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HomeMy WebLinkAbout9483-zTOWN OF SOUTHOLD BUH.nlNG DEPART~R~ Town ~lerk% O~ice Southold, N. Y. Certificate Of Occupancy No... ~.9/4.~./*.... Date ......~.a..r.c.h.....2.9 .......... ,19.77. THIS CERTIFIES that the bui]dlng located at .. 9/~75' Bey .Ave ........... ~ Map No...~... Block No.. ~ .Lot No ...... ~ .................. conforms substantially to the Application for Building Permit heretofore filed in this office dated . .Oc~.o.b.e.r.../+. ......... , 19..7.7. pursuant to which Building Permit No..9~.8.~.Z... dated . .Qc.t.o.b.~I'../+. .......... , 19.7.7.., was issued, and conforms to all o! the require- merits of the applicable provisions of the law. The occupancy for which this certificate is ~ued is ........~l.v.~,..One. F.a. mi .~7...~w. eA .~.in~ .V,i.~.h.. $.d.d.t..t.ip.n. ............... The certi_'~icate is issued to ....... 1~.,. ~.o.s. ,ph .I~.s:[.1.~.ga.r) .......................... (owner, of the aforesaid building. Su~olk County Department of Health Approval ............ I~/.A .................... UNDERWRITERS CERTIFICATE No ............. .N.~?. 9. .6 .q .2. ....................... HOUSE NUMBER ...2~.7.~. ....... Street ......... .B.ay..Ay.e ......................... New York ............................................... ..................... Count'y. T~x Number 1000-1~.4-~.- 5 FO~i~ NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK ^UTHORIZED) Ne 9483 Z Date Oct )+ Permission is hereby granted to: .......... ........... New Suffolk to build an addition on existinE dwellinz at premises located at ...~./.J~...~..~ ................................................................................. l~at t ituck pursuant to application dated ........................... ..0..0...~. ....... ~. ............ 19.~.?..., and approved by the Building Inspector. Fee $..!.~.'...0..©. ........... Building Inspecto{ FOBM NO. 6 TOWN OF SOUTHOLD 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 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 o~ 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 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 3. Copy of certificate of occupancy $1.00 $5.00 Date New Building .................... Old or Pre-existing Building ..... .~'..~ .................. Vacant Land ............................ Location Of Property ...~../.-~'.. ....... ..~....~..~.. ....... .~..~.~..?.v...?.....~......,.........~7....~.~...7?./.~/A(..~:....~,... .............................. Owner Or Owners Of Property ....... 9..J:..~, ~...~ ~..~ g .~., tz~..~..' ........................... Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No....~.~..~.~:..~.... Date Of Permit .?~../.~./..Z.? ./...Applicant .... ;~....~....~.;.~-../: ...... '.~.~..~.~...~; .................. Health Dept. Approval ......'~..t..~ ................................ Labor Dept. Approval ....... ..~..:.)~ ............................... Underwriters Approval .............................................. Planning Board Approval .....'~.:../.~ ............................ Request For Temporary Certificate Final Certificate Fee Submitted $ ...,~.:..(h~ ..................... Construction on above described building and permit meets all applicable codes and regulations. Sworn to before me this Applicant ...~..~.~,~.......",~......~..~: ............. ................ day of ............................................ Notary Public .................................... County (stamp or seal) THE NEW YORK BOARD OF FIRE UNDERWRITERS gf BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT ~o~eph ]-alligan, oAT AVE, Mattl~Qck, N.~. in th~ follotving location; [] ~ement [] tst Ft. [] ~nd Ft. OUtJl.tde Section B~oclt Lot was e~amined on J~',J~ ~2j, 1~?~ an~ found to ~e in complia~ce wlth the requirements of this ~mz~d, D~YERS FURNACE MOTORS FUTURE AI~UANCi FREDRES SPIOALIIC,PT. ~6T. K, W. O~L H, P, GAS H, P, A~T. NO. A* W.G. AMT. id SERVICE EXSCONNECT NO. O~ S ! ' ~ : CB 1 X ] -%~oke Detecto~ ,NS. I 6-lite; ¢ E EXHAUST FANS AA(T, H* P, DUAMERS 1/0 1 1/0 Anthony J. Uarrls Twomey Ave. Ca~lYerton, o~. f. 11933 :~ic. 301-n This certificate must ~t ~ a~ in any ~n~r;. ~urn to the office of t~ ~a~ if inmrr~. Ifls~n may h i~iM by t~r credentials.' copy F~ ~ILDI~ DEPARTMENT. THIS COPY OF C~TIFI~TE MU~ NOT. ~ m ~ MN~. '1 ·OBM NO. ~ TOWN OF SOUTHOLD ~~, , ., BUILDIN~ DEPARTMENT/~~ TOWN C~RK'S OFFICE ~ ~UTHOLD, N. Y. Exomin~ ............~....~ ...... 19..~} ~pli;ati~ No....~.~ ........ ~.~ r~ ~ r~ ~ e ,tNo ~~ ~p ........................................ , 19.....Z P ~' · ...~ ........................ ' (Building Ifls~tor) APPLICATION FOR BUILDING PE~IT ................................... INSTRU~IONS a. This applicati~ must be complexly fill~ in by ~pewriter o~ in ink and submi~ in triplicate to the Buildi~ Inspector, with 3 sets of plans, accurate pl~ plan to ~ale. F~ according to ~h~ule. b. Plot plan showing I~otion 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 the diagram which is ~ of this applicatJon.~ c. The work covered by this a~lication may n~ be commenc~ before issuance of Building Permit. d. Upon approval of this application, ~e Bbilding Ins~tor will issue a Building Permit to the applicant. Such permit~ shall be kept on the premises available for inspection throughout the work. e. No building shall be ~cupied or u~d in whole or in pa~ for any pu~ose whoever until a Ce~ificate of ~cupancy 'shall have bee~ granted by the Building In~ector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of o Building Permit pursuant to the~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable lows, ordinances, building code, housing code, and regulations, and to.~ admit authorized inspectors on premises and in buildings for necessary inspections. ..... ~~~r name, if a corporation) ~ess of applicant) State whether applicant Js owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of Premises ..~~ ........ ..~.~,~.~...........~..... i~..* .d. ~ ............................ If applicant is a corporate, signature of duly authorized officer. ~.~a~ J~,~.~q_~.__ ~//-'/- (Nome and title of corporate officer) Builder's License No ...... ,.~......-~..~.....~......../....~..:~ ......... Plumber's License No .... ...~'.'.'.'.'.'.'.~,...,~..,,/~,.~ ........................ Electrician's License No..~..~a~.~.~t.~ ........ Other Zrade's License No ............................................... 1. Location of land on which propo~ed work will be done. Map No.: ........................................ Lot No ......................... Street and Number .............. ".~......~.. ....... ~ ........ ."~....~ ..................................................... ~' Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ..... -- -- ~" ~s/ L.~~/'Z''~''' ..~..~i...~....~ ............ ........................................ b. Intended use and occupancy .......................................................... :.: ................................................................. 3. Nature of work (check which applicable): New Building. ................. Addition ,.~...... AIteration'...'.'...]~' ..... Repair .................. Removal .................. Demolition .................... Other Work ..................................................... ,~ / ~_ ~.~.~ (Description) 4. Estimated Cost ............................................................ 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 cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ..~7....c¢..;...~. ........... 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 ........................................................ Name of Former Owner ..~..~...~...~. 1 1. 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 ....~..~..l~). ............. Will excess fill be removed from premises: ( ) Yes (~o 14. Name of Owner of premises .................................................... Address ................................ Phone No. ...................... Name of Architect .............................................................. Address ................................ Phone No ....................... Nome 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 lot. STATE OF NEW/Y~,J~, /£ ~ Sc COUN. TY OF ...(~..~./~...czz.... ....... f~ ~/ ~ ~~ -ein (Na~'~~.~, ~ contrac~ duly sworn, deposes and says that he is the applicam above named. ~ He is the ........................................................ ~..Z........Z ..................................................................................................... (Contractor, agent, co~orate officer, etc.) of said owner or owners, and is duty authorized to perform 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 manner set fo~h in the application filed therewith. ................. .......... ........................................