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Home My WebLink About8858-zFOn. M NO. & TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy P THIS CERTIFIES that the building located at . .Ig/8. N&ple l~a..(..AYs.,,}.. V~treet Map No.. ~ ....... Block No....XX... Lot No .... X~. .....8..O~.$.hg.l.d... N.-.Y.: ...... confoms substantially to the Application for Building Permit heretofore filed in this office dated . . . .~.e.p.t; ,~19.7.6. pursuant to which Building Pemit No. dated ......... 8..cpi;...1.6.. , 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 is issued is Priva.t;e..one f.a.m.i.ly...d.~.e.l. 1..!rig ..................................... The certificate is issued to ~..o.hr~..&..Ll!.c.y' T.e.r.p .... .0~. e.rs ......................... (owner, lessee or tenant) o£ the aforesaid building. Suffolk County Department of Health Approval ....D.ec...9....17.7.6.. by. .R:. UNDERWRITERS CERTIFICATE No..N.).].l+.6.~.2. ..... N.Oy...~.0., .1.97.6. .............. HOUSE NUMBER .7.~0 ..... Street ...t~..p.%..e..~.'~.?..(..L~..) .... ~..o}t..l;.h.o..1.d .......... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8858 Z Date ....................... Permission is hereby grante~J to: Co=~e.1;:L..C.oz~s. tr.,....J~/.C..,~.o~..~c..~te~...Terp ................ ~o~t~ko] ~ ....... N.~.~ .......................... /~uild new one family., dwelling ~ p~emises located at ..~/~..[~.D3.e..~_~..e ..... .(~Z.~...~C~) ................................................................ ~ .:L.:...~ ............................................ .q.o.~.~k.o.~......~.,%.., ................................................................... . ...... -%?~- ~o application' dat,e~'; ............................ ~a]D:~---?. .......... , 19..~J~., and approv~ed by the '~,, ', ,,;,~ t,~ ITHEi'NEW'I'YORK,, BOARD' OF FIRE,',UNDERWRITERS , ' 4"3~ ' 'r i ..I ' ' ~ ~ u~i~[~h d q ,~ll,~'lr '/F:,;P85 JOHN STREET, NEW¥ORK,, NEW YORK lO038 'only the electrical equipment ~ ~scn~d bel~ and [nt~pc~ by t~ appl~nt ~qm [he ~ ~p~a~on ~u~r ~n t~r~m[~s of , ~ ', John, Terp, Maple Lane w/s' Accross mthefollowlnglocation; ~ B~emen~ ~ lst~l~'~ 2nd Fl. ' . Section ' Bilk ~t ' , November 29, 197~ andfoundtobei, compliance with the reqolren~en~s of th~s Board. fiXTURE, ' FIXTURES OUTLETS · FLUORESCENT ',? "~1~3~'' 17' "~' DRYERS FURNACE MOTORS ~SEI[VICE DISCONNECT ?l~Smoke~l'De 'i ,1~ ,ill ~!UI RANGES OVENS D1S)'I WASHERS EXHAUST FANS I'IMR CLOCKS ' UNIT HEATERS MULTI.OUTLET DIMMERS SYSTEMS NO, OF FEET 'S--,~ , .E ...... V ' I C E Thins cerhficafe must not be altered in any manner~ return fo the office of the ~ard if Incorrect, {nsp~tor~ may be identified by credentials TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD N Y. ........................................................................ ......................... : .... APPLICATION FOR BUILDI~ PE~IT INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ in ink and submitted in triplicate to the Buildi[ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing Iocahon of lot and of buildings on premises, relationship to adjoining premises or public streets , areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of th~s applicatio, c. Thu work covered by this application may not be commenced before issuance of Building Permit. d Upon approval of this application, the Building Inspector wdl issue a Building Permit to the applicant. Such perm 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 o Certificate of Occupanc 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 th Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe, The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t, admit authorized inspectors on premises and in buildings for necessary inspections. /~'-/(Signature of applicant, gr name, jr a corporation) .......... Electric,an's License No...~..~.~...~./...~'.../'..(.,.~.. ........... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ............................................... .......................................... if apphcant is a coj:porate, sianature of duly authorized officer. ~ ~-Iame and t,tle of corporate officer) ~'~ Builder's License No ..................................................... Other Trade's License No ............................................... _ _~- ,, ,JFUh"i) ~'~U Locat,on of land on which proposed work vi,il be done. Mop No'. .... ,,~ ./~...,~.~...C...~..~..'.~.' ....... Lot N/o ................... Street and Number ........... ~.~.?../:...~. ..... ~.../...E. ................................................ ~....'.-. ..... ~'~.~L~.'..~..~...~./~. ....................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction' o Ex,s,tinguseandoccuponcy ............ ~..Z~...~..~...~..~.Z ........................................................................................ b. Intended use ond occupancy ........ ~..,~.~....~..... ,~.. ~....7~..~.N/......~.. ~..~..,.,~.../.~.~.. ................................................ / 3 Nature of work (check which applicable). New Bu~dmg ........ J/........ Addmon .................. Alteration ............. Repair ................. Removal ................ Demohhon .............. Other Work .............................................. 4 .................................... ~~/'~? ~ (~ / ° ~ (Description) Estimated Cost .,...-- ~/--.-.- ............... 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 oF mixed occupancy, specify nature and extent of each type of use .......................... ,,,/' ,, .-- ~. ,/,/ ....,...........3~.///.~.. 7 Dimensions of ex~stmg structures, if any Front . .6~....~. ............ Rear ...~.,x.....~... ................ Depth Height ..../...~..--~' ............ Number of Stones ..... ./.. ................................................................................................ D~mansions of same structure with alterahons or addmons Front .................................. Rear ....................... Depth ................................ Height ....................... Number of Stories .............................. 8. Dimensions of entire new construction' Front ................... , ............ Rear ............................ Depth .................. Height .................... Number of Storms ....................................................................................................... 9 S~ze of lot. Front .................................................... Rear ....................................... Depth ............................... 10. Date of Purchase .................................................. Name of Former Owner ....................................................... 11 Zone or use d~stnct m which premises are situated .......................................................................................... 12 Does proposed construchon violate any zoning law, ordinance or regulahon 13. Wdl lot be regraded .....~'.~..~... ............ W~ll excess fill be removed from prem,ses: ( ) Yes (~'i No / ................. .... Phone ,o ....................... Name of Architect ......................... ,6 ............................ Address ................................ Phone No ....................... Name of Contractor ..... ~..:..~'~ '....~.../~4~/ ~/" Address ~.~/.~..~...~.../<.?... Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~sting or proposed, and mdmate all set-back d~mens~ons from property lines. G~ve street and block number or description according to deed, and show street names and indicate whether interior or corner lot STATE OF NEW YORK, COUNTY OF ...... ,,q.~f,~o. Zk. ........ ................... ..O'..o...~..e.~..b.....~........c,..o...~..~...e..~...].. ....................... being duly sworn, deposes and says that he Is the opphcam (Name of individual signing contract) above named. He ~s the .......................... ~O~t.r~o~'. ........................................................................................................... (Contractor, agent, corporate officer, etc ) of sa,d owner or owners, and is duly authorized to perform or have performed the said work and to make and file this applicahon, that all statements contained m thru apphcahon are true to the best of his knowledge and behef; and that the work w,II be performed Jn the manner set forth in the apphcat,on filed therew,th Sworn to before me this ........................ 76 " .................................. County ......................... £t IZ~I~TH At/N NOTARY PUBLIc S~at.,, nf No 52-'8125850 e.. ,, ,Term E~res March ~9, DE~ED: SUFF, CO. HEALTH DEPTiAPPROVAL _J 6,50 5U~Ot_K Cou~-r'Y, ;4.Y. RODERICK VAN TUYI.- P. C. 19" ~uIrF. CO. DEPT. OF H~ALTH FOR APPROVAL OF CON~E~UCTION ONLY ~rI'ATE~ENT OF INTeNT THE WATF.~ SUPPLY AND DiSPOGAL SYS'I'E:MS FOR THIS DBC[ WILL C~F~M ~ THE ~AND~DS OF SUFFOLK CO. D~. OF H~L~. SERVIa, APPLICANT OWNER; Yot~d Ave. ~he sewag~,~is~os~lDand water suppl7 ~aoilitles for this lgcatlon have bees Inspected by ~hts ~men$ ~d found / DA*TE: H. $. REF, NO,: ................... ~$TANDA*{~{ZM{$ OF ,~UFFOL.~ ~ OElWl'. OF H~r. ALTH. $ER¥1C~21t',S.