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Home My WebLink About9459-zFOR~ NO, ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at..~/.~.t.~...e2~...' .~.....~.. ' Street MapNo...~. ........ Block~o...~ ...... ~,ot~o ......... i ........ :.... ~Z conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... . .~...~: .~..../. ?...., 19. ?.~. pursuant to which Building Permit No..~...~.~.'.f. dated ..... ~.... ~-.~.z~.. ..... , 1977., was issued, and conforms to all of the require- ments of the.~applicable provisions of the law. The oceupane,~or which this certificate is The certificate is issued to .~/~.~.~.c~.~.~.. ~T......~'w~.. .... ~ .~..[..~.(..~.~. i~ ....... ~ ........ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . ~ .4/4~1 ~/~/~-- ~)_~.~ d-/~ 7'/ UNDERWRITERS CERTIFICATE .... , ....,~..~ ......~"f..'~. ~; .............................. ~ . .~...~?~ HOUSE NUMBER. ! .0 ?.~ ........ Street ~.~./ ~..~ ...... ' ..................... Building Inspector BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9459 Z Date .......................... ~e~t.....;g~0 ........ , 19..r/.~. Permission is hereby granted to: ~an~,..~a...Zree.....A/C..~La~e~ce..A~lde r son .......... b*~ t't'~'~ ~1~.....~'r¥., .................................. to ...~uJ,~..~e~..~u~..~'a,~;y...d~e;L~2,ng ................................................................................... at premises located at ..~G.t,o,T.~'&e~,'...~)gr.$v~ ..................................................................................... .......................................................... ~u.'eh~,~d ................................................................................... pursuant to application dated ..................................... ~et~t...1.9.., 19.~.~..., and approved by the Building Inspector. Fee $.~...~0. .......... ............ ,. ::. ...(. ' "~;ii~i.a i'~'~;;~ ....... "[ ............. FOl~l NO. 6 TO. bi OF $OUT~OLD , Building Department Town Clerks Office Southold, bi. Y. 11971 APPLICATIObi FOR CERTIFICATE OF OCCUPANCY Inctructions 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 lines, streets, and unusuat 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 natur01 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 Date .... New Building~c~x~ ..... Addition ................ QId or P, re-existi~g Buil~ -,-A .......... Vacant Land .............. Location Of Property ~~~w~-~-~`:~-~`~x~`~-~`~t.:~..~..~`;~ .................................. n r ~v Inland HOMBS, Inc. ~ /,. L~L~ t~ .............. Ow e Or Owners Of Prop__~ ...................................................... ./....~...~.~... .............................................. Subdivision ................................................................ Lot No ....... ?..... Block No ............. House No ............. Permit No. ?..2..8..?...~ ...... Date Of Permit .~../..6./..7.[.7.....Applicont ..~,l;l~,~.13.d...~.e,B.~...;T~c.o ...................... Health Dept. Approval 7.~-S...O.~.~.3~/J5../.~.?. ......... Labor Dept. Approval ................................................ Underwriters ApprovalN.<3~744& ...... 3~/8./.7.7,,...,Planning Board Approvgl .... ~,e~ ............................. Request For Temporary Certificate ....T~Q ............................... Fined Certificate yes Fee Submitted $ ..5......O..0. .......................... Construction on above described building ~cl~l permit n~eets oil applicable codes and regulations. Applicant ..i~~-/(x~...' .............................................................. Sworn to before me f;t~is Notary Public ..... ~.%,..~.,o..,3..,k. .............. County INLAND HOMES~ INC. (stomp or seal, ~Z/~ ~, i. m., , !977 &,,,u,,.~,,,,No.o,,yu. 941398 L~ AndePson~ Waterview DRive~ Main Sayview Rd~ ~ ~.~,~,,~,,~ ~ ~.~,'/. ~ ~.,~ ~l. outside ¥1ME CLOCKS v I c / i L l/o r ~: %otor/s: l-3/~-thp ;' :'? Smoke DeteogoP ";~ N.x~n~rd Relyea D ....... ~z Dz'ive~ P.O~Box 372 , . La, ure!~ L.I. 11948 LZo.2148E This certificate must not be altered in any manner;, return to the office of the Board if incorrect, Inspectors may be identified b~ crede /~,L.~M/v/'~,~O~,t',/.Y:. tO80B (/'T~/. 91~--f$~-~'tc~) The sewage disposal ar~ wa%er sup~ol.V facilities for this location ha~e been inspected b7 this depBrtm~t ~d found DI2.1VE t,4.59'0~'40 'W. - 150.0 I~III~K V/d4 ~ II. C,. FOR APPROVAL- OF CONSTRUCTION ONlY DA'TB:, ~' H. ~S- I~[F. NO.: AI,~eROVICD: 1'Hi; WA'I'll! IUpIFL.Y ANI ~'ANDA~De OIf gUII?~Uc GO. DEPT. OF HIIAI.I"H. t~RVIC~:B. TOWN OF $OUTHOLI~r~X r_/~. / ~_z // BUILDING DE.I',A. RTMENT/O/A~-/~!'? ~ ~ ~- ~/~ TOWN CLERK S ~UTHOLD, H. Y. ~ D'sapproved a/c . ~ ' ~ .... / ,~ ~ ~~ . ..................................................... .... ~PPLI~TION FOR BUILDING FERMIT ~ a. This application mu~t be completely filled in by typewriter o~ in ~nk ~nd submltt~d in tdpi~cat~ to the Bu~ I~spector, wit~ ~ s~t~ of plans, ~ccumte plot plan to ~1~. ~e ~ccordi~g to b. Plot plan showing Io~tion of iot ~nd of buildings on pr~mise~, relafion~hip to ~d~oining premises or puNi~ streets areas, a~d gNing ~ detailed d~scriptio~ pf I~yout ofprop~ty must b~ dr~wn on the d~agr~m w~i~h is pa~ o~ this application. c. ~e ~or~ co~er~d by this ~ppli~atian ~ay not be commen~d ~e~ore~ssu~nce of Building P~rmlt d. Upon ~pprovai of this ~pplic~tion, the Building inspector will issue a Building P~rmff to t~e ~ppl~cant. Such p~rmit sh~ll ~ k~pt on t~e p~mis~s ~wil~ble for insp~cflon t~roug~out t~ ~. No building s~all b~ occupied or used in w~ol~ or ~n p~rt for ~y pu~ose w~at~ver u~fil ~ ~ific~t~ o~ ~cup~n~y s~all have been granted ~y t~ Building I~spector. ~PPLIC~TION ~S HEREBY M~DE fo th~ Building D~partment for th~ issu~nc~ of a Building P~rmit pursuant to the Building Zone Ordinance of t~ Town of $out~old, Suffolk County, N~w York, and ot~r ~pplic~ble Laws Ordinances ~egulafions, for t~e constru~ion o~ ~u ~d rigs, ~ddifio~s or ~lter~fions, or ~or r~mowl or d~molffion, as herein described. · ~e applicant ~gre~s to comply wit~ ~ll ~pplicaN~ l~ws, ordinances, building c~e, hpusing code, ~nd r~gul~tions, admit ~uthorized ~nspe~tors on pr~mis~ ~nd i~ ~uiidin~s fo~ n~s~ i~ctio~s. (Add~ess o~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor Nome of owner of orem ses Lawrence A. Anderson If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. 517-P Electrician's License No .... ,~.~4...8..-...E.. .......................... Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map N- .]B~yview .,u .......................................... Lot No ......................... Street and Number ~.~./..~s..~.~..t.~.e..~.~.v.~.e.~.w.~.D..r.~.v.~e.'~.~...~..u~.t..h.~.~.~e~ ........................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy Vacant b. {ntended use and occupancy 1 - Family. 3. Nature of work (check which applicable): N~e~,Bui!ding~ ...~ ..... Addition .................. Alteration ................ Repair ............... ..: .Removal .................. Demolihor~ .................... Other Work ................................................ .... (Description) .#30,000.00 · 4. Estimated ~osT ................................................. Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... .3... ................... Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6. If business, commercial ar mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front .......~ ................ Rear ...... .~.~ ..................... Depth ..~.8 ............. Height ........................ Number af 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.. ................ 3.8 .. Number of Stories .................................................................................................................... 9. Size of lot: Front 3.00 Rear 3./30 Depth 150 10. Date of Purch~se'?,.:~..~...;..., ......................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... no 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded ....~ .................Wil{ excess fill be removed from premises: ( ) Yes ( ) No 14. F~ame of Owner of premise~,.~Y/~.~,~f~.e...~ke...,'~,~eN.~.... Address ................................ Phone No ....................... Name or- Architect .......!1 ...................................................... Address~ ............................. Phone No ....................... TN~.AND HI3MP. S, INC, B~ 117, M&tti~u~,, 398-96.9..6.. Name of Contractor .-.'.:.~..,-..: ................................................ Add'~-'T~C..., ......................... Phone mo ..................... / ~LOT DIAGRAM Locate clearly and distinj:fly all buildings, whetser existing or proposed, ond"%~icote all set-back dimensions from property lines. Give street c/nd block number or description according to deed, a'h~k, show street names and indicate whether interior or corner lot./ ~u ~ 7rr~ ¢~£~./ ~b~ ~w STATE OF COUNTY OF above named. · ~ng uly sworn, deposes and says that he is the applicant of individual signin '." Contractor He is the ......................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or l~oVe 'l~erformed the said work and to make and file this application; that all statements contained in this application ore true to the best of I~is knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn tok.~re me this ~ · ..~...~....O...~..:4... day of ....$e~'l:emi3e,~ ..... , 19..Z.Z. Nota~ Pu~ ic~~ .............................. Coun~ ................................ ; .......... : .................................... ~ ~LtZAB~H ANN N~IL~ ~ NOTARY PUG[G], State of New Y~lk t No, ~2-~125850, Suffolk d~Uhtv~ iAP~ E~ffites March ~0; ~ APPROVED AS NOTED % 5L~" UP J -t