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Home My WebLink About9541-zTOWN OF SOUTHOLD BUn,nlNG DEPART~,NT Town Clerk's O~ic~ Southold, N. Y. Certificate Of Occul: ncy THIS CERTIFIES that the building located at ~.~0...0?.qh..a~. ~ .~..~?.e.e..~ ..... Map No ..... .g.~7~... Block No ........... Lot No ........~. ........................ conforms substantially to the Application for Building Permit heretofore fried in th~ office dated November 7 19. 77 pursuant to which Building Permit No. 9541Z dated . .~Tg.v.e.m..b.e.r. ..7 ......... , 19..7.7., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which thi~ certificate is Private One Fami.ly..Dv..e.l.l.i.n.g i,mued is .............................................................. The certificate is issued to ......... H~.r3(. ~ .F.%0y.~¢ e. ~.~.az3$ ..................... of the a~o~e~4 budding. Su~olk County Department of Hea]th Approval January 11, 1979 7-S0-147 .......... Rb15~%' '~: ' Vt'II~ ........ N403520 UNDERWRITERS CERTIFICATE No ............................................. HOUSE ~ER ... 35.~.Q ...... Stree~ ................0.r. qh..~..d..S..t?.e.e..t .......... 0r~ent, New Yo.r.k. County Tax Number 1000-027-S-Part of Lot # ~ Building Inspector FOP~f 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) N? 9541 Z Date .......................... N.OV.....~. ................ 19..?.~.. Permission is hereby granted to: Degoe ..C~r~s ~, .. Co~.p .....A/~.. [-[ax.z~ ..& ..]i'~,o z,e~.¢ e E, va~. s ............ Or ~'et',.'t; ..................................................... to ..... ~.t.1~[...new.. erie.. ~e~m.l.t.y...d~e .t.t.l~g. ................................................................................ at premises located at ~-et,..4>.....~eeu.,$oe~t,..Ae.ree ....................................................................... ...................................... ~xtee~a.~d..~a, eet, ........... O~.i. er~t; .............................................................. pursuant to application dated ............................. 'J~o~ ......... ~ ....... , 19...~, and approved by the Building Inspector. Fee $"~0 ,~ ........... ~uilding Inspector FOBM NO. 6 TOWN OF SOUTHOLD Building Depoltmo~t Town CIc~c~ Office Soutbold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate 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 ..... [~e o~m~e ~...:7.; .. · ,l,~ .'/~ .... New Building ':xx~ ........... Old or Pre-existing Building ............................ Vacant Land ............................ 3 ch . location Of Property ...7..~.~.e~.r..~.~.~o~.&..4:o~n.t,¥.,...N,~w..;Zckz:k. Owner Or Owners Of Property ...... I-I~R~Y...F,v..~N&)...F..I~DRF_~ .C~..A,..~ZAN,.q ........................................ Subdivision .......Be~u,j.o3,a£s..Ac~es, ..................Lot No. _6 ........ FEg~c~....6..3...7..3.. House No.....3.94~) Permit No...9,~4.3,Z ......Date Of Permit],l/.7./..7.2....Applicant /5...&...E..fl~.v. ar~.8. ........................................ Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval ...... N.=.4~353.0 ..................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ......... ~.~ ............................ Fee Submitted $ ......~.(~0 .................... Construction on above describedApplicantbUilding and permit.,,~~meets all a~lic~~ and regulations. Ha~5~=E and Florence A. Sworn to before me this Evans ................ day of ......... D~c~ber.,...~3.8. (stamp or seal) ~ o,ory Pub,c .................................... cou.ty v/'77 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT ~y t~ ~t~ ~u~t ~ ~c~ ~ ~ int~ ~ t~ ~t ~ ~ t~ a~ ~ ~um~r in ~ ~m~ o~ Har~. Evens, O~ch ard S ~., Orient) L. I. ~.=.~o. September 21) 1978 andfoundtobeincompllancewizhther~ui~mentsofth~. ~A~., ~ IC~OK,NG~KSI OVmS I mSH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS AMT. K.W. O~L H.P. GAS H. P, SERVICE DISCOflNE T lo.o, i s R EQUIP. I.e'2W 1.~'3W 3,~3W 3.f/4W NO.C~C~.COND, i 150 CB X FUTURE AI~tJANCE I~ED~RE T~LR~C'j TI~u~M~¢LOCAMKj TBi~Li~s'~UNITH~ATERS I I I R V I C 1/o OF HI4EG MULTI-OUTlET DIMMERS SYSTEMS Wiggins Lane Oreenport,N.Y. I194~ ~is cedific~e must not be al~r~ in any manner;* return to t~ office of the ~ard if incorr~. Inspectors may ~ i~fie~bK./be~entials. COPY FOR BUILDING DEPARTMB(I'. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ,A~sJAN 11 1979 The sewage dls~osal and ~ate~ supply .'act. lltles for this location hav~ l~een ~o be satisfactory. ' ~. ~ ,~, ~, ~' -- .... "MAP OF ~HE LAND SiAL / or,, ;,6 - ~' FORM NO. ! ' '/ , ./. / / ~'"~- TOWN OF SOUTH''*-'~///'~?~?(~ ~ "~4~"~'~// BUILDING DEPARTMEN? .-~'~., '~'r/~'-'/~Z"~r-Z~<-~"l~ 'tOWN a.":K'S omc: '~,-,Z.~ ~,.,~ .a,~ ~/ ~{ ~7 .......... ....... ............................... ' A cat~ No ~/ ~ .................. .............................................. ) ........................ ~ ....................................................... ~..~ ......... ~ ~~ ~ O~ ............................ ~~~ ........ ;......~ (Building Ifls~tor) A.. ' INTRUSIONS ~ O~ ~- ~ ~ ~ o. lhi~ application must b~ compl~t~l~ {ill~ in by ~p~riter o~ i ..... ~t~ to th~ Inspector, with ~ ~*t* o~ pl~n~, ~ccumt~ pl~ plan ~ ~1~. F~ ~cco~in~ to b. Plot pl*n showino I~otion of lot ond o{ building, on premise~, relotionsh p to ~djoinin~ premises or public ore,s, and OivinO ~ detoil~ d~cription o{ I~out o{pr~ must b~ drewn on the dio~rem which is ~ o{ this ~pplic~tion. c. The work covered b~ this o~lic~tien m~y not b~ commonced before i*~uonce of Buildin~ ~ermit. d. Hpon opprowl o~ thi~ applicotion, th~ Bulldin~ Ink,tot will issu~ ~ Buildino P~rmit to the opplic~nt. Such sholl be kopt on the premis~ ~vail~bl~ ~or in~p~tion throughout th~ work. e. ~o buildin~ ~hall bo ~cupi~d or u~d in whole or ~n po~ ~or on~ pu~ose whatevor until ~ Ce~i{icat~ of ~cuponcy sholl hove be~n ~rented by tho Buildin0 Inspoctor. 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 app icoble 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 lows, ordinances, building code, housing code, and regulations, and to~j admit authorized inspectors on premises and in buildings for necessary inspections. (S'g ature of applicant, or name, if a corporation) ' (Address of applicant) State whether applicant is owner, leNd. ct, engineer, general contractor, electrician, plumber or builder. Name of owner of premses ~..x{. ' ..~....~..-~.. ~ ..... ~:Z~ ................................................. If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..........~ ................................... Plumber's License No ...... ~~ .................. Electrician's License No ................................. I ......... ?_-7- .3- 3. ~. Other Trode's Licenso ~o ............................................... ~ ~ 3 7~ ~o=.o~ o.,~ o~ ~,~ ~ro~o~ ~,, ~o~~~.~~ ~o .......... ~ ............ Street and Number ........... ~ ......... ~-~..-.~..Z..~ ................................ Municipali~ State existing use and occupancy of premises and infended use and ~cu~ncy of pr~osed construction: a. Exisiting use a~ ~cupancy ~~?~ b. Intended use and ~cupancy ~ ....... 3. Nature of work (check which applicable): New Building.. ......... Addition .................. Alteration ...... :2.: .... ~ Repair .................. Removal .................. Demolition .................... Other Work ................................................ . (Description) 4. Estimated Cost .......................................................... 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, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ Purchase .................... blame of Former Owner ........................................................ 10. Dote of .............................. q,z~_ '~ /~/~/-~0 11. Zone or use district in which premises ore situated ..Z_! ........ (.~. ........ : .......................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ..... .~......0. ......................................... 13. Will lot be regroded . ......~.~.., ....... Will excess fill be removed from premises: ( ) Yes ~ No 14. Name of Owner of premi~/es .~.~....f~;~..~..~. Address ................................ Phone No ....................... Name of Architect ............................................................ ...~._......... Address ............................... '-'"'-'"t~;:" Phone No ....................... Name of Contractor ..~...~: ................... Address ...~ .......... Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly oll 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 NE'v~O~I'-~./~, I S S ~ COUNTY OF ~~k~,-:f,/' ~ ....................... ~...~......-~..:,....I ........... ; ....... h..; ....... being duly sworn, deposes and says t~t he is the applicam (N~'~iMdual signing contracO above named. ~ He isthe .............................. ~~ ....~.- ~ -.~ ~~-~-'~ .............................................. (~r~o~,"~g'~,"~rporate o 'c , .) 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 that the work will be performed in the manner set foffh in the application filed therewith. Sworn to before me this ~ ~ ~ '~;;;;"Z";' i;" . ..... :~~'~un¢' ...... . ........... ~...~ ......................................... '" (Signature of applicant) ~TA~PUBLIC, State of New YorJ~ No. 52.4643721, Sulfolk County Term Ex~ires March 30, ~9~ d-.-/- {2 -o regolations efc ~ =~,.'~'~,')k~: , ' ' t ~I! , .,, ,,. ,'' ~fications for this'bu'ildi, n~ an'd shall take preference' fmplied wher~ Parlances 6~cnr. i