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Home My WebLink About8517-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No... Z962.5 ........ Date .................... Au&'U~ · 8 .... 19 THIS CERTIFIES that the building ................................................ Location of Property . ./4090. ......... 0rohaz'cL ,q~ o ................... 0~.J.®rz~ ....... Hous~ No. Street Hamlet County Tax Map No. lO00 Sectinn .. 27 ....... ~lock .. ~ ........... Lot .. ~'~7 ........... Subdivision Bea. u~o'l 4 8.*. Ao~e,. (.~.~. 7.~.~...Filed Map No. 6~.~...Lot No..? ........... conforms substantially to the Application for Building Permit heretofore f'ded in this office dated ......... Apz'J.1. 2.0.., 19.7.6 pursuant to which Building Permit No ..... 8,5~.T · Z .......... dated ... ~,~.. 2/) ............... 19 7~, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ... ~.lva.~e .one, .famlJ,y. dw. elling .............................. The certificate is issued to ................. Robert. & .~oanne. D,,Y. oe ................. of the aforesaid building. SuffoLk County Department of He~dth Approval 6.-RQ-.72~. :~/2~/.76,. Rober~ .A...V. ill&.. UNDERWRrrERS CERTIFICATE NO.~r~22094,..1/26/.77. & N272850,. ~.9/7& ........ Building Inspector · * FO~,M NO. & TOWN OF $OIJTHOLD BUll.DING DEPART~ffi. NT Town Clerk's Office $outhold, N. Y. TEMPORARY Certificate Of Occupancy No.z7280 ....... Date ............. .0.q~;...~. ....... ,19.9.6 THIS CERTIFIES that the building located at . ~rehard. St ............... Street Map No. ]5~ol~as B]l~ek~o.. 'xx ...... Lot No .... ~x. ? .... .Or.~.e.n. ~;. · .~,¥.. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............... Ap~.. ~019..?{5 pursuant to which Building Permit No...8.~1. ?.Z. dated ...........Apr...30 .... , 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 -Pr~i-vate· .one. _ _'~,, c · '~.~/~ · ~' ' ~'~'~"~ ~ r~ ~' ...................................... The certificate is issued to . .Robe~.t. &. ,~oanr~.. D~¥oe ... ~ne re, ................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~ep.t...2~...~7~..by. ~,. ~':L3.1&.. d UNDERWRITERS CERTIFICATE No .... pq~.~ .~z~g ................................. HOUSE NUMBER ....... .q.Q90.. Street... 0r~hard, .St ........................... FOBM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 8517 Z Permission is hereby granted to: ~.~c.n~. ~. ~.o.m:~.e.....~.~y.~ ........................... ............... 6~'.a enp~.t, ........................................... to .. ~xd.3A .. ne~.., oz~e...£a~.~...d~ 3.3.~g ................................................................................... ....... at premises'located~a~ .../...~,Q.~...2.....~.~.lJ, J.O~,~B ~C~.~. ..................................................... ..................................................... .o..r..c.h .~r~....s..~r..~..:.~ .......... .o.r.~.~..n..~. ................................................. pursuant to application dated ...................... ~.~......~.0.. ........... , 19.7..6...., and approved by the Building Inspector. Building InspectOr FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 Inspec- tor 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 installa- tions, 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 peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date....~ .~/..I.~.~ .~ ......... New Building ~J// Old or Pre-existing Building ............ Vacant Land Location of Property ...~-~::~ ~ .... .O?,. ~J~.~..~).....~. '.+- .......................... .~. ~L~. ,.~.? ...... House No. Street Ham/et Owner or Owners of Property . .~.~.~.~.J)'.. ~ .-.-'~'..O..A~..,? .[4.....~d.0.~. ......................... County Tax Map No. 1000 Sectio ~cck ........ .~. ~... ~ Lot .~..~ .~. ........... Subdivision .. .~ x_g ~.<J . .~..~..c~.' ..... .~.' · .c:~. ;~ . .Filed? Map No ...........Lot NO ..... .~. ....... Permit No. ~. [ .'7..,~_... Date of Permit . .~.3~.~.-/~..Applicant .~,P.~[.~ .~. ~q t~z,,~ ~...'~ r.~.'< ~ ....... Health Dept. Approval .4~{ 'v .~.1 .-t ~ . ~. ~/.~ .~.~. d)< ..... Labor Dept. Approval ........................ Underwriters Approval .~.~.~.~\. ?t .-)..-3 .......... Planning Board Approval ..... ~ ......... Request for Temporary Certific~e~)~-. '~'t', ~'~" '-)'~ '/~ ....... Final Certificate ....................... Fee Submitted, ........ ..... ...... I.. Construction on above described building and permit meets all applicable codes and regulations. Applicant . .~ .~-,~-~....~,~/~L.~ ........................... L) Rev. 10-10-78 FORM NO. ~ 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 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 far 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: ]. 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 ........... ................ New BHilding ../~ ........ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..0i~3 ....... .~.~., .~Z.J(', .................. ..0,...~.!.~..'.~. ........................................................... Owner Or Owners Of Property ..~.. ...................................... ;....~. ........... .~...~/...~?...a~. .......................................... Subdivision ~.~...U..~.:.~...~.~ ....... .0=~..~..~..~...~. ................. Lot No. '7 Block No ...... .:..... House No,~,~.. N o.~..[..-[ ......~=... Date Of Permit .~'~,.~!,~1 .~..Applicant ~:~:'-~.~...'~..~1~..~. ....... .'~--~, ............ Permit .eo,th pt. ^pprova ....... ................ Labo, pt. Appr o Underwriters Approval .............................................. Planning Board Approval Request For Temporary Certificate ~ FinaJ Certificato ........................ ~ ............. Fee Submitted $ .................................... Construction on above described building ~nd permit meets all applicable codes al~l.,~., Applicant .....~.~..~~ ........ Sworn to before me this ................ day of ............................................ Notary Public .................................... County THE NEW'YORK BOARD OF FIRE UNDERWRITERS dl- BUREAU OF ELECTRICITY SS JOHN STRIEET..NEW YORK. NEW YORK 10038 ..,. MarCh'9;. 1976'. . , . .~,~.llc.tlo.~'o.o,,.r. eS43701 N272830 THIS CERTIFIES THA~ ~ ~ ; : ~ onl~ the electmcal eQB~men~ ~ dese~b~ below and ~nt~duc~ by the applicant nam~ on the a~e appl~atton number -Robert rEg ~DeVoe, :Orchard Street, Orient, L.I. ~.,t.]~tto~.} ~.t~..~ ~ ~ ~.l.~t ~ ~t~t ~ 2.,~ rt. outside ,~t~on nto~ w~ ~am~n,q Z.' March' ~ ~;.1976~ · and found to be in compliance with the requirements of this IJoard. RANGES ~'OOKING DECKS OVENS DISH WASHERS EXHAUST FANS OTHER APPARATUSi Jeanne DeVoe 87 Beach Rd. Greenport, ~,:L'I' 11944 Per OEN This cerhflcate must hal be mildred m any manner; return to the office of the Board if incorrect. Insoectors may be identified by the~rede~.tia[s, credentials. .qervl CO.q % ~ ' ~HE LAND SU~VEYOR'~ INK[D S~AL O~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This aPPlication must be completely filled in by typewriter oe in ink ia. nd submitted ~in triplicate to the Building Inspector, with 3 r4t~ of planS, accurate plot plan to Icale. Fee according to scheclule, b. Plat plan showing location of lot and of buildings on premises, relationsh, ip to adjoining premises or public stresS., or areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this applicabon. c. The work covered by this aPPlication may not be commenced before issuoncei 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 regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ..... ............................. : ............. ($igna{,~re of applicant, or name, if a ¢o~rahon) .... g.o. .a......9.r .e. ........................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................... ~me~...-..b~l. Lcl. e~. ............................................................................................................ Name of owner of premises ......~..o..b...e.~..~....~....d....o.~.e........~..e...T..o..e. ........................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) cnme~' Builder's License No ..................................................... Plumber's License No ........... ~.IRO.Q.~K ....................... Electrician's License No ............ ~T.1~'..~...~,~.~.~,1 Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. ~wap ~o.: ...... ~l~8.~.~l,~k&la..~.o~l~ No.....~. .................. Street and Number ....... Q~.g. Jl~,:~l~,..J~.~G~.e. JL~ ......... .9~::LeILf, ................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ....?..8...?....8~...~. ............................................................................................................... b. Intended use and occupancy ...... ........................................................................... 3 Nature of work (check which applicable): New Building' .....~ ...... Addition .................. Alteration .............. Repair .................. Removal .................. Demolition .................... Other Work .................................................. (Description) 4. Estimated Cost ...........2..~..~...0..0..0......_.+ ............................ Fee ....~'..0........O~.. .......................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... .013.~t ............. Number of dwelling units on each floor ............................ If garage, number of cars ............O..~...e. .......................................................................................................................... 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 ~lterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of S~tories ................................ 8. Dimensions of entire new construction: Front ........ ;~.0 .................. i.. Rear ....~g. ................... Depth ..... ,~0 .............. Height .................... Number of Stories ....'J~. ............................................................................................................ 9. Size of lot: Front ....1..~..~.. ............................................. Rear ............ 0..8.. ......................... Depth .....~.,,~ ..................... 10. Date of Purchase ....t~ .................................................. Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ."JL". fJ.~,S.t~ ......................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .~9. .................................................. 13. Will lot be regraded' ...~..e.~. ................. Will excess fill be removed from premises: ( ) Yes (~r) No 14. Name of Owner of premises ..~...o..~..e.....t.....~....~..o.~.e.......g...e..~....OeAddress ...... ..G.~..e..e..~.~..o...z.~.... Phone No. ...................... Name of Architect .............................................................. Address ................................ Phon~ No ....................... Name of Contractor ....... Q1CJ~e~. ......................................... Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from propcrty lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. See filed plans TATE OF NEWJn S COUN-rY OF ........... ..................... J ........... ~DI~3~a.....D~De ............................... being duly sworn, deposes and says that he is the applica:,t (Name of individual signing contract~ above named. He is the ..................................... ..01¢~f~....-..~]~&Ck~,~l,~. .......................................................................................................... (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 applicction are true to the best of his knowledge and belief; that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this Notary P.ublic, . ........................ ~,~,,"~:..~.Z.~.. County . "kJ (Signature of apl~ii'~;~')' ............................ NOTARY PUBLIC, State of New York ,o. 52-8125850. Suffolk County. ~rm £xplrBs March 30. ,I