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Home My WebLink About9568-zFORi~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z9058 Date May ~0 ........................................ , 19..78.. THIS CERTIFIES that the building located at .. 6295. Brid~e .Lane ...... Street Map No....6390 ..... Block No ........... Lot No ....... .~.0 ........................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ... November...2.5 .... , 19.77. pursuant to which Building Permit No. dated ... NoYelabel;'.. 3.0 ..... , 19.7.7., 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 . .. PRIVATE. 0 .N~.. F.~..!L¥. D..~.. L!N~ .................................... The certificate is issued to .~..w2Y~.. e Construct:l. orl Cot1)· (owner, ~) of the aforesaid building. Suffolk County Department of Health Approval ..... 7-r$.0.-.~.72 ...................... UNDERWRITERS CERTIFICATE No .... ~.8..05..8~.. ......... HOUSE NUMBER . .629.5 Street Bridge Lane Cu q.h9 N.Y. Building Inspector FOB~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIC~ ~OUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9568 Z Permission is hereby granted to: O~w.z~e..Coz~a~,J.~ r~ ..~p ......................... ..t63A ....... ~:~ls...ff~. ......... ..~.~........~..~..t...o..n l~Ts · to ....~ L~...~.e.~...o...n..e.....~.~.~..Lz.L .~.e. L~ ~.~ ~. ................................................................................. at.premises located at .....L..°..~...1...O.....~..~...~..~...~...~...).i...~.~'..~..°.~.e..t'...~..e.....~.?..~ ................................................ ............................................... ~.~,~.~.e.. J,,~, ......... .~t~,o~ ............................................................. pursuant to application dated .................. ;....,~r.,...~.~ ...... : ........ , 19..~.~.., and approved by the Building Inli>ector. Fee $...~...~...*..0...0. ......... Budding Inspect~lr TOWN OF $OUTHOLD o Building Department 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: I. 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 disposals(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 end 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: ]. 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 x Date ........... .......~. .......................... New Building ............... G~Jti~l~';~J~;~..~l,~~ Building ................ Vacant Land .............. Location Of Property .............~1~e...~,~i~,3~.~..~.3~ .............. ~ ............................................. Owner Or Owr~.~l~,4~eS. ......................................... ~,0'" ............... i ............................. e2~5 ...... su v s ongS6eZ ................................. l d30/.3.7..Lot No ...... e, a k s _ t,ametSm:p. ...... Permit No ..................... Date Of Permit .................... Applicant .................................................................. Health Dept. Approval 6~//L3.~7~ .............................. Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fin~ Certificate ...~... ................................... Fee Submitted $ .......~.o.~...~. ................. Construction on above described building(~di]~rn~ll~li~jjc.__ ~edes and_ regulations. V -- Sworn to before me this .... of ............ Notary Public ~: ............ County (stamP or seol) THE NEW YORK BOARD OF FIRE UNDERWRITERS :~1 BUREAU OF ELECTRICITY F'- 85 JOHN STREET, NEW YORK. NEW YORK 10038 /~" Aprt~ 3, [978 ~.,,c.,... ~..,,,,ft. 9~95~9 N . THIS CERTIFIES THAT ~y ~ ~t~al equipment ~ d~cri~d ~l~ a~ i~t~c~ by t~ ~l~ ~ ~ t~ O~ ~i~t~ nu m~r in the ~em~es of C~ymne Con~z~. w/, ~z~d~e ~ne, 9~*n/o Middle C~atty ~d; Cutc~ue,L.I. fiXTURES RANGES FANS ~mcu~e Appliance Feeders: 1-~8, 1-3{10, 1-2~12, smoke detector--- JOY Elec. Serv. 54. Stratler Dr. Shirley, L.I. 11967 Ii c. 712E GENER~ M~J~AO~ INSTRUCTIONS ~. This .%op~cat?n .m.ust be complete.h/ill!ed in by .typ~_wrJter or in ink and submitted in triplicate to the Building ~nspecto~, ?? ~ se~ m' p~ons, aceurate ~at plan to ~am.,~e~ a~co. rding.~o ~ule, b, plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas~ and giving a detailed description of layout ofpmperty must be drawn on thediag~m which is part of this application. c. The w~ork covered by this application may nat be comme, nced befo. re i~uance 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 impactioh 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. '1 B iAIdP~LI ~CATIO~N'!S HEREBY.MA_DE to the Building Department for the issuance of a Building Permit pursuant to th, e~. .u~ a~r~.. ~on,e ur.amance at ~.he ,own.of Southol,d.~ Suffolk Co~.n. ty, New York, and ~her applicable Laws, Ordinanc..es ? ~egu~at~,o. ns, mr the construct,.on of buddings, additions or alterat,ons, or for removal or demolition, as homin described. ~ ne app,cant 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 nocess~ry inspect_ions. _ ~wy-z~te ~o~st:z~¢t~.on aarp. ......... ...... ............... ........ 'ix i ss ........ ............... State whether applicant is owner, les~e, a~nt, ar~hit~zt, engineer, general contractor, etoctrician, plumber or huil~r.~ ...................... ........................................................................................................................................................ Nome o{ owner o{ pr~mise~ ...GI~II~...~,~II&CI'II~J;:II~Irl...[~iI'~, ..................................................................................... I{ applicant is o corporate, signature o~ duly authorized officer. (Nome and title o{ corporate officer} Builder's License No ..................................................... Plumber's License No ..... 2~.O~. ................................ Electrician's License No. 7~2-~. Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ....6..~?...O. ........................... .Lot No......]...0...;.._~ ........ Bri..d~e La "$ lor~. " Street and Number ............................. a ....... ~ ............ .]~.~.~.~..~.~...,....~.~.~.....q~lJ~.,. ......................................... Municipality State existing use and occupancy of premises and intended use and occupancy of_j>roposed cemtruction: o. Exisiting use and occupancy ..v..a..c...a:.~..t ..]...a..~...~. ............ b. Intended use and occupancy o~e..J[~m~llF..xt~ll'L~ .................................................................................. 3. Nature of work (check which applicable): New Building',~.,.x, ............ Addition ................... Alteration ................. Repair .................. Removal .................. Dem0tifi0n;,..;,,:,~;;.,... Other Work ................................................ . .... , (Description) 4. Estimated Cost ~.40s. 0.0..0..00 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, if any: Front ............................ Rear ................................ Depth ....... ............. Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height .., ........................ Number of Stories ................................ 56 ~ 32 34 8. Dimensions of entire new construction: Front ...... ; ............ , ................ I~e~r ............................ Depth ........................ Height Number of Stories 2 9. Size of lot: Front ..... [~.~.A .......................................... Rear .~.Q~.'.'..~.~-.i.i.... ................... Depth ...~.~..8..t..~..~.. .............. 1~0~' Date of Purchase ........................................................ Nome of Former Owner ........................................................ 11. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...~.O.. ................................................ 13. Will lot be regraded'. ........................... Will excess fill be removed from premises: ( ) Yes ( ) No 14. No me of Owner o f premises .(~.~.e...~.C...o..~..~...t..~....C...°..~'.P..-.~ ..... Address ..,.~..~...]~..Y.~..'...,' .....,. Phol3e No.7..2. ,8.=.?..2...2.[.~..~ Name of Architect ~.d..R3:icl[SOX3 ................................... Address ~F"Q3;i~,~,~J....,.. Phone No..~.Z~..'.~.~..Q,?... Nome of Contractor ~w~TJt~I.e...Co~s.~,...Co;~3.. .............. Address ............. Phone ..... PLOT DIAGRAM Locate clearly and distinctly all buildings, Whether existing or proposed; and indicate all set-lx~k dimensions from property lines. Give street and block number or description oocording to deed, and shaw ~treet n~mes and indicia whether interior or corner lot. See Attached survey & Plans STATE OF NEVille;lit ~ ¢ c COUNTY OF ................................ . ' Everett J, ~chs ...................................................... ., ............................... ~ .......... being du~y sworn, d~s end soys t~t he is the ~pplicCnt (Name of indjv~dat ;Sig~ing cenfm~ ; · t above name. He is the ........ .~...~e~ ...................................................................................................................................... (Contractor, agent, co~orate officer, ~c.) of said owner or owners, and is duly authorized to perform ~ hav~ :PerJ0~ed the ~id work a~ to ~ke and file this application; t~t all statements contoin~ in this applicott~ ore tree to the best of his kn~ledge and belief; and tha~ the work will be performed in the manner set {~h in. Sw~ to before me this a~e Const~ction CO~. ........................ .................... ~oto~ ~ublic, ..........~.~..~.~.~.... C~n~ ................ ~ ......... Everett ~. Fuchs, V.President ~otaTF ~bl[c, State of ~ ~o, 52 -46~6407 Suffolk BUILDER'S JOB NO.~ SUFFOLK BUILDER'S .JOB NO.~ TITLE NO, BLOCK i ,G '0 0 I ,I 0 d m BUILDER'S JOB NO.~.- T[TLE~ No~ '