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HomeMy WebLinkAbout9578-z~0~ NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. Z9294 Date November 6 , lg. 7.8. Hater Road & THIS CERTIFIES that the building located at ...8.0.0..M~i.d...F..aL~....l~).a.d. ..... Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated . .D..eg.e.m.b..e.r .... ? ...... , 1~.7... pursuant to which Building Permit No.. 9.5.7.8Z. dated . .~.e-9.e'.m.b..cF .... ? ......., 19..*[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 ......... ~ ~ag¢..One....arazly..Ii~elling ............................... The certificate is issued to .......... Thomas. & .Catherine. Cai~ey .................. (owner~t) of the aforesaid building. Suffolk County Department of Health Approval .... 7. T~.0.'~1. ?.3. . .1. 9.-.2.5.-. .7.8. .......... UNDERWRITERS CERTIFICATE No. N397588 HOUSE NUMBER .... .8(~©. ......Street ...... .~.~..d..F.s~..R.o.a..d. ~..H..a.~.e.~.,..R.o.a.d.... ................................. .//f~utho[d~ . . Building Inspector County Tax Map 1000-70-04-38 SOUTHOL! IFFICE N~ Y. BUILDING ~ERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9578 Z Permission is hereby granted to: ~:~..~......~.:....~..~.~.~.,~:~.~..-.~. .............................. ..... ~.~.:,~...~.,.~..~.:~.;..~....~.: ........ pursuant to application dated ........................ 19...~2r~.., and approved by the Building Inspector. FOV, M NO. ~ TOWN OF $OUTHOLD 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 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 prmexisting dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 gate ...... ...... New Building ....4~'....~....~... ..... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ..././,Z,z(.~....,~.z~..'~..Z~.~...~...~...-~.~......~......~..~...~....z~..d~..,.....~..~.~ ....................................... Owner Or Owners Of Property ..~z~..-.~ .,FT...~.....~..~.~.,('~./...'.~...-~......~....~.x~./,~.~ Subdivision ................................................................ Lot No... ,~,. ,~,,,. Block No....,~,.Z... House No...~,~,..,~. Permit No..~..~..Z~...Z~. Date Of Permit../Z.z..~.r..~.:..Applicant ~.x~.Z.~...../~-.r...~..~..~-..~../~.. ............. Health Dept. Approval ~.~..:..~.~'~/.~....~.....~...:~.~.;:../..~..Labor Dept. Approval .............. ~.~ ........................... Underwriters Approval ..~....~....,~......~..~...~.~....~.. ............ Planning Board Approval ....... .~...~... ......................... Request For Temporary Certificate ........................................ Final Certificate /'~ Fee Submitted $ ...... .~.~.~-..4~....~.?. ............. Construction on above described building and~,p_~a:nkt meets all appl~able,~odes and regulations, Sworn to before me this Applicant .......~_,,~,,,~..~.....4.,:~:....:....~,...x~-'~/~//~~-Z,Z--~ ~, ................ day of ............................................ Notary Public .................................... County (stamp or seal) THE NEW YORK BOARD OF FIRE UNDERWRITERS pR1 BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CEMIFIES THAT in the follo~ing locatlon; [] Basement E~Ist FL [] ~d FI. Section BIx~ck Au;lust 7. 1978 and found to be in compliance with the requirements of this Board. Lot nam icoQ~,,~.c,~sl ov. Ns io,sHwmns I 1.2 EXHAUST FANS S V I C °~ appl Ilnce Feeders ~ I-3f 10. I-3f6 ~ I-~f8 ROOM Heelers I-4.5K~ HO~ WatEr Heater I-i.SK~ Elec, Furnace I/0 -Robert 0'Brlen 21 North Ocean Ave. Center Horlches, I.,I, 11934 zLic.2338 E ~is ce~ificate mu~ not ~ al~ in ~ manner~ return ~ the office of t~ ~a~ if inc~rKt. ~specto~ may __ _ ¢O~YFOR B~..I~,OIPARTMINT. THIS "~ '" ~ ' " '~ BUILDING DE,P,.~RTMEHT .. .... 7":C""5 ....... · '~:'~ --' APPLI~TIOH FOR BUlLiNG PEblT iNSTRU~iON~ a. This application must be complexly fill~ in by ~ewriteV~ff in'i~ and s~mi~ed in triplicate to the Buildin~ Inspector, ~ith 3 set~ of plum, eccumte pl~ plan ~ ~ale. Fee occo~ing to ~h~ule. b. Plot plan showing I~ation of lot and o~ buildings on premises, ~elationship to adjoining premiss or public str~ areas, and givi~ a detail~ description of I~ut ofpr~e~ must be drawn on the diagram which is ~K of this Qpplication.~ c. The ~ork covered by this a~li~ation may n~ be commenc~ before issuance of Building Perm t d. Upon app~val of this application, ~e Building Ins~tor will issue a Building Permit to the opp cant Such shall be kept on the premises available for insp~ti~ through~t the work. e. No building shall be ~cupi~ or u~d in,~hole or in pa~ for any pu~ose whoever until 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 the Town of Southold, Suffolk County, New York, and other appl cob · Laws, Ordinances or~. Regulations, for the construction of buildings, additions or alterations, or for remova or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, build ng code, housing code, and regulations, and to~ admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of ap'~ii;c;r;~T;r-~rr~'~';;"i~"~";~;'~;;~i;;;;~ ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~ ~ Plumber's License No .................... ~ ........................... Electrician's License No ................ ~.~, .......................... Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ........................ '~v~ ...... Lot No...~ ........ Street and Number .//.,~{'/~ ~,~.~'..~,,~..~..ee~'.,~.e.,p.~..,~..~../~'./~..z~T..4..~.~ /~..~.d.~. ,~...~...~'~.,~.-(.~. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...... .~.,~..d.~..~...~...,.~.~..~.~..?,..~.?.,~.. ................. . ........... b. In;tended use and occupancy ........................................... ~ ....................................................................... 3. Nature of work (check which applicable): New Building.. ..... Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... 4. Estimated Cost ............. .Q.~...Q .............. Fee .f~C) .. (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 .~./~..4( .~..4~.~.. .~...r~. o 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 .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ....~...~.~t(.~....Z.~...7..4...../..~...~..~ .............. 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: ........................................................ 13. Will lot be regraded . ....... . .~..~ ............. Will excess fill be removed from premises: (~K'~ Yes ( ) No 14. Name of Owner of premises..'~..~.~.~...~..~...~..,.....~..~..~...~.~... ......... Address].~.: -~ ...................... $~"~'¢~ ~'~..., Pho~e No. ...................... '-/'~'~-- Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ 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 STATE OF NEW YORK, COUNTY OF ................................ .' / .... ' ............................................................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contracf) above named. · . He is the .....~.~~ .............................................................................................................................. ; .................... (Contractor, agent, corporate officer, etc.) 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 perforrj~-"ql in the manner set forth in the application filed therewith. Sworn to~)efore me this / / / .... ......... day of ...... :. ........ . *~// , /'% (Signature of applicant) Ho. 52-4643721. Suffolk TOPOGRAPHIC MAP " S~AU~: i TO ~U~EOLK CoUN%Y TAX MAP ~ ~UARANTCL8 A~[ NOF T;(A;JSFL::A:~LE TO LOT ~7. ~ A~~ q~.~ ~3 ~.~ q~ 0 H A R P E R (CA~V~S NE~) ,ROAD P P-..O P E R.T '1" 5 IT U A-TE._ $OUTHOLD TOWN OF ~OUTFIOLD ~ SUFFOLK ¢0.~ ~.Y. ScAL~ ; I "' ~0' 070 Lo-r 37. Z N 34-' HARPER / 19' Oo"E lS4.75 ' Lo~ 3G ,r oo O d AL~E D.T House Beautifurs Special Pubhcalions specially developed far he readers al House Beautiful s Build~ng Manual/Houses & Plans/Vacauon Homes ./ I "Alteration of this Document excep~ by a Licensed P,rofes- sion-~ Eng,ne~r, Is ~llegn~l '. ®l- om. .......................................... planner., inc. ~0~ ! I1 1P 22¸ "Alteration of this Document exceet by o Licensed Profes- sion-~ Engineer, [s illegaV'. .cot, 7~b9, Subdivlscon 2, .... ~ ~_. / 1 "Alteration of this Document except by o Licensed Profes- ..... ,1 7269, Subdivision 2, / R Iff'/'~ N. 'r. Sto~e Education Low. ~oo~d £cr ,niHM use of drowrn! ,/ "Alteration of this Document except by a Licensed Profes- -sioiTnl En~!neer, is Illegc~l". 3cot 1 72~9, Subdivision 2, N. ¥. Stme Educc~hon Law. I 17" T - - ' I