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Home My WebLink About8703-zTO~I OF SOUTHOLD BI~.nING DEPARTMk~NT Town Clerk'~ O~ice Sou~hold, N. Y. Certificate Of Occupancy No..Z. 792,5 ..... Date ..............8ep.t, ... 30...., 19~.. THIS CERTIFIES that the building located at ........~;~J. ve.t.e.r..AY~ ... Street Map No.. xx ........ Block No... xx .....Lot No.. ocxx~... Cu.t, cho&um ,. N.,~. ...... conforms substantially to the Applicat~an for Buildin~ Permit heretofore ~ed in thi, office dated ............Ju.~y....6, 19.76. pursuant to which Building Permit No..670~7~. dated ..............J.u.~y .... (~, 19. ?.6., was issued, and conforms to al~ of the require- merits of the applicable previsions of the law. The occupancy for which Sbt, certificate is issued is . P~J, va.t.e., sw~lng .poo:l, .~l~h. f. enc~[~g .~. &cce~ory~ ............... The certificate is issued to .~FaP, k. E~,c$ ........... owr~er. .......................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ...N.,.R.: ............................. UNDERWRITERS ~ERTIFICATE No, .. ~I~.0.1~ .... ABg .~...197~. ............... HOUSE NUMBER ..... .~.O2~ .... Street .... ~X],~ate~: .ATe ...... .~utchogue. .... Building Tnsl:~ctor TOWN OF SOUTHOLD BUILDING 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? 8703 Z Permission is hereby granted to: De~te--.P~.]:~...~.~e.-.-.A./~...~.l~-.}¢:.]:c~ ....... ............ ~ %.1, ~.~,t~: .............................................. to h~.~.ld...~.~:~,z..:~,~;m'~te...~.~,~:~:i~4f .~Z .~,~:~:~,- .~e~g ~,. ~- e~s~.~.~ .................. at premises located at ..~,]~..~-~!.~.~.w~te.v...,~Ve ............................................................................... .................................................. C.u~h~,'~,~ ..-..N., .% ,, .......................................................................... pursuant to application dated ........................ ~.~.]:~.. ...... .~ ............ , 19.~..., and approved by the Building Inspector° ~1'0~l Nee~l 'm'sde~"z'tte~$ eer%lflcate :For e3.ee, hookup foz' C/O Fee $ .']..~.. D.O ........... TOWN OF $OUTHOLD , Building Depnftment Town Clerks Office Southold, N. Y. 11971 APPMGATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICA, TE 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 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" lend 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 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 Date New B~ d ng ~....~:~. Addition Old or Pre ex,s ,n Bu,ld,n ' ' -.~.~-~.: ....... ~, ..;..r..~.. ...... - ~is[i g ' ' g ............... Vacant Land .............. Location Of Property ¥~.-~P~;'~.~.f..~.).~.~.~..,~:~..~..~..~'._¥~z~.~ Owner Or Owners Of Property .~..~...~..4.~>~_ ' ~-~ ~ . ......... Subdivision ..................... ~ ..................... '] ............ Lot No..~L...:.~/...~Block No ...... , .~...~. House No ............. Permit No.Z/~..~.,~.:..~¢ Date Of Permit .~..~...~:~..?...~.....Applicont ~ .~..~...~.~;~%.~d.'~..~..'~. ............................... Hearth ~t. A~rovol ...... l.~ ................................. Labor ~t. ~roval ................................................ Unde~riters Approval ~PJ ~ ~; P an, n B~rd 'OVO ................ . ....... g ............................ Request For Tempora~ CeaifJcote ...... ~ ........... F n~ Cea f cote ~. ..... ~.~ ~ · ................................... Fee Submitted $ ....~ ............................. ~nstruction ........ CZ: day of ......... (st m or Noto~ Publ,c~~~.., Coun~ THE NEW. YORK BOARD OF FiRE UNDERWRITERS ak E~UREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW' YORK 10038 ~.~August 31, 197~ th,S CERTIFIES THAT N 3 O 12 5 3 . only the electrical equipment ~ described belo~ ~ ~ntroduced by the appAcant na~ on t~ able appl~ation ~umber in t~ premises of Frank T. K1Os,~Stl!!~ater Avenue' Cutchogue, L.I. ~'.~.~.,,,u~.d,m August 26, 1976~. andf°undt°be~neompH.ncew~ththerequirementso/thisBoard. FIXTURE OUTLETS SWITCHES' DRYERS OTHER APPARATUS: FUTURE APPLIANCE FEEDER! (Swimming Pool) inspection only. to have frequent RANGES SPECIAL REC'PT. COOKING DECKS: TIME CLOCKS t UNIT HEATERS C MULTI-OUTLET SYSTEMS E NO, OF NEUTRALS This certificate covers compliance at the date of Because of unusual environments it is advisable test and/or repairs made by a qualified person. DIMMERS ~ Stillwater Ave., r ERA.[ MANAGEP. IN Cutchogue, L.I. 11935 GRN TOWN OF ~OUTHOLD BUILDING DEPARTMENT Sou'rHOLD, N. Y. ., roved ......................... Oi, prove, ...... ........ ................ ................... :-. ........ ........................ {Suildi~ Insp~:tor) APPLICATION FOR, BUILDING PERMIT INSTRUCTIONS Application No ............................... (~?,.~...~... . '~ a. This application mgst be cdmpletely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector~ with 3 se~s Of p. lar~s., accurate pl.~/plan~to ~ale. Fee according to schedule. b. P~ot plan sh°Wi~g !ocation of lot and of buildings on premises, relationship to adjoining premises or public streets of areas, and giving~3"detaJ'~d.descrJptJon of layout ofp~oPetty must be drawn on the diagram which is part of this application. c. The W. qrk c.,~ve~ed by th s appl co.t on may nm be commenced before ssuance of Bui ding Permit d. Upon approval' of this application, the Building Ipspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout ~the work. e. ' No building shaU be occupied or used in whele or in part for any purpose whatever until a Certificate of Occupancy shall have been granted:by the-Btiilding Inspector. APPLICATION IS HEREBY/V~DE 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 regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ....... DOR:T~...:P. OOI,,S ............................................................... (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................... '....q...oll~.~.e,g..~..o. t'. ........ ; ......................................................................................................................................... Name of owner of premises ...:I~A~.BJ3,t~..~;;],.(R.a ......................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of co~3orate officer) Budder~ [-~cense No ........................................ Plumber'~ licen~ No ................................................. Electrician's License No ............................................. Other Trode's License No ..... 3./3.~.~. ................................ 1. Location of land on,which proposed wo~'k will'be don~ Mop No.: ........................................ Lot No ......................... Street and Number ...~L~L~e.t, az'...A.~.a.,.,..¢ttt, ebag:te~...~,:.~,...:],;Lg~ ................................................... Municipality State existing- use and occupancy of premises and in~ended use and .occupancy of proposed construction: o. Exisiting~ use~and: occ~ncy.....,,,; ....... <~.TL~..-.,f'.~lt~,],~r...~.g ............... ~ ................ ~ ............................... b. Intended use and occupancy';~:~;..,;.i;..;..g~§..-.~'.e, tll~,.~.1~ll;L],;l,~...; ............... ...~.. ........... 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration .............. Repair .................. Removal .................. Demolition ................... Other Work ~.:JJ~R~T~.,,~..~g.~, ................. (Description) 4. Estimated Cost ..... J~3.,.(~.c)~,.0.0 ................................. Fee ....$15...0D. ................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling unit4 an 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 ........................ 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 proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded ............................ Will excess fill be removed f~j.[~;r~:~ .a,~]s ( ) No 14. Name of Owner of premises .F.~.aJ:~..E1Qs ........................... Address CLtmt~J~Qf~l~.~...~,~o~e No. 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 oil set-back dimensions from to property lines. Give street and according deed, and show street names and indicate whether interior or cc'net lot. ~ - / STATE OF NEW YORK. ~ S S COUNTY_OE. ~..~...~.~..o...l~.. J . ~ ua~li'~rzne .............. ................ ~..~.~.]~$S .......................................... bein~ duly sworn, deposes and say~ th~he is the applicanl (Name of individual signing contractO above named, agent for/ ' ' c ontz, ac t az, ............................................................. SHe is the .................................................................................................................. ~ (Contractor, agent, corporate office% etc.) ~, . of said owner or owners, and is duly authorized to perform or have performed th~ said work and to make and file this application; that all statements contained in this applicetton are tr~e to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........ 6.¢.h ......... day of ................................. Notary Public, . ....................... ~',~l~'~].[C .......... ~County NOTARY J~USLIC. State o! Ne y~ll , .................. ............ .......... (Signature of. ~pljcant) ·