The URL can be used to link to this page

Home My WebLink About8406-zFOUM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No.. Z908.1 ..... Date ...... J~-~e. THIS CERTIFIES that the b,,ilding located at ./*950' 8~c; .Peconl¢. -Blvd.,. Street Map No .......... Block No ......... Lot No ................................. conforms substantially to the Application for Building Permit heretofore fried in this office dated ... J.a~uex~y. 20... , 19.7.6. pursuant to which Building Pemit No. . ..~..0.6.Z dated ... Earch .... .~. ....., 19.7..6., was issued, and confoms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... PR~I~rATE. ONE .F~.IL¥ .D .~r. :LIN~..~!~.H...A~.D.~.T.! .0.N. ............ ......... J.o~eph .$,. C.o.~mel~Ly. ...................... The certificate is issued to of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE No .......... N~0.96~8 ........................... HOUSE NUMBER ·../~9.~0 · .. Street ..... D~'ea~c .Peconic. Bay. B3.vd .......... ........................................... Laurel,. New. Yo~k ................. Building Inspector ~'OIC~ NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N:. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTklORIZED) ~ 8~06 Z Date ...................... I~ll~]~ ....... ~. ........... , 19.~6.. Permission is hereby granted to: at premises located at ...~..~eJ313JL~l.,J~...~llt~ ........................................................................ ....... -?, ........ :..~:i:.' ............................... ~ ...... '~'~ ...... ~.,~t~,: ............................................... ...~ .............. ~,_to_ application dated ..................... ~,lll~...~O.. ................. , 1~.~., and apprgved by the jn. spector. FOKM NO. $ TOWN OF SOUTHOLD , Building Department Town 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 buddings 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 cerhficate 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 ]957), Non-conforming uses, or buildings and "pre-existing" land uses: ]. 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: I. 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 Building ................ Addition ................ Old or Pre-existing Building ........ .g/..... Vacant Land .............. Location Of Property .¥.9~'~) ~ ~i~.~-~xc-- ~ ~v'~=/ ~..~__~...,~.. Owner Or Owners Of Property ..~ ..~.... ..... ...~.... ........... ~.../~....~ ................................................. Subdivision ................................................................ Lot No ............. Block No ............. House No ............ Permit No ....... .¥~.¥..~...~.~-Date Of Permit .................... Applicant .................................................................. Health Dept. Approval ................ ..~....:...~....:. ........... Labor Dept. Approval ................................................ Underwriters Approval ......~.......~.....~...?....~...~.-~..,.~,. ......... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fined Certificate ~ Fee Submitted $ ~' ~ Construction on above described building and,~,~.~/~-~)~__~rm!ti'm~eets all applicable codes and regulations. ........... ..................................................... A~oplicant Sworq3to before mR this r~ ~-.(~ ..~'.,,...~...,... day o~ ............................. .,~.,...! .... (stamp or seal, THE NEW YORK BOARD OF FIRE UNDERWRITERS ~-~k BUREAU OF: ELECTRICITY B5 JOHN STREET. NEW YORK. NeW YORK 10038 ,,.,.O~ober ~, ~.~','~ .~,,,,,,...,,.,,.,,,.o.~,e 862440 N $09 35 THIS CERTIFIES THAT ort~y tl~e e~ectr~cal equ~I~rn~,~ as descr~eci t~elow a.d ~.trod~ce~ by the applicant natned on the ~bot'e appllca~:on ~unlber ~n {he pr~mi~es of Joseph Conne!ly, Jr., s/side Peconic Eay Blvd., #4950, Zattituck, L.I. i,, t~,./ot~o,,.,,L~/oc,,t,,,,,~ ~ rt,,~,.,,,,..~ ~ ~,,t ,r~. ~ ~,,a ,,'~. outside .,.,,,.~,.,,,.,,.do,, October 22, 1976 .ndfou.dtot, eincompl, ancewtth~herequirement~ofth,~lfl,ard. FIXTURE I FIXTURES | RANGES I(~OOKING DECKS I OVENS DISH WASHERS ] EXHAUST FANS RECEPTACLES SWITCHES ~ecur~ ~ .-~--~ ~ DRYERS [ FURNACE MOTORS [ FUTURE APPLIANCE FEEDERS ~SPECIA~EC'PT~ TIME CLOCKS j BEtL JUNIT HEATERS ' I-OuTLET DIMMERS ~ 30 ~3~0" ' SERVICE DISCONNECT J NO O~ ~ S E R V i C t 3W('3~' OF CC COND OF HILEG ~ OF NEUTRAL ~ EQU~ ' NO OF HI LEO OTHER APPARATUS Harold T. Seebeck, Sr., 917 Roanoke Ave., Riverhead, L.I. ll901 . Lic.8?4E P~r_ This cerhficote must not he aJtered in any manner; return to the aff~ce of the Board if incorrect inspectors may be ida f y ....... ............... ....................................... ~.~ ...... ~ ...... ~.....~~, ,_, , _ - .~ ~ -~.~ ~ ...~......,, ~..~.~... a. This a~licati~ m~ ~ c~pl~ly fill~ in by ~w~ter ~ in ~le. F~ ~o~i~ I~, wi~ ~ ~ ~ p~, ~cum~ ~ pl~ ~ b. PI~ pl.n ~ing I~ationof lot and of buildi~s ~ pr,mi~, ml~i~ip to ~ioini~.~r~mi~ ar~s, a~ givi~ a detail~ d~ripti~ of I~ ofp~ must ~ drown c. ~e ~ c~ ~ ~is a~licati~ ~y n~ ~ comme~ ~fom i~uanc, of Duildi~ P~. d. ~~al ~ his ~licati~, n. Buildi~ In--tot will shall I ~ ~ ~i~ ~ail~le ~r in~i~ ~ ~ ~rk. e. No ~il~ ~ ~cupi~ or u~ in ~ole or m ~ ~r any ~all ~v. ~ gmn~ ~ ~e Buildi~ In~or. APPLI~TI~ IS HEREBY ~DE to th~ Buildi~ ~ment ~r Buildi~ Z~ ~i~, of tbe T~n of ~o~, ~lk C~n~, N~ ~k, 0~ ~*r.~ ~ ~l~ or ~ulati~, f~ ~ ~i~ of building, a~ifl~ or alte~ti~s, or ~r ~e applica~ ~ to co~ly with all a~licable I~, o~i~, bulldi~ ~, h~ admit au~iz~ i~tom ~ pmmi~ ~ ~ ~i~ ~ ~ i~i~. ............................. (~ig~ ~h~, or ~, if~ co~i~) (Address of applicant) State whether applicant is owner, lessee, ent, architect, engineer, general centmctor, electrician, plumber or builder. ........ ........... ... .............................................. : ......................................... .............. I~ac ~ '::,°~i:r:fc:rer~omi~e: '~"signature of~'duly a~"h~'rb~ "o;;; ': 'e':: ' ' "~' ' ~2v~"/J~ -~'~ ............................................" ' ' (Name and title of c~orporate officer) Builder's Lie,, No .... ..~...~.~..~.~.........~...b...~...~..°1..~.~'-", Plumber's License No .... ~: .................................... Electrician's License No..: ............. [ ............................ Other Trade's License No ............................................... ~ :~ ,. ,~a,,~ of ,on~ ~ ~ich ,,~.wo~ ~'" be ~.~Mo, No~.--q...--....~..~.~.~o...,.,...., ............... Street o~ Num~.~.~.~Z.~....~..~....D...~~.~...t...~-.~:.~.:....."-; ............... o. ~isiting use ~ ~cupon~ .......... ,~, ............................................................................ ,. ,...~. .. .. ~..~ ...~.~.....~....~ .................................................. 3: NatUre of work (check whi plicable): New Building.· ................. ition ....... A ration ................. Repair ............. .~. Removal ..................Demolition .................... Other Work .................................................... /)/ ~ cr~3 (Description) ' 4. Estimated Cost ...~..~...~....~. ....................................... Fee ..... L!...;~ ............................................................................. (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 ............................ Front ~.~'...~...~..~ / /) Z,,~ / I /) Dimensionss__of existing structures, if any: , ~.., ........ Rear ...~:~..~.. ..................... Depth ~,~'.,.~. .... 7. Height J.:~. ..... Number of Stories ....... l....,-'J,4(~r/,.~ ....................................................................................... Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ · , , 8. D,mensmns of ent,re new construction: Front .~ ............ Rear ..l~...-~.~'. .......Depth ..~... ............... / / ' Height ...~.. ............ Number of Stories ........ /. ............. ; .............................................................................................. · lot: Front /~1 / ~ /~ 9. Size of ....~.(~.(:~. ...................................... Rear ....... .7....(0 .......................... Depth ,(V../.<~....-:...~:...;,/.~. 10. Datm~e~gf Purchase ..~4{.~...!....../.~:~.~...~...7.~. .......Name of Former Owner ....~ 11. Zone or use district in ~l~ch premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ .....~...~)~ , ~,~ __--~WJll excess fill be.removed from premises: ( ) Yes {~') No 13. Will lot be regraded 14. Name of Owner of premises ~..~..~.~,,~.~W~3~.(~Address'~7~.~.~0...(,~.,... Nam f-r ht ' /} [ ] /--' e o ^ c eot ..... ~..~,<......;-.;.~/ ....... nn ......................... /.Address ......................... , ...... 'f'l~one mo ....................... Name of Contractor ..~.....~....c~..~.~..~.!.J~, ....... Address ~.L'J,Z~I~.~.. ...... Phone No.-7'~..~..~./,~. 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 and indicate whether interior or Corner lot. OF NEW YOR~: STATE ........................... · ~l~l~..~.~,~..~lll~ ........................... being duly sworn, deposes and soys that he is the applicam (Name of individual signing contracf) above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform 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 thor the work will be performed in the manner set forth in the application filed therewith. Swam to before me this Notary .Public, . ........................ ~ .......... County (Signature of applicant) TITLE po¢ ALDEN V~J, YOUNG f0rr¢fly SURVEY FOR: JO,C~PH ,¢. CO/VIVEI/_Y ~ ELIZ,4/~ETH T CO/VN£LLY iA'{' 'row~ o, SOUTHOt_D ,fillFFOl t( C0,, ht Y. NOTE ' m .- IdONU/dENT REVISIONS ,g YOUNG 400 OSTRANDER AVENUE, RIVERHE! ALDEN ~V, YOUNG ~OrCdcci SURVEY FOR: JOSEPH .9. ~ON/V~LL Y AT L,4UREL Tow~ or SOUT'HO£D SLI[FOLK CO., N Y. 1