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Home My WebLink About8412-zTOWN OF SOUTHOI,D BUH,DING DEPARTMF, NT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ZZ~.$.8 ....... Date ............ ~.B'I Y .... 2.7 ....., 19. ?~. THIS CERTIFIES that the building located at .P.~.n..e..~.e.c .k..R. qa.~ ........... Street Map No..x~c. ......... Block No.. xXX ..... Lot No. ~....S..oB..t.h.o.l.~...N.;Y., ......... conforms substantially to the Application for Building Pemit heretofore filed in this office dated ........... ),.', .a$'...be.., 197.6.. pursuant to which Building Pemit No..8~.2..Z.. dated ........... ~hr...8. .... , 19F.6., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is . .P.V~[.v.~te. s.~l~r~4[ng .pool .vith. aacessac, tes .......................... The certificate is issued to . Ge. arge~aldine.. $.e.h~'~b ..... .0wner. s (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .N :.R.. .............................. UNDERWRITERS CERTIFICATE No..~.. ~?.8.~.Q~ .... A.p~., .1~.. J.9.76 ............... HOUSE NUMBER . .. 2~00 ...... Street ... P. tme. Neck. Road ...................... ..... ......... FOEM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT '('i-HIS PERMIT MUST- BE KEPT ON THE PREMISES UNTIL FULL COMPL~ION OF THE WORK AUTHORIZED) Permission is horeb¥ granted to: FOP. M NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This apphcation must be filled m typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings ar new use' 1. F~nal 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 d~sposal--(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 fram the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed s,te plan requirements where applicable. B. Far 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 ~te .~,,..~.~.~.~.~ ....... New Building ................ Addition ................ Old or Pre-existin~ Building ...... .......... Vacant Land .............. o, ...... /u Subdivision ................................................................ Lot No ............. Block No ............. House N~....~.~.~.. o, .. ............ Health Dept. Approval .......... .~...~. ........................ Labor Dept. Approval ........ ~....~.. ............................. Underwriters Approval .............................................. Planning Board Approval ...../~'....~.. ............................. Request For Temporary Certificate ........................................ Find Certificate ....... L~..../.. ........................... Fee Submitted $ ~./...6..r~.. ........................ Construction on above described building and,~x1,./~/.,_~-pqrmit meets all applicable ~odes and regulations. .... /~.~./..~~.;'. ............................................ Applicant Sworn to before me tl~s ........ .... Notary Public ........ ~~..~..~.~.?County (stamp THE NEW YORK BOARD OF FIRE UNDERWRITERS __ d { BUREAU OF ELECTRIGITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 D,,,; April 14, 1976 4p, m..,.m,o.o.f.[, s5o2o2 N 278708 THIS CERTIFIES THAT ~EORGE SCHWAB, 2~00 Pine ~eck Road, ~ou~hold, ~.~,,,t~m~t~vdon Apr i I I 2~ 1976 .ndfoundtobeln~ot~t,h~zn<eu~h thereqt~rem,,nt~o, fth~,sllo~rd FrXTURE OUTLETS I SERVICE DISCONNECT ina O / S E .... i -- ---J METER~ , , / OTHER APPARATUS iRECEPTACLESj SWITCHES I FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS ~ .... ~ K W AM~ K W AMT KW - K W FURNACE_ ~O]~L% ~ FU~RE APPLIANCE FEEDERS :SPECIAL REC'PT~ TIME ~LOCKB j ~UNIT HEATEES J TRANS R V I C E EXHAUST FANS DIMMERS Panelboard/s: I-Icir.7Oamp I GFI (Swimming Pool) This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable ¢o have ~reQuent test and/or repairs made by a qualified gerson. Spuds Elec. Svce. Box 166 I I 8 L I C" 192E GENERAl. MANAGER St. James, L.I. 7 0 ~ .-~ ..... (~"-~? This cerhhcate must not be altered ,n any manner, return to the office of the Board ~f incorrect Inspectors may be ~dent,f,~d by~e~ credenho]_s Disapproved a/c ~ ............... MESSlNA BUILDING PERMITS o ~ONKONKOMA, L.I.N.Y. 11~9 TEL JU 8-1243 IN~U~I~ ~ a. in by typewriter Inspector, with 3 set~ of plans, accurate plat plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or p~..bile st..r~., o~ areas, and giving a detailed descriPtJon of layout ofproperty must be drawn on the diagram which is part of ~ls application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. This application must be completely filled in by or, in ink and submitted in triplioate to the Building e. No building shall be occupied or used in whole or in. port for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New .York, and .other,applicable La~s.., Ordinances or Regulations, for the construction of buildings, additions or alterations, or tar removal or aemolltion, as herein described. The applicant agrees to comply with all applicable laws, ordinancge,~buil,dl%ng ccx~ housing cade, and regulatJora, and to~ admit authorized inspectors on promises and in buildlngs for nec~liry Inlpect~. .. ~ .~.:.~, ~.Y....~.~......~.~.~.~..o.m..& ~..~.....~...V..~I.:LT.~. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......................... ~....~..~.~ ................................................. : ................................................................................................... Name of owner of premises ...... I~...~..~...~..~.....~.../f...~.......~. ........ .~ls~.......(. ............................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) , Builder's Licanse No.. ...3...~.~1~... '~.c:~. ~-~.'er-~7 Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ..~.....~...~..~./..~..e...b.....~....~....'~..~l~'J~o ......................... Street and Number ..~-,.~...O~.......'~../..~....~....x~..~..~.../C.....~,'Z~., ..................................... :~.~..~..~.~/.-?.--~....~. ................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ~' ~' ~ ' b. Intended use and occupancy .......... ~I~..LO:?...~;7./.~....~....~......~.~.. .................................................................... 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost ............ .~....,,.Z,~,....o~... .............................. 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 ............................ , ry.' 7. Dimensions of existing structures, if any: Front .....~....,~...~. ........ Rear .............................. Depth Height ...... L..'~.,. .......... Number of Stories J .................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... ~..~. ........................ Rear ........ ,~.~-~, ............... Depth ...~..~... ............ ~ ...~.,~...~'.. ....... Number of Stories ...................................................................................................................... 9. Size of lot: Front ...~...~..:.~. ........................................ Rear ...... J....O~....: .......................... Depth ......~,.<;;;C~....,..; ....... 10. Date of Purchase .................. ; ..................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ,e,~,~ 12. Does proposed construction violate any zoning law, ordinance or regulation: .... .t~....O.. ............................................ 13. 'Will lot be regraded ..../~.0 ........... Will excess fill be removed from premises: ('X) Yes ( ) No ........ 14. Name of Owner of premises .E-~'_._.~.~....~...~'.....~.~./ff.t~...~l..~. .......... Address .~.~.?.(, .P~....P..~..%.~..~:Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ...~...R../~.../?.¢~...~.~ .................................. Addressl~.l....WT...~...H....v?..R.~'. ...... 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 and indicate whether interior or corner lot. ,' COUN~ O ................................ ' . ~ ~ ~.~ ~ ~ ...... ~.~9..?.~:~.....~. ................... being duly sworn, deposes ~nd soys t~t he is the applicanl (Name of individual signing contrac~ above n~m~. He is the ..................................................... ~.~ ......................................................................... (Contractor, agent, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke ~nd file this application; that all statements contained in this applicotion ore true to the best of his knowledge and belief; end that the work will be performed in the manner set fo~h in the epplic~on filed therewith, Sworn to befo~ me this . ...... ..... ........ ............................. NOTARY PUBLIC State of fl~ YO~ ,o. ~.4~5e~ su.o~ coun~ R~KONKOMA, L.I.N.Y. 11779 Term Expires M=rch ~, tg~ TEL JU 8~1243 Z b~F'I-~ I L