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Home My WebLink About8582-zTOWN OF SOUTHOLD BUT~.I~ING DEPARTMI~NT Town Clerk's Office $outhaM, N. Y. Certificate Of Occul~ncy conforms substantially to the Application for Building Permit heretofore ~ed in dated ~.//,/ff~..~. ~'/.-~g..7~.., 19 .... pursuant to which Building Permit No. dated .d'/O./.).~..././.0/5../.7.Z.., 19 .... , was issued, and conforms to all o! the require- ments of the applicable provisions of the law. The occupancy for which this certificate is · . · ~ . . ~,~,.~- ~. ~.-.~----.~...~..~ ~,~,.:~:~.~.~..~..~,.o ........... .N.. ..... .~ ..... ~ ..... ~e eerlitie,,t,e is ~ssu~! to. ~.../.~ ......... ~ L. ......... (owner, lessee or temmt) of the aforesaid building. Suffolk County Department of Health Approval .~. '. i.~.: ..... . ......................... UrrD~WmTSSS C~T~F~CAT~ So. ~.~..? ~ ~'~- /?~ ~ ~o~. ~.~ .... ~.~..o .... s-- ~ ~K_ ~n.~.~J .~~ ...... ~.~ -. 7. ....... Building Inspector ~ FO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOI.D, N~ Y. BUILDING I~EIU~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION O~ THE WORK AUTHORIZED) 8582 Z Date .......................... 2,:~ ....... .1.~ .......... , 19...~.6. Permission is hereby granted to: 26~ Con~.~.~.~:~.;l..~..~J,c~...~.~;.£..lq.~eaala~) A/¢ ~'~1c I~lovslr, l ..... ~-.~./~o-~-...3~8 ....... ao~o3ak, ma& ................ t~k..~w...D~'~..~...p~o~..~l~..~e~c~..~.~ce~aG~ .................... ~ premiss l~a~ at ~.C~.~..i~4~...[~...~)...~...~'~2~..~c~ .............. ~ ........................ ..................................................... ~e $.h g.~C~....)~.,.k ,. ....................................................................... pursuant to application doted ........................... ~;~.....J,.1 ............ , 19.~.~..., and approved by the Building Inspector. ltO~ Undez'~rl~ers certlfica~® requ~re~, Contractor must obtain To~m license Fee $..1.~,..~0. .......... FOBM NO. 6 TOWN OF $OUTNOLD Building Delm~tmont Town Clerks Office Soothold, N. Y. 11971 APPLtCATION FOR CEKTIFtCATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the fallowing; far 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, industries 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 o'f property showing all property lines, streets, buildings and 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 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 3. Copy of certificate of occupancy $1.00 Sworn to before me thirst. ........... ,. 'day of ..... .... Notary Public ...~.~!:~/.;./.~..C~.~..../'~//~C"~ County New Building .................... Old or?re--ting B~,ding ............................ Vacant Land ............................ Location Of Property ,.~.~..~.~ ......,~/.2/.~../.....~.~? ......... "~'J..;...~.~.~./..?~.(-.~.~........--.~.././.;..;~....: ..... Owner Or ~ners Of Propedy ........ :~.~4J~/~....~XZ~g~/. ........................................ Subdivision ...~ ......................................... ~..../ ........ Lot No;~'~Block No;'.~ Hou~ No.~.~. Permit No..~.~J..~... Date Of Permit/~Z~/Z~.Applicant ~(~..~z~.L ............. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approva~..~ ........ ~..~ ............. Planning Boord Approval ........................................ Request For Tempora~ Ce~ificate ........................................ Final Certificate .......................................... Fee Submitted $ .~ ................. Construction on ~bove described building and permit meets.~(~applicable c~es a~ regulations. ................................ (stamp or seal) THE NEWiYORK BOARD OF FIRE UNDERWRITERS ...... -- BUREAU OF ELECTRICITY ak ~ ' [ ' ; ' 485;~OHN STREET, NEW YORK, NEW YORK 10038 D"t"June 8,1976 . , .,tpp,i.,,tio,,]~o.o..fil. 8593~3 N 287234 THIS CERTIFIES THAT ' : ' : o~ly the electrical equipment ~s'descrlbe~ bel~w: and ~ntrodu¢~d by the applicant named on the above applieatlo~ ~urnber in the premises of F. Milowskl, 2 John Road, Mattltuck, L.I. 2nd Fl. ..;.,,,i..d o. June 3, I 1 a 'V,~.,,~. :: , andyound to be itt compliance with the requirementa ofthls Board. CC. COND OF HI-LEG ?anelboard/s:l-2cir.i!25amps.-: ' ~I~ ~ 1G.F.C.I. r~,''~i__',rr~ (Swimming Pool) This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have frequent testmand/or repairs made by a qualified person. s W G eaner Eiec.Con r. 150 So. Country Road - ~N ~ GEa East Patchogue, L.I. 11772 .Lic. 7U1E ~ Lm,~ ~ ~ULL pEE[N~T[R SAFLF~' State whether applicant is owner, lessee,(~ -- Name of owner of pren, ses .....~ ......................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer).. .~. ~lumber'~ Lieen~ No ............................. .. · · ..... · -.-..-.- -. (Address of applicant) \ ~."l "1 ~ ~chitect, engineer, general contractor, electrician, plumber or builder. ................................................................... . Electrician's License No ............................................. Other Trode', Liconse No. .............................................. ~.. .... 'i Location of land on which propcm~ work Will be done. Map No.: .......... :..... ................. Lot No/...:,c ...... , .......... Street and Number ....... .~....~......~. ............. ~'~.~..-, .~Lt~ ~...'~J~'..! ~ ....... ~ ............................. State existing use and occupancy of promises and intended use and occuponcy of praposed camtmctlon: a. Exlsiting use and occupancy ....... .~...., .................................................................................................... b. Intended use and occupancy ..... :~ ........... .~......~:~...J,/~l~t':~.t..~....(-a ...... ..~.....O.....~.. ................................................. 3. Nature of work (check which applicable): New Building.....~..~...'Y.....~.... Addition .................. Alteration .: .......... ; .... · Repair .................. Removal .................. Demolitior...... ............... Other Work ................................................ . .... O~:~ '' 'Fee /~' ~' ........ (Description) 4. Estimated Cast . .~...~ ........ (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. Dimensionsof existing structures, if any: Front ......~....~.. ............... Rear .....~T...J~'.. .................. Depth ..~J,.~. .......... Height ........................ Number of Stories ........ J.. ...................................................................................................... Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height .......................... Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... /..~. ................ Rear ....... .~..~.. ........... 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 prol~osed construction violate any zoning law, ordinance or regulation: ...... ~...~. ....................................... 13. Will lot be regraded ............~.......~...... Will excess fill be removed from premises: ~ Yes ( ) No I4. Name of Owner of premises ..~...,/~.,..~,,~.,.J~. ...... ...~..~...L...~.~..~Acldress..~..~...a.~;.~.....~...~. ipl~'~'j~ ~..~.~...~.~.~' Name of Architect .............................................................. Address ..~.~._~ ~,Jl~ Ne. ...................... Name of Contractor .~...-~..[;.z...-~...~..~......~...--..-......,e .............. ,~oaress ....~.6?~.~l~..~',~=~.'PlJ~le ~ ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and Jnd .ca.te all ?t .-~k d, imer~..o? from,. property lines. Give street and block number or description according to deed, ana snow street names a~¢l ~ndicate whether interior or corner lot. STATE OF NEW Y~J~-~__. ,~ t ¢ c (Na~ of i~ividdal signi~ c~mc~ able na~. He is the ............................................................. ~.~ .................................................. : ............... : ................................... (Contractor, a~t, co~re~ officer, ~c.) of ~id ~ner or owners, and is duly aut~riz~ to pe~o~ or ~ve performed the ~id work a~ to ~ a~ file this a~lication~ ~at all st~em~ ~n~n~' in .th~ ~licotion ~re tree t~the ~t.of his k~e a~ belief; and tha~ t~ work wdl ~ performed Jn the ~nner ~t fd~h ~ the a~p~ fll~. ~ S~m to ~m ~ this ~ ) / /~ // (/ (Signature of ~plicant) V ~ANNE YA~RES , H0. 52-435B565 Suffolk C0un~