The URL can be used to link to this page

Home My WebLink About8387-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Off, ice Southold, N. Y. Certificate Of Occupancy No ............. Date ............................ , 19 .... Tt-IIS CERTIFIES that the building located at ............................ Street ~01 Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................... , :19 ....pursuant to which Building Permit No ......... dated ....................... , 19 .... , was issued, and. co~onns to all of ~e require- ments of the applicable provisions of the law. The occupancy for which thi. certificate is L~sued is ........................................................................ 'l~.e ce~ificate is issued to ................................... ,,.... :..~ ............ (o~_er, lessee or tenaf~t) of ~e aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE No. HOUSE NUMBER .............. Street .......................................... ~5L] 1' i~ O L-L~ /xl. tr. Building Inspector ~FORM NO. 2 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) 8387 Z Permission is hereby granted to: ...~... Z.~ .~ ~ .9.. ..... .~..:...q.~.~Z..~.~.~. ...... ............. ........ ............ at premises Io~ated at ................................. _. ..... t"t't; ............... : ........ .~ ................................................... ............... ~'"T'"': ...... ;'";') ........ " ........... '27'~'"'~?'}":":~';r ' ;" Y y ...... ;I~'V';'- .......... ~ ................................................ ~ursu~Jht ~o ;a~-~lication dalled -:~,' - "~'- b*~: '~.~ ~,~i~. ' - .... Building Inspector. , ; - ;. Umlclmg ~Insnector.. FORM NO. 6 TOWN OF SOUTHOLD , Building Deportme~t Town Clerks Office Southold, N. Y. 11971 APPLIGATION FOR GERTIFIGATE OF OCCUPANGY Ins~ructlons A. This apphcation must be filled in typewriter OR ink, and submitted in DCJPLICATE to the Building Inspector with the following; for new buildings or new use: ]. 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" 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 os to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspechon of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $§.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property .... ./..Y..?.~...?.2 ...... ~....~....~ ....... .r..~..e...~...~...~ ............ ~~ .................. Owner Or Owne~_~ Of Property .................. ~ ......... ~....- ......................................................... . .,,_ lib Su s~on /.~ /~,u~c~_.- Lot" £ . BI k'o / bdivi ' .L-~..¥...~'.~ .................................................... mo ........... ac N .............House No ............. '7- 7 (/ Permit No....~.. .......... ~,~-uate Of Permit ............ , ....... Applicant ...~..~..~ ./2~.... ............................................... .... Underwriters Approval "g'""~"?"?'~"'~"'l .................. Planning Board Approval ..... ..~.....:../~.. ...................... Request For Temporary Certificate ....................................... Find Certificate ~ Fee Submitted $ .................................... Construction on above described building and~germit meets all applicable codes and regulations. Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or seal)/~_ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~_ak BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,,,,,e August 2~, ~76 ~pp,ic.,ion~oon~,e 860243 N 299941 THIS CERTIFIES THAT only tile electrical equipment as described below and introduced by the applicant named or~ the above application number in the premises of Otto Gerry, e/side Rambler Rd., Pleasant i,~ the yotlo.,.~n lo.at;on; [~ Basoment ~ I.~t ,~,..~.,,,,,,ed,,n August 19, 1976 FIXTURE [ ' ] FIXTURES OUTLETS2~ ~ECEPTACLES28 [ SWITCHES2~ INCANDESCENT25 FLU~ESCENT ~ ME~CU~YvA~R DRYERS FURNACE MOTQRS FUTURE AP~IANCE FEEDERS ~,T K W OIL H P , GA~ H P J ~T NO A W G ~ 2nd Fl. otuslde Sectmu Block and found to be in compliance w~th tho requirements of this Board. RANGES SPECIAL REC'PT /*,MT J K W AMT KW MT K W COOKING DECKS, OVENS , DISH WASHERS Lot EXHAUST FANS AMT H P SERVICE DISCONNECT ~A~T } A,V~p TYPE i 200 CB OTHER APPARATUS. ' OFI S E [~pR ,.e. ~w 1 ,e- ~w ~.8' :~W ~.~W NOO~,E~CC.e. CONO x 1 R~ V I A W G NO OF HI LEG OF CC COND 4/0 MULTI.OUTLET DIMMERS SYSTEMS NO OF FEET E C OF Ht LEG OF NEUTRAL Motor/s: 1-3/~hp 1 G.F.I. 1 Smoke Detector Electric, 51 Staller Drive, O'""A''?f'i..., This certificate must not be altered in any manner, return Jo the office of the ~ard If incorrect. Inspectors may be identified by,,t~ *~creden~lals BUILDIN~ DEFARTMINT~'c~e~,~ o ~.. Examined ........................ ~ ...... ~ Zg! x/ /'~a~< + ~V~t~, ,~t,-~ , ,., r-- Ar~lp.,,~.~ .......... ~,,...~,,.~ /,~ ~ ~,~ ~ ,~ . - ~ ........................................... ~r~ .' ..................... ~..~.~. 19:~... ~'t No.....~.~.Z. ......... ........................................................................ ............. ............... . ........... ............. .............................. ~~ (Buildi~ I~r~ APPLI~ FOR BUILDING FE~IT I~RH~l~ b. ~tot plan ~in~ I~fion of lot ond o{ buildi~ ~ premix, m~ation~ip 1o ~loini~ prem~ c. Th* ~ork c~r~ ~ thi~ ~lication ~ n~ be comm*~ ~ore i~uonc~ o{ Buildl~ ~. ~o buildin~ ~h~ll ~ ~upi~ or u~ in ~o1~ or in ~ {or ~n~ pu~ whoever until ~h~ll hav~ ~n Omnt~ ~ th~ Building In~or. ~Ti~.A.P..PLI ~CATION .IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the ui,a!ng ~on.e Ominance at the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. · applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors 'on premises and in buildlng~ for necessa~ i~-~oections. re of applicant, or name, If a corporation) h (Address of applicant) whether applicant is owner, lesse~gen~architect, engineer, general contractor, electrician, plumber or builder. State ame of owner of prem,.s ........................... ....... ................................................................................................ If applicant is a corporate, signature of duty authorized officer. Bu Ider s L~conse No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ................................................ ,,~ / ._ 1. Location of land on which proposed wo~__w, il' be done. Ma~o No.: ....... ....~.:...~..~...../.. ............ Lot No...Z~.. ............. Street and Number ...~.~.~.~.Z~.~ ........... ~.~'~ .......... : ............................................................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Exisifing use and occupancy ................................................................................................................................. use and occupancy ..../. ....... ~ "~"~'/"/"~'"'' ' ......... /~)"'"~"~'"'/""/"/'"'"/~'"7--" ~ ............................ Intended 3. Nature of work (ch~ck wl~lich applicable): New Building.. ................. Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... ~/, ~- (Description) 4. Estimated Cost ............. '~./...~...~.....~.. ................. Fee ..................... .~...0. .............................................................. / (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... .~...~,..,,~:~,.......Number of dwelling units on each floor .~....~.....~E...-~... ....... If garage, number of cars ~(,/6 ~ (~'-~ ....... If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ Dimensions of existing structures, if any: Front ............................ Reor ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or oddJtions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ................ ..'.~....~.. .......... Rear .......... .Z~'...~.. ......... Depth ..~ .............. Height ...x:;~..~. ...... Number of Stories .....~.....'~....~'... .................................................................................................. 9. Size of lot: Front ................................. ././..~. ............. Rear ..,Z'..~..~.. .............................. Depth ../'.~...<~ .................... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... ]2. Does proposed construction,/,--<~vi°~late any zoning law, ordinance or regulation: ....................................... ; ................ 13. Will lot be-regraded ...../~..x~..~.. ......... Will excess fill be removed from premises: ( ) Yes ~ No 14. Name of Owner of premises ...~..~..~....~..~...~....~.. ..... Address ~,~.Z~, ......... i ..... Phone No ....................... Locote clearly and distinctly all buildings, whether existing or proposed, a~hd 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 NEW YORK, COUNTY OF ................................ .......... ~..A...Y.:..F.?::~.-~,..:: ...... ~ ....... ..H..~..,~.,~....~.!..A..~.I. ............. be ng duly sworn, deposes and soys that he is the applicant (Name of individual signing contracf) above named. r~e is the ................. ,,...; ........... /. ............................ ~ ................................................................................................... ' - (Contracto~?geat~corporate officer, etc.) of s~id oWner or owners, and is duly authorized to'~rrn or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the opplication filed therewith. Sworn to before me this ,-~ NOTARy PUBLIC, State of New York No. 52-8125850, Suffolk Cou~j[y Term Expires March 30, ~g~_.,~ .~ £ . _ ,I DAT~ fl. D. KEF. ~ ~o,,-~-, I .~ ~o ~ ~ ~ U°T ~ ~he sewage dlsp0~al and wat}~ nupplg ,./- . k facll!tle~ ~or t~s ~ocat~h ~ave ~een ~ ~ ~ ~- -~-~T~.~..~ ... ~ . . , ................................ ~ S~'mehief o~ gene~a%Enginee=tn~ " i ............................ ~,~ ,, GRADES TO ~~ DATU~ SURVEYED ~- ~ , TAX BLOCK ~AX LOTS BLOCK LOT/ ~ 0 ROADS MAINTAINED BY To~ _ L~ATION SURVEY (ON FND) MAP OF ~-~.~ ~~ GUARANTEED TO' ~ ~ ~- ~- FINAL SURVEY JEROME D'AMARO ~ ~~ ~,~ ~OFE~IO~AL ENGINEER & LAND SURVEYOR FILEDMAPNO .... ~O[ FILED ~, ~ , [~ ' , , NYS LIC. NO ~L~7~ SITUATED AT ~[~, ~M ~ ~O~. ~¢L~ ~. 1~ DEER P~X A~UE DRAWN BY CHECKED BY 516 ~HAWK 7~13 or sub~uent owners -- OH~tsareno~tobeu~ toestabhshpr~ertylmes ~r~ ~ ~ ~ ~. -- ~ /~,/~-~f~O ~ /~/~7~ 1. BEFORE BACKFILLING FouNDA" IT~ON OR START ~:RAIV,~G. ;"E' ' r '-! ~ 'Z, BEFORE COVERING plP~LuN ., . ~INAL WHEN JOB CO ETED ' F- Lr v^T~a ~1 F E ~ 1 'i /