The URL can be used to link to this page

Home My WebLink About9588-zNO. 4 TOWN OF SOUTHOLD BUtr.nXNG DEPARTM~NT Town Clerk's Office Southold, N, Y. Certificate Of Occupancy No..Z907.5 ..... Date ....June.. 21. .............., 19...78 THIS CERTIFIES that the building located at . .1185...Widths. L~ne ..... Street Map No...&.650 ......Block No ...........Lot No ........7.9 ........................ conforms substantially to the Application for Building Permit heretofore filed in this office dated .. I~ecember...1.3 ..... , 19.77. pursuant to which Building Permit No..9~8S~. dated .. December...43 ......, 19. ?.7., was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ....... PRIVATE .ONE .FANCILY. DN~.T.IN~ ................................. The certificate is issued to ........ I,To~.%h. Eork. 12qui~;iea .Inc, .................... ( owner, ~t ) of the aforesaid building. Suffolk County Department of Health Approval ...... ?-.S0-187 ..................... UNDERWRITERS CERTIFICATE No ...... 1~389a~4 .............................. HOUSE NUMBER... ~ .~8~ ...... Street ........~i.~in .Lm'~a .................... .............................................. ~..~e~crt~. ~ew..~ork ........... ..... /..~Sf..rf~.~.. ~. ·'./...~<r..??~/7.. Building Inspector SOUTH'OLD, N.Y. BUILDING PERMIT (THIS PERMtT MUST BE KEPT ON THE PREMISEs UNTIL F,ULL COMPLETION OF THE WORK AUTHORIZED) No. 9588 Z Permission is hereby~anted to: · - -- ............... ~~~.~ ............. ~t premises located .t ............................................... .:.....,~ ............................................. ................................ ..~/.;~...m...:.~..~....~...~... ............. .~...'.~~..... ...................... pursuant to application dated ........................~..~,~..£ ....... !1..:~ ....... , 19.?.2.., and approved by the Building Inspector. ~.~ .... Fee $ .....";, · · TOWN OF $OUTHOLD , Building Department Town Clerks Office Sou~hold, 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: 1. Final survey of property with accurate location of all buildings, property tines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage dispasal--(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 pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 ........ New Building ...... .~ ..... Addition ................ Old or Pre-existing Building .~ ............. Vacant Land .............. Locaton Of Property .~/.~. ....... ,,,r~-.,,, ~.', ,-,_ .-~ --__ "~'/'C~l~"s'"'"~'~'""a'~a'"" '~/~' ...... ~'~'"'~'""~/"~ ....... Subdivision .C.~.~.....~L~.~ ............ Lot No...g~... Block No ............. House · ~' '~7 ? · ~ ~ ~ ' Perm.t No...~....~ate Of Perm.t .......... Z.,~.Appl.c~t ~&...,~-..~J...~O..~...~ .................. ....... : ....................................... Unde~riters Approval .~.;~.~.~ ................... Planning B~rd Approval Request For Tem~raw Certificote ....... ~ .............................. Find Ce~ificate .......................................... F.e S.b~i.ed ~ .......... ~..~.... .......... Construction on above described building and,per,nit me~tli all applicable codes and regulations. Applicant ........., ,~/'-'V..~.. ........l~4,~ ~ ................................................ Sworn to before me this ................ day of ............................................ Notary Public ................................... County (stamp or seal) THE NEW YORK BOARD OF FIRE UNDERWRITERS lS BUREAU OF ELECTRICITY ~-- Ju~e 12, 1978 s- JOHN STREET, NEW YORK, NF..~V YORK 10038 THIS CERTIFIES THAT in the foll~ing ~a~ w~ exami~ on ~ found to be in ~mpliance with the r~uirements of this ~. RX~URE F I I RXTU~ I ~s ~sl o~ im~w~m EXHAUST FANS ~THER APPARATUS: 1 Smoke detector 1 ~,.P.C.I. John102 OakT' SapanarOAve. Inc. 4 4 ~.." Shirley, L.I. 11967 Lle. 33 E rhls ce~ificate must not ~ alter~ in any ~nner;, r~urn to the office of the ~ard if incorr~. Inspecto~ may ~ identH~ by ~redenfial~ COPY FOR BUImlNO D~ARTMmT. THIS COPY OF CERTIFICATI MUST NOT U_~. ~T~D~ _1N ~ MA~I~ N~. ,~, J BUILDING DEPARTMENT // TOWN CLERK'S OFFICE ~/~/~- Examined ................ ~../.~ ........ , 19.~ Application No. ~. ............................ ............................. ~ .......... , 19.. Pe~it No ............................ .~. Disapproved o/c ............... ~ ~/~//2~ ............................................................................................ ......... INSTRU~IONS a. This application must be completely fill~ in by ~pewriter o~ in ink and s~mitted in triplicate to the Building Inspirer, with 3 set~ of plans, accurate pl~ plan to ~ale. Fee according to schedule. b. Plot plan showing I~ation of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giving a detail~ description of layout ofpr~e~ must be drawn on t~e diagram which is ~ of this application. c. The work covered by this a~lieation may not be commenced before issuance of Building Permit. d. Upon approval of this application, ~e Building Inspirer will issue a Building Permit to the applicant. Such permit s~all be kept on the premises available for insp~tion throughout the work. e. No building shall be ~cupied or u~d in whole or n pa~ for any pu~ose whoever until a Ce~ificate of ~cupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY ~DE to the Building Depa~ment for t~e ssuance of Building Zone Ordinance of the Town of ~uthold, Suffolk County, New York, and other applicable Laws, Ordinances or~ Regulations, for the constru~ion of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building c~e, h~sing c~e, and regulations, and to admit authorized in~tors on premises and in buildings for n~es~aw i~e~ns. (Signature of applicant, ~me, if a cor~r~'~'~ ........ whether applicant is owner, lessee, agent, architect, engineer,~ electrician, plumber or builder. State Name of owner of premises ................................. .. .................................................... If a~li£ant is/'~orpgrate, signature of duly authorized off'icer. ................ i~bme and~itle of caOarate officer) Builder's Licmse No ..................................................... Plumber's license No.~..: ..............................~k.~..~.....~,...~..g: Other Trade's License No ........................................ ,,~ ~/~0 ^ ~ Location of land on wh"h proposed work will be ~'~'~il Map No.: ~/~....?~./...~.~. Lot No..~.~. ............... Street and Num~r~..~la~/~..~.~:....~/o....~~~ ........ ~0[ ]~~ Munlci~li~ State existing use and ~cu~ncy of premises and intended use and occupancy of proposed construction: a. Exisiting use a~ ~cupancy ...... ~~ ................................................................................................. b. Intended u,, and ~cupancy ~[~.~ ~ £ 3. Nature of work (check which applicable): New Building.....~... ......... Addition .................. Alteration ....~...; ...... Repair .................. Removal .................. Demolitior ..................... Other Work .................................................... t~'~ '~T ~ /{'{ 0 ~" (Description) 4. Estimated Cos ..... ~ ...................................... 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 c~rs ......... .Cq~- .................................................................................................................. 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 .............. , ................ t 8. D mens oas of entire new construction: Front ....... ........................ Rear....~..W. ................. Depth ................ Height ..L./~..! ........... Number of Stories ...... J. .................................................................................................... ~ ..... 9. Size of lot: Front ...~.~.(~.'......'--- ' ' ..................................... Rear. -l.0.~..'.--t ............................ Depth ..J~..~.../. .................. 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: ..... ~.~.....~?T.. ..................................... 13. Will lot be regraded ......~. -~.~ ............ Will excess fill be removed from premises: ( ) Yes (~ No 14. Name of Owner of premises~--~2 .~..~...~0~..~.~-,-,-J.~f~.lNOS, ddress ................................ Phone No ....................... Name of Architect .............................................................. Address ....~.~0/~.~/.~). .......Phone No..0.~..~.,.~.~.O. Name of Contractor ~-2z.~....~.CO~_.Z*(.(~:.... Address 1.2~~Phone No. ~..~./~.~/..~- .... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-b~ck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate ~hether interior or corner lot. I~o ' STATE OF NEW ¥~'//~ COU~ OF ..~~f~'~ -' -~ ~'' ........ ~.....l~C~~ ..................................... being duly sworn, deposes and soys ,~t he is the applicon, (Name of in~i~dual signing controcf) above na~d: _~ ~ He the ......... ................ ................ ............................................................................................................ of said owner or bwners~nd is duly~to perform or hove performed the said work and to ~ke and file this application; that oll statements contained in this application ore true to the best of his knowledge and be ief; and that the work will be performed in the manner set fo~h in the application filed~herewith. Sworn to b~e me this~ ......................... . ............................. No. 52-0344963 ~uf:o:k Coun~ ~missJon ~pires Marc~ . oWNI~R~ FORK EQU~ h::~ DEP~jR1 HEN T OF HEALTH RWE RHE ~O~ N~Y. (VAC^NV~ IPROPO~D HOU~,£ ~ (v^c~N~) faoillt, les for th~s l',:a'tico i:,~,~e beer~ ,~.~%9'~'E. JP~H. / WA~R MAIN [ S~CTION 7209 OF ~E NEW YO~ STA/I ~ O ~DUCATION LAW. ~' I ~AP LOT NO. ~EENPO~T ~OI--I-OL.K CO. T/~ MAP O~.'~t61~ATION ~ lUFF. C,O. DEPT. Of HIALTH Ill. Ii ITATl~llJlfr OJf IJ O' I FOR A~NOVAL ~ ~U~ON ONlY J [NOT ~i WA~ SUP~Y A~ I~A~ ~=~b~'}~'" ~ DATE: OliVE ~ ~ ~ll ~1- ,/