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Home My WebLink About7846-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No...Z7.1..4.2. .... Date ...... .3..u..ly .29. ........... , 19.7.6. THIS CERTIFIES that the building located at West Cove Road Nassau Point, Cu~chogue, Map No. ISa$~.a.u. pt... Block No ........ Lot No, .2.77, .27.8.,.77.9 .................... conforms substantially to the Application for Bui]ding Permit heretofore filed in this office dated ... Ap. rik .10. .. , 19.7..5. pursuant to which Building Permit No..7.8..4.6.Z.. dated . April .24 ........ , 19.7.5., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . One-.f.ami],y. d.w~!.n.g..w.i.t.h., a.d.di.t.i. 9.n .a.n..d..a.l.t. 9.r. at..ig.n' ............. The certificate is issued to ...R.o.b.e.r,~..an.cl..B.a..r.b.a.r.a...L.e.w.i.s. ,...o.w.n.e..r.s ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. N/.I{ ............................. UNDERWRITERS CERTIFICATE No ............................................ HOUSE NUMBER ... 70 q ..... Street .... ~..e.s.t..C. gy.e' .R. 99.d' ..................... ...................... N.a.s..s..au...Pg!.n.t.,..c.~C ,b~_~u.e.,..~.: ..Y., ......... Building Inspector FOI~M NO. 2 TOWN 0F $0~T90£~ BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 7846 z Permission is hereby gronted to: ~a-~-.-...~um~-.-t-ne .....A/C...t~b~.~..&...~a.~bra Lewis ....... .A,.,.7.. O...I~e .v.~.. ~.k ....................................... ................. ..R:t.v.e ~,he~6 ...................................... ot premises located at ...]..0~..]~.~..,~.~.¥...~..~.~¥...~79 ....... ]N~S,~-.~...s~..O..,l.m..b...~.l-.O,,p ......................... .................................... I~r~..~desf,...ho~]p.- .(....W e a ~...(;~ve.. R(t.) .......... (Pa~. ehegtte .................. pursuont to opplicotion doted ...................... ~'p~'i'~' ......... .1.0 ....... , 19.~Z.~.., ond opproved by the Building Inspector. Fee $. J..~ ,,..O.Q ........... u, g ~to~ FOBDI N~. ~ TOWN OF SOUTHOLD , Building Department Town Clerks Office $outhold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A, This apphcation must be filled in typewriter OR ~nk, and submitted in DUPLICATE to the Building Inspector w~th the following; for new buddings or new use: 1. Final survey of property w~th accurate location of all buddings, property hnes, 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 ~nstallat,on 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 requ,rements where applicable. B For existing buildings (prior to April 1957), Nomconforming 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 build~ngs. 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: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelhng or land use $5.00 3 Copy of certificate of occupancy $1 00 ._.~,~ ~ / ....... New Building ................ Addition // Old or Pre-existing Building/7/7"'"'-7..v .......... Vacant Land Subdiwsion .~..~~../...~ ................. Lot No. -.~--7'~-. Block No ....~ .... House Permit No .7.Z~.....~,... Date Of Permit../..J~.<//'~....-.~...-~pplicant ~.~..../~(~P~,..~ .... Health Dept. Approval ..... /-~..~.....~.....: .................... Labor Dept Approval-_....x~.,c...r....-~.....: .................... Underwriters Approva~......-Z. ...................................... Planning Board Approval ~./~..: .................. Request For Temporary Certificate ........................................ Fined Certificate Fee Submitted $ .~..'~....~..~.. ..................... Construction on above described building and p~rp~,t/~eets/~ll ppplicabJ~//~es and regulations. ........................... ................ day of ............................................ (stamp or seal) · ~'~ 0 ' .................................... ?,% THE NEW YORK BOARD OF FIRE UNDERWRITERS ~__~ BUREAU OF ELECTRICITY i 85 JOHN STREET, NEW YORK, NEW YORK 10038 ,,ate November l, 1976 .4~q, li,..,ion,~,o.a,.hl,,869o2 N 310156 THIS CERTIFIES THAT only the electrical equipment ~ described belo~ and int~uced by the applicant named on the above application nttmber in the premises of Ro~e~t Lewks, ~/8 Old ~ove Ra,, 800~ s/o Haywate~s, Gutchogue, was exantined on 0 C t ob er 21, 7 aad fout~d to be in compliance tvith the requirements of this Board. FIXTURE OUTLETS RECEPTACLES SWITCHES 13 17 DRYERS I F,XTUR~S INCANDESCI! NI' T: LUO~T~Sc£Nr ~v~(~¥ 13 FURNACE MOTORS FUTURE APPLIANCE FEEDERS SERVICE DISCONNECT RANGES ,MT K W ~PECIAL REC'PT OTHER APPARATUS: *Multi-outlet Panelboards: 1-4.5kw Hot Water 1-2 ton Ac Unit 3-G.F.C.I. TIME CLOCKS BELL V I A W G NO OF HI LEG OF CC COND systems No. of Feet~ 1-10cir 125amp. Heater 80-0 Plugstrlp, UNIT HEATERS AULTI-OUTLET SYSTEMS AMT H P NO OF~. FEET C E J A W O NO OF NEUTRALS OF HI LEG EXHAUST FANS 48-Receptacles DIMMERS AWG OF NEUTRAL Hal Young Inc. A-70 Heeves Park ~ Riverhead, N.Y. ll901 Lic. #1010E GSN~aA£ mANAgeR This cerhficate must not be altered in any manner, return to the office of the Board if incorrect Inspect~ " ~4~~ ,fi- ~--t~ =t~-~_~ ~a.~:~ ~ --: ... ' ~ .' , , ', , ' ~. '.~' ' , .' ' , ~ ' - ~ ,,,~ t: ..7: ' · .. -~' ,. .......~ . .,, .,, ~.~ . . . .... ,,~ . _ . ,~ , · ,." ' ,~ ; :NOTiFy BUlL . .' ' '"," : t~,,: ~" ..... ,:" J~ ::~')~ , ' ~ '~ - '~' ~:.'. ~ION OR'START FR~ti',O ,' . ~. .~. _ ~, . ,., ~;.. . , ,, . . '3. FINAL WHEN JOB COMFLE3,.~ BUILDING DEPARTMENT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 ~-t~ 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 or areas, and giving a detailed description of layout ofpraperty 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 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 Deportment for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lav~, O. rdinances or Regulations, for the construction of buildings, additions or alterations, or for removal or. demolition, as hemm described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing cnde, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (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. .................. t & ........... .C-. ................................................................................................. Name of owner of premises ......... .~......~...~.~-~-~.. ....... ~......~..~.~....~....~..~..~. .......... .~.,~.~.../~.. .............. i~ ......... ,: ............. · If applicant is a corporate, signature of duly authorized officer. ....................... ....... ............ (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ............ ~...~...~ ......... ~ ............. Electrician's License No ....... ~...~..~.~.......~'. ................ Other Trade's License No ............................................... /~.~..'~., .~.. T ..,~Lo~N~[ Location of land on which proposed work will be done. Map No ' Street and Number ..~1~,.~,.~,.~',.......,~..~..~,.~.. ....... ~,,.{~.~,,.~ ....... ~.~1~.~,~'..~.,~,,......,.~,...~,.: ............. ~;.~,k~.:~,,~..d_~,~... h'~unlcipolily State existing use and occupancy of premises and intended use and occupancy of proposed construction: e. Exisiting use and occupancy ........... ~...~, .......................................................... ~/ ........ -...-jr ................................... b. Intended use and occupancy .......... ...~....~...'..: ....... ..'~........~...-~'~..~.../...~....~.. ....... ...~.....(~..' ........ ..~'..~ ~-~: .................... 3. Nature of work (check which applicable): New Building.. ................. Addition ..... ~ ......... Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ................................. .'. .......... ; ....... (Description) 4. ~timated Cost ........... .~..~.., ........................................ Fee .....-- (t~ be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ..L ......................... 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 ....... ./..~.-..~. ....... Number of Stories .......... /. ................................................................ ~ .................................... Dimensions of same structure with alterations or additions: Front Depth ....... .-~.....O....~ .............. Height ....... .~..?....~. .......... Number ef Stories ....... ~. ....................... 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ............. ~...~...~...t. .............................. Rear ....... ..~....~...~ ................. Depth ....~.....~......~. .............. 10. Date of Purchase .......... J...~...~.-/ .................................. Name of Former Owner ......'~.. ................................................ 1 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........ .~'....O.. ........................................ 13. Will lot be regraded ....._N~... ................. Will excess fill be removed from premises: ( ) Yes (~ No 14. Name of Owner of premises ..~.~.~.1~.~...~1~'.........~...~'....1~.../..~.. .......Address ................................Phone No ....................... Name of Architect ..~...;.....~..!.~..~.t.~.41([..~... Name of Controctor ./~.a.~.....~..~...V...~'..~.l....~....~...¢..; ............ Address[~l.~'~Z..lt*~'.~...../I[...~. Phone 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. STATE OF NEW X-~RI~'.t~ I¢ ~ .................... .~~~ ............................ being duly sworn, deposes and says that he is the ,pplicom (~e ~ ~iv~u~ signing ~ntrac~ above nam~. ~ ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or h~e performed the said work and to ~ke and file this application; t~t all statements contained in this application are tree to 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. ......... . ....... :... ~o. 52-81258S0, Suffol~ C~uat~ l~rm [x~ire~ ~arch ~0. 1~ 4-1 "1 ~ ,TF'QW'i,,~ ,DC, ,~;,)c,,L.,-r ~OL;% ~-DONF'D.'FF, EZ2e [,SK'TtTION F'~T41L %,, 3:C-CT!ON ' A \ // ,iT TOiLeT O~T TIL~ TI LB/I~, CT, It APFROVED AS NO'~ED DATE: BY NOTIFY BUILDING DEPARTMENT .. ,, ~65.2660 9AM TO' 4PM FOR REQUIP ED INSPECTIONS: 1, BEFORE BACKFILLING FGUNDA- TION OR START FRAMING 2, BEFORE COVERING PIP~:LINE 3, FINAL WHEN JOB COMFLETED NOT I~ESPONSiBLE FOIl. DESLGN OR E;ON- STRUCTION ERRORS