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Home My WebLink About8637-zFO~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. y. Certificate Of Occupancy No..Z.?f.8.3. ..... Date ............. NAY.. 31. ...... , 19..~.~. THIS CERTIFIES that the building located at . ~.O~.ie~/. A~ ........... Street Map No.. ~ ....... Block No .... ~...Lot No.. ~ .... ~...~*~.* ........ conforms substantially to the Application ~or Building Permit heretofore filed in this office dated ............. J~. ] ]., 19.~. pursuant to which Building Permit No...~ dated ............ ~..~ ~..., 19.7~., was issued, ~d confo~s to ~l of the requffe- ments o~ the applicable provisions o~ the law. The occup~cy ~or which this certificate is issued is . ~Y~. ~. ~$1~ .~l.l~g. w~h. a~ .~ddl~iO~ .................. The certificate is issued to RO~ I..ar. (owner, lessee or ten~t) of the aforesaid building. Suffolk County Department of Health Approval ~,R, ...... : ........... UNDERWRITERS CERTIFICATE No. HOUSE NUMBER ..... ] 8~... Street .... ~0~..~$zw..A~ ...... ~ut~d ..... ~uilding l~OE~ 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) N? 8637 Z Permission is hereby granted to: Cor~etlOonstrt.~otio~ ...... .~/..~.;....~.Lo.×...~.~.~ .~,. ~.~.~,.~..~;~.~. ;; .......................... ...... .1.80.2..~...~ et premises located at .......... J~/..d...~O~.~.;~'..~...e,,~....~}~O3,~...~.~..~., ............................. pursuant to application dated ........... ~T~...].~ .................. Z ........ , 19....~ and approved by the Building Inspector. Fee $~ *.u:~ ............... ' Buildin~ 4n~pector , FORM ~0, S TOWN OF $OUTHOLD , Building Depmtment Town Clerks Offlee 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: 1. 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 end 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 oil 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 New Bud ng Ad ' on ?....., ........ Old?,or Pre existing Building ........ Vacant Land. . Locoton Of ;~';~'r;i;"ii~...~/.iii:~~Z ................ '" Owner Or O.nors Of Praperty ........... Subdivision ................................................................ Lot No.~.~, Block No.' ....aZ.... I-J~use No ............. PermitNo ~.,'~'~..,.~. DateOf Permt4~../..,/,dZ~7../Annlicant ............. l, '/'" /"~ ...... rr / '~-~ ............ ~ .... v~"l· ' ' · o~'~' ................... Hea th De t A roval l~/z'~ De .................................. g PP ...... /,~.(..~, ..;. ..................... Underwriters Approval ./.~./. ~ ~'~- ~ ~..~. .... Plannin Board A royal Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ..~....~ ...................... App cant~.. ...~, .~....,\ [~/x'"" l' J/~/~'--~' ............................. .~__ ................ day of ............................................ (stamp o~' seal) Notary Public ................................... County /vT/, THE NEW YORK BOARD OF FiRE UNDERWRITERS BUREAU OF ELECTRICITY ~- d'] 85 JOHN STREET, NEW YORK, NEW YORK 10038 I I ,:,,,t,. August ',97 ,, 'i' N: 300346 THIS CERTIFIES THAT Only the elee trlcaJ equipment as described below and introduced by the applicant named on the above application number in the premises of Ivar Martin, Soundview~-Avenue w/o Mt. Beula Road,~I Sgu~h0!d,' L.t. in the following location; [] Basement was examined on August. 23, 7 13 DRYERS [~x lst Fl. [] 2nd Fl. outside Section Block ~t 19 7 6 and found to be in compliance with the requirements of this Board. RXTURES RANGES , FLUORESCENT OVENS ', DISH WASHERS EXHAUST FANS DIMMERS R V t C NO OF CC COND [ A'W'G NO. OF HI.LEG PER .~ OF CC. COND. OF NEUTRAL i 2 1 4 OTHER APPARATUS: Feeder/s: 1-3#6 garage to base. Lic 5"/8 '~' D Tbs certificate must not be attered in any manner; return fo the office of the Board if incorrect, inspectors may be identified by G & S Constracting Box 215 Southold, L.I. 11971 · rr ~ TOWN CLERK'S OFFICE ,~j / *~/ , · SOUTHOLD N.Y. ::,/.,'~/~ ~ .~,~-~,~/-~v~ Disapproyed a/c ................................................. ~.~ ................................... ...................... ........ ~...1] ........................ ,19.....g6_. Dote I~STRUCTIO~S o. This ~pplic~tion must be completoly fillod in by typowritor o~ in ink ond submitted in triplicate to the Inspector, with 3 ~et~ of pi,ns, occur~to plot plan to ~olo. Feo ~ccordin~ to schedule. b. Plot plon showin~ lecotion of lot ond of buildings on premises, relotionship to ad~o~nin~ premises or public streets oreos, ~nd Oivin~ o detoil~ doscription o{ la,out o{proporty must be drown on the d~oorom which is port o{ this opplication. c. The work covered by this opplicotion moy not bo commsnced before issuonce of Buildin~ Permit. d. ~pon ~pprovol of this opplicotion, the Buildin~ Inspector will issue o Buildin~ Permit to the opplicon~. Such permit sh~ll be kept on the premises avoil~ble {or inspection throughout the work. e. Mo buildin~ sholl be occupied or usod in whoto or in port for ony purpose whotevor until o Ce~ificote o{ ~cuponcy sholl h~ve been ~ronted bg the Buildino Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk 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 all applicable lows, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. Cornell Construction Co. (Signature of applicant, or nome, if o corporation) Sou, thold ~ l~. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 1' Name of owner of premises ................. .~.p~.....~.~....}.~p..~..~.z..~ ............................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No...g.o..r.~.e..1...]:....~.o.~.~t,..q~.~..o.~. Co. Plumber's License No ......... Ma.~t.~.tuml~..,P.t~mDSn~ Electrician's License No ..... G,*as.~Z',le3,lo, ............... Other Trode's License No ............................................... (Application To be submitted) 1. Location of land on which proposed work will be done. Mop No.: ........................................ Lot No ......................... ~,~ ~ ~,.~h~ //1807~ ~oundview Ave. S~.uthol~. ~. ¥ Munlcipalily 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ........ .~.~.Jr..~.~...~..e.....0..~,.e.....?.'~.D...~.~....]~,-~l~L.~.~ ...................................................... b. Intended use and occupancy ........ ,~.~.D.e....~.i.t~..~cl~:t;£o~S .......................................................................... 3. Nature of work (check which applicable): New Building.. ................. Addition Front~,~la~, ........ & Alteration .............. ~ ~..,~,-- . Repair .................. Removal .................. Demolition .................... Other Work ................................................ ,.. (Description) 4. Estimated Cost ........... ~3';~'00'-' ................................ Fee ....... .................. 5. If dwelling, number of dwelling units .,..~ ................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................ 6. If business, commercial er mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of. same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Reer ............................ Depth ........................ Height .................... Number of Stories ............~ .................................................................................................. 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase .................................. : ..................... Name of Former Owner ........................................................ 11. 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 .......~ ................ Will excess fill be removed from premises: ( ) Yes (~) No 14. Name of Owner of premises ~'~'"'r"o"'~.~ ..................... Address ................................ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Nome of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly oll buildings, whether existing or proposed, and indicate oll set-bock dimensions frorn property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~S S COUNTY OF .......... Suf.:~o.'l-.k.....~' ' Jly swor~6§b~ an~l/soys that he (Nome of l':~:z:~ ........ above named. I He is the 8 '~' .......................................~O~'~oIn~''~'',''~''~t a e ........ offl:~"e eta of so d owner or owners, and is du~y authorized to perform or have perf~r~d-~-the'said~work and this application; that all statements contained in this applicat on ore true ~{~he~best of h~f knowled~ that the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this ....... '1'~ ....... day of .....~ ............................. , 19.?~.. ~ ~ ~ ~.~ . o n ~ ~ ~ Nota~ Public, . ............................ ~ ..... C u ~ ................. ~..z.~: ........................ ~ ........ ~ ~ ~'Z ~ // //(S~gnoture of applicant) tLIZABETH AN~ N~VILLt ] ~ NOTARY PUBLIC, Stat~ of New ?lIth ,~l,'" No. 52.8125850, Sflffolk gountv_ ferm Expires Mar~fl 30. ; the opplicom make and file and b~lief; and