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Home My WebLink About8458-zTOWN OF SOUTHOLD BU~.BING DEPARTM'I~ Town Clerk's ORiee Southold, N. Y. Certificete Of Occupency THIS CERTIFIES that the building located at . Arro~hea..d..L.a.n..e .......... Street Map No..~..r..~r.h..e.a~. Block No ........... Lot No ........... .P.e.~.o..n.i.~.... ~.o.~.: .... conforms substantially to the Application for Building Permit heretofore ~ed in thi.~ office dated ............ 1.~..1'....~..., 19.7.6.. pursuant to which Building Permit No..8.~.~..~.Z.. dated ............ .1~..r...~.?..., 19..~.6, was issued, and conforms to all of the require- ments o~ the a~pl~cab~e ~rovisions o~ the ]~w. The occupancy' ~or which this eert~iea~e is ~ued is .~..~.~.~..e..o.~.?..~..~.~..~..~.v.e.~.¥..~e ....................................... ~ne certificate is issued ~o . .~.~.~.Z.~.~.~...~.~..e~..e ..... . .(~..e..r ............................ (owner, lessee or tonan~) of the a~oresaid building. SuffoLk County De~ar~men~ o~ ~eeJth AM~rovnl .... ~.u~. ~.0... 1. ~.6... b~..~..*. Y.~-~-~. U~TD~W~IT~.~S CERTIFIC~ ~o. ff291+986 ~r ~? ~976 HOUS~ ~u~ .. ?.! ~.0 ....... S~....~..~.o.¥.h.~.~.~...~?? ....... .~.,.e. ~.S.~ ...... FOEM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8458 Z Permission is hereby granted to: at premises located at ..'LO[..~..&..2.~ ......... ~'Zt. Cl~e&~...l~l~l~l~ .................................................... .~ ................................................ A~.ow~a&.L~m .............. P.~a. on~.e ............................................. pursuant to application dated ........................~:~l:]L~ ....... ~0 ....... , 19...~.~, and approved by the Building Inspector. Fee $..13~,..,~,~, ..... · T" Building T~spector [ TOWN OF SOUTHOLD , Building Deparfment Town Clerks Office Southold, 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 fallowing; 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 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), Nomconforming 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 .......... .,/,,c'..::.~.z..-..Z.:e. ......... New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..... .~./,e~6~.,.../J.P/,/~_....d,.4.'.~,.~....~..,~../.~....~...~,,.~.~ ' ' · ' ............................ Owner Or Owne. Of Prape y .......... .'. .......................................... Subdivision ,~..:~.....P~.~/,-~.~....~..~.~..~.......~....O.....~/..~z .......... Lot No.............~ Block No. ............ House No ............. Perm.t .-~....-Z~O =7~ ...... ~ ................. ~.~/,~¢ ......... ../. ........ Permit No. ~....~.,~.'..~.. Date Of ' · ................ .~/~pplicant ~...~./~..~ ~.~ ~' ~- Health Dept. Approval ............................................ or Dept. Approval ................... ~.: ........................... Underwriters Approval ............................................. Planning Board Approval ~' Request For Temporary Certificate ........................................ Fincd Certificate /~ Fee Submitted $ ....... ~,~.-.~..~'~..0.. ............... Construction on above described building and pe_e~rmlt meets~ all applicable Codes and regulations. ~ · ............................................. ~ ~ .... ,~~,,~.... ~ .......... ~ ............. ........ .d. ......... z THE NEW YORK BOARD OF FIRE UNDERWRITERS j--ak'- ' BUREAU OF ELEcTRIcITY ,: , ' SS JOHN STREET. NEW YORK, NEW YORK 10038 ,~.,..T~.~ z'r~' i976 A.p,,c.,,onNo. o.S,,e '85S?02N 294986 only the electrical equipment az described below artd introduced by the applicant named on' the above application number in the premises of William Blake, w/side .Arrowhead Lane, Peconic, L. I. ,~e.,,mt".,,~o. July 19~ 1976 . ,.. and found to be ~n eompllanee wlth the ~equirements oS this Bouea. fiXTURE ~ RANGES OVENS DISH WASHERS FANS OUTLETS Motor/s: 1-1hp 1 G.F.C.I. 2-4.5kw Hot water heater !-2 ton, 1-4 Ton AoC. Units 1-9.60 & 1-19.47kws Electric Furnace Ruland Elec.Co., P.O.Box 143 Mattituck, L.I. 11952 Li c. 242E GENERAL MANAGER This cerfifkate must not be altered in any manner;, return to the office of the ~~ b~y t~ i credent~ i/ TOWN OF SOU mOLD BUILDING DEr2RTMENT TOWN CLERK ~UTHOLD, ....... ........................................ , ................... ...................... INSTRUCTIONS a. This application must be completely filled in by typewriter or' in ink and submitted in triplicate to the Building Inspector, with 3 set~ 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 adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn on the 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 P~ermit to the applicant. Such permit shall be kept on 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 until a Certificate of Occupancy shall have been 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 on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) ~.~ (Address of applicant) State whether applicant is owner lessee, agent, a~rchitect, engineer, general contractor, electrician, plumber or builder. .................. ................................................................................................................. Name of owner of premises ~"~/z.¥._.~.'~...x...,~.-. ~.,~./<'~ . If applicant is a corporate, signature of/duly .~'thorize~icer. ....... , .,.~,.. ~-~..~ ~r.., .~'~'.~. ~..~. ~..,....~H,. 4: ~.u~,~,..' ......... ,/ (Name and title of co~f~orate o~Ficer) Builder's License No ..................................................... Plumber's License No ..... ~.~...~ .......... Electrician's License No ..... ~~...~.~... Other Trade's License No ............................................... Location of land on which I?ropose~ work will be doDe. Mop No.: ........ ~d./..~ ............. Lot N°~"~'"'; Municipality · State existing use and occupancy of premises on, intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................. ./:../.~..r~...~.~../.~..~ .~...~.~.../..~ ................................................................... 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work ................................................ (Description) 4. Estimated Cost ............................... ..0...~. ............. Fee .......................................................................................... (to be paid on filing this applicatio/~) 5. If dwelling, number of dwelling units ............ f .............. Number of dwelling units on each floor ..... I... ................... 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: 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 .......... .~..4~. ................. Rear..-~.~....~..~ ...... Depth ......~...6~....-~...../..~.~ , · .... / / meJght .................... ~umDer at btories ..................... ~...~..~ .................................................... ~/~ ............ ~ ........ 9. Size of lot: Front ...............~.~.~ ........................Rear ............... ~,.~ ......... ...~epth~... ................... 10. Date of Purchase .................... ~ ............................... Na~e~,~. --F°rme~'Owne~"'"C/ -- .............................................. 11. Zone or use district in which premises are situated ............ ~.~..~.~........~ ................................................ 12. Does proposed construc~io~ 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 .~~ ................. Addre~~~ Phon~ No. Name of Architect .............................................................. Addre~ ................................ Phone No ....................... Name of Contractor ...~~.~.~.A~ress ..~~. ~hon~ ~o. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from 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~¥4D~RIC~ ,, , ~ ¢ S COUNTY OF ..~:~.]..1~......£~'~-~ ............... ..~...,~.~...~./.~../......,~...~.~./.... ..................... being duly sworn, deposes and soys that he is the applicant (Name of individual signing controcf) above named. He is the .......................... ~..C~..~',~*¢~..~..4).~.~..': .................................................................................................................. (Contractor, agent, corporate officer, etc.) of sa d owner or owners, and is duly authorized to perform or have performed the said work and to r~aKe ona this application; that all statements contained in this application are true to the best of his knowledge/rind belief; an~ that the work will be performed in the manner set forth in the application filed therewith. / Sworn to before me this ~ / day of ....... -, ,-,,-, ...... . ,--"' / Notary Public,. ................. ~:~,"~. · · ./~..(.~' ..... Co,,nty ......... ~~~ ........... ,~ ~ ,., ~ ' ~ (Signature o~pplicant) ,. v N0~.~k~ ~UBL~C. State 0 New ¥0 Coun J ,kW/z_z /,aM C. The sewage disposal and water supply facilities for this location have been lngpeeted by this department and found to b. satisfacto:~-~~ O' of Chief Ceflerel ~nsine_QP~n~ J ~/~ ,50; t' TO THIS SURVEY IS A VIOLATION OF SRCYION 7209 OF THE NEW YORK 5TA'~ EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT IIEARIi~G THE LAND SURVEYOR'S INKED SEAL OR EMJOSSED SEAL SHALL NO? JJ CONSIDERED TO BE A VALID TRUE COPY. ,5'u,"v,,v,,,~t July z., ~ro~'n/oor¢, AIe~V )-~r/~ J ~ ~'.~o" ~ ~'.~,' ~'-~" ~L ~'.,o' I~'- %' , ~'-Z" I+'- ~" Jj~ APPROVED A5 NOTED ,, I~L 5" I~'-~" ~ ' 3~'- Io" NOTIFY BUILDING DEP~T~ENT AT ~ [, .~ 1. BEFORE BACKFILLING FOUNDA. ~ / ] ~ / ) ~ ,, h TmON OR START FRAMING 2. BEFORE COVE~ING PIPELINE -" / 3. FINAL WHEN JOB COMPLETED I F.UCT,O, ' ' ' - / BETTE~ HOMES' ~0~ ~ ', I Fess]onal standards and practices, However, local variations may reqt, ire minor changes. TOTAL I m ~ ~ R VeriFy dimensions on ]ob. ! = Z Z L I o" ~ DESIGNED BY Henry Nards, A,I.A. STUDy 2&'-4' ?L~,~ F CLOSET 9695[, , ~: IZ,,. 0 N T ~ LEVAT ] O~ tZ L EFT ~IDE E. LF.¥ATION ,~ ,I Z9695 BETTER HOMES FOR AT,T, AMERICA I PLAN-NO. 3709-A Bet~er'ttomea' ~ ~rd ~e~ Thisplanhasbeenpreparedlomee~topp~o- OOEETHO. 4. [ess~ona~ ston. dards and protegees. However, local varia~ons may require minor ckanges. I TOTAL II Verily dim=nsions on job. L .r -oC / .,t BETTER HOMES F0~ ALT, AMEEr'CA. PLAN NO. 3709-A~/~ ', Better Home~ & Gs. rden~!~:,L~ This plan has been prepared to meet top pro- fessional standards and practices. However, SBEETNO 5 local ~ari~tions may require minor changes.' TOTAL mi Verify dimensions on job. '4:l~' --\ Sc.: $~CT ion 19695 BETTER HOMES FOl% ALL Ai~'ERICA, PLAN lq9. 57o9-Ar.~; Better Homes & C~'de'hj~:~2,~. [eSslonol standards and practices. However, I:i.' 6 Ioco{ variations may require minor changes. -:TBTk[;; Il J 1969 i BETTER HOMES FOR ,~TJ, A ~.M'RRICA PLAN 'I~O. $ 7 0 9- A ' Better Hom~s & Garde]:~ Thb Ion has been p eporea toame~t top pro- [ ess anal standarc~s and practices. However, JocoJ variations may require minor changes, '[~[ Verify dimensions on job. , [ . ~2 J5 19695 10 BETTER HOMES FOR ALL AM.E~i~ICA PLAI~, NO. 3709-A · Better Hom~ & Oaxde~, c This plan has ~een prepared to meet top p~-¢~ ~esslonol standards and practices. However~ local variatians may requ~,e mino~ changes, '~L I I Varify dimensions on job. ' " /I,~,' DININC, I?M..$~ELF ~ ,~11';r ~C.?'/~/ L 'z,, J :~'- CA~4HF_T O;.TAIL, CO, -,,~ ..00.4) 19695 BETTER HOME~ FOR ALL AMERICA PLukl~NO. ~,709-A , Better Hornea & Gardens~:~ ~, L ' Ioc,~l variations may require minor changes. TQT~!. I I I I~l T CH~.N ~ AI~)~IET ~T O~..kG~ GLO(,~-T EL~V. ~z'~ ILO" t VAN ITy ELEYATIOH5 '! 9695 BETTER HOMES FOR AT,T, AIViERIC$, PLAN NO. 5709-~ Better HSmes & Gal~ .,.e~ ~ ,~:,, oco ,var orions may require minor cl~c~nges.' ~T~TIIL I I / / / / / / / ~d , / /, / ~c- X'4 :l-O" 19695" BETTER .HOMES-FOR ,~T,T, AMERICA PLAN NO. 3'~09-A Better Home~ & Goxd~,{I locaL varl~ions moy require mlno~ c~anges. J I Veri~y distensions on jab,