HomeMy WebLinkAbout8803-zl~il~ NO. 4
TOWN OF SOUTHOLD
BUII.IHNG DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No..Z~.397. ..... Date ............. DES...1. ..... , 19. ~.~
THIS CERTIFIES that the building located at . F~.8.. So~md.~ew. A~re .... Street
Map No. Northwo~sBE~ No ...... Lot No.. 1.0 ... Soul;he, Id.. iI,Y: ........
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ...... AUgust. ~19.. 76 pursuant to which Building Permit No.
dated ...... A]ag .1.~., 19 ~6., was issued, and conforms to all of the req,,ire-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is .P,~;~a$O..O~U~ ~'~:~lY .c~e:L.]~..ng ...........................
The certificate is issued to . .Chain. Neim ...... 0w~®r ...........................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval 1~0~...~0 . ~ 976 · .by R, .Villa ....
UNDERWRITERS CERTIFICATE No. ]~.~997. -. ~ov...~7..$976 ...............
HOUSE NUMBER ~90 ... Street ... Sound..V. ie~. ave ....... southolcl .....
Building~
FORI~ NO. 2
TOWN OF SOUTHOLD
BUILDING DEFARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON ~HE PP, EMISES UNTIL FULL
COJVIPLETION OF THE WORK AUTHORIZED)
N? 8803 Z
Permission is hereby granted to:
.~,, ,,."~ , '",,~ THE,~, ',~NEW YORK BOARD ,,OF FIRE, UNDERWRITERS
1 ' ~ 'Il ~ "1 r Ih ' ' ,' ' BUREAU OF ELECTRICITY
' ' : ,l ,,~ t~ i ,' 85 ,.JOHN STREET, NEW YORK, NEW YORK~IO038 '
.a., N0vembel;;'17~ ,i1976,~,..,.ca.io..No. ou~,,. 881025',,, "-"-'" ~ '"' ' ~' '~' ,,~ N , 312997
THIS CERTIFIES' THAT ...... ~ ',l : ~
only the el~tr~al equipment ~ ~sc~bbd below and int~uc~ by t~ applicant ~m~ on' t~ a~ apP~i~atlon num~r in t~ premlses of
CA~les~els,~. s/s So~n~vlew Ave., ~00~ e/o~ Horton
~ ~ Estates, L.I... ,~, ' --
in thefollomlng I~ationt ~ ~ B~ement. '~ lz, Fl. ~ 2nd Fl. OUt side ~t~o,, ~ ~m~4
~.~.~..d.,' ~ove~e~ 1~, 1976 and found to be in compliance with the requiremen~z ~f thls Board.
~XTU~E ; I ' I RXTU~ES ~AN~E~ C~K~NaD~Sl OVENS DiSH wASHErs ~X~AUST FANS
SERVICE DISCONNECT } NO O~ } S E .... ~ ~ '
1-30~p, 1-50amp.
*Special Receptacles:
1-G.F.C.I.
1-Smoke Detector
Motors: .1-3/4hp.
Sapanaro & Mineo, inc..
102 Oak Ave. '
Shirley, N.Y. 11967 . Llc.' #334E
~nto the
. INSTRUCTIONS
a. T,his oPl~iication must be compietely filled in by typewriter aC in ink end submitt~ed in triplicate to the Building
Inspectot', with $ set~ of pla~e~ ocCU_mte plOt plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or pubhc streets
areas, a.F~d giving a detailed description of layout ofproperty must be drawn on the diagram which is pert of this application.
c. The work covered by-this application may not be commenced before issuance of Building Permit.
d. Upon approval of ti?is application, the Building Inspector will issue a Building Permit to the applicant. Such permit
shall betkept ~n the premises available for inspection throughout the work.
e. No bUil;d[~ Shall be occupied or used in whole or in pert for any purpose whatever until o Certificate of Occupancy
shall havebeen granted by the Building Inspector.
^PPL!CATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Buildin~ Zone Ordinance of t. he Town.of Southold, Suffolk County, New York, and other aPPli...c~ble Laws, Ordinances or
Regulations, for the construction of buddings, additions or alterations, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicablelaws, ordinances,/?,.Lspe°ti J~ ,ebullding code,.,housing code, and regulations, and to
admit authorized inspectors on premises and in buildings for necessa~ i' i
~¢'Yf-/'¢~ ~ ~ ' ' ........ i~i~'~c~u'~V:~' '.-- ~.....~.~ applico,et/or ~l~rm~,"if"~'~:'~i~'~ ........
/I:{:;:: ,' (Address of applicant)
State whether applicant is owner, lessee; ~dgent, architect, engineer,/general contractor,~electrician, plumber or builder.
Name o, uw.er of premises .......................................................................................... ~ ........................................
c~llj&tmtL/{~ i.~,~corpor~ate, signature 9f~duly~~~. ~[ ~horiz~ officer.
.................. .........
Builder's Lic~ No. *....~ ........ ~ ....................................
, , ,
Plum~rs kicen~ ~o ..... : ...........................................
, . .
Electricians kicense ~o ............................... :. ....... ,. ,.
Other Trade's License No ............................................... .* . ,, ~
1. Location of land on which ~d work will.be done. Map No.t~f-O...~~__.~. Lot No ..... '..~..: ...............
Street and Number ..... .~,~,~-/.~..'....~'~...~...~..~.,~/...~ .......~ ........................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
property lines. Give street and block number or description according to deed
whether interior or corner lot.
3. Nature of work (check which applicable): New Building..~,,~...~ ....... Addition .................. Alteration
Repair .................. Removal .................. Demolitior ..................... Other Work ................................................ . ....
~1~.~..~.. ~. '~.~ ~-f' 5-- (Description)
4. Estimated Cost .. .~.~.~ ....................................... Fee ....... .; ................................................................................
(to be paid 6n filing this application)
5. If dwelling, number of dwelling units ............................ Number of dwelling units, on each floor ............................
If garage, number of cars ...... .~....-m.. ..........................................................................................................................
6. If business, commercial or mixed occupancy, spec. ify nature and extent o.f each type of use ............................
7. Dimensions o~,xisting structures, if any: Front ..(~g .................... ' Rear .~.~' ........................ Depth ...~....~...
Height ...L..{~'L ................ Number of Stories ........ t ................................... ; ....................................................................
Dimensions of same structure with alterations or additions: Front ....................................Rear ............................
Depth ................................ Height ............ ~ ................ Number of Storie~ .... ............................
8. Dimensions of entire new construction: Front ................................. ... Rear ............................ Depth~..~... .......
Height .................... Nurn~er of Stories .......................... ~. ................ ~.¥ .....................................................................
9. Size of lot: Front ...[-~..~.;~': ......................................... Rear ....),.~...~.. ........................... Depth ....... ..~...~..: ....... ....
10. Date of Purchase ........................................................ Name of Former Owner ........................................................
1 1. 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 ...V.~--,~.~. ............. Will excess fill be removed from premises: ( ) Yes (~No
14. Name of Owner of premises'~t~J~.~.t~.....{'~....~...:..~..,.. Address/~.../~....~.~/~.~.J~ph°ne No. ~....~.~,~.t./J~o
Name of Architect .............................................................. Address ............. :;..; .............. Phone No .......................
Name of Contractor ..~...P/;l~.~r:.. ........................................... Add,-ess ....... -: ........................ Phone No .......................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-b~ck dimensions from
and show street names and indicate
STATE OF NEW Y.~,I~,, j ~ / [ ¢ S
COU N~i'Y _O.F ~...f ~'
¥~kl~ 'f~nina contra, f),~Nome at mmv[auol s~g g con c
above named.
He is the ................................................ ; ............................ ...,,~--,,--,,w~-..-~-. .......................................................................
(Contractor, agent, co(~r,ate office, r,?tc.)
· ~.,~.;,,', i rk n n f'
of sa~d owner or owners, and ~s duly author zed to perform-"6T-, ',,~.',~ j.. ...... ed the sa d wa a d to make a d le
this application; that all statements contained in this application are true to the best of his knowledge and belief; and
that the work will be performed in the manner set forth in the application filed there)M4~.
Sworn to b~)'e me this _ ·
Nota .............. ...........................
Ne~ u~'.0344963 SuHolk Coun y
SUFF, CO.H£ALTHDEPT. APPROVAL
LOT
SCALE: ~0/ = t"
J~ORIZED AL~E~N OR ADDITIO[~
THIS SUrVey I$ A VIOLATION OF
TIF. E[T HOLE SUFF CO DEPT. OF HEALTH SERVICES I STATEMENT OF
FOR APPROVAL OF CON~TI~UCTION ONLY
DATE: DIiIs~AL SY~'I'EM~ FOR THIS RES
D'EI',,/C£ WILL CONFORM TO TH
H, S. REF. NO: GTANDAAI~DS OF SUFFOLK ~O. DEP
OF HIEr, AL"r'H, BERVIC, E~,
APPROVED:
17' APPLICANT
~ NOV 301'
Zhe sewage disposal
faoilit~es for this loeat!nn
tnsDected h~ this de
%o be satisfac%o:
,41"1'
~.~OUTHOLD, N. Y.