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Home My WebLink About8660-zFO~ ~0o 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .~. ~ ....... Street Map No...~...Q.W~. Block No...~. ...... I, ot no../.~..-?. .... ,L'P~-~. ~./.~-~..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... ~-~ . ~.(.~ f. , 197.~.. pursuant to which Building Permit No. ~.~.~Q..'~-~ dated ...... //~..~..~..~:.~:~ ., 19~., was issued, ~d confoms to ~1 of the requff~ ments of the applicable prowsions of the law. The occupancy for which this certificate is issued is..~.~..~T~:..~~j .... ~~.~ ................ The certificate is issued to . ~. ~..~,~. ~...f~~...~ f (owner, lessee or ten~t) of the aforesaid building. Suffolk County Department of Health Approval ~'.~.~ /~Q2.~... ~..~ ~ u~awa~,~as c~ar~c~ ~o. ~ ........... ~..(f~.~ ..... Building Inspector FOI~M NO. ~ TOWN OF SOUTHOLD BUI~.DING 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? 8660 Z Dote ......................... 'J'o~""'2~ .............19'"~6 Permission is hereby gronted to: C,~.t. be.z~¢..&.-Cy~¢}~.a..-M.l.o~s .................. ..................... ~th~ ....................................... to ..~u±~Ld..ne~...one...£e~LIy...d~.aLiing .................................................................................... at premises locoted at ....l~O~.-.~.~'""])e~-'~ft~ ............................................................................... ...................................................... ;~e a~,.~Dri~a... ~,'at ~.it~ck ....................................................... pursuant to opplication dated .......................... J.~We..-2.~ .............. 19...~., and approved by the Building Inspector. Fee $ .~.2...,,~ .~. ........... TOWN OF SOUTHOLD , Building Depa~'ment Town Cterks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE oF OCGUPAblGY 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 disposol--(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 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 $1.00 New Building ..... ~ ..... Addition ................ Old or Pre-existing Building ................ Vacant Land Location Of Property Subd~ws~on .............................................................. Lot No./.. .......... Block No ............. House No ............. Health Dept. Approval .... .~g.:..~)...0...'.).!2 ................... Labor Dept. Approval ................................................ Underwriters Approval ....... ..~,.J..~.~,..~,'...~ ................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Finctl Certificate .....~,,. ............................ Construction on above described building and permit meets all bpplioable codes and regulations. ^pp,ica.t ............................ Sworn to before me this ~A -- ~j~ ~/ ~dayo . ,~-~Z-. ~,, (stamp orseol)~~F~ Nota~ Public ..~~~.. Coun~, ~ THE Novembez' NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU Of ELEC;TRIC~TY 85 JOHN STREET. NEW YORK, NeW yORK 10038 THIS CERTIFIES THAT Gllbert Mlebaelis, 715 Deer~Dr. tv~attltueA~ Lot. in the foflowln~~ locuti°~i: ~ Basement [] 1st ..... .~..~.,,~,~.lo. November 4, 1976 FIXTURE OUTLETS 27 DRYERS RECEPTACtES! SWITCHES iNCANOE$CEN¥ FURNACE MOTORS [~ 2nd FI. Outside Section Block Lot 15 FIXTURES RANGES OVENS t WASHERS EXHAUST FANS MULTI-OUTLET SYSTEMS NO. OF FEET 200 J CB OTHER APPARATUS: Motors: 1-1hp. 1-G.F.I. E R V I C I 3/0 1 3/0 Gilbert Michaelis ~ Cedar Dr. Southold, N.Y. 11971 GENERA This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspeclors may be identified by t ,~'~e ' . TOWN OF $OUTHO D ~ , ,~.~ BUILDING DEPARTMENT ~ - , ~'~ ~UTHOLD, N. Y. ~ ~" ~'~ ~/~ ~ ~' .............. f.. ....... , ................................. ._ .................................................. .......................... ........................... ....... APPLIGATION FOR BUILDING PERMIT ~~~~ a. This ~pphc~tion must be co~p~,teiy fi~t~d in by typewriter o~ in ink ~d s~mitt~d in trlplic~t~ to t~ Inspector, with ~ s~ts of plans, ~cc~mt~ plot plan to ~ole. ~e according to schedule. b. Plot plan s~ow~ng location of [ot ~nd of buildings on premises, relatfonship fo adjoining premises or publi~ ~tr~ets o~ areas, ~d g~ving ~ d~tail~ d~s~riptio~ of I~yout o~proper~ mu~t be dr~wn on the diagram w~ic~ is pa~ o~ tMs application. d. Upon ~pprowl of this ~ppHcotion, the Building inspector wili ~sue ~ Building Permit to the ~pplicant. Such permit shall b~ kept on t~e pr~mis~s availobl~ for inspection throughout t~ work. e. No building s~l b~ occupied or used in w~ole or in part for any purpose w~f~ver u~tii ~ ~ificat~ of ~cupan~y sholl h~ve been g~onted by the Building Inspector. APPLICATIO~ IS HEREBY ~ADE to the Building Deportment ~o~ the issuonce o~ o Building Permit pursuont to the Building Zone Ordinonce of the Town of Southold, Suffolk County, ~ew York, ond other opplicoble Lows, Ordinonces described. Regulotions, ~or the construction o~ buildings, odditions or olterotions, or ~or removol or demolition, os herein ' The opplicont ogrees to comply with oll opplicoble lows, ordinonces, building code, housing code, ond regulations, ond to odmit outhorized inspectors on premises and i~ buildings for n~esso~ inspections. ~ignoture of opplicont, or nome, if o corporotion) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of prem ses ..... ~.~.],~b. ez'.~,..~!zJ.~;~.e..~..,]:z:...~...~J£~,'@. ................................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No .... ~.:.o...g..~..~.o..~.].c..],. ................ Electrician's License No...,o.,~....~..e...r. .............................. Other Trade's License No ............................................... Deer Park Location of land on which proposed work will be done. Mop No.: ........................................ Lot No. 1 · Street and Number Deer Drl [e Mp.,t ~:k.~.~¢.~ .... Municipali~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: vacant o. Exisiting use and occupancy b. Intended use and occupancy one famil~ dwelling 3. t~o"~u~e ~t work (check which applicable): New Build,ng' ...~ ........ Addition .................. Alteration .............. Repair .................. Removal .................. Demolitiar: .................... Other Work (Description) 4. Estimated Cost ......................... ~.~.Q.Q.Q....,+.~ ............ Fee ..~..~..,...6.~.. .......................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... .o,.~.e. ............... Number of dwelling units on each floor ........................... If garage, number of cars ......~..~'...O. ................................................................................................................................ 6. If basiness, 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 28-1+ Height .................... Number of Stories ...¢~ ......................................................................................................... 9. Size of lot: Front ..... ..................................... Rear ........... ~i. 2..2..+.. ..................... Depth ....1...6..6.../....1.~Z .......... 10. Dote of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..!!A!!...Cl,~.~.~ .................................................................. ............. 12. Does proposed construction violate any zoning law, ordinance or regulation: ........ ~.o.. ........................................... 13. Will lot be regraded ..... .y~.~ ................ Will excess fill be removed from premises: ( ) Yes (~) No 14. Nome of Owner of premises ..G.~.]....b.?.,..~.~....~.~.~..q~..~..Z.?..~....8]?.....&:.. ~]'~ss Southold Phone No. Name of Architect .............................................................. Address ................................ Phone No ....................... Nome of Contractor ......... ~fi~,f~ .......................................... Address ................................ Phone 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 ~vhether interior or corner lot. see filed plans ETA"f E OF NEW, YORK. I ~ ~ COUNTY£~ n,/_ .^ C,~ ..~.~T~'.~.O..~]~ ............. f~.a r ................ ~.~.,.~....~1,- ....... ~..LI.I.~.~ ...... being duly sworn, deposes and says that he is the opplicor, I (Nabe of individual signing contract) abow~ named. He is the ................................. ~.~9.~ .................................................................................................................................... (Contractor, agent, corporate officer, etc.) of s~id owner or owners, and is duly authorized to perform or have performed the said work and to make ~nd file this application; that all statements contained in Ibis applicefion are true to the best of his knowledge and belief; tk, o~ the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ................... ........................ .......... , oto, ...................... ....... :.. , ............... ~ ~ ~ (Signature of applicant) ' ~PUgLIC, S~a'~e el Ne~ -1125~50, ~folk ~em ~pit~s ~itch 30. SUFF. CO. HI,AL'tH D~'PT. AppROvAL OWNER: 30UT/4OI. D, N', Y, 1/~71 L ~ ~ ,/ '"' 4,, 6.4.~'O~'ZO"W. - l~6.tg "', . - ' " ' ""'; "~' "' 'i:"'~ , ,,. c,,,,,s ,u.v,,'..,.o.,,..,.d:~,, ,., ~D~ICK vAN TUY~ ~, G. LiC. ~ND SURV~ORS-GREEN~RT, N.Y. ' SUFF. CO. DEPT. OF HEALTH SERVICE~ trrATEMENT OF INTENT FOR APPROVAL OF CON'=TRUf~ON ONLY : DENCE Wl~ CONF~M TO g 'so S. REF. NO.: . STAND~D~ OF 5UFFO~ CO. OF H~LTH. 8ERVI~[5. J ./ L /Y/AP Og LOT 1~ VAN TUYI. P, C, I. IC. L.ANO ~U IJYJIYOIII~II~JNI"~II~f, N. Y. ~ ~ APPI~)~D AS NOTED, NO -~ ~ FOR REI~UlB'' til, l]ttt l ill k~ 9L o" ? .... It I_ O,r (c t~ Lt