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Home My WebLink About8680-zNO. ,I TOWN OF $OUTHOLD BU[[,r)I~G DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..'Z..Y.~3. ~. Date ................. 0IC.T. · .~3., 19.7./~ THIS CERTIFIES that the building located at~.q.~ .-pLUlt .~0~l,15.. t.^~£... Street Map No. · ~ ./. b D... Block No ........ -~...Lot No ..... /.~-.~. ....................... conforms substantially to the Application for Building Permit heretofore ~ed in this office dated ........,j~.tJ.~-...! .O.., 19.7~ pursuant to which Building Permit No. dated .......,JO~/.£ .... P.~..., 19.Y.~,, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is The certificate is issued to ~Et ~q ~.~<~. · LO ~. ~ Y- ................................... (owner, le&~,~,~ ,'-' of the aforesaid building. Suffolk County Department of Health Approval . ~C '7' · ~-q;. I-9 ? ~o .... ~ ;-. 5.0 .-. ( .Q ~.... UNDERWRITERS CERTIFICATE No...~ .50. (,.~..7...~ ........................... HOUSE NUMBER. ~..~.~/.~ ...... Street. ~L.O ~.. X~te ~: ~.... t~.~/£. ..... /).~$ J/t-/. ?. ) ....... ..... Building Inspector FOI~M NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMIrNT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8680 Z Permission is hereby granted to: Z.,.9.~I..C..~2.2!:~,..~..o.~)~..~..,~.~.e:...../L/.~R..e..~.%,.L.,.&:: Patricia Lollot S outhold to ,,.: .................................:.,'~ .............;'":'"'~ ............................................................. at premises located at ...~.?tJ ~ ~r.~:~.~..~.~..~.~...~,~ ...................................... Pi~ Island L~ D~i~t~ pursuant to application doted '. ...................... ~!g?'~......~ ............. , 1~. ..... and approved by the Building Inspector. "'r " ................. 65.ijA'~'TA~%'~;; ....... ( ............... TOWH OF SOUTHOLD , Building Depadment Town Clerks Office $outhold, H. Y. 11971 APPLIGATION FOR GERTIFICATE 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 top~graphic features. 2. Final approval of Health Dept. of water supply and sewerage disp0sal--(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 "pm.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 pmmises, 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 Dote ............................. ..~ ............... New Building ................ Addition ................ Old or Pre-existing Building ................ Yacant Land .............. Location Of Property ~L..~ ..;{3L.U/.~ ~"~LAI'/~:> L/3, HE C~'~l El"/"/ Owner Or Owners Of Property "~E I - ~-' NE' !..~. ~ 0 './../~ 0 -"-~./.. Subdivision ~[1~/' ~'t' 'T'HL~ ~.~.../~.. . LotNoI..'~...?. ...... Block No. ....'~... ..... " ............................................................ Mouse INa ............. m,t No ................. ....~ote Of,Perm,4.1 .............. ..~.(.~l~hcont ........ .~ ........................................................ ~ealth Dept. Approval,~P ~ /'~ /_ ~ ~"~ ,.~'~'"'~ ............................... Lobar ~t. Appr~al ................................................ nde riters Apprava, ............. P,an.ing B rd App,aYal ........ .............. Request Far Temparo~ Certificate ........................................ Finc~ Certificate Construction on above described building gr~d permit meets all applicable codes end regu at ohs pp ca ................ ................................................................... Sworn to before me this ................ day of ............................................ Notary Public .................................... County THE NEW YORK BOARD OF FIRE UNDERWRITERS ""'" October 7, 1976 A,,,.,,.a,,,,.No.o./,,e 867601 N 306879 Reiner Lollot, 2345 Plum Island Lane, s/side, Orient, L.I. FIXTURE OUTLETS 18 DRYERS 28 SWfFCHE5 16 FIXTURES RANGES OVENS EXH ALIST FANS SYSTEMS NO. OF FEET OTHER APPARATUS: ! G.F.C.I. R V ! C 3/0 A, w G. NO OF NEUTRALS A W G OF HI-LEG OF NEUTRA~ 1 1/o Ruland ElecoCo., P.O.Box 143 Mattltuck, L.I. 11952 Li c. 2 ~ 2E GENErAl D Th~s certificate must not be allered in any manner; return to the office of the Board if Incorrect. Inspectors be identified by credential~ TOWN OF SOUTHOLD ¢,.,',,,.,,~..,:,,~ 0 ~L ~ BUILDING DE,P,.ARTMENT '¥~ ~ ~ ~ ~ ~ ~ ............... ..................... ............................................................. ,. .... ........................... q~(i~i;'~ i;~;7;;;~ .......... v ............... APPLICATION FOR BUILDING PERMIT / INSTRUCTIONS ~. This ~pplic~tion mu~t be completely filled in by typewriter o~ in i~k ond submitted in triplicate to the Building~ Inspector, wlt~ 3 ~et~ of plans, ~ccurate plot plan to ~le. Fee ~ccording to schedule. b. Plot plon showing Ioc~tion of lot ~nd of buildings on premises, rel~tionsh~ to odjoining premises or publict~treets ~re~s, ~d giving ~ det~il~ description of layout o~prop~rty must be dr~n on the diagram ~hich is p~rt of this ~pp~ic~tion. c. The work covered by this ~pplic~tion m~y not be commenced before issuonce of Building Permit. d. Upon ~pprov~l of this ~pplic~tion, t~e Building Inspector will issue ~ Building Permit to the ~pplic~nt. Such permit sh~ll be kept on the premises ~v~il~ble for inspection throughout t~e work. e. No building s~ll be occupied or used in w~ole or in p~rt for ~ny purpose whatever until ~ Ce~ific~te of Occupancy shall hove 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 regulgtions, and to admit authorized inspectars on premises and i~ buildings for n~essa~ inspections. (S~ature of applicant, or ~me, if a c~oration) ~'~Xddress o~ opplico~ State whether applications owner, lessee, o~ent, orchitoct, en~i~eer~ ~enerol contractor, electrician, plumber or N.~. o~ o~.~. ~ ~,~,~,, ........... Z~T~:......,.....,,. .................................................................................................................. Forpo~te~ig~u~e of duly~ori~ed officer, If (N~me ond t~tle of c~rpor~te officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trode's License No ............................................... ..~ Location of land on which p/~poz~d work v~L~lxbe done. Mop No.~Z/./...(.'.~..~...~::::. ......... Lot No. ......... Street and umber ...... ...... Municipali~ State existin§ use end occupancy of premises and in~ended use and occupancy of proposed construction: o. Exisiting use and occupancy b, Intended use and occupancy ' · ............................................ 3. Nature of work (check which applicable): New Building,. ................./// Addition .................. Alteration ............ ,. Repair .................. ~,R_ emoval .................. Demolitior ..................... Other Work ................................................... x'~'~2 ~ 5- O (Description) Est'mated Cost ............. z'.~ ........................................... 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 / i 6. If business, commercial ar 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 ..u..~,...¢?.. ..................... Rear ......... ~'... ............... Depth ......¢~.~. 9. Size of lot: Front ............ ../....?..~.....~ ............................. Rear ............. ...~..~(...'. ................. Depth ..../...3..~... .................. 10. [)ate of Purchase ........................................................ Name of Former Owner ........................................................ 12. Does proposed construction violate any zoning Jaw, ordinance or ragu[orion: ..... ../~',..~ ........................................... 13. YVil[ lot be regraded ...../~...~. ................... Will excess fill be removed from premises: ( ) Yes ( V'~ No 14. Nome of Owner of premises"~-'~ Z- cJZ L O ~ Address "'~';7 .................... Phone No ....................... Name of Architect .......... ~. .................. ~ .......................... Address ................................ Phone No ....... Z~'"'~' .... Nome of ............................... ...................... 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 ar description according to deed, and show street names and indicate whether interior or corner lot. STATL: OF NEW YORK, IS S COUNTY OF ....l~11~'~.~.~; ........... f ' ........................................... ]L:t,O~l~l~../.i....~l~. ................ being duly sworn, deposes and says that he is the applicam (Name of individual signing contract) above named. Fie 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 file this application; that all stoternents contained in this application are true to,9, the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application f, il'6c/therewith. ............ . ........................ Noto, Cub,c, · .................. ............. ............... .......... t'~'~7~ __ /, ~'~ ,/~,~ , ~ /7 ~' (Signature of appliconDV' No. 52-81258511, Suffolk County ~¢~m Expires March 30, 19~.~~' I FOR A~ROVAL OF CONS~U~N O~Y TH;~ WATER ~UPP~Y AND H. S. REF. NO,: OF SUFFOLK CO, D;PT. ~ OF H~TH. ~ERVI~ES. ~ : 'i~t t on- ~ve. been $0' = i~ O ta / ~7r' VAN TUYI- P. C. ~ ' ' t A~ ~ AS N~ ~TED / REVISIONS - - ~., LO LLoT b " I 'TH~cid 10" O,C REVISIONS S S U E $ '~, LOLLOT 510 ~', rZo.-r_U ~T,~ M,'-f', Q, ~. I-I R E V I El I 0 N S i REVISIONS (.,~"= I :o") $ S U e $ R. kOkkO I 5/0 P_..., gOT~ ,~"Tv k..,l,Y, C_, c.. II l o o0oo I IR,' LO LLO I . 510E,9_0~ ST,, S $ U ION £ S DR. CH. AP, ,I