kept on the premises available ~or ink,tim thr~ghout the work. e. No building shall ~e ~cupied or used i~ whole or in pa~ for any pu~ose whmever until a Ce~ificate of shall have been granted ~ the Building Insp~tor. APPLICATION IS HEREBY ~DE to the Building Depa~ment for the issuance of a Building Permi~ Building Zone Ordinance of the Town of Southold, Suffolk Count, New York, and other applicable Laws, O~inances Regulations, ~or the constru~ion of buildings, additions or alterations, or for ~moval or demolitim, as he,in d~ri~ed.~ The applicant agr~s to comply with all applicable la~, ordinances, building c~e, h~si~ c~e, ond ~gulati~s, admit authorized inspectom on premiss and in buildings for n~essaw i~tions. ($ionatu~ op~cont, or ~m~, La~el N.Y. If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) Builder's License No. Reil.]:.~. -- ~J_/~ Plumber's License No .................... '~'Z .......... '~'~ ......... -'T"/I-,.~ · / - .... Electricians License No ...... ~.. ............... Other Trade's License No ............................................... ,, Edgemere Pk 1 5' to 18 1. Location of land on which proposed work will be done. Map r~o.: ........... : .................. Lot No ......................... Street and Number ....~.~..~.~,J~..l~.Q~.S:J.~tJ[ ............ LJlll&t.e~, .......................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ........ ,~,,~,,,e,,1,,,1,~j ...................................................................................................... " with addition & Alteratiom b. L~t~nded use and occupancy ................................................................................................................................ 3. N~tur~~' of work (check which applicable): New Building,. ................. Addition ....~ ...... Alteration Repoir .................. Removal .................. Demolition .................... Other Work .................................................... (Description) 4. Estimated Cost .................. .'l..t.~...O~... .............................. Fee .....~.]~'..?..0..0.. ......................................................................... (to be paid on filing this application) 5. If dwelHng, number of dwelling units ....~ .................. Number of dwelling units on each flor ............................ If garage, number of ca~ ............................................................................................................................................. 6. If business, commercial or mixed occupancy, speci~ nature and extent of each ~pe of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Nu~er of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ J.~ ....................... Reor....J.~ ................... Depth ....~ .................. Height .................... Number of Stories ..~ ............................................................................................................. 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former ~ner ........................................................ 11. Zone or use district in which premises are situated ...~...~&~g. .............................................................................. 12. Does proposed construction vio[ate any zoning law, ordinance or regulation: ...... ~O ............................................. 13. Will tot be regraded' ...~. ................... Will excess fill be removed from premises: ( ) Yes ( ~ No 14. Name of Owner of premises .~,..~..&..~ ............. Addre~ .......~e~ .......... Phone No ....................... Name of Architect .............................................................. Addre~ ................................ Phone No ....................... Name of Contractor ~.~...~.~.~.~...~...~...~ ............ A~ress .......~~... Phone No ....................... PLOT DIAG~M Locate clearly and distinctly oil 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 Iot. STATE OF NEW~YQP,~, ,, ~ S S COUNTY OF .....~...~....X-.O...Az~... ........... f ' see filed plan ............................... ..M.....M......~..~,~....~.I'. ........................................ being duly sworn, deposes and says that he is t applicom (Name of individual signing contracf) above named. He is the ........................................ ..O~g/!~l'. ............................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duty authorized to perform or have performed the said work and to make end file this application; that all statements contained Jn this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the applicatio.~ filed therewith. Sworn to before me this .................... of ................ .............. , Noto Pub ,. .......... ..... ........... ........................ · x~x' ~' (Signature of applicant) Ff~tary Public, State of New'~?ork