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Home My WebLink About8684-zFOB, M NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office South&d, N. Y. Certificate Of Occupancy iv) THIS CERTIFIES that the building located at~.~e.e~..~. .~.~0.k. ~ ,1~..~..(P.~.q.~..~.h. Street Map No ............. Block No ........... Lot No .... ' ...... ~~ .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. ~O.. ~9..~ pursuant t0~whieh Building Pe~it No. ments of the applicable provisions o~ the law. The occupancy ~or which this certificate issued is Prl~at~ o~ Saintly d~lling The certificate is issued to . .~q .&. ~g~. ~ ...... ~ (owner, lessee or ten,t) of the aforesaid building. Suffolk County Department of Health Approvat ~..~3.. ~.~.. ~7. ~.~ .V!~ .... u~w~s C~CA~ ~o.~0~3~9. .... ~..~ .~.. J.~?~ ............... HOUSE NUMBER ...... 30.0~... Street .. ~..~9 ........................... FOI~M NO. 3 TOWM OF SOUTHOLD BUILDIFIG DEPARTME~'4T TOWFI CLERK'S OFFICE SOUTHOLD, FI.. Y. ~UILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N? 868 Z Permission is hereby granted to: Francis ~ose Hms "~'i3'~°'*~'*~':~'"~:~*1'cu:' ..................................... .................. ~4.~¢...~ 2~ .......... ~$..~ h~",~ tob..~.Z.~...h~.?.~....c:~.~...t.~?t:F.~i~:...d:./..~:.d~.~.:.~ ....................................................................................... at premises located at ..~/]~..~l~.~..i,~w-k../~d.....~e~:tta. s~%..A.V~.) .......................................... ................................................... C~t,c~.o.~;u~ ....... ~;.,.Y:~ ....................................................................... pursuant to application dated .........................~?~le....~.~ ........... , ]9.~.., and approved by the Building Inspector. Fee $..~.~. ~.~.~. .......... FOEM ~0. 6 TOWN OF SOUTHOLD , Building Deportment 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 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 disposal--(S-9 farm or equal). 3. Approval of electrical installation from Beard 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 formation required to prepare o certificate. C. Fees: 1, Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy Date 11/9/76 New BHilding ..,~. ............ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property .~...~../.~ .Flee~...~?,ek R~.;. (?ec!.qa.s..h.....A.y,.e., ) -1.?. . .5. .?. . ; 2,8..; .. ~/0 Wll]Low ............................... ...... ' ............... ¥. Owner Or Owners Of Property ..G..~.~,.~.o,...,~...,.~.,o,.$.,a,,...~,:J:..o,.~. ............................................................................ Subdivision ................................................................ Lot No ............. Block No ............. House No .... .30'1'5.. Permit No. 8684 Z Dote Of Permit 6~25~'.76 Applicant ~:~z'aDees ROse Homes~Ine. Ale .~ Health Dept. Approval ..9.,/..2...3.~.?...6.......6..~..~.'L.~.?...9.....Labor Dept. Approval ...... ~./..R. ................................... Underwriters Approgal N 303319 9/14/?.6. Planning Boord Approval N/R Request For Temporary Certificate ........................................ Final Certificate X FCcen;t~buc~iitot~do~ ~'~'~:~";'::':;;';':';";';;;';;ng a~/~permit meet, all appl~able codes and regulations. ......... ~.o day of ......~..! ...~.7..t.c.~......L..~.'~' (stamp or s~,~~- Notary Public .....,,,, ,~,- ~,, ,~., County (/ ~L~ ' TOWN OF SOUTHOLD ? /?- ,//'~ - ~., ~ d// BUILDING DEPARTMENT 7/ /~ ~, ~ ~/ ~ ~ ~ - · ~ ~ ~>~ ~'D 19 ~.,~ ~ ~ ~~ ~ ~ation No ~:.:~....:;1 ....... ~.. . ~ / ~ ~ ~a/,- aermtNo u[]-~ :.. ..... u Disapproved a/c .............. ~:~-: ............. ;::~ ....... : ............ ~ ~ _ ~ /" ~ / ................................................................................ : - / :: / / ' ......... .................... , ] ........ INSTRUCTIONS ~' ,~ 4 ~,,~ ~ ns ector, with 3 sets of pans, accurate plot plan to ~a e Fee accordi g , ~ ~ /~ &.~ ' /' b. R bt p a~ ~o~J~g Joc~tio~ oJ ~t o~d o~ bglldmgs on pre~ls~s reJabons~lp to. ~djolnlng ....... ~emlse~ or pub c stFeets o areas, and giving a detailed descHphon of layout ofproperty must b~ drawn on the dmgram which ~s pa~ of th~s apphcahon. c. ~ w~k co~r~ ~y t~i~ a~plic~tio~ may ~ot ~ commenced ~fore ~ss~a~c~ of B~il~i~g ~rmit shall be kept on the premises avadabie for nspechon throughout the work. ~ ~~ shall have been granted by the Building I~or. / ~ ~ %~ ~ ~_ ~'~ ~-/'~ ~ ..... APPL CATION IS HE~EDY MADE t~uildinD Department far the ~ssuance or a ~unam~ verm~t pursuant to ma Duilding Zone Ordinance of the ~own of Southold, Suffolk County, New York, and other applicable Laws, Ordinances ar Regulations, for the construction of buildinDs, add t OhS ar alterations, or for r~moval or demolition, as herein described. The applicant agrees to comply with all applicable laws ordlna~s, building code, housing code, and r~gulatian% and admit authorize~ ~inspactars on premises and in buildings for ~essa~ in~ections. ........ ' r : ~RANCES ~QSE HO~S ~ INC. .............. ~ ~,J :~ (Address of applicant) State v ant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ Oilmo and Rosa Flor Nome of owner of premises .................................................................................................................................................... If applicant is o corporate, signature of duly authorized officer. j~ (~ama and title,of co,roorate officer) eD ~leDO. ozza~ ~2eslU, en~ Builder's License No ..................................................... Plumber's License No ........ ~.:.~ ............................. Electrician's License No...~...~ ........................... Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Mgp No.: ........................................ Lot No ........................ ~ortheastez'l side of Fleets N~ek ~id.,' ' 'Cutc~og~e~N~Y. Street and Number . .. ,... ~......~.. ......................................... 'x ........................................................... ~75~;.2~ ~OU~ie~S~e~[y O~' ~{~OW St. ~.,xt. 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 1-family. dwelling 3. Nature of work (check which applicable): New Building' ......~.. .......... Addition .................. Alteration ................ P, epair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) 4. Estimated Cost ...... ';....7 ................................................ ~ee .......................................................................... (to be paid on filing this application) 5, If dwelling, number of dwelling units ...... .3: .................... 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 a~terations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ .~.9. ....... . ............... Rear ....... ~..9. ................ Depth .....2..~.. ............... Height 38 , Number of Stories 9. Size of lot: Front ........... ~.~..0.. ..................................... Rear ..... ~.-..~.~.t..5.~ ...................... Depth ..... ?:.0.0..'. .................. I0. Date of Purchase ........................................................ Name of Former Owner .......................................... ~ ............. 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... .~..O. ............................................ 13. Will lot be regraded .......y..e.,s. .............. Will excess fill be removed from premises: ( ) Yes (X) No 82'16 60 Ave. Phone No.(.2..l.,2.)....639' 14. Name of Owner of premises ...G.~.~.9...~...[.~..°.~..a.....~.;~I:...°Z ......... Address ~.[(~kt~[Dz,.§,~.¥...N~ ........ Nome of Architect .............................................................. Address ................................ Phone No ....................... 90 :Bo:( 992 ...................... Nome of Contractor .~,~.~,,,8:..~,~.,e,.~,,,,~.o.,.s.,e....~.],.°.?:?-,,8..~l.,..~,~o,.:... Address ~'6~'~)'~';'"~'~ Phone No. 73A-6662 PLOT DIAGRAM Locate clearly and distinctly al~ buildings, whether existing or proposed, and indicate all set-bock 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 YORK, COUNTY OF ..~.~;~.~P.~ ............ f~"~ Bezl ~e]:t~oz',~Pz'es, ~ ~8~0e8 ~¢8e ~0~)~ 'be n~ du ,, sworn, deposes' and says f~t he is the applicant (Name of individuql signing contract) ' above named. He is the ......... ~.~.Z~.~.~.~.~.~...~'.~$~.~ ............................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this application; that all st'atements' contained in this applicati,on'are true to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this __ ......... ~doy of ........ Commission Expires BUILDER: NO TE ; Frances Rose 1R°~e~, Inc. P.O.Box 992s Main Road Cutehogue, N.Y.i 11955 · -' MONUMENT NEAREST PUBLIC ........... Oilmo & Rosa Flor SUFFOL~ COUe4TY DEPARTMENT OF I,I~AL'I'H SERV~E$ FOR APPROVAL OF CONSTRUCTION ONLY OATE~ H REF. UNAUTHORIZED ALTERATION OR AODITtON TO TH~S SURVEY IS A VIOLATION OF SECTION YOUNO & YOUNG SLRVEY ~ON' G/L MO F/OR ~ ROSE F/OR CUTCHOGUE SOUTHAMPTON !: 76- ~$0 BuiId er: Frances Rose Homes, Inc. P.O. Box 992,~ MaSh Rd,, Cutchogue, N.Y. 11925 SUFFOLK COUNTY HEALTH DEPART~ENT :>AzESEP 2 3 1976 H.' D. REF. $ The .~ewaEe d~ 2po~al and water supply facilities for this loc~tion have been ~nspected by th.ts department and found Chief bf General Engineerin8 Services SHOWN HEREIN ARE F/~OM FIELD OBSERVATIONS AND/OR FRO~,/DATA OBTAINED FRO~ OTHERS SURVEY ['OR: G/L MO F10R ~ 'ROSE F10R CU TCHOGU£ . ~,SOUTNOLO SAVINGS BANK ©? ......................... AM£BICAN~TIT££ INSUI~ANC£ ~s~ ~ o~ ~ ~s~ · o~s I ~ .... I "= 30' ~ JUNE 9 1976 AI~OVED AS NO~'ED DATE: ~~ FEE: ~.~ By~ TION OR START FRAMING 2. BEFORE COVERING FeANCES'ROS; HoMEs, INC'* ' B RO 'A D W.,A Y-' r ROCI~,PO!NT, N. Y.-11778 " I 4