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Home My WebLink About8723-zF~M NO. · TOWN OF SOUTHOLD BU~.BING DEPARTMRNT Town Cle~k'~ Office SouthoM, N. Y. Certificate Of Occupancy Bio ............. Date . ~ ~. ££~ ~ tO~'" 'bPr ¢~F" 19 .... THIS ~R~ES that the buildin~g located at .. ]a~f~ T" 'I~O'T'' Z O ....... Street Map No ............. Block No ........... Lot No .................................. confgrms suhstanti~LtP t~ppl~on for Building Permit heretofore filed in t~ ~i~c~ dated .......... Jt)'t~'C "'~'~ 19 '7'~ pursuant to which Building Permit No ......... dated ....................... , 19 ...., was issued, and conforms to all of the require- ments of ~e ~1~ i~ pr~x~s~tons ~l_l~w. ~ ~c[~for whi~ ~ ce~fica~ ~ issu~ ~ ................. ~,~.~..~,~,~.. ~..~,~ ................. ~e certificate ~ issued te ....................................................... (owner, lessee or ~n~t ) of ~e ~oresaid b~ld~g. ~0/~ H.~ ~ ~ b-~0- ~ Z ~ I S~olk Co~ty Dep~ment of He~ Ap~v~ ~..~.~ ~9 .... ~F~' '~' {'97'b ....... UNDERWRITERS C~~ No ....... ~ ~'2 '~ 0U~ ...... '~'~" ~ ' '" ...... HOUSE NU~ER .............. Steer.. '~O U 'T~d' L'~ ....................... Building Inspector BUILDII~ PEKMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8723 Z TOWN OF $OUTHOLD , Building Depmtment Town Clerks Office Southald, iq. 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 Underwr tars. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance fram 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 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 New BHilding ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..................................................................................................... ~ ............................... Owner Or Owners Of Property ......... ~..~.~..~....V'..!.~...L~,: ........ ,,,-~,..,L..~. ....... .~.~....~........~. ............................................... Subd,v,s~on ..~.~..~.?..?..!~, ............ :~.~.~ ......... Lot No...~.~... ,~ock iqa ......... --:... Ho.seNor?~ ............ Porm,t Of ....... ............................... Health Dept. Approval ..m.4. ...................................... Dept. Approval ................................................ Underwriters Approval ........................... 4.. ............... Planmng Board Approval ..................... : .................. Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ Construction on above described building qnd pq~L~it m~_ts~ll 9pplicoble codes and regulations. Swam ,o before mo this ~,'1/~ ~-~ ~ ................ day of ............................................ (stamp o~ ~eal) /-~ Notary Public .................................... County ~ ~ 7 THE NEW YORK BOARD OF FIRE UNDERWRITER5 BUREAU OF ELECTRICITY ~k 85 JOHN STREET, NEW YORK, NEW YORK 10038 Ap,,li .,i,,nNo. o.S, le 884 402 N 315759 hat'December 8, 1976 THIS CERTIFIES THAT only the electrical eqt~ipment as described below and introduced by the applicant named on the above application number in the premises of Robert D. Prince, s/w/cot. Seawood Drive & North Bayview Rd. Southhold, L.I. in theSolh, wi'tg location; ~ Basement ~] ~st ri. [~X 'Z,d ri. out side .s¢¢tlo, alo,-k tot was exami.ed on De c emb er 6, 19 ? 6 and fro. nd to be in co.mlianre with the req,tlrements os this Board. FtXTURE OUTLETS 24 DRYERS FIXTURES 21 2~ FURNACE MOTORS FUTURE APPLIANCE FEEDERS S RANGES i I 50 CCA~OKTtNG DKECwI~SI ,~0 V R NKSw, Di' S~TH WASK J~wERS TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET E R V I C E OTHER APPARATUS' *Future ~pli~nce £eeder/s: 1-2#12, Motor/s: l-l/2hp 1 G.F.C.I. 2 Smoke Detectors EXHAUST FANS DIMMERS A W G NO OF H/-LEG 1-2#14 Sapanaro & Mineo Inc., 102 Oak Avenue, Shirley, E.I. 11967 Lic. 334E D This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by AP..PLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pumuont to the~ Build?~.. Zone Ordinance of the Town of Southold, Suffolk County, New York, ond other applic.able Laws, Ordlnanc~ .~.he~eulatlOnl, for the construction of buildings, addition, or olterotion., ,or for removal' or demolition, as heroin described. · applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulatiom, and to~, of me_, ,, State whether applicant is owner, lessee, agent, architect, engineer, ~, electrician, plumber or builder. Nome of owner Of pr~mise8 ........................ .~ ........................................................... If ao~licant is a ~q~rate,~ignature of dulv~authorized officer. ...... (Name' and title ~' ~rorporat~fficer) Builder's License No ..................................................... Pl'u.m~. r'$ License ,o. ~-:~.~r.~...~.~. ~(~ Other Trade's License No. :7. ...........................................~ ~-- 1. Location of land on which p~ work will be done. Map No..'-~.. '~...~....ZILA.k~.~i Lot hl'o ...=.....~... . Street and Number .................................................................................................................................................... Municipality State existing use and occupancy of p. remises and~t~z~ use and occupancy of proposed construction: a. Exisiting use and occupancy ...... V~..L.: ................................................... , ......................................... b. Intended use and occupancy ....... ~...(.5~C.~...~.~.~ ........... a. This al~lication mu.t be completely filled in by tyl~_writer or in irik and ~bmitted in triplicat~ to the Bull~dingT' Inspector, with 3 ~ of plQns, accurate pice Igen to Kale. Pee according to schedub; or public streets o,~ b. Plot pla? showing location of'lot and of buildings on premises, relationship to adjoining premises areas, and giving a detailed description of layout ofl~aerty must be drawn on the diagram which IS peet of this application. ~ c. The work covered by this application may not be commenced before issuance of Building Permit~ · cl,.,, U,pon approval of this application, the Bulld!ng Inspector will issue a Building Permit to the opplicont. Such permit~/ sna oe Kept on the premises available for impectmn throughout the work. e. No building shall be occupied or used in whole or in p~rt for any purpaM whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. ':b 3. Nature of work (chesk which applicable): New Building- .~.. ........... Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ................................................ . .... ~' 0 (Description) 4. Estimated Cost ....... ~,. ................................................... (to be paid on filing this application) .5. If dwelling, number of dwelling units ............................ Number of dwellirig units on each floor ............................ If garage, number of cars ........... ~.i~(.~... ............... ~ ................................................................................................. 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 .............................. / ............................................................................ 9. S 10. 11. Zone or use district in which premises are situated ....................................................... 4'; ........................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ......... ~..~.. ....................................... 13. Will lot be regraded ..~.~.. ............... Will excess fill be removed frompremises~ ( ) Yes ()~' No ./_ 14. ~:meeOfofOW;recrh::ecP:emises .._~.....i..~., '- ~.[~...~......~..... ~:~s~..~~Z ~! ~.1~....~...~ Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM 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 whether interior or corner lot. [ [~ L I STATE OF NL~,'V YORK, ~ c c cou NTY .OF ....... S~f~:c~ ........ ~ ~'~ ................. .~.~.'~ .......... ~,1~..04.~ .............. being duly sworn, deposes and soys t~t he is the opplican~ ~ame of i~idual signing c~troct) above name. ~ He is the ........................... ~.Q~t~Q~ ...... ~ ......................................................................................................... ........ (Contmcto~'~b~t, co~orate officer, etc.) of said owner or owners, and is duly aut~rized to ~Horm 9r have performed the said work and to ~ke and file this application; t~t all statements contained in this applic6tion are tree to the best of his knowledge and belief; and t~at the work will be performed in the manner set foffh in the application filed there~th. Sworn to ~fom me this ~ ~_ ........... &Zt~... day of .' ........................... ~y ...... , 19..~6. ~l~ i ~ -- ....... ......... ........ ~~~Natal, Public, . .......................................... ,; .... (Sig~m~ppli~nt) ~ ~ EL~H ANN NEVILLE ~TARy PUBLIC. ~l~ ~ New Yor~ ~o. 52-8125~50. ~Su~lk C nt ::~. .tm Expires ~arch ~. 1~ L