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Home My WebLink About8709-zTOWN OF SOUTHOLD BUn.F)ING DEPARTMENT Town Clerk's O~iee Southold, lq. Y. Certificate Of Occupancy No...~..7...~..t..~.. Date ]~Lrc: .2..I lg~. ~IS ~T~ ~at ~e b~d~g l~at~ at . ~... ~.~ ~....~ Map No... ~ ~l... Bl~ No .... ~ .... ~t No, . ~? ............................. co~o~ subst~ti~y to ~e Applica~on for B~g Pe~t h~Wfo~ ~ ~ ~ o~ dat~ ............. ~?N.. dat~ ............. ~.~... ~., lg~.~., was ~u~, ~d co,om men~ of ~e applicable p~o~io~ of ~u~ ~. ~. ~t.~.7.~,, ~ ~q...~a~ ~ ~... ~.~.~ t~.~ .................... ~e em~iea~ ~ ~suM ~ .... ~ 0.$.ff.P.~ .... ~ ....~ ~q.~ .................... (o~, of ~e Mor~d b~g. ~o~ Cowry Dep~ment ~WRITERS C~T~ICA~ No.. '. ~.. ~. (.~.~. ~ ~ .......... '.~7~?~ ..... HOUSE ~.. .... B~g ~r FOEM NO. :~ 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) Permission is hereby granted / ~ ~....~!~i~...!~.~..~ ~...!.~e......'?...~..d.. .o...~.:...,L pursuant to application dated ................................. ./. ................ , ........ , a ppr y Building Inspector. ....... FOP,,M NO. 6 TOWN OF $OUTHOLD , Building Department To~n 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 dispasal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Uhderwritcrs. 4. Commercial buildlngs, Industrlol 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 $1.00 Date ....D..e. 9.e..~..b..e..~... 2..0.t..h..:....~.?..7.§. ...... New Building .......X. ...... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property .~.~/.~...C~.~p..e..~..~..~..~..~..~..e...~.]~..e..qe~...~....~..e.P~.~¢...~..~.$~ ............................... Owner Or Owners Of Property ..... ..~.°.~.e.~..b....e.~.~..~..~.~.~.b..e..t..h...~.e..]:.R~ ........................................................... Subdivision t~,~..~t~f...B..C.¢.,...2..,...¢.],C~.~.¢.s...~..o.$..R.1; ......... Lot No....z}.9. ..... Block No ............. House No...O..5. ...... Permit No.....8...7.97....Z..... Date Of Permit ..7.../..7../..7..~. ...... Applicant .~?...~..o.?..:.:~.o..~..e.?..~...~..~...a.: ....................... Health Dept. Approval .~'...~..-~.0.z.]~2.9. .................. Labor Dept. Approval Underwriters Approval .~Z~.];.~.5..~...~ ............................. Planning Board Approval Request For Temporary Certificate ........................................ Fin~ Certificate ..... .~.. .................................. Fee Subm it ted $~......~..~7..~.. .......... Construction on above described building and permit meets all applicable codes and regulations. A,,,~licant ~.~ liras. ~o~es~ ................ day of ............................................ (stamp or seol) Notary Public .................................... County ~,~ ~. ,7~.~ ~'~' . Disapproved a/c ..................... ~ .......................................................... I ' · APPLICATION FOR BUILDING PERMIT r~., ,Iuly SI:h, 19......7..6..,?~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building~muL~ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. plot plan showing Ibcation of 10t and of buildings on premises, relationship to adjoining premises or public streets areas, end giving a detailed description of layout ofproperb/must be drawn on the diagram which is part of th s app cat on c. The work covered by this application may not be commenced before issuance of Building Permit. d. UPon approval of' this ap~p ication, the Bu Id ng Inspector wiU issue a Build, rig Permit to the apphcant. Such perm tr~p shall be kept on the premises available for 'inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy · shall have been granted by the Building Inspector. h-~ APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t · Bui d ng Zone Ord nonce of the Town of Southold, Suffolk County, New York, ohd other appli.c, able Laws, Ordinances or_T~ Regulations, for the construct on of buildings, additions or alterations, or for removal or demohtion, as herein described.~< The applicant agrees to comply with all applicable.laws, ordinances, building cat, q, housing code, and regulations, and to admit authorized inspectors on premises and in buddings for necessary irOn, fans. /,) /~oture of appliCatOr, or name, if a corporation) 276,9 Sunrise Hwy., lslip Terra,e, New York (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general Contractor, electrician, plumber or builder. General Contrac~gr ' . ..................... : .......... Nome of owner of premises ...~;Joseph..~,L~l~t~&[ ....... ' ................................................ ~., ............................................ If applicant is a corpor~*'/, sign,9~re of duly~j~uthorized officer. (~~'-c~"~'~orate officer) ' Builder's Liceqse No ..................................................... Plumber's License No ........ ./t.0..0..~ ............................... Electrician's License No .... ~sg.~E ............................... Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ........... .3..5..2..].. ..................... Lot No.....4...9. ................ Street and Number ...~./.~...~,~..g;~..]~,]~./Le.J~J.a~ca..am~.-~P-Le.~"~e ............................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed constraction: a. Exisiting use and occupancy .[Ta~pzo~ed. .................................................................................................. Oae (1) ~'ami. ly Home b. Intended use and occupancy ................................................................................................ : ............................... 3. Nature of work (check which applicable): New Building........~.. ......... Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost ............................................................ Fee .......................................................................................... (to be paid on filing this application) Orte u 5. If dwelling, number of dwelling units ............................ N tuber of dwelling units on each floor ............................ If garage, number of cars ....... ...T~..o....~.2..)...,.Cq....r..~.a.r..a~.e. ................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ........... ~[eme ........ Rear ................................Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ ........ '~2...-.6 .................. Rear ......3.7.:..~.6.~ ........... Depth . . . . .3. .0. .'. .~ .0. *. '. ........ 8. Dimensions of entire new construction: Front Height ....... 2.1. ......... Number of Stories ~.["q~s~.[~2~2~.".~"~a~`~T~s~ ...................... 9. Size of lot: Front ......... _1.0..0. ........................................ Rear ....... ,1.0.0. ............................. Depth ........ .1.,5.,0. .................. 10~ Date of Purchase .....O..c..l:,.°b..e..r....1..9..t..h.z...1..9.7.,3. ................ Name of Former Owner ..... .,W.~,l,1..i...a%..S..t..a...m~...t..i,.s. .................. 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... ..,N~ .............................................. 13. Will lot be regraded ......... .Y..e.p. ............. Will excess fill be removed from premises: (Z) Yes ( ) No 14. Name of Owner of premises .......... .3.9..s..ep.,h...S..e..1..u.l~.a. ................ Address ..3.,3.....C~...r..s..t..a..~.r.s....~..d... Phone No..7.,9..,1.Z8..6..0..8. ...... Valley Stream Name of Architect .............................................................. Address ................................Phone No ....................... Name of Contractor ..~.v..]lr, o~...J{omes.,..Zztc ................. Address .Z7..4~..J~,~J,s~.l~3tl~hone No. ,~li~..~.40f;0 ...... PLOT DIAGRAM 're llp Te~ace 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 whether interior or corner lot. STATE OF NE~V__V~. - ~¢5 (S~ COUNTY OF~,/~ -,,.-/J~_,,~.,z~..'..b.'J~..~.u...t~..~ ........ /~...~ ~- .~~/~ ' ~dul~wo rn .................... ~.....~~ ................................. being , d~o~e, end sey, that he is the eppiicant (N6me of individual signing controc~ above named. ~, He is the .......................~~C.~ ........ .~....~.~.....~.~.~. .................................................. (Contractor, agent, co~orate officer, etc.) of sa d owner or owners, and is du y aut~rized to perform or have performed the~id work and to ~ke and file th s application; that all statements contain~ Jn this application ere tree to theist.of his knowledge and belief; that the work will be performed in the manner set fo~h in the application filed ~rewit~ Sworn to be~ me this ~ '_ / ~/ // ............. ....... ...... . ......... . ..... coUn ....... r ~v -v' · ~ ~ ~ - /(Sig~ of applicant) ~BERT P. BOYD ( ~ Public State of New Yale No. 52-0377315 qu~ifled In Suffolk CountY 3e~ ~ires March 30, ~77 THE NEW YORK BOARD OF FIRE UNDERWRITERS ~ak BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 I,-,December l~i, 1976 .~,,pllcat,onNo. o,~yil<~ 8S:~02S N 3~6564 THIS CERTIFIES THAT only the electrical equlprnent as described below and introduced by the applicant named on the above application #lumber in the premises of Joseph Selvga, s/w/cot. Marine Place & Maple Lane, East Marion, L.I. intbe.golhn¢,it,gloc¢,tion; ~ Base~ner*t ~ lstFl. ~x2nd ri. outside sectlo, mo.n rot was exatnlned on December 9, 1976 andfound~obeincon~pliancewithtberequire,nentsoftbisBoard. FIXTURE OUTLETS 15 DRYERS OTHER APPARATUS' FIXTURES IECEPTACLES SWITCHES 32 19 15 FURNACE MOTORS RANGES :OOKING DECKS OVENS S E R V I 1 3/0 DISH WASHERS EXHAUST FANS SYSTEMS C A. W, O NO` OF NEUTRALS OF HI.lEG *Future appliance feeder/s: I G.F.C.I. 1 Smoke Detector 1-2#12, 1-3#10 Sayville, L.I. 11782 Llo.889E GEN'"k~q" / Per~ This certificate must not be altered in any manner; return to the office of the Board if incorrect, Inspectors may be identified by th 'r credentials. VALLEY S'I'~IEAM, N.~ 11~81 ~ ' .~, ~' ~ > ~ .I~ ~ ~ , ~/ ~ ~.h, : ~ ~m, ~U ~ HIS ~HAU I0 THI ~~- - ~ - _ _ .~. Inspected b~ this ~B~artmen~ and fo FOR APPROVAL OF DA'T[: ~ ~ FON THIB II- O~ HIALTH, IIrNYIG~. I I 22t~" ~ ts'- o'"