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Home My WebLink About8457-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Ottice Southold, N. Y. Cedi[icale O[ Occupancy THIS CERTIFIES that the building located at Little Nea!~~ & Baldwin .P~i~ Map No. ~:~ Block No. ~ .Lot No, conforms substantially to the Application for Building Permit heret6fore filed in this office dated ............M~.. ?~.., 19..7~ gursuant to which Buildifig Permit No ~.. dated .............. ~'~.. ¢~., 1~. 7¢., was issued, and conforms to ali of the require- ments of the applicable provisions of ~he' law. The oeeup~ey fo~}which ~his certificate is issued is Private one family dwelling ' The certificate is issued to ...~'. ~ .~?~.~.~9P.~9~. ~9~ .... ' ~lers . (owner, lesse~ or ten~t) of ~he aforesaid building. Suffolk County Department of Heal~h Approval 3~*.. ?~. J~... } ................. UNDERWRITERS CERTIFICATE No.~?~?9.~... ~.. ~...~ 77~.. ................ HOUSE NUMBEg ...... }~,~,.. S~ree~ .,~.~.~.~g. ~ ......... ' ... ' .... 60 Baldw~ Plaee O~tchogue ....... ns~ FORM 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? 8457 Z Permission is hereby granted to: ~o ~lcl..new...ol~e.. ~a~tl~.. ~lwellin~ ..................................................................................... at premises located at ...'~'.'lJ;.~lO...~g.~.}~...~......J~..~.ql.W;~:l....~.~, ................................................................ ....................................................... Cu%cho~ ......... t~o~;o ................................................................ pursuant to application dated ......................... ]~Z'.....~,,c~ .............. , 19.~.~.., and approved by the Building Inspector. Fee $..1.Q~.~.~.Q ........ FOP, fl¥I HO. 6 TOWN OF $OUTltOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CEKTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the fallowing; for new buildings or new use: l. Final survey of property with accurate location of all buildings, property lines, streets, and unusual nutural or topographic features. 2.Final approval of Health Dept. of water supply and sewerage disposol--($-9 farm or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and instu[lotions, 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 ]057}, Non-conforming uses, or buildings and "pre-existing" land uses: ]. Accurate survey.of property showing all property lines, streets, buildings end unusual natural or topographic features. 2.Sworn statement of owner or previous owner os 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: 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 /7~'nx~x ,/c?j /~. 7~.' / Dote '""'"'7" .................. '" ............ New Building .,..~.~ ......... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Loca,,on of Property Owner Or Owners Of Property ...x,Y~../.¢..;.v...../.../~C.J~.~:~¢¢/ J~ ~/' ...... ¢~..~/.~.~...¢~,~z:7..~..~-:..~.. ......................... Subdivision ........ ~:Z ................................................... Lot No ............. Block NO ............. House No.i~...,/,...O.: I'e mr n4oo../¢., ............. eu I~ mr.~.~.¢.~.., pp c ~..?,..<..~7.,..,~7 ....... : ............................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fin(~l Certificate .......................................... Fee Submitted $ .., ; ......................... Construction on above described building and permjL, meets all applicable_ codes and regulations. App,,cont .............................. ....... !..~., doyof .... t~..?k .~:.~.~ :~:......7. ~~. .... ..... c ....... NatoW Public ........... ~' '}lffi~!~!~r~ ..... Coun~ STEPJiEN E. STEID~ ~ ~ ." THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY i'~-~T 8[~ JOHN STREET, NEW YORK, NEW YORK 10038 Oa,; nppneat,o,,~Vo.o,,.m" 857066 N296905 THIS CERTI~ only the electrical eq~ip.~ent as described below and introduced by the applicant named On ~he above applicatio~ number in t~ premises of ~m. 3acobs, L~ttle Neck Rd., Eugenes Rd.~ Cu~chogue, L.I. in the.follawin~ Iocution ~ ~ B.semcnt ~ 1st FI. ~.~ex. mi,,eda- July 29, 1976 s~ F~xm.~s OUTLETS 23 44 24 [~ 2nd Fl. outside Section Block and found to be in compliance with the requirements of this Board, Lot OVENS EXHAUST FANS SYSTEMS NO. OF FEET E AW.G, AW.G` 4 Motor/s: 1-1/Zhp. * Special receptacles: 1 GFCI 1-50, 1-30amp. Robert Goodale / RRL Box 1SA Main Rd ...... f'GENERALi~ANAGER / J Per ~ / [ V ,als e alfered in an manner, relurn to the oHice o{ *he Board i~ incorrecl. Inspeclors may be identified by ~heir credenf . This certificate must not b y , ~ ~~~ ....... ~" ~] APPLICATION FOR BUILDING PERMIT ote .. ........ '..>...?.. .......... , INSTRUCTIONS a. This application must be compJetely filled in by typewriter o~ in ink and submitted in triplicate to the Building Inspector, wit~ 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoinirig premises or public streets or areas, an~ giving a detailed description of layout of property must be drawn on diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building inspector will issue a Building Permit to the applicant. Such permit,shall be kept 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 untd a Certificate of Occupancy shall have be granted by the Building Inspector. 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, 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 laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors or~ premises and in buildings for necessary inspections. ...... (Address of applicant) State whether applica~ ownz, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................... ............................................ =..,.;, ..................................................................... Name of owner of premises ..~L/~.....~....~..~..~.;.......~...~.~.~...~..(~.-/~/......~.~.~..:' .~....~..~'~./...~.~.~..~.. ............... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................................................... Plumber's License No ......................................................... Electrician's License No .....~....~..~.;...L~ Other Trade's License No ................................................... 1. Location of land on which proposed work will be done. Map No ............................................... Lot No ............ [...... ...... Street and Number ....................... ~ ..... f ........ ~. ...... ~-.~,....-~ .............. ' ....... ~. ~ ....... Municipa ~t¢ 2, State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................../------~..,,~ ......~.~ZL~....~-- ...................................................... b. Intended use and occupancy ................................................................................................................................. 3. Nature of work (check which applicable): New Building .....~,,, ............ Addition ..................... Alteration............? Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) /o 4. Estimated Cost .....~.~./. Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units .................Number of dwelling unit~ on each floor ......................................... H: 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: Front .....................Rear ........................... Depth ................................... Height ........................................................... Number of Stories ............................................................................. 13imensions of same structure with alterations or additions: Front .......................... Rear ......................................... £ epth He ght r . Number of Stor es ..................... 8. Dimensions of entire new construction: Front ....,~ ............ Rear ......~. ~ ... Depth ...~..~ ........ .~...~.. ......... 10. [)ate of Purchase ..................................... Name of Former~wner ............................................................................ 11. Zone or use district in which premises are situated ......... ~'r~LF.~.f.~.~A4-_-_-_-_-_-_-_-_27.~dr../ ........................ 12. Does proposed construction violate any zoning law, ordinance or renulation: ..... ~..: ......................................... · ~ ~ ,-~ L -- ~ , ,__ (AddressJ ~ (Phone No.)-- L ,~ I! I % ,~(Address). ,~3 (Phone No.) {.~ddress) IPhone No,) 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. STATE OF NEW YOR~, ~ ,, ) M'~ COUNTY OF .,~ ~.~,._~..~z~ ¢?./' .~. ................ ) S~ ..... . ................... being duly sworn, deposes and says that he is the applicant above named. He is th,, ............................................................................ ~-~-Z~.,~...~...~....,~..~.,~..~.. .............................................................................................. (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 knowiedge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ......... .......... deyof ......... ........... ' n Notar Pu '~' Iom52 8125 50. Stlffo k t ' ~/~¢[ .......................... ................... ~ ~ ~0 (Stgna?ffre oftapp'licant) ~be sewage d&sposaz ]a~d ~aclli%ies for this;locatj, on ~, .?) beo,u ~sPec%ed by this d~par%ment ' '¢ ~CALE 40~ ALTERATION OR ADDISON ) THIS SURVEY IS A VIOLATION OF APPROVED AS I~OT~D NOTIFY BUILDING DEPARTMENT AT ED INSPECTIONS: ,- 1. BEFORE BACKFILLING FOUNDA- TION OR START FRAMING 2. BEFORE COVERING PIPELINE 3. FINAL WHEN JOB COMPLETED PAUL J. STBDEL ARCHITECT 479 Micldle Counh'y Road Co~ New York 11727 .? P,&JJL J. S'[[I~,EL ARCHITECT 479 Middle Cou~t~y Road Corar~, New Y~k 11727 ~A~£ J SE~£L A~CHI'~ECT ~7~ M~ddle C~unt'-y r~o~d ~Zor'a~ New Yc~k \ .1 t ~, J C~ P~L J. STEiOE~ i~RCI,'I]JTI~CT 479 Mi4cL. Je Cc, untry Co~m, New York 11727' .I PAUL J. // / ~