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Home My WebLink About9566-zNO. 4 TO~gN OF $OUTHOLD BIJ~.~}ING DEPARTMENT Town Clerk'e Office $outhold, N. Y. Certificete Of Occupancy No. Z.,~.~/.. Date ............ ~P.~PJk ....2,.~l, 19.'/~.. THIS CERTIFIES that the building located at ,.5'7.0.. [D0~.~.a3[~...~. ~/~:-... Street Map No...~A~.~.... Block No ........... Lot No... !~. ! ........................... conforms substantially to the Application for Building Permit heretofore filed in thi~ office dated ...........~./~ ~....~ ~, 19..~. pursuant to which Building Permit No. ~.~. ~.b dated ...........N'0.v'....~.~., 1977, was issued, and conforms to ~11 of the require- ments of the applicable provisions of the law. The occupancy for which this certificate issued is. A..~E.i./An'. £..../~.£... ~.~t~ ~ LI. ¥. .... ~q ~ ~-.~)..~. ~ .............. The certificate is issued to .. ~ 8 h ~ .L E .~. ..... ~. ~.0.. ~.~.)~ .C.*.~ ....................... (owner, of the aforesaid building. Suffolk County Department of Health Approval ,4./.,.~..~ ...... ?.._. ~..0._. ]~.7 .......... UNDERWRITERS CERTIFICATE No ...... .~.~/x(.~. ( .~/...(~z.. ....................... HOUSE NUMBER .... ~.~.0. .... Street ....~..~.~..~.(~.0.~....L..~..M.[-. ................ ........................................ ....... .............. Building Inspector leO~m' NO, ~g TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 9566 Z Permission is hereby granted to: ~,/...C. Charles Cl'omek ~.~;~.. ~....~....[.?..~ ........ ................. ...~.~.~..~ ......................................... pursuant to application dated 1~,0~' ~ 19......~.., and approved by the Building Inspector. Fee $..,~.1'...0~... .......... FORM NO. 6 TOWN OF SOUTHOLD , Building Delm~tmeet Town Clerks Office Sou~hold, N. Y. 11971 APPLICATION FOR GERTIFICATE OF OCCUPANCY Imf ructions 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 dlsposal--(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. Swam 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 April 13~ 1978 New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Propert~D.°...9..~.....~..~.~.d.~"~La....n.~.e.~...E..a.~.s.~`M.~.r.i.~..n..:~.~.N..:..Y..: ............................................................. Owner Or Owners Of Property .................................................... ...%~. ......................................................... Subdivision ................................................................ Lot No ............. Block No ............. House No ............. · . . 11/29/77 . . . Inland Homes ~ Inc, Permit No. 9...5..6...6..Z. ......... Date Of ~ermr .................... ,%ap,leant .................................................................. Health Dept. -- ,7-SO-167 - 11/17/7---- mpproval ............................................ I-oDor Dept. Approval N/r Underwriters Approval .............................................. Planning Board Approval .... ..y..e...s. ............................ Request For Temporor%, Certificate ....... .n...o. ............................ Final Certificate yes. . Fee Submitted $ .5...OD. ......................... Construction on above described building ~r~n~~cod~ and regulations. Applicont ...... ................ Rober~ E. Hil'%z -~Tfland ome ~ ± . Sworn to before me this ................ day of ............................................ Notary Public .................................... County (st~mp or seal) i0 -'I ¢. HALL iZt_ ~' -LO-:,ET f 0 0 i ?Co' 13' d' ' SaUl'HOLD, N. Y. ................ . ~LI~TI~ FOR ~UILDING~E~IT' o. This o~lic~i~, mu~ ~ c~pletely fi~l~ in by ~ewriter In--r, w:~ 3 ~ of p ~s, accurate p ~ p ~n ~ ~e. F~ ~. Plot plan shying I~otion of lot on~ of buildings on premiss, relationship to o~joininG premiss or public struts or~s, and G~ o de~oil~d~crjpt~on ~ ]~o~ ofpr~ must be ~r~wn on the diagram which is c. T~e wo~ c~er~ ~ ~ o~ ~c~ may n~ ~ comme~e~re z~o~ce ~ BulldOG Perm:t. d. U~ approval of ~is o~licoti~, ~e Buil~iag Inserat w~ll i~ue o Buil~in~ Permit to the ~licont. Such permit s~oll ~ kept on the premises ~oiloble for inaction ~rouGh~t ~e work. e. ~o building sholZ ~ ~cupi~ Or u~d in ~ole or in ~ for s~oll ~ove ~en Gmnte~ ~ ~e Building Ink,tar. APPL~CATIO~ IS HEREBY ~DE to t~e Buildiag Depo~ment for the i~uonce of o Buildi~ Permit pu~uont to the Bu~l~ino Z~e O~inonce of the T~ of ~u~o]d, ~ffolk Count, ~ew York, on~ other oppiicoble ~, Or~inonc~ or Ragulotions, for the con~m~ion of buildings, o~diti~s or oltemfi~s, or for ~movol or demoliti~, os he,in de, rind. ~e applicant o~r~s to comply with o1~ applicable I~, ordinances, buildin admit outhoriz~ in~to~ ~ p~mi~s ~ i~ buildl~s ~r ~e~ i~tions. (SiGnotu~ ~ 11~ ~t~itu~ N.Y~ 11952 (Add.ss of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................................. .......................................................................................... Nome of owner of premises X:~r3.e~...C,z:g~aok ............................................................................................................... (Name and title of corporate officer) Builder's license No ..................................................... /ooo Plumber's License No. 517'P Electrician's License No. 2148-~ Other Trode's License No ............................................... ,-~C-'T%'O~'~ . -.~.-~:.;. ]. L*oti* of I~ o~ ~hic~ pr~--d work wili ~ ~*e. *op ~o.: ............... :.:....; ...... ;~.....;.~. ~ot~.' .~ ...................... Street ond ~u~ ~..~.~,...~...~.~.~...~.~**. ........................................................................ 2. Store ex~stin~ use and ~cu~ncy of premises and in~ended use and ~cu~ncy of p~ const~ction: ~. ~isiti,~ use ~ *cuponc~ V~cut b. Intended u~ and ~cu~cy ................................................................................................................................ 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .......... ~ ......... Other Work ................................................ ' .... · ' ~ (Description) 4. Estimated Cos ~,~,J ,.¢~.~..9. ................................ :....Fee ............ : ............................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... .]: ................. Number of dwelling units on each flaor ............................ 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 ............................ 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 35 Rear~. ....................... Depth 2? IL8 Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front .......... .~.0~... ....................................... Rear 70 Depth 26g . 10. Date of Purchase....;.~;..,:~..-~,.:..: .................................. Name of Former Owner ........................................................ ! 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....~...o. ................................................ 13. Will lot be regraded................Yes ........ .... Will excess fill be removed from premises: ( ) Yes ( ) No C:~a~les ] 4. Nome of Owner of premises .................................................... Address ............................. ... Phone No: ...................... Nome of Architect .............................................................. Address ................................ Phone No ....................... Nome of Contractor .~....~.~?......~?...C.... ................ Address ~oX...~].?e ll&ll.l:t;~.l;uc~¢ 298-9696 ............................ Phane 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. STATE OF N~ YORK. I c c COUN~ ~ ~.~ ............... I~'~ ................................................................................................. ~emg duly sworn, deposes and says t~t he is the applicam (Name of i~ividual signing contr~. ..~, ~za, ~'.::~ ,_ ._ -,;,.~ above name. Con~&C~o~ He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or ha~e ~r}~rmed the said work and to ~ke and file this application; t~t all statements contained in this applicati~.~(e ~ue to ~e best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the appli~io~ flied ther~ith. ~ x Swam to before me this ~~ ~~ ............................... .... ......................... No. 52-4643;21, Suffolk Cou~ Term Expires March ~, 1G~ IIUIrF, CO. HEALTH DEPT. APPROVAL I H. $. NO. OWNER: ...... ' * ...... ' ; ,~ i~ ' ' :; ~ , ' ~ ~CAL~ ~ ....... ~u~,~ev. ~, I ~,.?~0+ ~ ..,,." ~ ,,, .... ..... ~* .... ~ ~ 0 ' TO STATE :., ~,' .J: '~q ~V~Y~P.~. . . . '~-. , , . ,' ,- , .'. , ,,,, ',, , ~ ~ ~:~ .- , . - , ~ ; . ~ The sewage di~mo~i ~ water aupply ~,~ ~.~ Facilities for ~. ~ location have beth . ~..~~~.~. / ,I III J 851 P_ F_ A P,_ F_- L E V A -F I 0 I~ C F T L F_. V ,~. T I T Y P I ¢_.AL P- ,~, i I F g 0 NT Fo_ LE VAT \\ / ',, / / \ Whl[e every attempt has been made in thy preparation of this plan to avoid mistakes, th~ maker cannot guarantee againStrhuman error. The contractor on the lob must check all dlmenslans and other details and be responsible for same. GARLINGHOUSE PLAN SERVICE TOPEKA, KANSAS O,AW,-,:,.,-,,. "'-^"' 252 ~0. APPROVED- ~,,-'~ SHEET t OF 5 SHEETS 0~ ~"L ~ oiz L ~TUD5 TO CF_NT~--.[2. Op PACLTITiOIqS r "V,u~ '" -,~-~1~'0~,. . Fac). - ~ T~,~,A P ": , ,-{ % . ....~ 4 ,i.~... ..,... . ~,,, y I , ' EL ~oa'-8~a D~¢ -~ ~ -- '" i - , = ~ ..... ,]'- o" ~ ,l'-~ ,_ ,,'-o .... __ , " _, , ..... : ';, E~.,oo'-o" I ~) A%EMEkJT P LAi'q While every a,empt has been made in the preparation of this plan to avoid mistakes, the maker cannot guarantee against human errar. The contractor on the job must check all dimensions and other details and be responsible for same. DRAWN- D.L.M, GARLINGHOUSE PLAN SERVICE TOPEKA, KANSAS PLAN 252~ NO. APPROVED- R.d.A. SHEET' ~ OF 5 SHEETS F~" 84-" O.C, Co~c ~T~. ~ COAT% While every affempt has been made in the preparation of this pMn to avoid mistakes, the maker cannot guarantee a~alnst human error. The contractor on the iob must check all dimensions and other details and be responsible for same. GARLINGHOUSE PLAN SERVICE TOPEKA, KANSAS DRAWN- D. LM. APPROVED- R.J.A. ""^- 252. NO. SHEET '5 OF 5 SHEETS %TOML l LIVlN~ 4" pipE. OOLUMIq W/ 4% 4":, */~" PL~.'T e ~-.-e x Id) ME&~ While every attempt has been made in the preparation of thls plan to avoid mistakes, the maker cannot guarantee against human error. The contractor on the iob must check all dimensions and other detalis and be responsible fac same. GARLINGHOUSE PLAN SERVICE TOPEKA, KANSAS DRAWN- D.L.M. APPROVED- R.J.A. PLAN NO. 2:52 SHEET 4 Of 5 SHEETS · LtN~- / CD I~ DOWN ] ] ill UNIT FL. C T £10 Joi~T% I~'~.c. ] J ~-i J~_E pL/~ c E LOOP-.. ~/g'= I~" p__ A M I NIG Whi[e every affempt has been made in the preparation of this plan ,o avoid mistakes, the maker cannot guarantee against human error. The contractor on the job must check all dimensions and other details amd be respanslble' for same. GARLINGHOUSE PLAN SERVICE TOPEKA, KANSAS .,Aw,.,.,.,,. "'"'"' 252 NO, APPROVED- R.J.A SH~T $ OF § SHEETS