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Home My WebLink About9249-zlt'~ NO. · TOWN OF $OUTHOLD BUILI~ING DEPARTMENT Town Clerk's Office Southold, BI. Y. Certificete Of Occupnncy No...Z792O .... Date ..... S.e~.t.e..mb.~r.. ?.S.,. ....... ,197%. THIS CERTIFIES that the building located atE/S. .~..e.e.n.w.ay..E.~ .s.~.t' .0.r..... Street Green Acres Map No.. [~t~0 ...... Block No. XX ...... Lot No .... 27 ............................ conforms substantially to the Application for Building Permit heretofore filed in this office dated .. Nay. 16. ... , 1977 . pursuant to which Building Permit No. 921~9Z dated .. May..1.8., ........... , 19..7.7., 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 .. pti.Pate..o~e., f~.mi, ly..d..w~..l.li~..g .................................... The certificate is issued to . .F.r.a..n.c.is..&..Dg.r.o.t.h.y...C.a.r.r. ........................... (owner, ~X~~) of the aforesaid building. Suffolk County Department of Health Approval ...3e. p~.o.. 2. ~..,..~. ?.77..R.o..b.t..A. :..V~.I..1.a ND .RWR TERS CSRT CA No. ~OUSE NU~BER . .~.7.~ 0 ....... Street..~..~.e.e.n.v.a~r. ~a...~.t.,. ........ . ............. Building Inspector ]b'OE3~[ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFICE SOUTHOLD, bi. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 9249 Z Permission is hereby grented to: .F.~.~.~.ms. ...... ~.!~.~.~.~..s. ...... ~.,~,~ .................. '... ..... ..... ~t premises Ioceted et ..~ ......... i.!.?..{...~,. ...... .~.~.~...t~....~,.,,/~..,~......~.~:.S;..~. ...... i....~..~,,~.j~..l~.~.. ............. ......................................... ~. ............ ~ ..... ; ....... ; .................................. ~ .............................. :;...: ..... ;~.: ........... ~ ~ ~< ,~_~ ~ ........... · ..... -':'['u .......... 1 and, ,~,°PCr~- by t~ Building Inspector. .... Buildrng In~ector ' FOR~ NO. $ TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUFANCY ]nstructions 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, aha 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, 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 condJtion 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: I. 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 ......... ~ ........ J..~..~..~... rqew Building ................ Addition ................ Old or ~re-existing Building ................ Yacont I.ond .............. location Of Prope ..... ...... Owner Or Owners Of Croperrv ..~..t~.i.~....~-~l~.~...~.. ........................................................................... Subdivision C...~..~..~......~...~.~.~.~......~..~..~.~.~-~.,.Lot No..,2,.2... Block No ............. House No./.~.../.~. Permit No.C~c~.~...~.~...~... Date Of Permit~"~../~'/22.Applicant ~..~...~/~..~../~.~.~C....~.~...~..-,~..~...c. ........... Health Dept. Approval .~....~...~..I.~:..T...~..~.../..~..~...~ ......... Labor Dept. Approval ............................................... Underwriters Approval .~.~-...?..?..:.~..~....~.~..~..~1..., ..... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fincd Certificate ~ Fee Submitted $ .... ~.,.~..~. .................... Construction on above described building .and p~ermit meets all. apj~licable, codes Applicant .~~~.. ......... ~.: .................. Sworn to before me this day of ............................................ (stamp or seal) ................Notary Public .................................... County TOWN OF SOUTI-IOLD Building Inspector,s Office Town Clerk Building Southold, N. y. 765-2660 / 4 1 '" 'THE, NEWt;YORK BOARD OF FIRE UNDERWRITERs ..... ~'d(ill) [{ ' BUREAU OF ELEC, TRICI'I'Y t VII1 8~ JOHN STREET, NEW YORK, NEW YORK 10038 I)a~e ' ~ ' ' Apphcatlo'n No. on file' · .,s C=RT,i=msS~e~rember ,?,1,, ,~977 9239/46 N 3 5 only ~he ~lectrical equipment ~ de~rib~_below and int~uc~ ~y t~,app~ica~t ~med o~ the obove appllcatlo~ number Founders Homes~ Inc.,Greenway east, O~ient,' N.Y. ~ ~fo~.~.~ to~do~; '~ ~ ~ ~ F~. ~ ~,~d r~, outside ~ ,, ~ ~ ,s~o~ ~A ~ fOund to be i~ comp~i.nc~ wlt~h ' ~.,~..m~.~do~ Septembe~ 19, 1977~ _ ,~o~.~..~,o/~,~o~d. OUTLETS 2O DRYERS SWITCHES FIXTURES RANGES rOOKING DECKS OVENS DISH EXHAUST FANS INCANDESCENT ELUORE$CENT 27 2O A~WG AWG OF HI LEG OF NEUTRAL 1- smoke detector/ )ec~ion .only. ,, Because of ,~n~suai.=enviPonments , Ch_arles M. Hall Eie~. -, ; ...... ~ 760 Long Creek,Dr~ ,, , ',-'l~,,, ', i,(-::' ~'," ' -' ' ,: ",, GENEllA[. MANAqER ~1 ~ ' Southol,c;l, '~.y. ,,,1,09,T'l ,, : ~',,', , , Lic.65?E ,'" ,:' ' ' ~,l./ ~ [~ Thru certificate must not be altered in any manner; returri fo fee oi~f,ce'of the Board ~f ,n¢orrecf. Inspectors may be identlfled by/t~e~r creclentkfls. ~ i .~,,v,~ ' ~,~1 FORM NO. ! TOWN OF SOUTHOLD BUILDING DEPARTt~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c ................. /~'X 18"' ............................... ............................................................................ ............ ............................................ (Buildmg Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a Th~s application must be completely filled 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 lot and of buildings on premises, relationship to adlo~mng premises or public streets o areas, and giving a detaded descriphon of layout ofproperty must be drawn on the d~agram wMch ~s part of this application c. The work covered by this application may not be commenced before ~ssuance of Building Permit. d. Upon approval of this application, the Budding Inspector wdl issue a Budding 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 Occupanc shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Build~ng Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herren described The applicant agrees to comply w~th all applicable laws, ordinances, budding code, housing code, and regulations, and t, admit authorized inspectors on premises and in buildings for necessary inspections. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ................................................ ~:'"'~ ........ ;;4 ......................................................................... If applicant is a corporate, s~gnature of duly authorized officer. .~4.t'd~e~c~d t L~.¢ o~ r~ t e~i~e r ) Builder's L, cense No ..... :~....~j~... ........................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trode's License No ............................................... 1 Location of land on which proposed work wdl be done Map No: ..............'~....~... ............... Lot No .....".~...Z ......... Street and Number .................... .(....~...(...d. ................................................................................................................. Municipality State exishng use and occupancy of premises and mCended use and occupancy of proposed construction: a. Exisiting use and occupancy ......................................................................................................................... b. Intended use and occupancy ..... '(~"~'"'~'~ ~.~'~"~'~:7'""/~;-~"~'~Z'/~'~'~'~': ................................................ ---"3.* Nature of work (check which applicable). New Budding .......... Addition ................. Alterotbn ..... Repair .................. Removal .................. Demolition ............... Other Work .................... ~. 5'- (Description) 4. Estimated Cost ...~.t.i).-..~.~.tjr.,~_ ~ ................................. Fee -7 ~ ~ ........... ....... 5. If dwelling, number of dwelling units ........ ~. ............. Number of dwelhng umts on each floor . '1~ ~'~"~"'~.' 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 ......................... Rear ................................ Depth ................... Height ........................ Number of Stories ................................................................................................... D~mensions of same structure with alterations or additions: Front ....................................Rear ............. Depth ................................ Height ......................... Number of Stones ............................. 8. Dimensions of entire new construction: Front ........ ~5,.]~/,.~ ................. Rear ...~.~ ................ Depth .. Height ...... j.~., ....... Number of Stories ..... ~"f;i,'~, ............................................................. 9 Size of lot. Front ..........~, ,~. ...................................... Rear ..... ~ ............................... ~ Depth ....~ ~t/.)'~;' · ............... 10. Date of Purchase ................................................. Name of Former Owner ..... . .................................... 11. Zone or use district in which premises are situated ................................................................................... 12 Does proposed construchon violate any zoning law, ordinance or regulation ............... 13 W~II lot be regraded .............. ./~ ........ W~II excess fill be removed from premises: ( ) Yes ( ~ No 14 Name of Owner of premises .~,,~. ...................................... Address ..~:~..~.t..~.~..~.. ~-~... Phone No. ........ Ft(~,,-,~ ~,* ~ ~,, ~,"f r,,--'~i4,14 . .. ~, ~,~,,-* }~4~ Phone ixlame or ~rcnltecT .................................................... Address ................................ No ...................... Name of Contractor .,.F~;.~..~;~.r~...i.}.~;~.~.[....~ ./;;~.:... Address .~};,.;.~.il.¢.;:~,.;j.~..,.~hone No..~.~.~.;~..~ PLOT DIAGRAM Locate clearly and dishnctly all buildings, whether ex~sting or proposed, and ~nd~cate all set-b~ck d~mens~ons frorr property lines Give street and block number or descnphon according to deed, and show street names and ind~cat~ whether interior ar corner lot STATE OF NEW YORK, COUNTY OF ............................... ..........................................................~et 6~~~ng contract)' ~gY~""~ ............. bem~ duly sworn, deposes ond s~ys that he ~s the opph¢,m above homed He ~s the ........................... .~..:~:,m..t~.t.~;cr~...7.~.~..: ................................................................................................ - ~.onttoctor, agent, corporate officer, etc ) of said owner or owners, and ~s duly authorized to perform or have performed the said work and to make and ffl~ this application; that ali stctements contained ~n this application ore true to the best of h~s knowledge ~nd behef; onc that the work will be performed m the manner set forth mn the application filed therewith Sworn to before me this ....................... dayof ........................................., 1c Notary Pubhc, . ................................................... County ....... r . ~ ................ ~ .... na p t) AZ/AP o ~- Zo z' .,~ 7 TO THIS SURVE~ 15 A VIOLATION OF SECTION 72B9 OF ~hE NEW YO~ STA~ EDUCATION LAW FOR,,,, APPROVAL OF ,C~-~,~U~-'TION ONLY CH~ THE WA~ BUPPLY AND ~, DA~: ,, OI~L ~Y~M~ ~OR ~1~ O~ ~LL ~F~M TO ~ '" ~v'~'4~ ', .... ~ , .... ',~ ..... 7~ .~.~