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HomeMy WebLinkAbout9529-zFOBbJ[ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. Z9082 Date J~tne 23 19. 78 THIS CERTIFIES that the building located at . .3020 .The. Long..Way ...... Street Map No .... 6266. .... Block No ........... Lot No ...... 59 ......................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... 0¢~cober .... 27 ...., 19.7.7. pursuant to which Building Permit No ...... .9529Z dated .... October .... ~ ..... , 197.7. ., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...... . Pll~[VA.T.E .ONE .FA~-LY. DIqELLI~G ................................ The certificate is issued to ........ T...G. · Pl- · · Corlstr~u~'l~$en ...................... (owner, ~t) of the aforesaid building. Suffolk County Department of Health Approval ......... .7.,~S..O.-.~.h..9 ................. UNDERWRITERS CERTIFICATE No ......... N.~l~,~2.~ ........................... HOUSE NUMBER .... .~020 ..... Street ........ .~lae. Long..~/ay ................... .............................................. ~aa~ ~'la~on,. I~ew. Yo~.k ........ Building Inspector ~0T~. ~ ROOM ADJOININ(} THE OARA(}E, NOT TO BE USED AS A BEDROOM (THIS PERMIT MUST BE KEPT ON THE PI~.EMISE~S UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N? 9529 Z Dote .......... ............ ~.0.~ .......... 3.1 ......... 19..~.~.. Permission is hereby granted to: T · ~;-, ~,! ~.. Co~.~ %..... ,.,./~-.-~,~,.~ .. ( o~e ~-Ru.~ .l~er ) ....... ,9.~g)+ ....... ~e~ez~e..D.~ ............ ~e~.r.~ck at premises located at ....~,.~Q.~.,~.o~ ....... .~.~],~[~.~p~,.~¢~.C[g...j~'.~.~ .................................................... ...................................... ~...~.o~..~y......~. ,. Hg~.:l..oJ~ ......... : ................ ........................................ pursuant to application dated ........................... ~)¢,~;.....~-~. ............ , 19.~.~7;,., and approved by the Building Inspector. FOI~M NO. ~ TOWN OF $OUTHOLD 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. $.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 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 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 $I.00 New Building ........~./.'. ....... Old or Pre-existing Building ............................ Vacant'Land ............................ Underwriters pp .~ ....... ~...z ....... ~,. ..................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .....~.. ................................. Fee Submitted $ .................................... Construction on above described building and perm~ meets all applicabl~codes and regulations. me tbs .................................................................................... Sworn to before ' ................ day of ............................................ (stamp or seat) Notary Public .................................... County IUIUNN~ INIPARTMINT~ Ok' ~ ~ ,97- TOWN CLERK'S CNI~FICE SOUTHOLD, No ¥o ~ amin ............ .............. , ............ Disapproved a/c ..................................................................................... ................. .............................. }./_ ............... ............... ..... aPL ~0 INSTRUCTIONS o. This application must be completely filled in by typewriter o~. in ink and submitted in triplicate to the Buildingrr~ 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 or areas, and giving o detailed description of layout ofpraperty must be drawn on the d ogram wh ch s part of th s app ication. c. The work covered by this application may not be commenced before issuance of Building Permit. d.. U.pon approval of this application, the Build!ng Inspector will issue a Building Permit to the applicant. Such permit shall oe Kept on the premises available for inspechon ~ronghout the work. 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. B .A,P. PLI ,CATIO_N .IS HEREB. Y.MADE to _the BUilding Department for .the issuance of a Building Permit pursuant to the uilaing :one urainance o1' the Town at Southold, Suffolk County, ~lew York, and other applicable Laws, Ordinances ~ Regulations, for the construction of buildingst additions or alterations, or fbr removal' or demolition, as herein descrl .be~'~- The applicant agrees to comply with all applicable laws, 0rdi~ances, building code, housing code, and regulations, and teL, admit authorized inspectors on premises o~l in b~lngs for~ ra~cessary inspections. (Signature of apl~icant, or name, if a corporation) -- . (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~T'6~ c~-~ ~. ~ e.. ................................................................................ Nome of owner of premises ....................................... .~.. ............ ~ ....... If applic~ant is a corporate, signature of duly authorized officer. .................. i~igr~;'~L~";,~"~'gF ~'L~';L't';%¥~i~'~';i "" ..... Builder's License No ..................................................... Plumber's License No ....... ~..~...~....,.~.. ....................... Electrician's License No....~.!.~.......~.-.~.. ........................ ~0 0 - ~ /..f-,D 7- So - ,'Y'~ Other Trade's License No ............................................... I' ~..~,~..,- ~;~e~¢~ ~n~-I~' 1. Location of land on which_p_ro~osed work will be d~o~e. Map No.: ...~..~....6..~ ........................ Lot No ...... .~..'~...~ ...... Street and Number ...... '..~...'~.......~.? ........ ~....'.:/. ........................ .~,~...~.....kT/.(~.o...~..i ......... : ............. i.iiii 2. Stateexistina useandoccupancyofprLisesandLendeduseandoccupancyofpraposedcanstMm~ioCin:polity a. Exisiting use and occupancy ........................................................................................ [ ....................................... b. Intended use and occupancy ................................ .y ................................................................................. 3. Nature of work (check which applicable): New Buildi0g .................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior.,..~ ......... i ..... Other Work ..................................................... ~ ~-- (~ ..~ (Description) 4. Estimated Cost .~-~,~o~.7..~. ,o O ~ee ~'~ ~-- .......................................... ....... · ......... .................. p b 5. If dwelling, numbor of dwellino units ........ ~..~ .......... ~um er of dwellino unit~ on ~*ch {l~r ............................ If ~ro~e, number of corn ............. ~.~ ............................................................................................................... '6. ff business, commerciol or mixed occuponcy, speci{y notur0 and extent o~ ~ch ~poo{ u~ ............................ 7. Dimensions of existino structures, ff ~ny: Front'. ........................... Reor ................................ D~pth .................... , ~ Heioht ........................ ~umber o{ Stories ................................................................................................................. Dimensions of s~mo structure w{th o~e~*~i~ons or odditions: Front ....................................R~or ............................ Depth ................................ Height ............................ M~ber of Stories ................................ 8. Dimensions of entire new construction: Front ...... ~.& ..................... Rear .....~ .......... D~pth ........................ Height .~ ........... Number of Stories .... ~...~.~ ...................................... ' · ..................................................... 9. Size of lot: Front ...... ~ ........................................... Rear ..~..~ ......................... Depth ~ ............... - ~+ ~ · f Former ner ~'~ ~ ~'~ ~ 10. Date of Purchase .~ ................ Z~..~ ...................... ~ame o ~ ~ ......................................~ .... 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 . ........ ~ ............... Will exce~ fill be remo~ fz~ promises: ( ) ~es ( ~o 14. Name of ~ner o premises ........................... ' ..................... .... A~m~ ................... : ...... ~.,. Pho~ No. ~ ............ ; .... Nome or Architect .............~ .................... ~ ........................... Addre~ ~..~.~.t~.. Phone No ................. ~.. Name of Contractor .D....~.~:..~.~.t ........... A~ress ................................ Phone No ....................... PLOT DIAG~M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set~k dimensions from prope~ lines. Give street and block number or description according to deed, and show street names and indicate ~hether interior or corner lot. STATE OF NEW,,Y-O~,.- /'~ ~ S S COU.~I.TY OF ....~. :~..~[~-.~.~r/~....~ ' ~..~.,.,llflJ'.~...~.~ ....... . .~..~.~'~...~. ...... be ng duly sworn, depos~ .......... _ ~a~; of individ~lUsigning contrac~ F?~,~ bov ,he .......................... : ............. ....................................... He is(Contractor, agent, corporate officer, etc.) of said owner or owners and is duly authorized to perform or have performed the said work this application; that all statements contained in this application are true to the best of his~n~e and belief; and that the work will b~ performed in the manner set fo~h in the application filed therewith. Sworn to before me this ~ .................... ................... .... NOTARY PUBLIC, State of New Yo~ No. 52.8125850, Suffblk C~ I ' ' BUFF. ~O. HI~4,L.'rH D~,. ~,VAI.. H. Chief of General ~0.0 ~ ~, . ~ ',' ; - ~ " '~ ' . ' , ' , ~,} ~' ~ ~ ~ ..~--.~'~"~:-~_ / : " ,~' ~- ~ , ~: . , i ' ~ ~ ~o , ~, ~ ~ ¢ ~ .. ~.~ O' .. C:¢'~'J__ c ~o. A""m'VT'U- O~ oommme'no- 1141 WA~ S~PLY AND ~t',~ DA~: ....... ~ ~' H.S. REP. ~,: ~A~ OF BUFF~ ~ c/a~ o~ .~. A~: h' . THE LOCATION OF WELLS AND CESSPOOLS SHOWN HERE(~NARE FROM FIELD OBSERVATIONS AND/OR FROM DATA OBTAINED FROM OTHERS THE WATER SUPPLY ANO SEWAGE DISPOSAL SYSTEMS FOR THIS RESIliENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT OFHEALTH SERVICES AI:>Ptj CAN T ADDRESS ........... TEL -- -- voCOnt 60 Lot 29 Lo t 59 ft. Area: 22679 sq. 58 Lot vacant REVISIONS FEB. I~ 1970 MA Y /2, 1978 ?Il-lB NO 7808-002/2 NO TE : ~= MONUMENK SUBDIVISION MAP FILED IN THE OFF/CE OF TH[' CLERK OF SUFFOLK COUNTy ON dUNE II, 1975 AS FILE NO. 626~. WATER SUPPLY- PUBLIC WATER YOUNG & YOUNG 400 OSTRANDER AVENUE, EIVERHEAD, HEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: ~/LL/,~/1// LOT NO..59, "PEBBLE 8E~CH F~RMS AT E~ $ T M~RION TOW~ or SOU THOLD SUFFOLK CO., N.Y. CHIC,~GO TITLE INSUR,~NCE CO 0C7~14,1977 t NO.77 w_ 764 u THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OSSERVATIONS AND/OR FROM DATA OBTAINED FROM OTHERS THE WATERSUPPEY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESI[~NCE W[LL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENF O~HEALTH SERVICES T~ ~ C~ ~-~ ~ ~. ~ ~ . A~ICANT ~ -- ~ -- S~FOLK COUN~ DEPART~NT OF HEALTH SERVIC~ FOR APPROVAL OF CONSTRUCTION ONLY APPROVED voCOn! 6O Lot Lo t 59 ft. AreO = 22679 sq. 58 Lot vocont UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY ISA VIOLATION OF SECTION ?209 OF THE NEW YORK STATE EDUCATION COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOflSE~ SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COP~ GUARANTEES INDICATED HEREON SHALL RUN ONLy TO THE PERSON FOR WHOM THE REVISIONS NO T£: m= MONUMENT SUBDIVISION MAP FILED IN THE OFF/CE OF THE CLERK OF SUFFOLK COUNTy ON JUNE II,/975 AS FILE NO. WATER SUPPLY - PUBLIC W,~TER. YOUNG & YOUNG 400 OSTRANDER AVENUE, EIVERHEAD, NEW YORK ALDEN W, YOUNG HOWARD W. YOUNG SURVEY FOR: I, VILLI.,~M LOT A/O. 5.9, BE-ACH FA/~MS " AT EASY- M,~PION TOWN OF SOU THOLD SUFFOLK CO., N.Y. GUARANTEED TO: iCALE: /" = ~0' DATE: OC~ 14,1977 I NO.77 ~ - 7~ ~1 ~;L THE NEW YORK BOARD OF Fl!RE UNDERWRITERS BUREAU OF I~LECTRIOIT~ ~' 8S JOHN STREET NEW ¥'ORK, NEW ~oRK iOO3E THiS CERTifIES THAT on~ the electrical equ~ment ~ descrt~d below and int~duced by t~2appl~ant ~d~on the able application number in the premises ~ inthefollowingloca*ion; ~Basemcnt ~ IstFI. ~ 2nd Fl. :0'~,$: Section Block Lot was exami~d on A p ~ ~. ]~. ~ ~ ~ l, ~I ] 8 and found ~o be in complla4ce With the r~quirements of this Board. FIXTURE I [ FIXTURES OVENS DISH WASHERS EXHAUST FANS DRYERS MOTORS FUTURE APPLIANCE FEEDERS DIMMERS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET E DISCONNECT OTHER APPARATUS: This certificate must not be altered in any return to the office :~_ 4/0 be c~edehfials. ANY MANNER. / / ;1 Jl E L F~V,~ T I l '" J & S I15T05 ~HIN&klr. t 1 Jl EMIL COCCHIARELLA f45 SOUTH FRANKLIN AVE ARCHITECT VALLEY STREAM, N.Y, 11582 DWG .o R 1488 r · ID LUMI~Ij~NO' Iq,.UMBING Muir BI; INSTAL.[,~) ,M:X:JDIDI~(J TO OI~DI: PII~/lelONS q-"~ FLO00, -.~ .~ECTION ~t'~O IIN~,[ALL.~- , = ~ Or' .I CONTRACTOR IOCHLC, ~,NDVLRI- FY ALL C©I~IDII~C)t~z 4ICl {x[tAkN 'dONSATSI~E A~-~D lC) k~F'Okl ANY ,)ISCREPANCI[S [0 FHE ARCHITECT, .0, z F I 12.5T FLOOP- pL&N, r