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Home My WebLink About8620-zFOlhM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. Z761.3 ...... Date ............. April .. 2fi .... , 19..77 THIS CERTIFIES that the building located at .G.~t.1..Pond..Lane .......... Street Map No.Fo~dham .Ae. Block No ........... Lot No, . .1 ..... Gre.enpor. t .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Ju~u~. ~. ·., 19..7.6 pursuant to which Building Permit No.. 862.0Z. dated ............ .J.~.Le. ~ ..., 19.7.0.., 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 P~:iva.te .one..f~d.ly. dw. elling..witk addi.tiSn..( .one. ~on~habi:&able inter&~ ior room The certificate is issued to . Harry. C.,. Fax:~ell... Owne~. ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . N.,.R, .............................. UNDERWRITERS CERTIFICATE No.. N~.k~6~. .... N.o.~. 3.0... ~ 9~.~ ............... HOUSE NUMBER .... ,~,90% ..... Street . .(~ll..p.o~d..L~e .... Gr.e. onpor, t ......... .... {. ~F~.,o~:~,~. × .... u_.~.<'.~ .-; 7 ........ Building Inspector ~ ~'0~ NO. ~ 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) Ne 8620 Z Permission is hereby granted to: ~ ,~ .................. :.5~,~.;.:.~;~e..~l~a~....:...~lle ,o ~.~:~.~.~..t..~$.~.:.m,~.~.~..~.~.~.L~.~.~.~:..~:i........"...~..;....: ........................... : ..... at premises located at .~3~..]~b~1~1~ .... _~ ....... ~t..~..,...] .............................. , ................................ ........................................... ~ ....... ~.e~o~'.t..'...~,,~,, ..............., ............ :....; ...... '.; ............................... ...................................... ~ ............................................. ; ........,--'~H ..................... ~ ........~ ......................... ~ .... pursu0nt to application doted ~'~ ':-:,~i, :: t , '~ .......................... ,- ...................... ....., . . an~ dpproved by the Building Inspector. Inspector~ [ ' ' ' FOIU~ NO. 6 TOWN OF $OUTHOLD ~ Building Department Town Clerks Office Sou~hold, 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: ]. Final survey of property with accurate location of oll buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposol--(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, o certificate of Code compliance 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), Nan-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 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 $1.00 Date ..;.....~./. / ~/. ;?.7. ........................ New B~tilding ................ Addition ...../. .......... Old or Pre-existing Building .......; ........ Vacant Land .............. Location Of Property ..~..~,../.......... ~.~......~...~¢~......__..e.... .............. ......................................... Owner Or Owners Of Property ....... ~ ............... .~...$T~...?../.....~.....,,L~,.~. ........................................................... Subdivision ............ ~'..Z~. ................................. Lot No ............. Block No ............. House No...~....~....~/. Permit No. ¢~..~...~.e.....~...... Date Of Permit ..~Z..~./.~..&.....Applicant ...., .~./t,~/~..,...~.~t,~.~..~"~.G~ ...... Health Dept. Approval ............................................ Lobar Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ~ Fee Submitted $ .~'.,.~..~ ......................... Construction on above described building and p/~rmit meets all app~able Codes and regulations. Applicant ....... YZ~..~~..,,e.~ h .................................... ... Sworn to before me tins /' '/ '/ O-~,~-~/j.~ (stamp or seal)~:~c~ ~ Notary Public .......:>...~..L~/...~.... County ~~ ~ ~~' Nota~ :'uMk:, S~m c~ New York ~ No. 52-0344953 Su~o}k ~un~ Commission ~pir~s March ~O, ? ( ~0 .o o .... ''THE NEW YORK BOARD OF FIRE UNDERWRITERS .' BUREAU OF ELECTRICITY ~ ~ ' I ~1 ' ~ I~ ~ 85 JOHN STREET' NEW YORK, NEW YORK 10038 D";~ ~'1 Novembe~'l.30, 1976 App,,catlo,~No. onfle 875?66 ' N 314687 THIS CERTIFIES THAT ,; ':; I I ' ~ only ~he e~t~al equipment ~ ~sc~d belo~ and ~ntroduced by ~.,.~.~do. :' ,November 29, I1976 andfou;atob;:inc;m~ll;ncewitatherequirementsojthtsBoard, OVENS EXHAUST FANS 3 Let Elec. Co. , 56 Dunn Court ; .."~^ r~. Sayville, NeY.I' J.J.'/O~ ~'~"'"' ..... ' ' ' Ifered in on monner~ return ~o ~he office of ~e Boord ff incorrect Ins~edors moy This cedlf,c~te must not be anereu , FOI~ NO. 1 TOWN CLERK'S OFFICE ~ .~//~.~ ~ ~ SOUTHOLO, N.Y. ~.~ ,~ ~~.~ _xamine .......... ~.~ ................ ; .......... , .... ~..~ / , pp a o ~o ................................. ..................... (DuddmD Inspector'~-'";'~F~ .............................. APPLICATION FOR BUILDING PERMIT .................. ..................... . ..... INSTRUCTIONS a. This ~pDlicntion must be completelV filled in bv tVpewriter or in ink ~nd submitted in triplionte to the Building Inspector. with ~ sets of plans, nacur~t, plot plan to s¢~le. Fee according to schedule. b. Plot Dl~n showing Ioc~tion of lot ~nd of buildings on premises, relntionship to ndjoining premises or public streets ~iving a detailed description of I~out of properW must be dr~wn on di,grnm which is Dnrt of this ~Dpliantion. ~. The work ~overed bv this ~ppliantion mnv not be commenced before issu~na~ of Building Permit. d. Upon ,DDrowl of this npplic~tion, the Building Inspeotor will issu~ ~ Building P~rmit to the aDpliaant. Suah permit.sh~ll be kept on~ the premises nwilnble for insp,ation throughout th~ work. e. No building shall b~ occupied or used in whole or in p~rt for ~nv purpose wh~t,v~r until ~ Oertificate of Occupanav shnll h~w be,n~ gmnted b~ th, Building Inspeotor. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone' Ordinance of the Town of Southold, Suffotk County, New York, and other applicable 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 with ali applicable laws.'~ ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. / . . / , ,v i. (Signature of applicant, or name, if a corporation) ........................... i ~.'~l'd';~' '~¥ '~'l~'~i i ¢ !~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................... ......... ................................. , ........................................................ Name of owner of premises ~/~- ,,~,,,Y,.'.,.r~,.,2,¢~r,~ ..... Z.~.,.,.~,,.K...~,..G, If applicant is a corporate, signature of duly authorized officer. (Name and title of corpo, r4te officer), Plumber's License No ....... ../,..~...,,~.....'~.. ................................ Electrician s L~cense No ..... .z/~.,.......~,..~ ............................. Other Trade's License No .................................................. ;, . g~/9 ..~..~44t~ /~?.¢~, .... /.. ................. 1. Location of land on which proposed work will be done. Map ~o ....... .~..' ...... .'. ............... ,~. ....... LOt I~1o. Street and Number ..... ~..~...~.....~.!.~.....~...~..~......~...~...~....~..t....~..~..~...~..~-.~..'.~.~...~ .Y,'./-- ................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Extstmg use and occupancy ......... ./. ................ ~ ................................................................................................ ~ature of work (check which applicable): New Bt~ ding'. .................. Addition ..................... Alteratio~...~¥...~.. .... Repair ......................... Removal ......................... Demolition ........................ Other Work (Description) 4, Estimated C .... .~./ ....................................... Fee ~ '-'-- pst ~ ~ ~ ..~.. ............................................................................................ (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 ................. ,Z. ........................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front ..... ~. .........Rear ........................... Depth o....-,~;....../...~...~..'. ......... Height ............. ~,/. .......................................... Number of Stories ............. /., ............................................................. Dimensions of same structure with alterations or additions: Front ,5--~' x Rear ........ ~ ............................ Depth ....... .~...~.'...~./.~&.&'..¢.~.5/...~...~. Height ........... ~...'~....( .................... Number of Stories ..........~ .......................... 8. Dimensions of entire new construction: Front ......................... Rear ............................ Depth ................................. Height ................................................. Number of Stories/...:..7 ................................................................................. 9. Size of lot: Front .......... ~....,~...~.../. ............... Rear .......... Z--~. ........................ Depth ....-,~=....~.../..~/,../....~..~.../.. .............. 10. Date of Purchase ........ ../..~..,~...~. ................ Name of Former Owner ............................................................................ 11. Zone or use district in which premises are situated ......... Cz-.x~.~..~...~.~,.~.. .......................................................... 12. Does proposed construction vioiate anv zoning law, ordinance or regulation:~ ......... /..kC..~ .......................................... 13. Will lot be regraded .......... ~.~-.~...., ............... Will excess fill beremoved from premises: [ ] Yes D(J, No~, 14. Name of Owner of premises .... /.~.&~.~f...~...(~./21g. Y.~..~./.~........~..~..~/c..¢.ZL.....~...~../...~.~,~.~.~.~...~'~ (Address) (Phone No.) Name of Architect ..................................................................................................................................................... ,,~ (Address) _ (Phone No.) Name of Con,rector....~.,'~J. ·/~.../~. ~ .~ ........ "~' '/' ' 'x~' 'O' ~ ' '" "~' '~' ~' ' ' ' ' '[~.'~ k'~"~,'~' ~'/' j'~;~' ' '/~' '~' ' ' ' ' ' '~'/~'~'L~'~L'''~2 '~'~" // "'-"~-- -- "uu~ --~,,~,,,,,~.,. .............. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. 2.,/ STATE; OF NEW YORK, ) SS COUNTY OF ............ S~£~olk ....................... ............................ R±chamd..Smil.e~p.i .................................. being duly sworn, deposes and says that he is the applicant above named. (Name of individual si~ning contract) He is the .................................................... .Go.r~.%~aC.~D~ ................................................................................................................................. (Contractor, agent, corporate officer, etc'.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file 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 iu the application filed therewith. [LIZ/~BET~ ANN NEVILL[ . Term £xplres March 30 ~9~Y ' ' count Notary Pubhc ................................................... ~ y ........ .¢z....~_...: ............ ; ............ ';-~ '"'W .................'/'"/' ............ (.2'~~ ~.~_~~ (Stgnature bf apphcant) /