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Home My WebLink About9450-zFO~M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupancy No. Z.90k0 ...... Date ....... l~tax 12, ...... , 19.7.8.. THIS CERTIFIES that the building located at ............................ 7930 Sound View Avenue l~%lil/e~X Map No. ........... Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .. september. 1.~ ..... , 19..7.7. pursuant to which Building Permit No. 9450Z dated .... ~p~:..e~.b.e~:..~2, .... , 19. ~/!, 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, One-Family Dwelling The certificate is issued to William and Phyllis Jarosz (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. M.a.Y. ~'~.'...~ ?8. !~.e~ :..7.-.~o. ~2.1' !. 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' ' ~ ' '' ~ ~" ' "'" " ' ' - ' ' .... i ' ':"..!.i":':'" ""'" · : .... ,~;";-."'-'-'.'.;:'.,:.'-~'-~;;--'.:--' .... ;'.-~..'..'.;¢..~.~,,:,~.k~,,.t,L~.,.~..'.,:.;...~;.~.~': ...~.-.'.......~ ...... - ......... '.:...".., :' ..~'......~..:',:.-..,~?,,.-,-,.~ .... ',,...:.'~;,;;;: .... ' .:.". :"":!..' FO1E~ NO. 6 TOWN OF ~OUTHOLD Building Dejmi~mont Town Clerks Office Southold, N. Y. 11971 APPUGATION FOR CERTIFIC:ATE OF OC:CUPANC:Y instructions A. This application must be filled in typewriter OR ink, end 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 oil buildings, property lines, streets, onci unusual natural or topographic features. 2, Final oppro¥ol of Health Dept. of water supply end sewerage disposol--(S-9 form or equal). 3. Apl:,rovo~ of electrical installation from Board of Fire Underwriters, 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, o 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 exl, sting buildings (prior to April 1957), Non-conforming uses, or buildings and ' pre-ex'sting" land uses: 1. Accurate survey of property showing oil property lines, streets, buildings and unusual natural or topographic features, 2. Sworn statement of owner or previous owner os to use, occupancy and condition of buildings. 3, Dc~te of any housing code or safety inspection of buildings or premises, or other pertinent in- fo~rmotion required to prepare o 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 Dote . ~. ~.Q/..7.6 .............................. New Building ]~I~W Old or Pre-existing Building ............................ Vacant Land Location Of Property ~.~"~u~`.~`V.~.~.`e.~w.-~.A.~?.~e~*~`S~.~.~.~.~e~.~.~9~-~~t~`?~? Tow~n. P~ope~tyo Owner Or Owners Of Property .....W.,i.[..~..J:.,,e~,.....~....~,..~.[.]:~..J:,8,.,..~.,~o..~.~ .......................................................... Sulxfivision ................................................................ Lot No..~.?..~..?:..3, Block No..~. ........ House No..?..g...~,. p~,~i+ ~ 9450 ri,to nf ~e-~ +9/.12/?? A~ ~n+ Robez't Btz'eckez' ....................... ...... 7 -;I. ; ?: ..... ......................................................................... nderwr,,er, ^pprova, ....... P,onn,ng B rd provo, ........................................ Request For Temporary Certificate ........................................ Final Certificate Fee Submitted $ _~ Construction on above described building and,,,~-,r~mit meets all/at~.licab, J~codes and regulations. Sworn to before me this ................ day of ............................................ Notary Public .................................... County (st,,mp or seal) ' I'' BOA FIRE UND THE NEW 'YORK RD OF~ '" ::i' ,' February-15, 1978 ~z,z, tlc, tio,~'o.o,,fte.-942893 P#9450 '":' "N -~"~)Q'~ electrical equipment :~ descrlb~d below a;~d i.tr~d~i~ed by. the applicant named o~ the above appl~catlo. .umber i~ th~ W. :Ja'rosz, s/s. Soundvlew 'Ave., I/4 mi ~w/o ~ys .R~ ~"~ ,' , ,, , · ; ], ... --~, Id :1~-~, ...... . ~- ~ . ~ ~rasex(.n[nedo~i. , ./ ,~ February ~; 1978~ ~ and found to be in~ ompl~anceu'~ththerequtr, r '' '''+~ Coram Electric .. :..'.. ,;Rou~e ' 112 .Box ,242 or~am~'~ E;' ' , ~ ';,":-:'.; ~ I. ' I APPUCATIOfl FOR BUILDING PERMIT ~.~ ,at, .............. ......... Z..., INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 set~ of plato, aocurete plot plan to male. Fee according to schedule. b. Plot plan showing locatiOn of lot and of buildings on premises relationship to adjoining premises or publ c streets 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 Inspsctieh throughout the work. rq 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 ssuance of a Bu lding Permit pursuant to the`) ~Build!ng Zon.e Ordinance of the Town.o.f. Southold, Suffolk County, New York, and other applicable Lav~, Ordnances or ~eguloti.o. ns, tar the construction of buddings, addltioe,~ or alterations, or for removal' or demolition, as herein described. ~1 ~ ne applicant agrees to comply with all applicable I~, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and In buildings for necessary impections. ....... ............................. ~ignOt~re of dpplicont, or nome, if a corporation) 4~' ................. ~ ............. .~...£...~. ................................. .~ ,/ ~,, ,.~ddr~,s o~applicont~-~ / · 11"/,~.6 State~. ether, ~apl~cant is owner, lessee, agent, amh,tect, engineer, general contractor, electrician, plumber or builder. ....................................... ..... : ........................................... ....................................................... Nam~'~'~:'~o~'~'~Jmi~iii.~.~...i.~.i~.L:}~....l~......'~...i...~.....~...~i~i¢ii~: ........ - .~. ~.~..~:i~..~ ...................................... I{ opplicant is a co,orate, signature o{ duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ........ ~ .................. Electrician's License No ....... .~......~... /ooo ~ 5'..w- ~_ /3. / Other Trade's License No ............................................... /'"~° / andonwhch osedworkw be , Ma No.~..~R'.o~...~ ~lq~C:~l^,l~t, 1. Location of prop ',.: ~ ~,/.~-- ~ cJon . _ P ..............................,, ..v, · ..... ? ............. ~... ..... : ...... ;: ........... ~..~.......-...-.....U.x..z~........~...-....~ ........ ~.....~.A/..~. .......................... Street and Number Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ..... ~..Z~....'.'.~. .............................. ~, .................... ~,.......~. .......................................... b. Intended use and occupancy ....... J ...... ~,,,~ ..................................................... 3. Nature of work (check which applicable): New Building. ,..x--.~ ..... Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .......... '. ......... Other Work ..................................................... · ---~-(,o OOO ~ [ ~ ~O _ (Description) 4. Estimated Cast ................. ~,~.......,~ ............ ; ............. .~...Fee .., ...................................................................................... (to be paid on filing this application) 5. If dwelling, number of ~welling units .............. l. ........... Number of dwelling units on each floor ............................ If garage, number of cars ........... l ................................................................................................................................ 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. S~ze of lot: Front ............ :../.. ...................................... Rear ......... ./.. ........................... ~. Dap h ................................ 10. Date Of Purchase ............ ~..:...~..2 ............................. Nome of Former Owner ..~....[...~....~.~...~......~.e...~..[~.....~..~..~.,: 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' .....~...O......,.;v ..... ,Will excess fill be removed from p.re~i~s: (~, I yes (~No 14. Name of Owner of p~remlses ........ .//~...~ ....... ~ ....... ~.. ............. Address ...~..~.~.'~.~.<.~..5./..~..I Phone No ....... .~ ............... Name of Architect ............................................................. l/Iii,,.~- ~ Address ...... ~'.~.,¢¢/~' ................... F'~','~,'-~ Phone No ....................... Name of Contractor ...J~..~..~..,~.~....A....C?..~/4~',~....~(..~..r.¥.[. Address ..... ,/,,ji~l,.~-.~_,a~..~ Phone No. .~.~;Z.:.~...Z]..~ Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock 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. ~TATE OF NEW Y. DR,I~, -- t ¢ ¢ ~OUNTY OF ...... ...~.. ~..~.?..+..K. ......... [~..~ l~ob~zt, ~1'. ~tz~kez ................................................................................................. being duly sworn, deposes end soys t~t he is the applicant (Name of individual signing contrac~ above name.. ~on~o~ He is the ................................................................................................................................................................................ (Contractor, agent, co~orate officer, ~c.) of said owner or owners, and is duly authorized to per{arm or have performed the said work and to ~ke 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 performed in the m~nner set fo~h in the application filed therewith. Sworn to be~ore me this 'h .......... °' ................... ....... ................................. NOTARY PUBLIC, State of New Yotli No. 52-8125850, Suffolk Calming'.. Term Expires March 30, 19~..~ A /~ , : ' ,: ~ ~'~ ~U~Y AND ~EWAO~ ...... ~4 :"; :-: Ul ZI kid tgi o" I~'r FL 1.5' 0" 1 .-% SC&L~ [/¢"-' 1~-0'' APPROVED AS NOT[D r~ J aO (A~PHA~T 19'- 2." pkywoo~ .I ,4-I' CO'~ C. it 4~4' L ................ 0~ Fhoo~ 0%4 Z"X 4-x ~/.~" Phy v..JOOD 0 ~"X4~'' STUD, I BOLTS PA,~T