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Home My WebLink About8470-zFO~M NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Cedi[icate O[ Occupancy No. Z'7'~ Date OCT ~_~ 197{~ THIS CERTIFIES that the building located at ........ ~o0 ~ R'FH. .............. ~ W~ I_/~.~ .... ~ Street Map No. ~ ~ t~ Block No. --- ..,Lot No, ~ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. !~ .F..~....~, 19.~..~. pursuant to which Building Permit No..~..~( dated ~ P ~{ ~ 19.W..~. was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is . .~....'~f} f.~. ~...~.~! .~...~.A. ~.~! ! ~ .~(.. ~.b. ~.~. ~.~: ~ ~ ~ .............. . .......... The certificate is issued to ~ ~ ~ LI~bA (owner, ........... t) of the aforesaid building. Suffolk County Department of Health Approval ~7 ~ [~7 UNDErWrITErS C~TIFICATE No ............................................. ~OUS~ ~ .............. 8~ee~ .......................................... Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Ns Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8470 Z Date ............................ Apr,ti,....2 ........ , 19-7.6.. Permission is hereby granted to: Rob ~,x,t..&...L..; ad~s..:r&p~.:t ia ............................. ................. 6'~ark"itd"'"s~'l:h~fl'd' ................... to b~lild., rAe~ ..ome...£a~&l¥...d,,m 1...t.t~g. ..................................................................................... at premises located at .........']-~t'"9 .......... ~o'~h~x:~od~"~s~ ........................................................... .............................................................. Kat;thevs..t,a ......... ~t~ho~ue ........................................ pursuant to application dated ........................~'""2 ................. , 19r~6..., and approved by the Building Inspector. Fee $.~'K~.0.~ ........... FORM NO. 6 TOWN OF SOUTHOLD , Building Depmtme.t Town Clerks Office 5outhold, 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. Fina~ 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), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey.of property showing all property lines, streets, buildings end 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 B~ilding ............... Addition ...~ Old or Pre-existing Building ~ Vacant Land .~..~... ~. Location Of Property .... .~...l~..~,.'~..~'l.....~..{l.O..~....S ............ ..~..~...~....~w~..~..~...~....C~.......~. ...................... .... ........ ............ ~ner Or ~ners Of Prope,y .~.,..,~' ~ ~ Su~,v~on ..~.~.~....~.~.~.~. ............ ~ No..~. ...... B,~ No...~... ,o~, .~. Permit No. ~Y.~.~ate Of Permi~....~..Applicant .~0.6.~.~....~..~Z~....~ Health Dept. Approval .~.~.,~.~..~....~....~bor ~pt, Approval . ............. : ......... ,,row, .......... ....... ................. Request For Tempora~ Ce~ificate ........................~ ............... Fin~ Ce~ificate ..~..~ ......................... Fee Submitted $ ..~ .............................. Construction on above described building and~ pej;mit meets all oj~JJr, able codes_gl~regulations. Applicant ................................ ~ ................................................... Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or seal) THE NEW YORK BOARD OF FIRE UNDERWRITERS ak BUREAU OF ELECTRICITy ~-~ SD JOHN STREET. NEW YORK. NEW YORK 10038 ,,,,,,.October 12. 1976 ~,,la..t,o,,No. onf.~ 867559 N307404 THIS CERTIFIES THAT only the electrical equipment as described belotv and introduced by the applicant named on the above application number in the premises of Robert E. Taplin III, Mathews Lane, Cox's Lane, Cutchogue, L.I. ~nthefolh,wlnglocation; ~ aas*,.o.t x~ r~trl. ~ ~nd ri. outside Se~tio. mo& tot #9 ~a.~e~,.,,i,,edo,, October 8, 1976 andfoundtobeincompliancewJththerequlrementsofthi$11oard. F[X;URE FIXTURES RANGES EXHAUST FANS OUn~TS SW~TC.ES F~uo~sc~., 20 31 27 DRYERS FURNACE SYSTEMS NO. OF EEE? OTHER APPARATUS: 1 G.F.c.I. 1 Smoke Detector 1-10 amp. Vacuum Unit 1 R V I C OF CC. COND. OF HI-LEG 4/0 1 2/0 Gagany Landing,' P.O.Box 306 Southold, L.I. 11971 ~m~a~t~ This certff]cete must not be ollered in ~ny monner; return to the off$ce of the Boerd if incorrect. Inspecfoi~$ moy be identifled~r credenfiob. Approved ........................................, 1y.~..7.... Permit No. r~,..¢../...~. ................... /~ ~..- Disapproved a/c ....... ~ ............... ~.;:.;~ ................ ~ /~ ........................................................................... )- ....... APPLICATION FOR BUILDING PEI~IT INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ in ink and submitted in triplicate to the Building Inspector, with 3 sere 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 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 o{ Building Permit. d. Upon approval of this application, the Building Inspector will issue o Building Permit 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'y' 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 cede, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant,' ' 'or name, if a corporation) ........................... ('~ r;s';' ~ o~bli~;~i .............................. FORM TOWN OF BUILDING DErARTMENT ~"TUALD State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises e~ Tf-~,/~ t If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~ Plumber's License No ................................................. ti Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done Map No' ~D ~- Lot No Street and Number ........ ..~[..,,~. ~'.~.~....~.....~....~..~.......~.-.~.i.~....~.-. ...... ii.iiii~~ ........ w....'.iiiiiiiiiiiiiiiiiiiiiill Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ......................................................................... , ....................................................... b. Intended use and occupancy ..... ...~./...~..~..../...~..~....~........~... ............................................................................... 3. Nature of work (check which applicable): New Building~ .......~... ........ Addition .................. AlteraHon ................ Repair .................. Removal .................. Demolition .................... Other Work ................................................ ~'~ ~'~ ~'~' ~'5- ~ ~'- (Description) 4. Estimated Cost ~.-.~?..~.C~'r~{2,~/) Fee ~ (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: 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 ....... ~....~.. ..................... Rear ...... .~'....~.. .............. Depth ..~....f ............... Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front .... ~ .................. !...~....~.. ....................... Rear ......... ,,~.,~-~.. ...................... Depth ... Z~.D.. ................. 10. Date of Purchase ,~'-- 3 -- 7~' (c~s;~4dS/Neme of Former Owner 1 1. Zone or use district in which premises are situated ,.../~..~.~..:~'..~....~...~.~../.;~...~z.. .......................................................... 12. Does proposed construction violate an~; zoning law, ordinance or regulation: ....... ..~...o. ........................................... 13. Will lot be regraded .........~..9 ............... Will excess fill be removed from premises: ( ) Yes ( ~x~ No 14. Name of Owner of premises ~ob¢~--[- '~ kL~.~ T~t~b ~0..-~.. Address ~'~' (~'/ ....................... ° ....................... I~.o...c. 10A.%.~t..~..~.~.t~$.~( Phone No.L~.~...;. ............ Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back 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 YOm'-,__ ~,- COU i',5,TY OF ..... .5.. ~ ~ .~..°..1.!.% ...... ~' ~'~ ........ . .~....O....~....~../..~.~........~...,, ........~ ~.~..~...~..{,~. .............................. ~ being duly sworn, deposes and says that he is the appficam (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 fife this application; that all statements contained in this application are true to the best af his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ......... ............ .... ............................. .......... ~> :3 SuffoLk Count~.~ ~mmJa~ion Expires Mm~h w/Il ?/'4 1 t I I I Ii Ir I I [ [ I I I. _L" I APPROVED AS NOTED ,,a~-IIFY BUILDING DEPARTMENT AT z.4 ~.[','i' L~!M'):~,~ CD. I,NC, 11944