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Home My WebLink About9218-zFOW~ NO, 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.. Z9.296 .... Date ...N. ovemb, er ..8 ......... , 19..78 THIS CERTIFIES that the building located at ....~620. Beztl~.e. ~Beach .l~d, ~ Map No ............. Block No ......... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated . .Aprt.~,.. 25 ..... , 19.7.7. pursuant to which Building Permit No..92.~8 · · dated ...A.p..r.:[.[l:....2.9. ........ , 19 .7.7.., was issued, and conforms to all of the reqnire- ments of the applicable provisions of the law. The occupancy for which this certificate is ~sued i~ ....... . .m?.~.¥.a~e...0p.e..F..~?~.¥..~..e.~.~.~..n.g. ............................... The certificate is issued to .... R..u.s.s.e. 1..1..C.....&..D.q .rm.a..S....V..a~..d.c..r'.b.e.c.k. ............ (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval ......... .N./.R. ................... UNDERWRITERS CERTIFICATE No .......... .~?~..57.87.~. ......................... HOUSE NUMBER . .~ .6~0. ..... Street ...... .B.a.l.~.t.e..B..e.a.c.h..1~. 9.a.d' ............... l~;tituck, New York Building Inspector ' 'iTHE UNDERWRI,'I'ERS , *",", NEW'~YORK BOARD OF FIRE ~, : ;" ,,, ,, BUREAU OF ELECTRICITY ak ~"" 85 JOHN STREET. NEW YORK, NEW YORK 10038 ~o,~ August B0,'1977 , . ....,-o,,o.~,o.o,,zi~. 922215"' ,,, , N 353893' THIS CERTIFIES THAT , ', only the elect rical equ{pment as described bolero and i~troduc~ by ~he appllc~nt ~a~ed on the a~ve appJlcation number in the premlse~ o~ R.C~ Vanderbeck, e/side Bailie Beach Rd., 800' n/o East Side Ave. Mattituck~ L.I. ~ ~ ~ FIXTURE ~ I I FIXTURES ~ RANGES ~cooKINGDECKS j OVENS ~DISH WASHERS EXHAUST FANS D~"S I" - ~u~.~O~~' X~i~c~ ~uo~.s '[s.&,~(.~'P~, ';,~c~b~s t"~t I'u"'¢'"~"S l~ut''~Ou t~, D~"S -- " METER ........... *,,,*, , ,-, ~ -- ~ OTHER APPARATUS, Elee.room heaters: 3-2.0kw,' 3-1.Skw,' 1-.75kw 1 G.F.I. ~, -, :, , 1 Smoke Detecto/' ,, , , , ,., ,,:,., ,, 1-0.Skw Hot water heater" ' ...... Mattituek, L.I.' 11952 ' ,' r , Lic,2~2E '~~ / Th,s certificate must not be altered in any manner; return to ~he office o~ tbs Board ~f incorrect Inspectors may be ide'nhhed by th~als NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT~. / . TOWN CLERK'S OFFIGE ~UTHOLD, :..~.:..:.. ~..,.~.~?...., ~..~.~ Exemined ~ ~pplication ~o..~.~L~ ................... ~proved ........................................ , .............................................. ........................ ........ INSTRUCTIONS a This application must be completely f, lled in by typewriter or in ink and submitted in triplicate to the Buildin Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of [at and of buildings on premises, relationship to adjoining premises or public streets ~ areas, and g,ving a detailed description of layout ofproperty must be drawn on the diagram which is part of thru applicatio~ c. The work covered by this applicahon may not be commenced before ~ssuance of Budding Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such perm shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used m whole or in part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances ~ Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe, The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and i~ buildings for necessa~ections. ~' ~'Signature of applicant, o,r,~ame, if a cor~mtratlo~[) ...~......~.~ ~...../..& ...... .0..(~. ~'~..,..~,..~ (Address of applicant) ~') ~'/~'~CJ State whelher applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde~ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~/~///'*""/"~/'~ ,'7~- Plumber's License No. Electrician's License No. · ~....~:~/~ O,,e, ~.,.'. ~,~en, ,o..~~.Z.....~....~"'~ ~'" of o. .or ~,r~, ~., ,.m~.~ ...... ~:.~. ......... ~.~Z ............... ~.~.]-.-:~f~:::~.": / Municipali~ State ex~stmg use and occupancy of premises and intended use and occupancy of proposed construction: ~ .xi.,.,.guse..d~up.n~ ......... ~¢~ ...... ~ ......................................... .~ .................. ....................... ........................................... ...................... 3. Nature of work (check which apphcable). New Building .................. Addmon.............Z"'"'""'- ............. Alteration Repair ................. ' Removal .................. Demolmor. ........... Other Work .................................................. . .~....~.j. ~-~ (Description) 4 Estimated Cost ....... ..~...d...~..: ............................. Fee .............. .~..'.~.... :...~....~. .......................................................... (to be pa~d on filing th~s apphcat~on) 5 If dwelhng, number of dwelhng units .......... ~ ........ Number of dwelhng umts on each floor .................. / ~.../.?.....~.... If garage, number of cars ........... ~.z~.//~...~.~, .................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .......................... 7. Dimens,ons of ex,st,ng structures, if any Front .... ./..~'..../. ........... Rear ........ ?.....~...' ............... Depth ...~...~../. ..... Height ...... /..~....'. ..... Number of Stones .......... ...¢~.-~..Z-.~.~. ....................................................................................... D~mens~ons of same structure with alterations or addmons. Front ........... /..~.. ................... Rear .. Depth ........... .~....' ..... He,ght ......... ./..~..~. ..... Number of Stories ........ ~'.Z'.~.~.~.. ........... 8 D~mens~ons of entire new construction' Front ....... ~ ..................... Rear ............................ Depth Height ........-'--~. ........ Number of Stories ................ ~ ..................................................................................... 9 S,ze of lot Front .......... ~..~.. ...... / ....................... Rear ......... ~..S .......................... Depth .....~..~...~.. ................. 10 Date of Purchase ....... ./.~..J .~'.....~.,/~...~... ............. Name of Former Owner j.Z~...~...F../.../...7~..~. ...... ./...~..C~.-~..../~....,~'...J~.... 11. Zone or use distnct in which premises are situated . ./..~..~/...~7..-~...~/...~....Z~.. ............................................................. 12 Does proposed construction wolate any zoning law, ordinance or regulation- . ...... ~ ........................................... 13 W~II lot be regraded ....... ,¢~.,~ ..... Will excess fill be removed from premise~: ~ Yes ( ) No 14 Name of Owner of prem,ses ...~ .~.:...~.././.~...~...~..?.4~...~..z'.~..~. Address ...~.~/~(..~one N .o~...;...~..)'.);....~..~,/../, Name of Architect ...... ~ ~ Address ~' Phone No. Name of Contractor .~.(.~..Z:.f.~ ....... .~.~....~/'..~ ......... Address~..?...7'.2?...,F-.......~'..'~........~..~.....-~. Phone No. PLOT DIAGRAM ~,~-~ ~ ~v_~ Locate clearly and d~stmctly all buddings, whether ex~stmg or proposed, and red,cate all set-back d~mens~ons fror property hnes Gwe street and block number or descnpt~on according to deed, and show street names and indicat whether interior or corner lot STATE OF NEW YORK, IS S COUNTY OF .......................... ................................................................................... being duly sworn, deposes and says that he ~s the applica~ (Name of mdwldual signing contracf) above named He is the ...................................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, a~d ~s duly authorized to perform or have performed the said work and to make and fi~ this apphcat~on; that oil statements contsmed ~n th~s apphcation ore true to the best of Ms knowledge and behef; an tk, a~ the work will be performed ~n the manner set forth m the apphcat~on filed therewith Sworn to before me th,s ~ C~.¢~ ~~ ....................... day of ............................... , 19.. Notary Pubhc, . ................................................. County ..... : .............. : ........................ : .......... (S~gnature of apphcant) 2~mo ~$ · Fz-ust~ APPROVED AS NOTED DEPAPT~ENT AT ~-~.6~ 0 ,~ to 4~M F~ REQU~R. G[~OR~ BI' ~;~U~P ~r~1~A' 4A,,D /oo ~M P 2. ~o FORM ~0. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .........~......~.....~ .... 19.Z..7.. Approved ..........'....~.! .......... ...~....~. ..... . 19.?.~... Permit No. ?.~../..,?..,..Z~.,. ............... INSTRUCTIONS a This apphcation must be completely f, lled in by typewriter or in ink and subm,tted in triplicate to the Buildir Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets, areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of th~s applicatiof 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 ~ssue a Building Permit to the apphcant Such perm shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan~ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or aJterat~ons, or for removal or demolition, as herein describe, s )-(Signature of,al:Lolicant, or,/~e, if a corp~n) ................ ....... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bu,lde · ............. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) t Electrician's License No.~.~.~..~.....~..'~..../~ ~' Other Trade's License No~..'~...~..~...'''' ~ ~~/ Locat,o. of land on w~;~['~;[['[~-~' M~ /~ ~ Lot No Street and Number ..~...~'~..~~ b. Intended use and occupancy ..~_~.~ ........................................ .~. ............. 3. Nature of work (check which app[~cabl~) New Building ................ Addition .................. Alteration ............... Repair ................. Removal .................. Demolmar. ............. Other Work ................................................ ....~../Z~./ ~/ (Description) 4 Estimated Cost .......... ~..~...~.. ........................ Fee ..............~z-)? 0 .=..-.?..-.- .......................................................... (to be pa~d on filing thts applicatiqn) s ,f dwe,ing, number of dwe, ng un,ts ...... --/.. .............. Number of dwe,ing un,ts on each ,oar .... If garage, number of cars ...................... .~....~. ~/..< .............................................................................................. 6 If business, commercial or mixed occupancy, speofy n. ature and extent of each type of use ' ' 7 D,mens,ons of exist,nD structures, ,f any. Front ..... /~. ............. Rear ...... ~..~.. .................Depth ......'~....~../. ..... Height ..... ,./.~.f. ' Number of Stones ...... .~....%~..~.~. .......................................................................................... D~mens~ons of same structure w~th alterations or addmons Front ........ /..~. ...................... Rear ........................ Depth ..... ,~..~.. ................ Height ... ~.~../. ..... Number of Stones .......... .~..?~...G. ........... 8 D~mens~ons of enhre new construction Front .............. ~-~...., ................ Rear .............~ ........ Depth ...................... Hmght ..... ~ .... Number of Stones ......................................................................................................... 9 Size of lot Front ...... ~A.~. ...................................... Rear .........(~.(~. ........................ Depth ...... (.. ...................... 10. Date of Purchase ...... ~....~'../~..~'..Z?~.. ................ Name of Former Owner"~ -- --./..~/.¢~.~..~...~'.~......,~...~..~..~.~...77...~.. ll. Zone or use dlstr,ct in which premises are s,tuated ...... , ./..~..~..s~..//~..~....~d..~..../../../...~T~¢. ................................................ 12 Does proposed construction wolate any zoning law, ordinance or regulation' .......~... ............................................ 13. W01 lot be regraded ..... Z~'...~-.~,,~ ......... Wdl excess fill be removed from prer~is~s: (~ Yes ( ) No Name of Architect .... /~. ......................... Address ~ Phone No. Locate clearly and dist,nctly all buildings, whether existing or proposed, and red,cate oil set-back dimensions fror property lines Gwe street and block number or description according to deed, and show street names and indlcat whether interior or corner lot STATE OF NEW YORK, COUNTY OF ....................... [5.5 ....................................................................................... being duly sworn, deposes and soys that he ~s the applicar (Name of ind~wdual s~gmng contract) above named He ~s the ................................................................................................................................................................ (Contractor, agent, corporate officer, etc of sa~d owner or owners, and is duly authorized to perform or have performed the said work and to make and fil this application; that all statements contained m th~s apphcahon are true to the best of his knowledge and behef; an tha~ the work w~ll be performed m the manner set forth in the apphcation filed therewith. Sworn to before me th~s Notary Pubhc, . .................................................. County ........ ~,, ................................ (S~gnoture ,~f opphcant)