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HomeMy WebLinkAbout8074-zTOWN OF $OUTHOLD BI.mLDING DEPAR'I~NT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy Map No..~. ..........Block 1~1o....~. ...... Lot No...~...~.a..hA~...o..~.q.~..z conforms substantially to the Application for Building Permit hereto/ore ~ed in this office dated ........... ,T..u~. y.....1.~., 19. ?~. pursuant to which Building Permit No..8.Q~..Z.. dated .........?..~..7.... 1. .~..., 19.7.~.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy/or which this certificate is 'issued is .$Le.e. ,..O.e.v, era. t~!~g..~t~e.t.i.o.~, vLt.h The certificate is issued to .L. :.~.,.L.!P!!n. i. !O. ....... . .0!~n..e.~. ........................ (owner, lessee or tenant ) of the aforesaid building. Sui~olk County Department of Health Approval .'.?.e~ .~. I...~../.1 ?./.??..-.. (..~,..1.~. 9..8./.7/? UNDERWi~ITERS CERTIFICATE No..N. :~.o ....................................... HOUSE NUMBER .... 69.8.2.~. .... Street...1~..!z}..R.o.a.d...(.R.? .2~.)....O.l'.e.e.n. ILo~.t' ....... Building Inspecto/ ~0~,~ ~0. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 807 1 Z Permission is hereby granted to: .L~I., z.l~ktl~..Co ........................................... .......... ~ .~O.....03~lcou~t~.. ~ .......................... ......................... 14$a~o~.& ...................................... to .Bu~d..a~.~t ~..~..e~&t ~g...bu.i.ldSn~ ............................................................... -at premises located at ..... ~/,~....~a~zn....~o~ud...AF~elae, e~t~ ..................................................... ...................................................................... G~enpor~ ......... ~Jf., ................................................. pursuant to application dated ...................... J~-~...1..~ ................ , 19~.~ ..... and approved by the Building Inspector. Fee $..~.~.~.L~ .......... ~ Bulling InstrUctor t TOWN OF $OUTHOLD , B#i[dlng 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 buildings or new use: 1. Final sun/ey 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 disposol--(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 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 $1.00 D te ?..T..Z. ............ New Bqilding ................ Addition ....~. ......... Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..... J~.,q. aiZ.~...~,ia£n....13, oad.,...G~i~.r~p, oi?.t, ...................................... " ........................... Owner Or Owners Of Property ..... .............................................. Subdivision ................................................................ Lot No ..... ~. ...... Block No......r. ...... House No...;Z ....... Permit No...80.?.11.~ ....... Date Of Permit .?./.!.5/..~.5..Applicant ...LILt©. .................................................. Hearth Dept. Approval ...~$.~.~,...6.'g..~.e,~..~l ............ Labor Dept. Approval ................................................ Underwriters Approval ..... ,~[Q.~...~'~,~Lg.~.~..g~. ........... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ FincLI Certificate ........... ~. ............................ Fee Submitted $ ..~.~..0..O .......................... Construction on above described building a~ p/~mit meets ,all ~l~licable codes and regulations. App,,cont ... ...................................... Swomtobeforeme.this /// / '" ~ - u W ~01/I Nota~G~~~?~.. Coun~ N~a~ PuNic, State of New York ~ : No. 52-g~18500 Qualified in Suffolk Court y Commission ~xpJres ~rch 30, 197~ , ~ith p)aps and app)~catlonS on file In the Office ~e~)ces ~,8 approva, ~s grimed on cond,flon that t~e prop~ ~Jth these p!3ns. Th:s approva~ is not authorized to ue u variance of any )oca, ordin~ce or requ[remen~ LONG ISLAND LIGHTING COMPANY ENGINEERING D -~PARTM EN'T 175 EAST OLD COUNTRY ROAD HICKSVILLE, I',; EW Disapproved, o/c ..~ ............ ~ ......... ~ ......... ~ AP~PLICATION F~)R BUILDING PERMIT~~'~ - ,, ~ ',~ ' Date .......... ~...~.., INSTRUCTIONS ~ / TOWN OF SOUTHOL BUILDING DEPARTMENT _TOWN CLERK'S OFFICE ~UTHOLD, N. Y. Application No ................ '.~' .......... 19.Z~j'Permit No. ~.~.~.~ .... a This a lication must be cam letely filled in by typewriter o~ in ink and submitted in triplicate to the Buildina'~ · PP P · 1 - ~' Inspector, with 3 sets of plans, acc,.rate pi,at plan to scale. Fee according tg?ct~e~..dule~ ' ~ b. Pl~t'plbn showing la?tiaa of tot and ~f buildings on premises, relatiod~hip to adjoining premises or public streets or m areas, and giving a data ed desc~ pt oh df a~out ofproperty must be draw~ a qn~the~diag(a ~m whiqh is part of this 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 &'Bbilding PeFmit to the applicant. Such permit ~'~'~ shall be kept on the premises available for inspection throughout the work. ~ e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy 3~ 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 Laws, Drdinances_o~r Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in, buildings for necessary inspections. Lon Island Lighting Company (Signoture of applicant, or name, if a corporation) 250 old Country Road, Mineola, New york 11501 (Address of applicant) State whether applicant is owner, lessee, agent, architect,, engineer, general contractor, electrician, plumber or builder. Long Island Lighting Company ' Nome of owner of premises ............................................................... ~ ...................................... ~ ............................................. If applicant is a corporate, signatu.re~ of duly autho~, f ic~ ............ (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work will be done, Map No.: ...,', ......... .'. ........................ Lot No ........... .'. ............ N, Side of Mata ~d,, 431.34 Yr, W, of Chapel La,,...G.,r..e..e..n..p..o..r.,.t.!~..~.Z.Y.:..;.~..Z' ...... Street and Number ..................................................................................................... ~unicipoJity State existing use and occupancy of premises a~d in~%nded~.se.?pd occupancy o~f p~r,opose, d con~r~qti0n: a. Exisiting use and occupancy .~.J:.e..c.~?..~..?...g?..?.e..??..~.~..§....8..~..a.t.~..o.~,...~ ................................................ b. Intended use and occupancy ..S..a..m..e...~...~.?.~?..~.~,,e-,9~,-,.(.,1-.~).e...~,s,.,°,[.~,.,~.°-~,,.s,?.~;?,~.,.~.~.?.?.~). .............................. 3. Nature of work (check which applicable): New Building,. ....... ". ......... Addition ........ ,~. ........ Alteration ....... 7 ....... Repair ' Removal ........... '....... Demolmon .................... Other ark (Description) $6,000,00 $15,00 4. Estimated Cost ............................................................ 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 ......... '. .................. 7. Dimensions of existing structures, if any: Front ....~.2....~.~: ............. Rear ......... ~.2...~:. ........... Depth ....~...~.~:. .... Height ......~..]:...?~.% ....... Number of Stories .......... .0..~..e. ................................................................................................. Dimensions of same structure with alterations or additions: Front ............. .3:..2...~.,. ........... Rear ...... .Z..2...~.~.t .......... Depth ..~5...~:.L,.6...~.a.:. .... Height .....]:~..~.I::: ............. Number of Stories .........O.b.e. .................. 8. Dimensions of entire new construction: Front .............. .'...., ................ Rear .......... '. ................. Depth .......... r: ............ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ....~..l~.:..5..0...?..t.r ................................. Rear .~..16..:~..0....~..t.: ..................... Depth ..~.5.:.~..~.,. .......... 10. Dote of Purchase .?i.~....1..3.~...~,..9..6.~ .............................. Name of Former Owner .~..a.~.o.~..,~.~.o.y_e....C..o.~p.... ...................... 1 1. Zone or use district in which premises are situate~l "B" I2. Does proposed construction violate any zoning /aw, ordinance or regulation: ........ .~..o. ............................................ 13. Will lot bf~ ......~..°. ................... .Wijl e)~c¢ss fill be removed from preJ'nises: (X) Y~s, ( ) No J/---~' Lon§~ls~and Lig~t£ng 2~.g 0~ Country ~, 14. Name of ~pwner of premises ........... ..u..°..m.~Z .......................... Address ,,t~.z.~.e..°.A~., ............. PhQn, e No. 2~.?.'..1..0..0.0. ...... ~ Architect .~.r£stotte ~akt~kos A~r~*~c~v~e~°UncrYDh~' Nome ..................................................................................... ; ................. ne No ....................... Nome of Contractor ...... ~.°....~,,e.,,~.e,~,e,~t,e,~ .......................... Address ................................ Phone No ....................... PLOT DIAGRAM L.ocote 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, SEE ATTACI{ED PLOT PLAN - STATE OF NEW ¥_Q, RK. [ c S COU NT-Y OF ..... ~.i~ ...... ....... I~i~E~..E.*.~.P.~E~,..,...'A ........ ; ...... ~..~.,..:.~ .................. L'~..,~being d~ly sworn, deposes end says that he is the applicam (Name ~ individual signing contrqcf) above named. He is the ..~9.~T.~?.~.~..?~...~.~...~.~.~.~...~. ..................................................................................... (~enVoctor, ageot,: ~orporot~ o[ficer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make end file this application; tHat'-~ll ,statements contained in t~s opplicmign ar~ ~ue t~ the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the application filed therewith. Swam to before me this .......... I..~. day of .~ .......................... , 19.~ ~ ~ ~ ~ ~, J Noto~ Public ................ ~.....~.[,~.. Coun~ ..... :~~.Z.]-..Z~~ ............................. ~~~~ (Slgnotu~f opplicaht) 0 1 ARO'I. 2 3 I,I 0 I ENGRG. 2 3 K843 10973 A~DITIot~ To UTIL. ITy rSulcOlNC.. $oU-rHO~-l~ G-~UEFZATIkl~ 6TATIoi, J GIz~_~t~po~T, NF..I.U yolzN,. LONG ISLAND LIGHTING COMPANY OFFICE OF ENGINEERING I75 EAST OLD COUNTRY ROAD HICKSVILL.E, NEW YORK 4s ~oT~o W0 - 4~;254 N E ,. f' PFC (IGOPSt T~5~ PLOT I00' p [20P~TY ~AIL ~-~V~. N '/'y~/CAL DE'TAIL '/,~ ' = 1-o" /~D D EO Z/-h',/D~C,4P/AZ G 5 0 U, Tf f O £ D- GENER~4 TtN G LONG ISLAND LIGHTING COMPA'N¥., ENGINEERING DEPARTMENT 175 EAST OLD COUNTRY ROAD HICKSVILLE, NE~V YORK ~'. ~, ,~-, sc*c~ WO Y'~'~' II x SouTH do~c-, Fo UM OA'l'lo~ A FLoo 1~. p LA/-J ~ C~L/L' ~4": ILo'' V,°., . ;:;.' . . ,, OF_.CTtoI,,.) "A-A" 0 ! ARCH, 2 3 I,I, 0 1 ENGRG. P 3 O NSR.- DRAFTEX (o.,, ~ ,, ~-/~ wwF- CKD APPD APPD ADDtTIOA3 To UTILIT)/ LONG ISLAND LIGHTING COMPANY OFFICE OF ENGINEERING 1'75 EAST OLD COUNTRY ROAD HICKSVILLE. NEW YORK ~ ~OT~, WO' 4.5Z5~- H o