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Home My WebLink About8431-zFOF,,M NO. 4 TOWN OF SOUTHOLD BUILI~ING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy N ZT~O /~an 5 ...... ,19.77 o .......... Date ...................... THIS CERTIFIES that the building located at .L.i?.J; .~?..N.?e.k .R..~..d ......... Street Map No.. ~.~9..~~ ......... Lot No ..... ~....~.qg~...~,~.~ ...... co~orms subst~tially to the Application for Building Permit heretofore filed in ~is office dated ....... F~.. 2~ 19..76 p~su~t to which B~ldMg Pemit No. dat~ ......... ~5~.. ~.. , 19.~., was issued, ~d confoms to ~1 of ~e req~ ments of the applicable pro~sions of the law. The occup~cy for which ~is certificate issued ~ P~Va~?. ~e ~?.? .~.~ ................................. The certificate is issued to qeo. ~, Pg~. ~.~ ..... C[~.~ ...................... (owner, lessee or ten,t) of the ~oresaid building. S~olk County Department of Heal~ Approv~ . ~ee ~3...~.~ .... ~. ~.~.. UNDERWRITERS CERTIFICATE No.~ ~9. .... P~q.. ~... ~9.76 ................ HOUSE NUMBEd 7a 9 .... Street .. ~$~!~e. Fg~. F.q~¢ ..... q~q~9g~ ..... FO~ NO. ~ ,: TOWN O~ $OUTg~LD BUILDING DEPARTMENT TOWN GLERK'S OFFICE - sOUtHOLD, N~. Y. and approved by the BUILDING PERMIT ~-.- , '~ ,:j~ ~HIS PE~,,IT ~UST B~ KEP, T ON THE P~EMISES UNTIL FULL ~,_ .... ~"',: C~PLETION' ?:C -'.. THE: :.WORK AUTHORIZED)._ 5~: ~- ~. 8~31 Z Dote ................... ~,.~: ' Perm~ss~ :s hereby grant~ ~: ~ .... -' , ~r p~, ~,~ *~-~.~:.:.~~:~:--.,-~-., ........... , ............................................... FORM NO. $ TOWN OF $OUTHOLD , 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 buEldmgs or new use: 1. Final survey of property with accurate Iocahon 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 from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed s~te plan requirements where applicable. B. For existing buildings (pnor to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: ] Accurate survey of property showing all property hnes, streets, buddings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buddings 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 $5.00 2. Certificate of occupancy on pre-existing dwelling or 1and use $5.00 3 Copy of certificate of occupancy $1.00 New Building ................ dition ................ Old or ~re-existing Buildino ................ Voc~nt I_~nd .............. Location Of Property ..... L:~..~.~.~.~'..~ ~J~.~.'.)..~. ...... ~,.,~..~.O.~--~..l...~/...~..l.,..; ................................... Owner Or Owners Of Property ...~J.,.~t~.$../~]~..O..~.....~....~L...~.....~.~.' Subdivision ..L.,..~'~.~.~ie~.~ ....... .~.: .................. Lot No...~ .......Block No ............. House No ........... Permit No .... ~..~..~.l....~Date,,j. ~1~/-~/'Of Permit ..~.~.,J..~..~.~pplicant ..~..~..~..~.X~..~..~.~.~?...~.~!.?...~;../.~..)...~. Health Dept. Approval ..../.Z..~...~./..<...~.. ................ Labor Dept. Approval ............../~....:..?'.. ....................... Underwriters Approval ..../..~../~../.Z...~.-,-,-- .................... Planning Board Approval Request For Tempora~ C~e~rtificote ........................................ Final Certificate .......................................... Fee Submitted $ .....~.,.. ........................... Construction on above described building and ge~rmit meets all applicable codes and reguJations. Applicant .............. ~ ........... ~,z~....~_~~,~;.,~... ~/~ · · Sworn to before me this. / -- ~'- - ~/~/~1 .......... ~.. day of ..... ~~ ........ /..[.. .... (stamp or seal)~ Nota~ Public ...........~~~.. Coun~ THE NEW YORK BOARD OF FIRE UNDERWRITERS V,] 'T, ~' BUREAU OF ELECTRICITY . ", '.!' , -' 85 .JOHN STREET, NEW YORK, NEW YORK '10038 va,e December 6, 1976 A..I,canonNo. enfle 882642 N' 315449 THIS CERTIFIES THATi~ , only th~ electrical equipment a~ described below and introduced by the applicator r~amed or~ tile ~bo~e application Windsway Building, 710 Little Neck Rd., Cutchogue, L.I. ,.th~folto~.~locaao,; ~ Bo~men~ [~ l~t~(. [~nd ri. Outside Sect;on ·ras examined on , De c emb er 2, 19 ? 6 a,~dfound to be i~ comptianee with the requirements of ~his Board. FIXTURE ' ' " FIXTURES RANGES COOK NG DECKS OVENS O SH WASHERS EXHAUST FANS O"YE~S - J ' 'FUiNACE ~OTo~s J FU.U'E ^.'U^.CE ~EEDE.S ~C'^'~EC'.T T,~qOC~S ~m U.,t 'W sERVIcE DISCONNECT "'- J NO. OF J ......... S E R V -- C OTHEI~ APPARATUS: Motors: 1-1/2hP. 1-Smoke -Detector Robert Goodale ~ ~. f/ / ~ RR '1 Box 1Sa Main Hd. ~.~f.~ .,M .... / Mattltuck, N,Y. 11952 Llc#7 3E ~'~1~"~'" / D Per - I\ Al ?5" 5~' Z$"E ~ ~5° ..~3' P3"I,V £or Mo ~ MOOSE TRAIL FX?~qNK H. ATKIAI$OM ~ ~ T,~I U I< ~ ?' Al. 'If. MOOSE TRAIL I The water supply and sewage disposal tstems For this residence wi1! conform to the standards o£ the Suf£olk County Department of 'Health Serv~ceso Applic.ant: Robert hendell Winds Nay Building Corp. Glenn Road Southold, N.Y# 1197! SUFFOLK COUNTY DEPT. OF HEALTH SERVICES F/~'/qNK ,W. /qTIKIMSOA. I Z 5 SETAUKET Y. Y FOR APPROVAL OF CONSTRUCTION ONLY DATE HS REF NO,. APPROVED A OOSE TRAIL Applicant: Robert Wendell Winds Why Building Corp. Glenn Road Southold, N.Y, 11971 ~'~/'9/V/4 td. /qTIKIM$OM Z 3 · 3ETAUKIZT N. Y _ I The weter supply and sewage dls~sal : 'stems for this residence will conform to th( :.,tandards of the Suffolk Coun.~ Oepartmj;nt of// "L / TTLf NECK ~OPEfFIE~ " E-~ 8 / C U TCHOGO~ FEbRUArY. 18) ~~: 1" = ~0~ SUFFOLK COUNTY DEPT. OF HEALTH SERVICES o~/Y ~..,7,,, FOR APPROVAL OF CONSTRUCTION ONLY ~lt No...~...~ ................. ~ ~~~,~ .......... · ..................................................... .... x 1...~:.,. ~ ~ , . ~-?~ ..~.--.: .................. ~~~i ................................. - .......................... a. ~is a~llc~i~ m~ ~ c~pl~ly flll~ in ~ ~ter ~ in b. PI~ plan ~1~ I~ation of'l~ a~d of buildi~ ~ p~mi~, ml~ip to ~joini~ pmmi~ or ar~s, a~ g~ o ~i~ ~p~ of ~ ~ mu~ be d~ c. ~~ ~ ~ ~li~ti~ ~ ~ c~ ~ i~u~ce~ Bulldi~ Pe~. d. U~ ~1 of ~ls applic~l~'~e Buildl~ Im~tor will ~'a Build~' Pe~Jt to ~all ~ ~ ~ ~ ~1~ ~ll~le>~l~ ~h~ ~ e. No ~11~ ~11 ~ ~cupl~ or u~ in ~ole or in ~ ~r any pu~e ~r until a ~ifle~ shall ~ ~ gm~ ~ the Bulldi~ InCr. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Law~, Ordinances or ~0 Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, a~ herein described. The applicant agrees to comply wth all appl cable laws, ordinances, bu Id ng code, housing code, and reguldtionl, and to - admit authorized inspectors on premises and in bulldlng~ for nacessa~/inspectlom~. -oF Se ~,~o L40 ~ ........ .. ,/~,. ................ ;..~ ,~ (Signature o? app or name, if ........ ~.o~....~1.~..~,~....~...~.~..~..~..~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or ~uilder~, ........................................................... ~.~.,m..~ ........................................................................................... i~ .......... ; Builder's License No ..................................................... /o°° .- 09? _ '7- ~.~,b ~ Other Trade's License No ............................................... Lc~:ation of land on which prppasecl wark will ~ ~e. Map .k'l ~:~.~r.~...~ Lot No....~..... ........... Street and Number; ...... ~.-.%..~.-~.~...L.~.....~I...I~L~...~A~ ............................... .~...~.-~'...~,.~...~J~.~T.... ......................... ~ Mu~iCllmlity State existing use and ~cu~y of premis~ a~ intend~ u~ and ~cu~ncy of p~ c~: Exlsiting use and occupancy ................................................................................................................................. Intended use and occupancy ....... 8~...~...~%.Y:l~..~..~.t~.- ....... ~.'b~..l:-~ .......................................... 3. Nature of work (check which applicable): New Bui ding.. ..... Addition .................. Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work ..................................................... 4. Estimated Cost ..... ~...~,~...~.~,,~......= ................. Fee ~X ~ (D~ription) (to be paid on filing this application) 5. If dwelling, number of dwelling units ..,.....~.~....Number of dwelling units on ~ch flor ............................ If garage, number of ~rs ............ .~.~ ............................................................................................................ 6. If business, commercial or mixed ~cupancy, speci~ nature and extent of ~ch ~pe of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ............... : ........ Nu~er of Stori~ ................................................................................................................. Dimensions of same structure wi~ alterations or additions: Front .................................... R~r ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... ~...~ .............. Rear ....... ~..~. ............ Depth ..~....~. ....... Height ...... J.~..~ ..... Number of Stories .......... O~.~...~.~.~ .......................................................... ~. 9. Size of lot: Front .......... ~..~.~ ................................. Rear ....... }.~..~ ........................ Depth ....~.~.....~.. 10. Date of Purchase. ..~....,.~.~.~..~ .............. Name of Foyer ~ner~...~.~.~ ........... 11. Zone or use district in which premises are situated ................................................................................................... .;~ 12. Does proposed construction violate any zoning law, ordinance or regulati~: ............ ~. .................................... 13. Will lot be regrdd~ ...~.~ .......... Will excess~ fill be removed fr~ promises: ( ) Y~ ( ~o 14. Name of ~ner of premi~es..~.~,..~..~.~re,~~.. ~.~.~...~ ~.~ ~-- ~' omo o* ........... ....... ...... DIAG~M L~at~ clearly and distinctly all buildings, whether existing or propo~d, and indicate all ~t~k dim.nsions from propa~ lin.s. Give street and bilk number or description according to de~, and shaw street names and indicate wh~ther interior or corner lot. STATEJkOF NEW YORK, · ~ S S COUN~ OF ........ SU~':~O~....;.,.~ '. .............. :,4......~...~..~...~L.'~.../~.;C...k~.....~'.~..~....~...~...!./.. ............. .being duly sworn, deposes and says that he is the applican! ~ (Nan~e of iddiViduaf ~igjning contracf) above named. He is the ................................................... ~.o~i~'~.~.~.9.~'. ..................................................................................................... (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, contaioed in tl~is app ication arg t~e to the best of his knowledge and belief; and that the work will be perfo~ned in the manner set; forth i~ the application filed therewith. Sworn to before me this ......... .'J~t;~.... day of ..... oto. pub,c,. ......................... ........ co.. ..................... ..... · ~ . (Signature of applicant) HOTARY PUBLIC, State of New ~'ork t~o. 52-8125850, Suffolk Court~ ,, Term Expirbo March 30, ].9._~ L,, I, I ~JERT IC~L. ~ I OIl, l 6, RSPHt~LT ~.H iPGL¢,~ L'--q .o, A R - '~ E VA E BACKFILLING FOUND/ 3. I:INAL WHEN JOB COMFL~TED ~0j- d F 0 U M g A T PLAN '1 LI /: I / P ° CR 0 S F_.,C Tt 0 kt S DF 'ELF_VAT