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Home My WebLink About7724-zTOWN OF SOUTHOLD BUN~DING DEPARTUk~T Town Cl~k', Ot~iee Somhold, N. Y. Certificate Of Occupzncy THIS CERTIFIES that the building located at ................<.~ .,./~. ~.. Street Map No...~ ..... Block No ..... . .~....Lot No., ..~.. ,., ~~..~.-~.c~... :... conforms substantially to the Application for Btfilding Permit heretofore ~ed in this office dated . .~ / ~'~ 197.~ .~pursuant to which Building Permit No..~..~. ?. .... ...... ' , 19 .... , was issued, and conforms to all of the require- The certificate is issued to~...~...~ ............................ , (owne~, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval ~ ~ ~ UNDERWEITEES CERTIFICATF. ................................ :: .¢.:/~ .... Building T-~pector TOWN OF SO4/THOLD BUILDING DEFABYMB4T TOWN CLERK'S OFFICE SOUTHOLD, PLY. BUILDIHG PERMIT (THIS PEP, MIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7724 Z Permission is hereby granted to: at premises located at .~.~.....~Cl~i'~..~i~ldll...!....~ri .............................................................................. ........................................................ ~tt~t~l~r...~ll .X.*. .................................................................. pursuant to application dated ..................... Feb ....... $8 ............... , ~19~..., and approved Building Inspector. INSTRUCTIONS a. This application must be completely filled in by typewriter o~. in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets of areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which 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 a Building Permit 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 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, Ordinances or 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 mgulatiom, and to admit authorized inspectors on premises and in buildings for necessary inspections. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............. O..U~.~ .f.. ..................................................................................................................... :,..= .......... i~ .......................... Name of owner of premises ....... . .~..~.~.~.......~.. ........ ..~I..~-~.."~Z~. ............................ ............................................................ , .... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..~..a,.~....~i.~.~.../~il~.l:~.~...~r Plumber's License No ..... ~.l~).~.........~... ..................... ". Electrician's License No ...... ~.~.~,..~ .................... Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ............................. Lot No: Street and Number .]T'.I?..[-:..I][.===-- -- -- '- ........................... ..... Municipality State existing, use and occupancy of premises and intended use and occupancy of proposed construction: a. E ,,,,ing use and occupancy ..... .. .......... b. Intended use and occupancy ......~..~. ~/.~,:/~......~..,~.I~'...~././~.,~..~.....~Y~ .................................... / 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................. Repair .................. Removal .................. DemolitiOn .................... Other Work ..................................................... 4. Estimated Cost ...........~../-%,~...~...~...~ ........................... Fee ~' ~ (Description) (to be paid on filing this applicqtion) 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 end extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ...... .~.~..'. .............. Rear .....~.~..~. .................. Depth ..~.~.~...~...;i. Height ...,,~.~. ............. Number of Stories .......... .~/~..~. ............................................................................................. Dimensions of same structure with alterations or additions: Front .:...~,~..*. ....................... Rear Depth ...~...~...~.~..~.~. .............. Height ..... ~1~. ............... Number of Stories .....'~...iO. ................ 8. Dimensions of entire new construction: Front /~..,.~(~..H~.f~t~..~...~l. Rear ~j~'t4~;~/~ee~'c~l Depth Height .../.~.!. .......... Number of Stories ......... ~tJ~ ............................................................. i .................................... 9. Size of lot: Front ........ ~..~..1. ........................................ Rear ....... .~..~.m.~..~...~ ................ Depth .../~.~....'.;...., .......... 10. Date of Purchase .....~.~..~'/.1~....~. ....... ./.~..~..~. ................ Name of Former Owner .~t~..(.../~...~. ....... t~.&~4.~.~ ...... 1.1. Zone or use district in which premises are situated ........ t~...-.../. ................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~.1~. ............................................. 13. Will lot be regraded ....~.~. ................. Will excess fill be removed from premises: ~ Yes ( ) No 14. Name of Owner of premises .~/~/...~..]~.~'.D.~J .............. Adclress~.~.~...Z.~I/,~....~..~..*. Phone No. ~.~....~...~..~'.J/'~' Name of Architect .../~/.~./~.~. .......... ~ ........................... ~ ...... Address ................................ Phone No ....................... Name of Contractor :....~:/~... .......................................... Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buil~n~sl 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 STATE OF NEW_YORK, , i ~ c c COUNTY OF, ..O.~.~|.IC ...... ~'~ ................... ..~..~..~n,~'9,.....~..,....~...~'...~'....T-.~...~,. ' ........................ being duly sworn, deposes and says ,~t he is the applicon, (Name of individual signing controc~ above name. He is the ................................................................................................................................................................................. (Contractor, agent, co~orote officer, etc.) ~owner ~, and is duly aut~rized to perform or have performed the said work and to ~ke and file this application; t~t oil statements cantoned in this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set fo~h in the application filed therewith. Swam to before me this ...... ...... ........ . Nota~ Public~./~~ C~nW .................... ~..~:..; .~.~.~..c ~.~; ....; ................... BARBARA M. HAURUS ~ ,/(Signature of applicant) ~ ~blic in the State of New Y0~ [ / No. 52-~06770 ~ ~ ~ldln~ in Suffolk ~.~ / Commlssio~ Expires March 30~ [~ ~ ~ FO~,M ~0. 6 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 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 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 rmturol 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 o 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 ............ New Building ................ Addition ...... ~ ...... Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ~..7..~....~....~....~.~.~.....~..~`..~.~....~......~..~.`~..4/.~....~..~`..`~.~.../~.`. .~......./..~.~.~..~ ................. Owner Or Owners Of Property ........... ~...~..: ................... ~...?....../~.....~...r.~.d..~ ...... ,....~...3. ......... .~ ............ Subdivision ...~../,.~,~.~...,~,~..~..~.**~-., ............................ Eot No ............. Block No ............. House No***~..?.,.~.~. Permit No..~...7...~...~....Z/... Date Of Permit ...~.//,..~.../.?....~.Applicaflt ...,..~....o,../7.../.?....,~/~,.~....~,...~..~....~.. ...................... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval ..~......~....7.....~...,~....~....~.. ............ Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fina. I Certificate .......................................... Fee Submitted $ ~- C~. Construction on above described building and permit meets all applicable Codes and regulations. Sworn..~..~....'t° before me~./,~thi~ -- day o~/7~...,~....~../.~.....? ~/ (stamp or seal) MMI~ Public in the State of New York No. 52-6806770 Residi, ngrin ~uffolk County Commissio ~ xDi es March 30, FOltM NO. 6 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 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. o~ 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 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 Date ....~...e.. ~.....~,....~ .../...?.. ~..?. ......... New Building ................ Addition .....v~.. ....... Old or Pre-existing Building ................ Vacant Land .............. Location Of Property .................................................. ~ ....................................... r....~..~.. ............................ Owner Or Owners Of Property .~.~,n ~). /C~s,~'~.~.. "' /"~t,'q,~*','~ /~ Subdivision ............................................................... Lot No...~..r ....... Block NO ............. House No..7..~..~.... PermitNo. 7-/2~/ ~- Date Of PermJt .-?.~/~..~./7....~.. Applicant ...~...~...~....4...~..~/'/-~Drl Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .... ..~.....~...'7...~'....~....~...~. .............. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fined Certificate ~ Fee Submitted $ ....~... ............................ Nets~ Public in the State of New York No. 52-6806770 Residing in Suffolk County Sworn. Ia before me this/' /~. (sta .... BARBARA M. HAUHU~ ~c open pourch I 7' Open 1 TI b THE NEW YORK BOAR[" ~ ..... dl BUREAU 0 ELECTRICITY i~ V 85 JOHN STREET, NEV¢ YORK, NEW YORK 10038 ,,.,,, ~,~rch 2~, [97~ -,,,.,,~..,,,,,, ...... .~,,. 7~7~8 N 275349 THIS CERTIFIES THAT John A~hton. w/s Love L~ne 200~ s/o Route 27A~ Hatt2tuck~ L.[. .~.~ ~.,,,~.~d,,,, March 22, 1976 .,,~f,,.,.~ n, ~,~ ~,, ~.o,,,/,~..,.~ ...~, ~,~ ~,m~,,,~-~ ,,y ~,~ OUTLETS IECEPTACI. ES SWITCHES DRYERS SERVICE DISCONNECT NO OF FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS DIMMERS · - 1-1.5kw Elec. room heater/s.1 .Skw, Panelboard/s: 1-15clr.100amp W.B. Ruland . Electrician __ Mattituck, L.I LIC# E242 This certific~]te mull not be ohered in ony Qnner; return fo the office o{ the Boord if incorrect. Inspeclor~ moy be idenhqi~ by