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Home My WebLink About9452-zFOB.,M NO. 4 TOWN OF SOUTHOLD BUiI.DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at .7.8.q..B.a.l.1..e.y..B.e..~.c.h..R..d; .... Street Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .S.el~9.m.b.e.r, .... ~,~ ....., 19.7..7. pursuant to which Building Permit No .... 9..6.5.2.Z dated .S.e.p.~..e.m.b.e.r'. .... 1,3. ...... , 19.77.., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is ...P.r.i..v.a.~.e...0D..e..F..ap).i.l.y....L~.e. 1..1.i.ng..w.i. ~.h..A..d.d.i.~.i.o..n ..................... The certificate is issued to Herbert; Golclschmtd~ (owner, ~) of the aforesaid building. Suffolk County Department of Health Approval ............ N./.R UNDERWRITERS CERTIFICATE No ........ . .N .~ .8.6. 6. .0 .~ ............................. HOUSE NUMBER . ...7.8~ ....... Street ...... .B.a.i.1..e.y. Beach Road l~Ia~c~;ituck, New York / ........... Building Inspector TOWN BUILDING TOWN SOUTHOLD, N..~. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMiSES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9452 Z Permission is hereby gronted to: ~ b/v/K/r-z.) I/tl/~ I//~ '/ ,.~l: ~? ~ ~ 19.Z.Z and approved by the pursuant to application dated ........................................................ , Building Inspector. Fees ......... , .............. Building Delmftment Town C:lerks Office Southold, hi. Yo 11971 APPLIGATION FOR GERTiFIGATE OF OGGUPANG¥ 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 approva~ of Health Dept. of water supply and sewerage disposol--(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), Nomconforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing oll 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. Dote 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 ~ Date ....~...~...~./ ............................... New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property .................... : ................................p ......................................... Owner Or Owners Of Property ..../'.~. .......~. ................... .g. ................. .~...~'~.L.~. ............................................... Subdivision .............................................. Lot No ............. Block No ............. House No ............. Permit No..~.~.~..~...7.~.. Date Of Permit .~. '~./.~./.Z.:~...Applicant .~,1,~..~~ ............... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .~...~..?...~../:.~..6.~. ................ P ann ng Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate Fee Submitted $ ..~ .......................... Construction on above described building and permit meet~applicable codes and regulations. Sworn to before me this Applicant ..~,,~.~..~.~'-~¢~.~"'~ J]~' ................ day of ............................................ (stamp or seal) Notary Public .................................... County '/~¢ ~'lq'7~ 0 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10033 ea,~ ~'4ay 17, 15}78 ~pp,c. tlo. No.o./ile 950~35 N386605 THIS CE~IFIES THAT OTHER APPARATUS: E~2nd FI. ou.t; S ~.de Section Bioek and found to be in compliance with the requirements of this Board. C EXHAUST FANS DIMMERS 2/0 Huland Elec. Co. P.O. Box 1~13 emmd~4 ~ ~ M&~:tlt. uckm L.I. ~952 Lle. Bq2 E .__ ~i~ ~/ p~ ---- ~ ~ ~, -. ' Th,s cen,i,cme must not ~ oltered .n o.y me.ner~ return ~o the o~e of the ~or4 i~ i.corr~. I.s~ors moy ~entif~ by t~crede.tiol~' ~OPY FOE BUILDING DEPARTMENT. THI~ COPY OF CERTIFICATE MUST NOT BE ~TE~ IN A~ ~NER. ~' ~C. APPRO~'~D AS NOTED DATE= 765-2660 9,~,~o 4Ph~ FOR REQU[R- 4. Fff:AL W>.::i ~'2~ CO>.tPL'iTED NOT ~PONS.~_:,:~,~ D~S~GN 5. ALL ~O~,~::..- ...... ~..~ ?,,:EET lUll. DINe DEI, ArrMIHT ....... ................. Examin~ D,~ ./c .............~~'"'"'"'"'"'"' ....................................... .......................................................................... ~ .......................................... ......... ~~ ......... ~u,d~~~ INS 1 ~U~lffiS a. ~is a~lication mu~ ~ c~pletely ~ill~ in ~ ~ewriter oe in i~ a~ ~mi~ in tripl~ ~ ~ Bul~i~ In~, ~ 3 ~ ~ p~, ~cu~ pl~ pl~ ~ ~e. F~ ~i~ to ~ule. b. Plot plan shying I~afion of lot and of buildings ~ premis~, relationship to ~joini~ premi~ or public st~ ar~s, and givi~ a detail~ d~ripti~ of I~ ofp~ must c. ~e work c~r~ by this a~lieation ~ n~ ~ c~nc~ d. Up~ a~al of ~is applic~ion, ~e Buildi~ Im~tor will issue a Building Permit to ~e ~l~a~. S~h pe~it shall ~ ~ ~ ~e premiss available ~r in~i~ ~h~ ~ ~rk. e. No ~ildi~ ~all ~ ~cupi~ or u~ in ~ole or in shall h~e ~en granted ~ the Building InCr. APPLI~TION IS HEREBY ~D~ t~ the Building ~ment for ~e i~uance of a Bui~i~ Pe~t Buildi~ Z~e Ordinance of the T~n of ~thold, ~f~lk Co~, N~ York, a~ ~er ~lc~le ~, O~1~ o~ R~ulatJons, for the constru~ion of buildi~s, ~iti~s or altemti~, or for m~l or ~iti~, ~e applicant agrees to comply with all a~licable I~, ordinates, building c~, h~si~ ~mit authoHz~ in~o~ ~ premiss ~ in ~l~Ings ~r nme~.~ i~i~. (Sig~tum of a~licant,~r ~, if a co~l~) ........................ .............. ................... ................... Z.=. " (A~m~ of ~llca~)I 193~ '. Store wh~r ~pplic~nt i~ owner, I~,, o~nt, ~mhit~, ~n~in~r, ~en~ra~ c~tmctor, ~l~trici~n, plumber or buildor. of of ...... ................................................................................ If applicant is a co.orate, st~ature of duly authoriz~ officer. (Name and title of corporate officer) Builder's License No .............. ..'~'......~.. ............................ Plumber's License No. ~/]'' I~ Electrician's License No. ~ ~ ~ ' ~' Other Trade's License No ............................................... Location of land on which proposed work will be done. Mop No.: .: ...................................... Lot No ......................... Municipality State existing u~ and ~cu~ncy of promises and intend~ use and ~cu~ncy of p~ cm~ti~: a. ~isiting u~ a~ ~cupan~ ~ ~ L ~ d ~ ~ ~ b. Intended use and ~cu~ncy ................................................................................................................................ 3. Nature of work (check which applicable): New Building-. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ................................................ . .... 4. Estimated Cost ...........~?....O....O.......?~... ....................... Fee /' ~.~,----- (Description) (to be paid on filing this application) 0 N~L. ~: tlC. 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, specif'z nature and extent of, each type of use ............ x ............... 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth ....... · ............. Height ...... ./...?..' .......... Number of Stories ....~../.~ ................................................................................... , .................. ...... D,mens,ons of same structure w~th alterat,on.~ gr additions: Front ...................... ? ............. Rear ............................ Depth .......... ~....-. ................. Height ........ %: .................. ~Number of Stories ......... '~..~ .................. 8. D,men,ions,of.e.~t~re.. n.~ aon*~ian.' Front ......... ........................ Rear ............................ Depth ...'...'.. ................ Height ..Z..'..... ........ Num.~.er of Stories ....O..~.~ ..................................... * ....................................... .. . - - E ~ ' - leo. '~;'~F ............ 9. ~ize of lot: I-root ........................................................ Rear .......................................... Depth ...~ ........................... 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: ........................................................ 13. Will lot be regraded ..... ~...e..~ ........... .. Will excess fill be removed from premises: ( ) Yes (~'"~' No ]4. Name of owner ,. · ......................................... ; ............................... ~"no~ ~1~ ....................... Name of Architect .............................................................. Addr~ ................................ Phon* No ....................... ~ome of Controctor .~:.~.~.:.:;.~...~.~.~t. ................... Addre~ 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 NEW YORK, ,-- .... COUNTY OF ................ ~.~.~L ...... f~'~ ~ a ~ U ........... ........... ~.~.~Z..~..~..J.. ........................... being duly sworn, d~oses and says t~t he is the applicon, (Name of i~ividual signing c~trac~ above name. c~~.%.~.~...~ .................................................................................................... He is the ............................................ (Contractor, :~,"~orat, officer, etc.) of ~id owner or owners, and is duly authorized to ~rform or h~e performed the said work a~ to ~ke and file this application; that all statements contained in this application are true to the be~t of his knowledge and belief; and that the work will be performed in the manner set fo~h in the application fil~ t~r~h. Swam to before/~ medaythiSof ................. ..... .............................. ...... .~ .......... ~ ................... ;... z4.. ~n~ ........ ~.~......~.~ ................................. ~ E. DA~ N~A~ ~L~, St~ ~ New Ho. 643721, Suffolk Term Expires March 30, SURVEY FOR DESMOND N. FAIRBAIRN ANNIE E. FAIRBAIRN STANLEY N. I~,~ITTLEMAN ELLEN S. MITTLEMAN MATTITUCK TOWN OF SOUTHOLD SUFF. CO.~ N.Y. SCALE: I": IOO' FEB..~9,1960 MAY 5, 1960 GUARANTEED TO, NOVAE TITLE BUARA?YFY CO.