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HomeMy WebLinkAbout8875-z~0~ NO. & TOWN OF SOUTHOLD BUH,DING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy No. Z739~. ...... Date .............. I)~e... 'i ......, 19..g6 THIS CERTIFIES that the building located at l//S. Barton Lan~ ......... Street Map No. Xx ........ Block No. .:X~ .. · Lot No, . .~,.. ~c~t$2aold. · .N,Y,, ........ conforms substantially to the Application for Building Permit heretofore fried in this office dated ...... Sept 20 , 19 76, pursuant to which Building Permit No..~.~7~'~. dated ....S.e~.~...2.0 .... , 197.~.., 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 Px':L~ate one, £a~:EL~ ,dweJ, l~z~g ...................................... The certificate is issued to F~,~P. eOSc.a .& Gllber~ .Sheff:i,eld ..... .C~r~ers ......... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .~.OV..21~.. ~.~76...]J]r. 1~,..Y~J,~a .... UNDERWRITERS CERTIFICATE No..l~nd.~P.[ ................................. HOUSE NUMBER . .68~ . .. Street .. Ho~tor~ ,~.ane ..... Southc~d ............ Building l. nspeetor / FO~M NO. 2 TOWN O~ SO~T9OLD BUILDING DEFARTM, ENT TOWN CLERK'S OFFICE SOUTNOLD, N. Y. BUILDING PERMIT (THIS P~RMIT MUST BE KEPT ON THE PP~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8875 Permissi~ is h?e gra ted to: ~ ~m~i~c~ ............................................. Date ........................................................ , Build new o 8m wellin ................................................................................ , ~ ................................................ premises located a,t \,~/~..]~o3~.t;13~..~e ..................................... ......................... ~ ~, ~O~t~O~ ~.~' .............................................................. ~ ~ ..~. ................................................................................................................. .... ; ~ ~ ,~ :; .... 8eot 20 lg 76 , and approved by the ~ ~pU~aht to apphc i~n 'date~ ....................................................... ' ........ t~ ~- BU,ld,ng Inspector FO~M NO. $ TOWN OF $OUTHOLD , Building Depn~tment Town Clerks Office Southold, N. I'. 11971 APPLICATION FOR CERTIFICATE OF OCCUFANCY 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: ]. 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 Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple 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-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 condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare o certificate. C. Fees: ]. 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 pete 9.:.....z2 .... New Building .,..,X~.. ......... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property .~.~/~.S.~.3~.~e~...~..-~.~.~..~.~.~e~.~-S~.°.~q~1:~.~.9~a~-~.~ ......................................... Owner Or Owners Of Property ...~.r..a.~.c..e.~.s..c.~.a..~..~.G~.i.~...b..e...r~.S.~.e..f`~.i..e...~..d. .............................................. Subdivision ................................................................ Lot No.........,...4 Block No. ............ House No ............ Permit No ...8..8...7...5.~. ...... Date Of Permit .~)/.~.7..0.....Applicant ..I...n..1...a..n...d....H...o..m.,e...s..~.....I...n,.c.... ...................... [Health Dept. Approval 6...T..S,..O.7..1..7...1.....1..1.../..2..4.../..?..G.....Labor Dept. Approval ,.~-...e..s. ....................................... Underwriters Approval .............................................. Planning Board Approval ...y..e...s. ............................... Request For Temporary Certificate ........................................ Final Certificate X~O{ Fee Submitted $ ..5.....0...0. .......................... Construction on above described building and permit meets all .epplicab~.. r_.~zles anc~-;regulati~ns. --]2landApplicant -"-'"-'""r~ ............. ; ~" -~' ........... n omes~ ±nc. K~nneth W. Thurber Sworn to before me this ....... dayof .... ...... ...... ~ County Notary Public ~~ .,,.~ ///3 o/? (stamp or seal)~~23~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE~ Ex~minod ........~.~ ........... ~. ...... , ]9 ........ ~pr~eo ...................................... , I ........... ~..., ......................... .... ........... ............................ .......... INSTRUCTIONS a This application must be 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 Iocahon of lot and of buddings on premmes, relationship to adjoining premises or public streets oF areas, and giving a detailed descnphon of layout ofproperty must be drawn on the dmgram which is part of thru application. c The work covered by this apphcation may not be commenced before issuance of Braiding Permit d. Upon approval of this application, the Building Inspector wdl issue a Budding Permit to the apphcant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used m whole or 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 ~ssuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described The applicant agrees to comply w~th all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and ir~ buildings for necessary inspections. INLAND HOMES, I-NC. (Signature of applicant, or name, if m corporation) Box 117, Hattituck~ 1N.Y. 11952 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budder General Contractor Builder's License No. - Plumber's L,cense No ........ .5. . .]:. 7, .Z.P. ............................. Electrician's License No. 2148-B Francesca & Gilbert Sheffield Nome of owner of premises ...................................................................................................................................... If appi,cant ,s a corporate, signature of duly authorized off,car. /~,~ i .................; fiJ;i ......... Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No ..~ .................... Lot No....~"~-~ .......... Street and Number ~..~..~.~`~.~.s~?`~..a~..~.e.~.~.~.~.~.b:.~..~.~.d.~L~.N~?..~'~ .............................................................. Municipality State existing use and occupancy of premises and intended use and~ occupancy of proposed construction' Vacent o Exisiting use and occupancy 1 -Family b Intended use and occupancy ............................................................................................................................ 3. Nature of work (check which applicobb). New BuHdmg .XX.:~ ......... Addition ................ Alteration Repair .............. Removal ................ Demohhor ......... Other Work .......................................... ' / ..~ ~'O. (Description) 4 Estimated Cost ~.30~OOQ.,..Q.Q .............................. Fee .~...~...:.....~...~ ............................................................. (to be pa~d on filing th~s apphcahon) 5 If dwelling, number of dwelhng umts ........................ Number of dwelling umts on each floor ..................... If garage, number of cars ...... % .............................................................................................................. 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use ....................... 7 D~mens~ons of ex~sting structures, ,f any Front ....................... Rear ................................ Depth ................... Height ........................ Number of Storms ........................................................................................................ D,aenmons of same structure w~th alterahons or addttians Front ................................... Rear .................... Depth ............................... Height .................. Number of Stones ........................... 62 62 23 8 Dimens~ons of entire new construchon' Front .............................. Rear ............................ Depth ................ 18 1 Hmght ................... Number of Stories zso ............................ ................................................... 270 9. S~za of lot Front ................................................. Rear ...................................... Depth ......................... 10. D,~te of Purchase .............................................. Name of Former Owner ................................................. 11. Zone or use district in which premises ore s,tuated 12 Does proposed construction violate any zoning law, ord,nance or regulation: ................................................... 13 W~II lot be regraded .................... Will excess fill be removed from premises: ( ) Yes (×) No 14 iNome of Owner of prem,ses Francesca & Gilbert Sh~ld Phone No .................. Name of Architect ................................... Address ................................ Phone No ................. h,'~ame of Contractor I.~.l..~D.d..~om...e.s.., ....TL.n.q ................... Address ..~.°..¥....!.l...7.;....¥..~..~.~j~o~elCNo..?...9..8...-.?..6..! PLOT DIAGRAM flmenslons f .~s and ind~ Lorate clearly and distmctly all buddings, whether ex~sting ar proposed, and mdmate all set-back properh, hnes Gwe street and block number or description accordmg to deed, and show street nar whether ,n.!en?~,°r~z ¥ ~_C~cP-rDer Iot,r f..~ .' '~- ~ ?~' ~ STATE OF NEW YORK, // [SS cou , w oF .................... ..~..o.~~.~ ................................. bemg duly sworn, deposes and says that he is the' apF (Name of ~,~'~dual sigmng contract) above named ~ . , contractor He , ', the ........... .~...~..o~.~.~.~.qj ............................................................................................. (Contractor, agent, corporate officer, otc ) of scHd owner or/owners, and ~s duly authorized to oerform or have performed the said work and to make ar th~s apphcahord~tatements contamed m th~s apphcat~on are true to the best of his knowledge and belie that the work writ be performed ,n the manner set forth in the apphcation filed therewith. Sworn to before me this c" ~-..._ . /,~ Notary Pubhc, . ..................... ~.%%~;~Q]~¢ ............. County ............. ~.,...~..¥~.....2 ...... /,....'~-.~ ........................ (Signature of a'~nt) ~ 0 LOT 4 ...©u HO~._O ~N ,¥. ~ t SCAL~: FOR APPROVAL OF OON~U~ON ONLY DENGE WILL C~F~M S. R~F. NO: ,, ~ANDA~ OF SUFFO~ CO. 1 OF H~LTH. THE NEW YORK BOARD OF FIRE UNDERWRITERS "' ~ BUREAU OF ELECTRICITY ~-~ 1 85 JOI~IN STREET. NEW York, NEW YORK 10038 THIS CEETIFIES THAT only ~ he electrical equipment as described below and ~ntroduced by the applicant named on the above appl~catlon number i. the prem~s, Gilbert Sheffield, Horton Lane, Soundview Ave. North Sea .D~ ~R~ .... I ~ I I FIXTURES I I I RANGES (cooKING DECKS [ OVENS {DISH WASH~ DRYERS { FURNACE ~OTO~S FUTURE APPLIANCE FEEDERS SPECIAL REC PTi TIME CLOCKS { aE/L [UNIT HEATERS MULTi-OUTLET~ TRANS SYSTEMS ~V~CE D{SCONNECT NO, O~ S E R V I C E OIHER APPARAIUS: Moto~: ~- 3/~p. [--S~oke Detecto~ Richard G, Relyea Delmar Dr. P,O. Box 372 I~ . ~T xr n'~,'~,'",O 'r T~^./~,'~"~ hO~ GENERAL MANAsGE,~ ~ Th~s cerhhcate must not be altered in any manner; return to the o{flce of the Board ~f tncorre~ Inspectors may be identl~by/the~r ere