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Home My WebLink About8633-zHO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~.71~3.~ ...... Date ............... De~... 23..., 19..~6 THIS CERTIFIES that the building located at . .~.~.~.h. ~t.o.a.~ .............. Street Map No.. ~ ........ Block No .... ~x .... Lot No. ~...([~'eel~l~Ol'~...1~,¥., ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. J. lllle...~ 19.7~ pursuant to which Building Permit No.. dated ........ June...lO ..... , 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 . Pl~,va.t;.e..olle..£a~.~l,y. d~.~l],:[ng ....................................... The certificate is issued to . .]~.~.hal'd..F~edlel' ..... .~zl'. ......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~. ~1~.~... ~.~... ~ ~.~.~.. b~ .It,..V.~a U~DERWRITERS CERtifiCATE No..~..~9~?~... ~. ,~'., .~.,~...~.~. 7.~. .............. HOUSE NUMBER ...~[38.O. ...... Street .. ]~h. tlO~d ..... ~:~ellpo~.t ............ FOBM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFfiCE SOUTH'OLD, N, Y. BUILDING PEfJ~IT (THIS PEP, MIT MUST BE KEPT ON THE PJ~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 8633 Z Date ........................................................ , 19 .... Permission is hereby granted to: Richard Fiedler ................... .~r..e.~ o.~ ....................................... to build r~ew one familJ, dwellin~ at premises located at ..... ~..a.g.~.!..~..°..a...~. ............................................................................................... ..................................................... G~.e~"~.t~ r.t, ..................................................................................... pursuant to application dated .............................. .~..t..~...e......~.., 19...Z.6., and approved by the Building Inspector. FO]P~Vl NO. 6 TOWH OF SOUTHOLD , Building Department 'Town Clerks Office $outhold, 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: 1. Final survey of property with accurate location of all buildings, property lines, ftreets, and unusual natural or topographic features· 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form,orl, equol). 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 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), 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. ............ 3. Sworn ~tatement of owner or previous owner as to use, occupancy and condition of buildings. · Date of any housing code or safety inspection of buildings or premises, or other pertinent .............. 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 New Bqilding ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property .~..' ~ ............ ~... c,-c~ ...~... c~~ ............................ ...~ .............. ~ ....................... Owner Or Owners Of Property ..... ~ ............................................................. Subdivision ........... ~ .............................................. Lot No...~7~.... Block NO..~, ...... House No ............. Permit No ..................... Date Of Permit .................... Applicant .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval Request For Temporan/Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building andJ~armit meets all e~Jcable codes and regulations. ....................................... ................ day of ............................................ {stamp or se~l) Notary Public .................................... County THE NEW YORK BOARD OF FIRE UNDERWRITERS ' ~..-' .-~. d~ BUREAU OF ELECTRICITY - ~-- 85 JOHN STREET, NEW YORk, NEW YORK IO03~ CERTIFIES THAT . - '- TH IS - mls~ of Rich Fiedlec, 1380 Beach Road, G~eenpoYt, L,I, in thefolh,zdngl~atlon; ~ B~ement "' ~ 1st FI. ~ 2nd Fl. OUtS i deSecti°n Block Lot tcasexamlnedon July 22, 1976 '~' '- Scuthold~ L'; ; -11971 ' ; ;::" .-',.~, -:" :;*: ~'"'-' LIC.l~/ ' -:' :::. - --~..;' ]~ This cedlfica~e mus~ n~t be al;ere8 in:any m*nnerr *eturn to the Of{ice of the Board if incorrect. Inspectors may be identifi~y.~e,r credentials. ,om ,~o. ~ TOWN OF SOUTHOLD TOWN CLERK'S OFFICE ~~// ~ ~ ~ '~ ~x_,~,~ ...~=.~..~ ............ ~.~.. ~ ~,,~,o~%A.~Z..L~ ............. ........................................ ' ~i,~ppro~ea ~/~ ....................................................................................... ~~-'~' ~-- ~, ,/ .... ~.. y,, ~ ~ ,), (~ ~,. /~ (Building Inspector) / ...... ......... , ..... ~hall ba kapt a~ tka pr~misa~ a~ailabla ~ar i~spactia~ t~ra~gkg~t tk~ ~rk. ~. S~ b~ildi~g ~kall ba acc~pi~d ~r ~sad i~ ~k~l~ ar i~ part {~r any p~rpa~ ~kata~ar ~til A~LICATION I$ ~E~E~Y ~A~E ~ tka ~ilding ~pa~tment ~ar tka i~ua~ca ~gulatia~, {ar t~a c~n~tr~cti~ ~{ b~ildi~g~, ad~iti~ ar alt~ratia~, ~ {~r rama~al ~r d~alitia~, a~ k~rei~ dascribad. admit a~tkarizad in~pect~r~ a~ prami~a~ a~d i~ b~ildi~ {~r ~a~a~ i~a~tia~. ........ ................................. (Si~notur* of ~ppli~nt, or n~me, i{ ~ corporotlon) ......... ~3Z:Z~h.. ~.~r.~... ~r.~a~.r ~...~.,.~., ................... (Addross State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder, o O~ER 2 Name of owner of premises .............. ~Ch~'d,.~.i~d~e~ .................................................................................................. If applicant is a corporate, signature of duly authorized officer. ~ (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ..... ..~..0.2..~ ............................... Electrician's License No .... ].,~.~.....~. ............................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Mop No.: .L][;~.F..~..72~. ............... Lot No. PAGP...[6:7 ..... Street and Number ........ ..~..e..~.,.°..~......~....~..~..,.~..~..e..~..l~P.~.~.t;...1~., ........ ~..o~..~o~th~l~ ................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a, Exisiting use and occupancy ........ .~...~.,~..¥..~..~...e...~.o..~l,..e ............................................................................... b. Intended use and occupancy .......... .~.?...~..~...~.~..e=....~..q.m...e. ......................................................................................... ~. No, lure o{ work (check which applicable): New Building' · ................. Addition ...... ~ .........Alteration .............. Repair .................. Removal .................. Demolitior-. ................... Other Work .................................................. 4. Estimated Cost '~ Fee r_~ ~i~r ,O~ (Description) (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 or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Fron~ .,.~.0...;Eel~.t; ........ Rear ..... I~.0...~.e~.~ .......... Depth .~.2....:;[e.e.'l;:.., Height ........................ Number of Stories ...1, ............................................................................................................ Dimensions of same structure with alterations or additions: Front ....d~0...:~,e:l;. ............... Rear ...fi0...;~,el; ........ Depth ..... .2.,.4:.....~.¢..e...t;. .......... Height ............................ Number of Stories ....... ~ ....................... 8. Dimensions of entire new construction: Front .,.~..8.....~.9~.~J; ................ Rear ....1`~l...~.~.e,.~. ....... Depth ...~..2.....~..e..e,...~. .... Height .................... Number of Stories ...... ,], ........................................................................................................... 9. Size of lot: Front ........ ,1,,5.0...;~,e,e.~ ............................ Rear ....... t~.61..~ef~.t; .................. Depth],81D.!...~..~ll~..~. ......... 10. Date of Purchase ......A~..I~...~-.~....~.Z.2. ..................... Name of Former Owner 1 I. 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 ....~.e~. ................. Will excess fill be removed from premises: ( ) Yes (]~) No 14. i'~ame of Owner of premises ,...,~.~.,c..b.,...a~..,~.....~,,$,,e,~,e,.,.~, ............ Address .~.;~?...-.~'..~...¢..t;:.~ ...... Phone No. Zl.?..7..-..~.8..~. .... Name of Architect .............................................................. Address ................................Phone No ....................... Nome of Contractor ............................................................ Address ................................Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from prapr:rty lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. %'ATF C,F NEW Y~CRIf.¢~ . /~ I ¢ S COUN'i-¥ Of: ..,F,~Y~~...f ............................................................................................... being duty sworn, deposes and says th4:t he is the applicam (Name of individual signing contract) above named. He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained thor the work will be performed in the manner set forth in the application filed therewith. Sworn to befgre me this ......... ¢~ ........ ,qday of ..... ~.?~ ........... ........ ...................... JUDITH T, BOKEN~ (Signature of applicant) '., :~,dc, State of N~York No :v..;4,i963, Suffolk County SUFF. CO. I-IFJ~Lr H DEP'~APPI~OV^L~ ..... 5.85,38', ~o4.5o NOT E *FL EVAT'~QN.5 A~-~E BAg[iD~,N-: .¢,N E~..EVA' ' * 6.5 __ jrO'B Fi: HONU F!,,EN T I'UTJ~ORIZED ALTEI~ATION OR ADDITION THIS SURVEy IS A VIOLATION O.c CTION 7209 OF THE NEW YORK STATE UCATIO;q LAW. OPI[S OF TMI$ SU:~V[Y MAP NOT B~ARING S'tA_~TTr~HEi~r Or ;N'rr~NT' THE WATER 5U~ PLY AND E, ESl D~C£ V,/ILL CQNF'~EI,,1 ro ~D~NDAIAD50t: 5UFFOLI~ 05U~T¥ ~ ~.~ OF HEALn4 ~E~Z¥~ C OW'NEVI RICI--t~RD A. FIEDLEP._ ~Z7 5EYENT N r. Eb. _47Z-_o_4 es ~,~^: ..!z~g4t sq. rT':. DEED 98' 5.85'38'~ 10~.50 MOLLE~ OFO, O A,T O[21~;MIGH VurAT'PT,~ tN CEI~TIR I , T~ r~E J MAP OF' '~' ,..AND ~_~ZT' GREENPO,L~T OF :;>';JuTH:cL P N,Y, 5.8 .SCALE-40'--I" ,12 "h~ON PIPE T~S,T MOLE k5 SURVEYED SEPT, VAN mY L, ,C, UC, L/~ND 5URVEYQ~5-C~EENI~21~ ,SUFECO · DEP'~',. OF NEAt . rH'SEtZVI CES - FOP. APPP. JDVAL ONLY ,DATE :.__ ~TAblDARD~ Ol= .~.}~EDLf~ ~JNTY "f