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HomeMy WebLinkAbout7894-zPORM NO. & TOWN OF SOUTHOLD BUll .DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . .0~h:. llgl'eat .............. Street Map No. EagQlla. ~s Block No ........... Lot No, . conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ ~ . ~.., 19.. 75 pursuant to which Building Permit No..78~Z: dated ........... Hair ....~... , 19.7~, was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is P~J.~rat~..one. fa~:[3~y..dwa11~_ng, w~.th, addi.t~on. & .~lt~&ti~. ate The certificate is issued to J[ohll .Glint, hey .... 0~el' .............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.,~[: ......................... UNDERWRITERS CERTIFICATE No. N2.br031~2.. ~ug.. 13.. ~.~t?~ .................. HOUSE NUMBER....~...~..O. .... Street ..... O...~..~. .~ ............... Building Inspector/ FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, FI. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 7894 Z Permission is hereby granted to: Tho~¥a~Lse~..&..Geclele ..... ~/.~.. Jo~.. ~}u~ ¢.he~. ........ ........ bf)....'W~od.~a~d.....Irr ............................... .................. ~y~po~-~ ........................................... at premises located at J~D.t,..~....~.6....~..1.~?.......~_~...g.?.~.?..~?..l...g..t..h..~ ........................................................ ................................................. 0~.. ,~.eet ......... C~tc~o~u~.,..N~L .......................................... pursuant to application dated .........................~.~ ....... ~ ............. , 19..~...~.., and approved by the Building Inspector. Fee $..1.~.~0 .......... Building In~ector l~O~.~ NO. 6 TOWN OF SOUTHOLD , Building Deportment 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 w~th the following, for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property hnes, 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 Underwnters 4. Commercial buildings, Industrial buildings, Mulhple Residences and s~m~lar 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 apphcoble. B For existing buildings (prior to April 1957), Nan-conforming uses, or buddings and "pre-existing" land uses: 1. Accurate survey.of property showing alt 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 formation required to prepare a certificate C. Fees: 1. Certificate of accupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or lend use $5.00 3. Copy of certificote of occupancy $1.00 Rte LNeW t?~lding .;.~..~;. ..... ~d~i~n ...~~-existinc]~_~,/~_.~ ~:;~"/ ~~ ~. ~'Buildincj'~ ............... Vacant Land .............. Owner Or Own~,DOf Property ..... ...~.~Z~..... ....... ~~ ................... ~ ................... Subdivision..~.,,~... ~~/.. Lot No./~/..~... Bl~j/l~o ..... ~use No~.~,.~..~)~ Permit No. ~. ,.~,-Date Of Permit ..-',~. '/~'~".ApP'.cant Health Dept Approval ~- Labor Dept ~provol ............ Underwriters Approval ....~...~...~..~....5..~...~ ....... Planning Board Approval .... .~.......~.. ......................... Request For Temporary Certificate ........................................ FinaJ Certificate .....~.. ....................... Fee Submitted $ .................................... Applicant ........ ~..~....~.T. 5..; .......... ...~-.-.-.-.-.-.-.~f..~ ...~C......':~.. ......................... Sworn to before me this s /~,~ct~, ~ 7 (a Cu7'c~,odu~ dNALITHO~ZED ALTERATION OR ADDITION To mis SU~VE~ ~s ^ V~OL^~ON OF EDUCATION ~W con~s o~ Tins su~v y ~A~ Nor s THE NEW YORK BOARD OF FIRE UNDERWRITERS ' ; BUREAU OF ELECTRICITY ~- dl i, 85 JOHN STREET. NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT. , , i o~fy the electrical equipment ~ ~scribed belo~ and i~troduced by t~ applica~ ~amed on the a~o~ applicu~lo~ number tn the premtses of ~, J. Gunther, 292 Oak St., Cutchogue, b.I. F XTURE I ~ I FIXTURES ~ RANGES ]COOKING DEcKs J OVENS ~DISH WASHERS { EXHAUST FANS OUTLETS ~ECEPTACLES~ SWITCHES INCANDESCENT FLUORESCENT ~Y ~T ~ ' K W ~T ~ W ~ ~T XW ~T K W ~T H P ' ' DRYERS - - FuRNAcE MOTORS FUTURE APPLIANCE FEEDERS ~SPECIALREC'PT~ TIME CLOCKS BELL unit HEATERS MULTI.OUTLET I DIMMERS ~ - ~ ~ I I I I ~ [ I ~ t TRANS SYSTEMS ~? WATT I ~ETER NO O~ CC CONOI -- ~ ~ ~E I i W G NO ~ NEUIIALS i W 6 Furnace/s: 1-1/8bp, 2-1/12bp ~ ' ' r lqO Elm St, . , GENERALMA~gE~ j 7h,s cerhfic~te must not be altered in any manner, return to the off,ce of the Board ,f incorrect Inspectors may be ,~ed b/t~r ~ed~t,~s © CUTC/-¢O~UE 7209 OF THE N~W YO~ STA~ 0 BUILDING DEPARTMEI4'r TOWN,CLERK'S OFFICE SOUTHOLD, N. Y. ....... ................ . ........................................ Disapproved a/c Building APPLICATION FOR BUILDING PERMIT ...... ................... , 19....~..~.., INSTRUCTIONS. o. This application must be completely filled in by typewriter or 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, pm. mises or po.blic str. eet.s o: fA areas, and giving a detailed description of ~ayout ofproperty must be drown on the diagram which ~s part of th~s appl,cat~on. 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 I~ shall be kept on the premises available for inspectiori 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, O. rdinances or Regdlations, for the construction'of buildings, additions or alterations, or for removal or demolition, as here,n described. The applicant agrees to comply with all applicable lav~ g~_ inances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buil,~ngs' for necessary inspections. (Signature of applicant, or name, if a corporation) (Address of. applic~ant) -- State whether applicant is owner, lessee, agent, architect, engineer, general contract~9~or electrician, plumber or builder. If opplicont is a corporate, slgq~,~ur~.~t/h~rized officer. (Name and title of corporate officer) Builder's License No ......... t.Q(~...~ ................... Plumber's License No ................................................. Name of owner of premises .....~...o....~...~... ...... .~..~ ...... ~./~..~.....~...~..~C'.. ..................................................................................... License No ............................................. --~-~- Electrician's Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ....... .~...~.....~- ...................... Lot No. ~ ~ ~' Street and Number ~a~.~....~.~.~..~....~.....O~..J~...~½~.~..~.~.....~;l(!~.~.,~l..~T....&~.Q,~...~.,..~....~.. p,.er'c<. Or, u< ) Municipality 2. State existing use and occupancy of premises and intended use and occupancy of p~oposedconstruction:CC~"/c~ o. Exisiting use and occupancy ......... ~.......~/22.,./.~......~...I~J..Li.//cL~.: ........... i .............................................. b. Intended use ond occupancy ............... Ki~'.! ....... 0~./~.-~ ................................................. 3. Nature of'work (check which applicable): New Building.. ........ ~. ....... Addition .......~... ...... Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... ~ ~ (Description) 4. Estimated Cost .........J..~..~..~..~..Q.~..~. ........ '~ ................ 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 ..........L~ .............. Rear ....... ~.~ ................... Depth .....~....c~...~ ..... Height ...... ~.~.../. ......... Number of Stories ...J. ........................................................................................................... Dimensions of same structure with alterations or additions: Front ............. s~.~.../. ........... Rear ........ e~.../. ........ Depth ...... ~...~....x. .............. Height ......... ]~:~.../. .......... Number of Stories ....... ~...//~. ................ 8. Dimensions of entire new construction: Front ........ ~.~.../, ................ Rear ....... .~:~.c~ ............. Depth ....... .~.~ .......... Height .....~J..~...../. ...... Number of Stories ....... ./...?~t ...................................................................................................... 9. Size of lot: Front ....... ..~.....O....~. ...................................... Rear .~'.)..~,.~.~%. ........................ Depth ./...~..~...~.....-~.../.~../..~ 10. Dote of Purchase .......... /..~....-~.../.. ................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .......... .~.~.~4..~.~4~ .............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~..u. ........................................... 13. Will lot be regraded ....... %..~...o.. ............. Will excess fill be removed from premises: ( ) Yes ()~) No 14. Nome of Owner of premises ...~..o..~...~......~..:...~,...~.....'~......~.-- ~ ........ Address ~.~'~.(.'~../~9.~..~.....~..~.?, ~~'" ~- No. ~...~..~..~.../~..~'~ Name of Architect ...~...q..C.~.. ...... ..~...q...!...O.~...om..:~r~ ................... Address~,...~..?...~.fljl....~?:~.r.~,..,' xl0~,p~,one No. ~..LT......~......~- Name of Contractor'7/)...°.~../C/..~t~..-~..;.?.....(~.~.~...~..../~....&:~./l...CAddressT@...~.~..~.~.l./~ ./'.i..~Phone No. ~.~...-...l~....~.O PLOT DIAGRAM Go, ¥ O t I)4- 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 YORK, COUNTY OF ................................ ............ ~--~ .~T.L....~JgD./;'..L)..qJ.~...~...~...r~.. ............................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contractO above named. He is the ....~'..~.../2.~f..~.~..l?..~...°~'.........q...~J..?... ....... ~....J~....~...O..~...~.....-~.... ...... ~D..~., .~..Z~.~....~..../~... ................................................... (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 contained in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth in the application filed therewith. Swam t~ before me this ................. doypf... . .......................... Notary Public, ..~ ............. County .......................................................................................... /'/,4.,4_ '/ ^ ~ ~q:Z, ~ j) (Signature of applicant) . ,, Do// 74 i ' I 7 F J' ! I _ .I J 0 .I ./ 12'-o" 5'-0"