The URL can be used to link to this page

Home My WebLink About8711-zFOBM NO. 4 TOWN OF $OUTHOLD B'[m'.nlNG DEPARTU~NT Town Clerk's Of[ice Southold, N. Y. Certificate Of Occupancy No. Z7.8.'13 ...... Date ................. AU~ .... 8.., Zg..77 THIS CERTIFIES that the building located at .. PV~..I~D. E/S. ~, .Hat. bot.. Street Map No.. XX ........ Block No. xx .......Lot No..xX.. Botlthold.. ~o¥, ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............July..7., 19.76 pursuant to which Building Permit No.. dated ...........J~.~y .... 7.., 19.7~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which th~ certificate is issued is . ~.~iva. te. one .fa~ity. d. wet.l.~.n~ .witl~ .a~ld.~.tier~ ..................... The certificate is issued to . l~be~);. ~ay~l~y ..... 0~na~ ............................ (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval ~,R, ............................... UNDERWRITERS CERTIFICATE No.. R3~799~. .... J. uly...~. ~$~? .............. HOUSE NUMBER.. ¶.~80 ....... Street ..... P~c. Rd..~0 .....8outhoLd .......... Building Inspector FOB~ NO. ~B TOW1,4 OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8711 Z Permission is hereby granted to: Robt L. Hyatt Ine A/C Robert Ba ley Southold Build an addition on exlstin d to ................................................................... g.......we..!l~.~g ................................................................. at premises located at .....P..V..T....R..o..a...d: off E/S ~o..u. th Harbor Road Southold ~[.Y. pursuant to application dated . . .. July.. 7 , 19.7.6. , and approved by the Building Inspector. FOIIM~ NO, 6 TOWN OF SOUTHOLD , Ruilding Deportment Town Clerks Office Soutbold, 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 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" lend uses: I. 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 .... ...... New Building ................ Addition/~ Old or Pre-existing Bdilding~..."~...'. ......... [Vacant Land Location Of Property Owner Or Owners Of Property ............ '~i.r.....~.~~. Subdivision .... .,~,,..~.~..~. .............................................. Lot No ............. Block No ............. House No ............. Permit No.~.:].lJ...'.~... ..... Date Of Permit -J.'.U..Q.'/..~...7.~..Applicont ....~-'~.r....[J..~..~...C.T.. ....................................... Health Dept. Approval ...~..~.,. ............................. Labor Dept. Approval ...~.~.~....~. ................................ Underwriters Approval ...~.)ff./....~) -lan in ...~..,'.~' ............................. .... ~ ....... ~ ................ I' n g Board Approval ' Request For Temporary Certificate /' FinQJ Certificate Fee Submitted $ .................................... Construction on above described building and pe.~ meets~t[Lapplicable codes~nd regulations. · f /7 -, / ........... ~. day of ....~ ........... ..~,./ .... (stomp or Nota~ Public ..... Coun~ ,,-~ :: I'THE,NEW YORK BOARD OF~FIRE~UNDERWRITERS , ~ak ~' ,~7 ~ :. · .... ' _. , , , ~, . BUREAU OF ELI~CTR CTY~i;iJdi~hh:;~: ,, , , ' ' only the el~trical equipment hs described below and iatr~ced by' the applicant named o~ the,gbove application number in the premise! of ' ' '' I" Mr; -R. Bayley~ South Harbor Rd. ,, Southold~::~L.tl. :~: , ~ OVENS - ' DISH WASHERS EXHAUST' FANS 3/0. h ~ I THE NEW YORK BOARD ;iOF FIRE UNDERWRITERS , ~ ' I I BUREAU OF;,ELECTRICITY , ; 85 JOHN STREET, NEW~i~YORK NEW YORK 10038 THIS' CERTIFIESTHAT ' Ir ~ ~ ' ~ ~ ' only the elect~tcal equipment as described below and introduced by!the applicant named on the above applicatio~ nu~nber in the prem~es of ~ ,,: r.R.,Bayley, off Pvt. Rd.,:S~Harbor Rd., Southold, L.I. ~ALR~PT T~M~CtOC~SJ 'BEL~ ~uN~THEA~ERf MULTI-OUTLET DMMERS ~T' ' K' W' OIL H' P GAS H' P' ~T' NO' A W G ~Z ~ ~ ' ~ A~p~ ~ TRANS ~ SYSTEMS SERVICE DISCONNECT ~NO. OF~ , S 'E / ' - : - ~ anelboard/s: l-lclr. 125amps. i G.P.C.I. ' ' I ' ~ '-: Gene Heacock, Cedar Beach Rd., , Southold, 'L.I. 11971 Lic. 943 E ~: be e?ered in ~., m~nner; return ,o t~e office of the Bo.rd if incorrect. ,nspectors mo, be Disapproved ale I~U~l~S I~, ~ 3 ~ ~ ~, ~ pl~ ~ m ~. F~ ~i~ ~ ~: b. PI~ p~n ~lng I~i~ of I~ o~ of bui[di~ ~ premix, relationship t~ ~joinin~ pmm~s or~s, ~ g~l~ o ~ei~ ~rlpti~ of I~ ~ must ~ ~mwn ~ the emgmm wh~ Is c. ~e ~ ~ ~ ~ o~li~ti~ ~ ~ ~ ~ ~fore i~uo~e of BulJdlng d.U~I ~ ~ls ~llc~i~, ~ Buildl~ I~tor will i~ o Building Pe~it to tho ~licent. S~h pe~it ~ell ~ ~ ~ ~i~ ~i~ ~r l~ti~ ~ ~ ~r~ e. No building shall be eoculged or used in whole or in part for any purpose whatever until a Certifico~ of ~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pu_~. ,t to the Building Zone .Ordinance of the Town of Southold, Suffolk County, NewYodork, and other applicable baw~, ~ or Regulations, for the construction of buildin~, additions or alterations, or for removal or ~, aa heroin described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing cede, and regulaUam, admit authorized inspectors on premises omi in buildlng~ for necessory impections. ...... ........................ ............................................. (Signature of applicant, or name, if a corporation) ........... ................................................... (Address of applicant) State whether applicant is owner, I~aG~,~ect, engineer, general contractor, electrician, ~lum...b~.~ ~r builder. If applicant is a corporate, signature of duly authorized officer. Other Tmde's License No ............................................... e/' u : Location of land on whic" -raposed work ill be dor~. AAgp No' ~. .. ~ ,Lot_ big. ~. ........ 0, ..................... Street and Number ..... '..~.L.....~..; ........ ~./.~.'.'.' .................................................. ~ ...................... State existing use and occupancy of .p~.is,;~d/ntended use ~nd occupancy ~f pro~. c~::. a. Exisiting use and occupancy ...... ~.~t ........ ~q ........... ~,~ .................................................... .... · , ....................................... t~ ntenaea use aha occupancy ....................................... T.. ., ....... ~ ............... 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) 5. If dwelling, number of dwelling units ....... ~ ....... 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 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 .......................................... , De~h ................................ 12. uoes proposed construction violate any zoning law, ord' a ce or regulation: ....... ! ....... ~,'~ ....... : ............................. 13. Will lot be regraded ............ ;~-;..~.....~Will. excess fil be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ..r,..xY~.....!~ .................. Address ................................ Phone No ....................... Nome of Architect ............ ~ ~,..~~ ................................................ Address .....~ .....~)~ .......... PI~ No. o, ...... .............. ............. PLOT DIAGRAM Locate cle~r~/ and distinctly all buildings, whether existing or proposed, and indicate all s~t-back dimensions 'fro~ property lines. Give street and block number or description according to dee~, and show street names and' indicate whether interior or corner lot. ~ ~,. o{ ~oid ownor or owners, ond i~ dul~ ~uthori~ to~or~ or h~ p*r ormed tbe ~aid ~ork ~nd to mk~ ond thi~ opplicotion; thor oll ~t~t~m~nts cont~i~ ~in thi~ ~plicotion ~r~ tm~ to th~ b~st o{ h~ kn~ledO~ ond b*li~{~ ond th~ tbe work w I ~ p~rfo~in th~ ~nn~r se~ {o~h m th~ opplic~tlon filed tber~i~h.