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Home My WebLink About9245-z~'0~,~ NO. · TOWN OF $OUTHOLD BU~I~IN(~ DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupency No..Z?.9.3.9. ..... Date ............. Oct...~ ..... , 19.7.~. THIS CERTIFIES that the building located at . .Yermecott..Dri.v~ ....... Street Pk, Map No. ~enr~eco.t.t. Block No ..........Lot No.. -~.9 ..... Sou~hold...2't .Y., ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ Ma~. 13., 19.77. pursuant to which B,,ilding Pei~mit No .... 9~+.5Z dated ......... ~JOY.. 15..., 19.77., was issued, and conforms to all of the req,,ire- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is P.r..ly.a.t.e...o.n.e...f.a~.l.ly. d.v?.l.~.i.r, g ....................................... The certificate is issued to J~eonldas Mousasas ....... 0wne~ ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .Oct..5..3.977. by..R,. ¥il3-a ...... UNDERWRITERS CERTIFICATE No... ~.~.5.551+ 1 .... Se~t. ~ ~... 19-7.7 ............. HOUSE NUMBER ..... ~1~.O .... Street .. ~/6ru~ecott. Dr. ....... South. ~Lc~ ........ Building Inspector ' / ]~0~,31~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT cTHIS PER, MIT i~UST:,BE KEPT ON THE PREMISES UNTIL FULL CO~PLI~I'ION OF '~ql} WORK AUTHORIZED) N? 9245 Z Permission is hereby granted lo: ......... ~.,,...~~..~ ....... .~.o..J,..a. ............ ~ '~ ~o ~,,~pl}ce, tion dated. _ .................... ~.~ ...................... , 19 .... ~nd opproved by the Inspector. ', FORM NO. 6 TOWN OF SOUTHOLD Bulfdlng Department Town Clerk~ Office Southold, 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 follow~ng; 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. F~nal 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 natural or topographic features. 2. Sworn statement of owner or previous owner as to use, ~ccupancy 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. Certihcate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of accupancy $1.00 New Building ..~.~,R ......... Old or Pre-existing Building ............................ Vacant Land ............................ Jo. · oco,,o ........ ......... ....................................... Owner Or Owners Of Property ..... .'..k~..~.0...~..~.~ ...... /...Vtj,~..¢~.(~,~.~).~. ....................................................... Subdivision ................................................... ./. ..... /.... Lot No...~...f .... Block No ............. House No ............. Permit No..~,.~....5...-...~.... Date~, ~"/'770: Permit ...¥~.../.~'[~.~pplicant/, ...~./.'-"~' .,~.~.~,~..~.~.~.~....]/-~..6'.i~.~.(~.,.;~ .......... Health Dept. Approval x...~ .................................. Labor Dept. Approval ................./~....:...~..;.~. .................. Underwriters Approval ...~.~..~....~..0 ........................... Planning Board Approval ......... ~.~./.....~..~ .................. Request For Temporary C,e,rtificate ........................................ Final Certificate .... ..~.....% ............................ ~ c~><-' Fee Submitted $ .~..............'~'--~. ................. Construction on above described building and permit ,m, eets all a~pplica.ble codes and regulations. Ap p li c ont ...... ~. ~ ~.~.. !~..~ ~,'/. ~ ...... b..~¥.~.~. ...... ~/. (.' ..................... Sworn to before me this ......... of ............. Notary Public ...X~41../'~,~.~.~:- ''~ ..... County (stomp or se~_~ ~ ~ . ~O~M NO. ~ TOWN OF SOUTHOLD Building Department Town Glerk~ Office Southoid, 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 build,ngs, 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 installahon 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 dwelhng or land use $5.00 3. Copy of certificate of occupancy $1.00 Date ................................................ New Building ...~.~f~. ........ Old or Pre-existin~g Building ............................ Vacant Land ............................ Location Of Pro~erty ..~,,.D...r...C..~..~......Y.E..~?..4Z.;.~:.C.:..O.~ .7~......~.~.~)...~/.~.~.~;J~-- _ _ ?~.', .................... Owner Or Owners Of Property .... ~-,~.~.~ .~.././..~.~...~,.~ ..... ./..;././~!.~..~[.~../~.~.~: ................................................... /J'/~: Bi Subdivision ................................................. ~. ...... , ...... Lot No ........ ~ ....ack No ............. House No ............. Permit No ~.C~..~.~..-..~.~. Date Of Permit ~-./~./.:~./~.7..Applicant ~Z~,~.~/~.~.).....~..~-~..~..(.~:..r. ..... Health Dept. Approval ............................................ abor Dept. pproval ................................................ ,n ........................................ Underwriters Approval ..... .~..~,..~ ............................. P an' g Board Approval Request For Temporary Certificate ........................................ Final Certificate ......... '7" .......................... Fee Submitted $ .................................... / Construction on above described building and permi~t meets all applicabl 4codes and regulations. Sworn to before me this ................ day of ............................................ (stamp or seal) Notary Public .................................... County THE, NEW YORK BOARD OF FIRE UNDERWRITERS ~'~ / BUREAU OF ELECTRICITY ~-- 8S JOHN STREET, NEW YORK, NEW YORK 10038 m.e September 12, 3.977 ~lppl~,-.uo,,s,,.,,./il~ 926406 N THIS CERTIFIES THAT ' only the el~trlcat equipment as ~scribed ~low and introduc~ by t~ appllcant named on ~he above application number ~n thc prettt~ze~ of L. Moussas, s/side Yennecott Drive, app. 800' e/o Boisse~ Ave. So uthold ~L .I. ~,th,fotto~,~to~,~o~ ~i~,t ~ ~t~t. ~ ~,,~ rt. outside .~.~ao, Bt~ ~'"~ ~9 a,~, e..mln~d o~ S eptemb er 8 ~ ~977 ..afo..d to be in compliance with the requirements of this Board / / DRYERS ~ FURNACE MOTORS { FUTURE APPLIANCE FEEDERS ~SPECIA[REC'PT TIMECLOCKS ~ BELL S UNIT HEATERS MULTI-OUTLET DIMMERS T N SYSTEMS SERVICE DISCONNECT { O F J ' S E R V I OTHER APPARATUS: G.F.C.I. Smoke Detector Post Lite Joseph C~ocombe, Box 1175 Center Moriches, L.I. 11934 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their Lic. 7~6E GE"E~A~AN??~.~ ~oproved ~ ~ /~ TOWN OF $OUTHOLD 7b~,/7. BUILDING DEPARTMENT. ~UTHOLD, N.Y. 4'~' ........... ..... ....... APPLICATION FOR BUILDING PERMIT Date .............................................. '~//t~ /'5 , 19..7~. ...... INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the BuildinL Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b Plat plan showing location of lot and of buildings on premises, relahonsh.p to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drown on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d Upon approval of this applicahon, the Building Inspector will ~ssue a Building Permit to the applicant. Such permii 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 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( Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicpbte Laws, Ordinances o, Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t~ admit authorized inspectors on premises end ir~ buildings for necessary inspections. ..... ........... ....... (Signature of applicant, or name, if a corporation) ..... ......................... (Address of applicant) State whether applicant is ~ner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ....... ~......~.~ ....................................................................................... If oppz~hcan~is a corpo_rate, signature of duly authorized officer. c. ..... ~'"~'G;;;";;;Z'~i~i';";;~";;;'q~;;'f;;";/~i;';';~ ......... Builder's License No ....... Plumber's License No ................ ,.~.. .............................. ~'~'~L~C Electrician's License No. ~.......-TT ......... Other Trade s License No ............................................... ~(~ 1 Location of land on which proposed work will be done Mop.~No...P~/c.~7. .... .~./.~..7. ........... Lot No ........ .~. ......... Street and Number ............. y..~...~....~...E....C~...~ ..... ~..~.,.]..~...~....,......~.?...~...-~./-/..C?..L.~. ................................................ / / Municipality 2 State existing use and occupancy of premmes and m.~ended use and occupancy af proposed construction' a Exisiting use and occupancy ............................................................................................................................. b. Intended use and occupancy ....... ..~...~...E......~., .~.. ,~. L! ~.x~.... ~....~.. · .E...L;..~.../. · .~....~. ........................................................... / 3 Nature of work (check which applicable). New Budding ............... Addition ................ Alterat,on ........ Repair ................. Removal ............... Demoht~or. .............. Other Work ................................................. (Description) 4 Estimated Cost ............ ~....~...~...O..?. ....................... Fee .....~...~... ~-~o (to be prod on fihng th~s apphcat~on) 5 If dwelling, number of dwelhng umts ...........................Number of dwelling umts on each floor .......................... If garage, number of cars ....................................................................................................................... 6. If business, commercial or m~xed occupancy, speofy nature and extent of each type of use ......................... 7 D~mens~ons of ex~sting structures, if any' Front ........................Rear ................................ Depth .................... Height ........................ Number of Storms ............................................................................................................ Dimensions of same structure with alterations or addmons. Front ................................... Rear ....................... Depth ................................ Height ................ Number of Storms ................................ 8 Dimensions of entire new construct,on' Front ....... .~.~..../. ................... Rear ...~./~. .................. Depth ................... · He,ght ................... Number of Stories ................. .O...&/.~.. ..................................................................... ' / 9 Size of lot' Front ............ J..~....~....~. .............................. Rear /3 S / Depth /. ~ ~ ................... 10. Date of Purchase ....................................................... Name of Former Owner ..................................................... 11. Zone or use district in which premises are s~tuated ................................................................................... 12 Does proposed construction violate any zoning law, ordinance or regulation' . ....................................................... 13 Will lot be regraded ............................ Will excess fill be removed frgm premmes' ( ) Yes (v'~o 14. Nome of Owner of premises ...~?~~.......~. ,~ .... Address~.]..~ · .. Phone ................ Address ................................ Phone No ....................... Name of Arch,tect ..... ~"~:' iC]i ~i ii.ii Address.~.~~,.~...:..PhoneNo..Z~..~.L/..~.7..~. Name of Contractor ...~:~.~.w: PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~stmg or proposed, and indicate all set-back dimensions frorr property hnes G~ve street and block number or description according to deed, and show street names and indicate whether inter,or or corner lot /~5- / STATE OF NEW YORK, IS COUNTY OF ..Suffolk ............. ~- S ...................... ~oh~..C....B~rn .................................... (Name of individual signing contract) above named. bmng duly sworn, deposes and says that he ~s the apphcan He ~s the ................................... ~ontracto= .......................................................................................................... (Contractor, agent, corporate officer, etc ) of said owner or owners, and ~s duly authorized to perform or have performed the sa~d work and to make and ill. ' t~his application; that all statements contained m th~s apphcahon are true to the best of h~s knowledge and behef; tha~ the work wdl be performed m the manner set forth in the apphcation filed therewith. Sworn to before me th~s ..... '13.th ......... day of ........ ~ ................ , 19. ~7 ~ /9 ~,~ ~b]ic,;.~....~ ......... ,~.~.*~ ........ Coun~ ............... ~ ..... C.:.....~ ................................ ~~ ~ ~ ~ (Signature of apphcant) EUZABETH ANN ~E NOTARY r'u~[~C Sta,,,~,~t~ York No 52-812535g, [erin Expires ~arch 30, THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON AHE FROM FIELD OBSERYAT~ONS AND OR FROM DATA OBTAINEO FROM OTHERS THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT OF NEALT~ S£F~VtCf.,,S.-. i~ . APPLICANT,_ t * ~_J~,,,_E. ~?~L~-~jZ ~ 3_~ P_~ ~ = VACANT Y£AIIVECO T T lot 50 HOUSE V/ATER MAIN Lot 49 Area = 22450 sq, ft S 88°5 7 '30"~. /,55. 15 now or former/y Moffat D/~I VE 137..96' Lot 48 HOUSE ""'pipe VACANT NO TE · = MONUMENT O: STAKE SUBDIVISION MAP F/LED IN THE OFF/CE OF THE CLERK OF SUFFOLK COUNTY ON OCT 9, 1966 AS FILE NO, 5187 REVISIONS SEPT ~6, 1977 YOUNG & YOUNG 400 OSYRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W YOUNG HOWARD W. YOUNG ,/. JOHN C BORN /' AT SOU:THOLD I % ' - ~ ~' ~._~ / TOW~Or SOUTHOLD SCALE i,i , DATE ] NO .-,, =40 MAY 6~ 1977 j .... 77-288 DEPARTMENt OF HEALTH S, CERHE.D, H.Y. -'ltr MAY ~ PM 3: Iii THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OOSERVAT~ONS AND OR FROM DATA OBTAINED FROM OTHERS THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE rILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTME~ SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY D,,',' ? ,sNO. "S 0- APPROVED ,, VACANT YENN£ CO T T Lot 50 HOUSE 'l DRIVE S. 88'57 '$0"~ 1.75. 15 now or formerly Moffat VACANT ~ p~pe N. 880/8 '.70 "1~. 1.77.98 ' '"pipe Lot 48 HOUSE NO TE · = MONUMENT D= STAKE SU8DIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON OCT. 9, 1968 AS FILE NO. 5187. .~WS~ONS YOUNG & YOUNG 400 OSTRANDER AVENUE. RIVERHEAD, NEW YORK ALDEN W YOUNG HOWARD W YOUNG SURVEY FOR. dOHN C. BORN LOT 40 "YENNECOTT PARK" A'r SO U TH OLD GUARANTEED TO. TOWN Of SOUl:HOLD " ' 1"=40' MAY 6. 1977 I 77-2RR 4 5° ~ ,L tl