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Home My WebLink About9549-zFOP,31 NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, BI. Y. Certificate Of Occupancy No .... Z9{39.7.... Date .... J.~t~l.y .... 6 ............... , lg...7.8 THIS CERTIFIES that the building located at . ,~.0.!5.. ~l)i.rAs. q .n..L..a~..e .... Street Map No.. ~4~./~ ...... Block No ........... Lot No ........ 2.2. ....................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ... 0.c~ob.e~.. 3.1 ...... , 19.7.7. pursuant to which Building Permit No ..... 95.~.9Z 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 ...... PI~E.VATE. ONE. FAlV~IL¥. ~fgLLIN~ .................................. The certificate is issued to ....... ~[~3_.'c.er.. $11~l~e¥;[.~Ch ............................. ( owner,~e~ll~ of the aforesaid building. Suffolk County Department of Health Approval ....... .7.'..S.0.'.1.5.7 .... J.u~. y...6~..~9..7.8. UNDERWRITERS CERTIFICATE No ........... N~.8.9.~52. ......................... HOUSE NUMBER ...~.0~5 ....... Street ....... .~o.b.~n..~9~..I~.a~.e. ................... ............................................. ?.ep. qn&.e.,. .N. e. .w. .Y. Or. .............. Building Inspector BuI,DING TOWN SOUTHO~I~ (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9549 Z Permission is hereby granted to: at premises located at .~/~..~i,o~:~,z~.~o~..~at~ ................................................................................. pursuant to application doted .......................... ~¢.t..-.-~.1 ............. , 19.~.~ .... and approved by the Building Inspector. Fee $ .~ 8,,~0. ........... FOBM NO. $ TOWN OF SOUTHOLD Building Deportment Town Clerks Office $oothold, 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 aT 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 houslng code or safety inspection of buildings or premises, or other pertinent 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 $1.00 Date ................................................ New Building ..... ,~..,e..~. ........ Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ~/~b"~q~9~g~D~e~'~7~/~q~Z~$Aq~e~9~*~9~$p~ Owner Or Owners Of Property ...... ,~..B...]:.~..e..~,...,S.,~..,s..~..,e..~,,~.,o.~. ......................................................................... Subdivision ..... ~?..e.,,c.,o,~.c,...~.,~.~,....0.~..~,.s..'.'. ............... Lot No..2.2, ....... Block No ............. House No...~,0,.,1.-~. Permit Dote Of Permit ...Z...Z./...Z. ff/.7.?App ca,t ...... Health Dept. Approval ............................................ Labor Dept, Approval ........ .~. ,.4(.~., ................................ Underwriters Approval ..~......~..8.?..~.~..~.....~/..~./..~..8. ...... Planning Board Approval ..... ~./..~. ............................ Request For Temporary Certificate ........................................ Final Certificate ....... ..~..e.D ............................ Fee Submitted $ ..~.:..0_0. ......................... Construction on above described building and permit meets all applicable codes and regulatior~s. Sworn to before me this Applicant .... ~'~'~tnces ............................................................................................. Rose Homes, Inc., Ben ~endozza, Pres. ................ day of ............................................ Notary Public .................................... County (stamp or ~ ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS ~)-~;~ BUREAU, OF ELECTRICITY ~-- 85 JOHN STREET, NEW YORK. NEW YORK 10038 :un. No.o./,,.952797 N389152 THIS CE~IFIE9 THAT ~anee~ ~ose ~omes, ~n~., e/s ~O~lnson ~ane yM~. s/o Indian Nee~ ?eeonlo s L.I. in the fol~ing l~ation; ~ B~ement ~ l~F1. ~ 2~ FI. O~1~ ~t~n Bilk ~t ~ exami~d on ~ ~ ~ ~ ~ ~ ~ ~ and found to be in complla~e with the requi~ments of th~ B~. FIXTURE | TA I I FIXTURES I RANGES ICOOKIHGDfCKSI OVENS IDISHWASHERS EXHAUST FANS OLIT~TS ~RECEP CtES SWITCHES INCANDESCENT FLUOreSCENT 18 I 3~ 26 oaYE,S I r-URNACE MOTORS I FUTUI~ APPUANCE FEEDERS LeECI&LREC'' TIM~CLOCKS [ ~ ~ MULTb4~JTLET DI~AMSRS TRANS SYS'~,J~S SERVICE DISCONNECT I NO. Of [ S E R V I C . AMT. AMP. ~ L~. ,~e'2w ,.~3w 3,ff3w 3.~4w NO*%RCC.~CONO* O~c~tGo~D. NO.O~ HI-LEG CN~H~:L~ NO. C~ NEUTRALS of A~q~0T~AL I 125 1-~.F.Io 1-S~oke Detector Four Point Elec. Inc. 350 Lake Ave. Nesconaet, L.I. 11767 LIc.307 E This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN Of SOUTHOLi) lUll. DING DEFARTMEHT' TOWN CLERK'S OFFICE / om,n ........... ......... .......... Lt... ., No. Disapproved a/c ....................................................... Date October 31 19....~. ....... INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ in ink and submitted in triplicate to the Building~ Inspector, with 3 sets of plans, accurate Plot plan to Kale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets of 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 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 t. he Town o.f. Southold, Suffolk County, New York, and other appl cable Laws, Ordnances or, Regulations, for the construction of buddings, additions or alterations, or for removal or demo ition, as herein described.~J~ 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. FRANCES ROSE HOMES, INC. (Signature oLapp[icont, or_name, if a corporation) zse~ Mena. oz,xa ,A'Te8. (Address of applicant) State whether ap~plicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. BUILDER Nome of owner of premises .......W.~l.$.fi~...$M~fl.v..it,9. h . If applicant is a corporate, signature of duly authorized officer. . (Name and t~.eOsf~cc~L~ate officer) Ben ~enGo ~. ~.a, Builder's License No ..................................................... Plumber's License No .............. .2...~..~....?. ....................... Electrician's License No. 307 E 7~- 22-- Other Trade's License No ............................................... q:::E'do~.c., ]~,~¥ 0~S Location of land on which proposed work will be don~. NtcLo No.: ..... ~1..~.~..~.. ................... ~.... Lot No....2..~. ............... :, .E../..S./..Q Rob.i...n..s...o.n Lane .4.3.7.4' S 0 Indian Neck Rd. Peconic NY Street and Number ...................................... ~.... ,./. ............................... ! ...... Municipality State existing use and occupancy of premises and intended' use and occupancy of proposed c°nstruction: a. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy ......... .1...~.~....a~...'.l..]:.[....Z~....e..]r..]:.~ .......... .2...-..C....a~......G..e...r...a:~..e. ....................................... 3. Nature of work (check which applicable): New Building. ,...~ ........... Addition .................. Alteration ................. Repair .................. Removal .................. Demolition ....... ,,...; ...... Other Work ..................................................... ,000.00 ' i Fee :~(~' ~O._~._~ (Description) 4. Estimated Cost at ~2~ (to be paid on filing this opplicotion) 5. If dwelling, number of dwelling units ..... .]:. ..................... Number of dwelling units on each floor ............................ 2 If garage, number of cars ..................................................................... ~..i .................................................................... 6. If business, commercial or mixed occupancy, specify hature 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 .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ....... .~...~..'. ...................... Rear ..... .~..~ .................. Depth ..~-~.,-~ ............ Height. ....... '[9.. ' ........ .. Number of Stories ............... ~ ................................................................................................. 9. Size of lot: Front 100' Rear 100' Depth 200 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ~.q. ........................................... 13. Will lot be regraded . ......... ~r.$.~ Will excess fill be removed fromDremises~( ) Yes (Z) No 14. Name~f~wner~fpremises~.~.~.]:.~.~.e..~.~.~..~.~.e..~.~..~.c.~.h.~::~Address~n~[~`~h~nekin ..(..2...~..2..).. ~- Name of Architect ............. ................................................. Address .~..~.~...~.~ ....... Phone No ....................... Name of Contractor .~ .~...a~....q.e...8.....~..o...8..e.....H..o...m..e. fl..~.....I..n..c,.:. Address .0~tleho-~te..~l.~'... phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed; and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. SEE FILED PLANS qTATE OF NEW '~OP, J~, ~- ~ c S ~ ~UI I'Ol~ ~ ,~- COUNTY OF ................................ Beta b~etadoz~.aePreB. ~France8 Ro~e HomeBeTnCbe n,, duly swam, deposes and says that he is the applicam ~ (Name of individua signing contracf) . above named. He is the Builder - Corporate Officer (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duJy authorized to perform or have performed the said work and to make and file this application; that oil statements contained in this application ore true t,~t~e best of his knowledge and belief; and thor the work will be performed in the manner set forth in the applicati&n find ~erewith. Sworn to before me this / , FR~N~ES ROSE ~ES, INC. / day of , . .................................................................. By, Nota Pub,c,. .................... ............. ........... ............................... , __ /z) '~].-~ ,~ , /// (Signature of apl:~:ant) ~,/,~.~,~, 6~/_.~,-- ~ (/Ben Me~dozza, Pres. ttOTARY PUBLIC, State of New Yol'k -- No. 5'2-8125850,' Suffolk C~ Term Expires March 30. I APPROVAL O1~ ¢ONS,i-iIiiU, ~/~N ONI..Y H. S. R£F. NO,: B'rAMP APPROV;D: ~TATI~bI~HT 0I~ INTENT THC WAT~R,$UppLy AND SEWAGE DISPOSAL BYST£M~ FOR THIS OF SEF OWN~I~: ~UFFOr,K ~O~TY ~TH ///,: ,, 'w? :'' . ~....~,., _ ~, . ~ '~T~ JUL 6 - ~/~0~- ~%(~,~.~ /[~ 'The sewage di~posa], and water supply faeiltties for this location ha~e been ~h~-~-~8~ Inspected bM this de~r~ment and found . ' ~hief of ~e~eral ~ngtneerln~ , m . ~ I "pEcoNIC ~Y ~" ~tl~ ~ '~ ~0~ ~ ~D~CK V~ TUYL P. C. H. ~- ~. NO.: A~ : APPROVED AS NOTED lJ/9 i /( /U ,l ¢~ · '1 · /7'- LIVIN: ,? 8x ? ooo,-~ I1'-- o ~w~7 D e, e, e,~ {' I 7~. ,s7~,~ £q. /6/- o l I