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Home My WebLink About9548-zFO~M NO. 4 TOWN OF $0UTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No ..... Z9OR1.. Date ........ June.. ~D .......... , 19.. 78 · 80 Sailors Lane THIS CERTIFIES that the building located at .. 220. Li.ttle. P. ec,. Bay. P~d~treet Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... Novemb. er.. 8. .... , 19..7.7. pursuant to which Building Permit No ..... 95.48Z dated .... November...1/4 .... , 19..77, 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 .... P~.lYate .One..Family. Dw. ellir~g .................................... The certificate is issued to ......... lViv.. & .l~Irz, .Ro.bert .Heald .................... (owner, ~t) of the aforesaid building. Suffolk County Department of Health Approval .... Ju~e .8,..1978 ..... ?-S0-.~62 ·.. UNDERWRITERS CERTIFICATE No ......... -P. ending ............. .N...~..?..~.~..9..6 $0 Sailors Lane HOUSE NUMBER .. 230 ........ Street .... Littla .Peconic. tt~y. Ro. ad .......... .......................................... C.utchogu/~. New. Y.~rk..; ............ Building Inspector · OB~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTltOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 95 8 Z Date .......................... E O.v......$.l~ .............. 19..~.~.. Permission is hereby granted to: ....... .6.12 .....~at cJ~o~m~ ..B~I ....... ?.~r.L,T.e 2re r son ~o .~l~..~m..o~c..£a&~ll~..dwallin~ ..................................................................................... at premises located at ..... ].~;i~..~.Q~'...~.~..V..~.~...~.~.~,.$.~....~ ....................................................................... ........................................... .9.~i~,~...~,..~,.. L~t ~1~ ...,.~c...~..~A ............ ~u~gho~ue pursuant to application dated ......................... ~.~)~. ......... ~, ........... , 19.~.7..., and approved by the Building Inspector. Built'lng Inspector 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 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 farm 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 ar 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 praperty 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 ....~...~...~....?.4 :/~,..~..~.... Date .... ./. ...... New Building .../~/. ........... Old or Pre-existing Building ............................ Vacant Land ............................ Locatio, of Property ..... ................ Owner Or Owners Of Property .......... .~.. ....................... : ........................................................................... Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit ate Of Permit .................... ^pp,co,t ....................................... _.,.. .................... ~/~ ..~._2~° ~ 7~c°'~' .. /J~ ...... Health Dept. Approval ._____..~..~..___.._. ........ Labor ~pt. Approval ....................................... Ooderwriters Approvol ............... 2 .: .......... Plonnino ~oord Approvol ....... ~..~ ..................... Request For lempom~ Ce~i{icote ........................................ Final C~rtificot~ .......................................... Fee Submitted $ ....... ~ Notary Public .................................... County above described building and per ' eats II app, licable c.odes and regulations. Applicant .................................................. Sworn to before me this ................ day of ............................................ (stamp or seal) THE NEW YORK BOARD OF FIRE UNDERWRITERS ! S BUREAU OF ELECTRICITY THIS CERq'IFIES THAT was examined on ~ 2nd FI. OUt~ ~ d~ Section Block and found to be in compliance with the requirements of this Board. FIXTURE LECEPTACt~SI WIT I FIXTURES DRYERS FURNACE MOTORS FUTUR~ AF~JANCE ~RS ~*aT. K. w, o~t H, P G~S H. ~. ~T. ~O. ~ W. ~. SERV~E ~N~ 40. OF S 200 CB OTHER A~A~TUS: Hotors: I-3/4 hp I~.F.I, 2 Smoke-detec*ors I aO.O kw Elco. Furn3ce ! 3 I/3 ton heat pump Stony 8rook Elec. 19t Junlpe~ ^ye. Smlthtovn, L.I. 11787 RANeES R COO~,.GO~:KSl OVENS laSH W~S'ERS ,.w. ,.w. TIME EXHAUST FANS H.P. DU~MERS ! 2/~1 I 210 LIc. I~SE This ce~ificate must not be alfred in any manner; return to t~ office of t~ ~ard if incorr~. Ins~ors may ~ identir~ by t~r credentials. COPY FOR BUILDING D~ARTMENT. THIS COPY OF C~TIFICATE MUST NOT BE ~T~ IN A~ MANNEL BUILDING DEPAItTMENT Inspector. ~ ~ b. Plot plan showing I~ation of lot and of buildings on premises, relationship to adjoining premiss or public ~r~ts or~ areas, and giving a detailed description of layout of prope~ must be drown on the diagram which is 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 ~rmit shall be kept on the premises available for inspection throughout the pr~re~ of the work. e. No building s~ll ~ ~cupied or used Jn whole or Jn pa~ for any pu~o~ whatever until a Ce~fficate of ~c~ancy~ shall ha~ been gmnt~ by the Building Insp~tor. A PLI~TION IS ~REBY ~DE to the Building Depa~ment for the issuance of a Building Pe~it pu~uant to the~ Building Zone Ordinance of the Town of Southold, Suffolk Count, New York, and other applicable La~, Ordi~nces or~ Regulations, for the construction of buildings, additions or alterations, or for rem~al or demolition, as herein descrJ~. The applicant agrees to comply with all applicable laws, ordinance, building c~e, ho~sing c~e, ~d regulations. (Signature of applicant, or name, if a corporation) /.2 ,~.~/'~,oq~c ,,~ ./454 ~ld~ ~-~ ~re~ of applicant) State whether applicant is owner, lessee, agent, architect, engi.neer, general contractor, electrician, plumber or builder. ................ ~/~"' Name of owner of premises ............ ./.~..O..~ ........ ..~.....C~..Z..C~.. ............................................................................................ /~oO- (/I- r co;;r;;; ................... 1. Location of land on which proposed work will be done. ~Aap No.: ........................................ Lot No.: ........................ Number ,,., ¢ ........................................... ........... ............ / n~un~c~pau~y 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................................................................................................... ,,se and occupancy ............. ........ b. Intended 3. Nature of work (check which applicable): New Building .... ...~.. ......... Addition ......; ........... Alteration .................. ~ Repair .................. Remo,¥al .................. Demolition .................. O~er Work (Describe) ........................ :....:....,, .... 4. Estimated Cost .................. ..~..~..9.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, sp~i~ nature and extent of each type of use ............................ 7. Di~nsions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stori~ ................................................................................................................. Dimensions of same structure with a.lterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... ~ ....................... Rear ...... ~.~ ............... D~th ..~.~ ............... Height ..~.J .......... Number of Stories .......... ~. ....................................................................................................... 9. Size of lot: Front ...... ~ ............... Rear ........ ~ ................ Depth ..... ~ .................. 10. Date of Purchase ....... ~. ....................................... Ne.me of Former ~ner ........................................................ 1 ]. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............................................................ 13. Name of Owner of premises ~...~ ........ Addres~..~.~,.~ P~ne N~F.~.C~.. Name of Architect ~ ...... ~5 ...................... Address ~~....~.-- ~.x ......... Phone No. · Name of Contractor~.~..~.~....~.-..Address ~..~...~..~~ ..... Phone No~.;~... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate alt set-back dimensions from property lines. Give street end block number or description according to deed, and show street names and indicate whether ~interior or corner lot. STATE OF NEW YORK, ! c c COUNTY OF ......... ~ .U~..~.Q ~,[ ...... ~' ~"~' .... .J.O..H..N.....J..;.....M..c.N.U..L...T..Y. ....................................................... be ng duly sworn, deposes and soys that he is the epplicant (Name of individual signing application) above named. He is the President (Contractor, agent, corporate officer, etc.) of said owner or 6WhetS, and is duly outhorized to perform or have performed the said work and to rn~ke ond 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 forth in the application filed therewith. Sworn to before me this ~_~ ~ . ...1At~ ........... day of ...~lc~zezt~be~ ..................... , 19..'/.7... Nota Pub,c, ..................... ............................. ~' ~ ~ No. 52.270~'713 ~' (' ~"~.... //~*~'~ Term Expires .f ...... m~v UV~T.m~ DE°ARTY~ENT ~ ; DAT~__ / ~' '.faeiiiti~s f~r this location ~ i~ ec~ed b~ this department ~" b~ ~atis~ac%~ry'~ :'~ : ~_. -" Chief O~ :enerat / L ...... ::~iZL:Z .... :..L_:L-'-'7..Z-~ ........................ , - 19<~ 6-9 u/ 6 3/ / ? 0 /,,,FPROVLD ~,S NOYED 4tI ],% REVISIONS 7 ¥4~- 0 I, '~- ,/ ./ DO,FfALD A. DE.IS, A.I~. ,,,,,.,,o,'= .,','. ,*,.,,',, ,¥ 77.c~ M.6J.N ROAD-.&T. 2.5L.I'TTL~ .AQUEB,D,GUn, I~, Y'. 11991,