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Home My WebLink About8243-zNO. & TOWN OF SOUTHOLD BUn.nINC DEPARTM~NT Town Clerk'~ Office Southold, N. Y. Certificete Of Occupancy No.Z V00Z Date b,~ A,f '-{ 19.~6 TInS CEaT~FmS that ~e b~a'-~ ~o.at~ Map No. ~ 5 6 Bl~k No .... ~t No, co~or~ subst~ti~y to ~e App~ca~on for B~g P~it here~fore ~ ~ thin office dated 0~7 ~ dat~ ~w ~ 5 1~.~., was ~su~, ~d co~o~ ments of the applicable pro~io~ of ~e law. The oc~p~cy for wM~ ~e c~ffieate is ~su~ ~..~'.~[~ ?~... ~.. ~~ ..... ~. F~ ~[~ ~ ............ (o~er, of ~e ~ores~d b~g. S~o~ Cowry Dep~ent of He~ Approv~ ~' U~ITERS C~T~ICATE No. HOUSE~gR .............. S~t ................................ ... .. . ... ......... ..... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PJ~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8243 Z Permission is hereby granted to: ~..*.~.~L...~.~!.~.~.;!~..?-....~!..*.~.~.....~'~c .~....~...~.....~.....~.~..u....N...~.~ .................... at premises located at ...................................... ..~...~...~)...~....-~...0....~.1 ......... ...--~...V....f?....~.. ................................. ................................................................... ~ ~.L! .o..~..u..~: ...................... Lo'T' pursuant to application dated ............................. ..~....?.. ........ ..~......., 19.~....~...~., and approved by the Building Inspector. F. ,.../~.~. ...... Building Inspector FORM 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. 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 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 ~ /'//~-/~ Iqew Building ................ Addition .~ ..... Old or Pre-existing Building ................ Vocant land .............. Location Of Property ...~..~...~"-.~......~.. .............................................................................................. Owner Or Owners Of Property .~.~. ...... ~..~...~..~./~..xq~....../.~..~..~/.Z~t~..~....-~.. ...................................... Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No..~....~.~...~. Date Of Permit .~...~../.-~..~..~....Applicant ~.4~-.~.~.~...~.. ...... ~..~....~...~..~.~.~. ............ Health Dept. Approval ................ ..,~...~..(?.....-. ............. Labor Dept. Approval ...................... ...~....~../.~......: .......... Underwriters Approval ~ c~ ~ 0 [///2 ....... Planning Board Approval ,A/~/--~. Request For Temporary Ce~icate ........................................ Fincd Certificate .......................................... Fee Submitted $ .......... ~. ....................... Construction on above described building and permit meets~ble codes and regulations. Applicant ..~ .................... ~ .................................................. Sworn to before me this ................ day of ............................................ Notary Public .................................... County // (stomp or '7O0 THE April 28, NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK ]0038 1976 ,~,,,,,c,,,,o,,.'~'o.,,,.me 833830 N 280419 THIS CERTIFIES THAT only the electrical equipment os described below and introduced by the applicant named on the above application number in the premises of William Brunet, 540 Vanston Road, Cutchogue, L.I. inthefollo,clnglocatlon; ~ Basement ~ lstFI. ~ ~.a rt. outside .%~,io. mo¢~ ~, ,,~ ....... ,,~,,.~ o. April 2 6. 19 7 6 ~.a/o.,,a to be in con,pliance with the req,zlrements of this Board. FIXTURES RANGES OVENS DISHWASHERS EXHAUSI FANS FIXTURE OUTLETS IECEPTAC[ES SWITCHES 20 12 OTHER APPARATUS: 1 G.F.I. 1-4.5kw Hot water heater I C AWG. OF HI lEG 2/O Gustav Bartra, I~ 227 East Brookwater Road, GENERA[ M. ANAGJ~II, Mattituck, L.I. 11952 Lie. 1529E ~This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by th~*r t[r?entials. Examined ................... ~.:.. ........., 19 ........ ~plicmi~ No ................... ~r~ ................. ~.......~...~., 19..../ ..~. ~it No ........... ~..~...,~....~.: ........ ~~ ~ C ........ ~- ~~ ............................................................... :: ................ ....................... .. ................... ~~...~..~~...: ....... ~ ...... - APPLI~TI~ ~ IUILDIN6 PE~IT ~ ~ ~ ~ ................. ...... , ..... o. ~Js o~lic~i~ mu~ ~ compl~ly filJ~ in by ~ewriter ap in ln~ o~ ' ' p ~e Ink,tar, wi~ 3 ~ ~ ~, ~cum~ pl~ plan ~ ~le. F~ ~J~ to Kh~ule. b. Plot plan sh~in0 IKofion of lof and of bu~l~i~s ~ premis~, ~lQfions~Jp fo ~joinino pre~i~s or public st~ or or~s, and 9iYi~ o ~toil~ d~ripti~ of I~ut ofp~e~ must ~ ~rawn on the ~io0ram which ~s ~ of ~is ~licoti~. c. The wo~ c~er~ by t~ o~licotion m~ n~ ~ c~K~ before i~uonce of Buildin0 Permit. ~. ~ o~ol of ~is o~licoti~, ~e Bu~ldlno Insofar will issue o Buil~in9 Permit ~o ~he ~licont. S~h ~rmi~ shall be ~pt ~ the premis~ ~ail~le ~r in~Kti~ ~gh~ t~ ~r~ e. No building shall be ~cupi~ or u~ in whole or in Pa~ for any Pa~e whirr until a Ce~ificate of ~cu~ shall h~e ~en gmnt~ ~ the Buildi~ In--tar. APPLICATION IS HEREBY ~DE to the Building ~ment for ~e issuance of a Building Pe~it pu~t Buildi~ Z~e O~inance of the T~ of ~thold, ~ffolk Count, New York, and ~er ~lJc~le ~, O~i~nc~ or Regulations, for the const~ion of building, additi~s or alterati~s, or for mm~al' or desitin, ~ heroin ~r~. ~e applicant agr~s to comply with all a~licable I~, ordinances, buildi~ c~, h~i~ c~e, a~ ~l~i~ a~ admit authoriz~ in~to~ ~ premiss ~d in buildings ~r n~e~ i~ti~. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. tm/X4~r Name of owner of premises ..... ~....~..o....~...~..~IP....~...?...~ ................................................................. ~ f applic~;~te, ~dulY auth°rized °fl icer' ................. ......... oem.p AM.e , ffe w Builder's. License No ..................................................... Plumber's License No ................................................. Electrician's License ,No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. N~ap No.: Street and Number ....?~..~JI...~..~L~J~/:~I~4t~a...~E[III[..'~I~ .................................. Municipality 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 .................................................... ~.~-..................... .................................... 3. Nature of work (check which al~plicable): New Building. ................. Addition .....~11 .......... Alteration ............... Repair .................. Removal .................. Demolition ................... Other Work .................................................. o-t) (Description) 4. Estimated Cost Z.....I~,I~.*....~.. ....................... ;......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 .......~ ................ Rear ......... ~ .................. Depth ....~ ....... Height ........ ~,~.1. ......... Number of Stories ...............~, .............................................................................................. Dimensions of same structure with alterations or additions: Front .............. ~. ................ Rear ...... 47. ................ Depth ......... .~..i ................. Height .......~,,~ ............... Number of Stories ....... ~[ ..................... 8. Dimensions of entire new construction: Front ....... ~.. ....................... Rear ..... ~J~ .................. Depth ....~. ........... Height ....... ..~..I. ..... Number of Stories .......... ~ ......................................................................................................... 9. Size of lot: Front ....... ~,~O.~a .................................... Rear ........ J~JeJ) ........................ Depth ..~'.....~J~eJJ ............ 10. Date of Purchase ........................................................ Name of Former Owner ....................................................... 11. Zone or use district in which premises are situated ................................... ~. ........................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................................. : ...... 13. Will lot be regraded ....~1~. .................. Will excess fill be removed from premises: ( ) Yes ( ) No "~"" ~ 14. Name of Owner of premise~ ..J~.e,..~Jll!lJe...~,..~J~. Address ~J~t,.~ Phone No .................... ;-.~;i;~. ess Illaee:l , Name of Architect ' Addr ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone ~o3.~'...~...~...~..r...0.. ..... 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. I t99t STATE OF NEW~YORJ~.,,,~ COUN-I"~' OF ;.-~.'.'~: ......... ~'~ ......... .r....~...~'.~..[.[-....~...~...I..z../..~....~....u~...[.'..-~...~.:..~.. .............................. being duly sworn, d~oses ond soy~ t~t he is the applican, (Name of individual signing controc~ above name. He is the .......... ....,~. ............................................................................................................................................................. (Contractor, agent, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the s~id work and to ~ke and file this application; that all statements contained in this application ~re tree to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the flpp~ication filed therewith. Swam to before me this APPROVED As NOTED DATE: I '~/, E'7"7~,~,~,~,~,~,~,~,~,~' FEE: ,/~' ~ BY_~ NOTIFY BUILDING DEPARTMENT 765-26fiB 9AM TO 4PM FOR REQUIR- ED INSPECTIONS: 1. BEFORE BACKFILLING FOUNDA- TION OR START FRAMING 2, BEFORE COVERING PIPELINE 3. FINAL WHEN JOB COMPLETED