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Home My WebLink About9269-zFOB, M NO. 4 TOWN OF SOUTHOLD BUH.I~ING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupency No. ZT..c~'.3 ...... Date ............ 0c.t...6 ......... ,19.77. THIS CERTIFIES that the building located at . Yenneco.t~. ~)r. ........... Street Pk Map No.](enne.c. otl:.. Block No ........ Lot No. ~ ...... ~B~9~.. ~.~ ~ ........ conforms substantially to ~e Application for B~lding Per~t heretofore filed ~ ~s office dated ......... ~y...~J , 19..~7 p~suant to which B~lding Pe~it No. dated ....... ?.~Y ....3~. , 19.~7., was ~sued, ~d confo~ to z]~ of ~e req~ merits of the applicable pro~sio~ of the law. The occupancy for which ~is ce~ificate ~sued is ~$v~te. s~i~ir~g po~l. ~.~i.th .fenc.e .~. acce ss.~rys .................. ~e certificate is issued to ~$$~w. ~:. ~o~p.~D~..~c~i~ ...... ~ ...... (owner, less~ or ten~t) of the Moresaid building. S~olk County Department of He~th Approval ~].'~ ............................. UNDERWRITERS CERT~ICATE No. E~ 556~ ....... Sep.t. 1~...19~. ............ HOUSE N~ER .... 900 .... St~et..~e~eet-t .Dr .......................... / B~lding l~O~[ NO. ~ TO~N OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, bi.. Y. BUiLDiNG PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) · N? 9269 Z Permission is hereby granted to: ............. ~a~.e~.t,~..~z-. ........... ~lo~a~l, ..... premises located at ....~..?..t'.,~'~.~,. ...... ~,~.~.~..z.a,..q.9.,t7¢,~....?..~..~.. .................................................................... ............................................... X~mn~.~.h~...~.~m .............. .~.[~ ............................................ pursuant to application dated ]¢a~ 31 · 19.77, an,d_?p.p[ov, ed by the Building inspector. N ~ ] ~ U ~~ ~~ Fee *..].~ .......... Bu%ldmg Inspector TOWN OF $OUTHOLD , Building Department Town Clerks Office Southold, H. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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, 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 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 $1.00 ................ New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Prope.¥ ..... .~..~..~.....~.~..e..~.~.'~.. ...... ~..~.:. ........... ~.~..L~....~..LI2 Z / ~ner Or ~nem Of Prape~y .~.~e.~ .... ~.~ .4:~.~...~.Z.. .~g~ .............. ............. .... ............. Pe~it No..~ ....... ~ ....... Date ~ Pe~it ................... ~phca t .~ .~ ................. ~.~. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .../~.~..~..P..~.~..~.~..~..~.. ............... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ FinaJ Certificate .......................................... Fee Submitted $ ~'~ ~ Sworn to before me ti ,, _ .... .... Notary Public ~ (stamp or seal) MYRTLE A. SELG NOTARY PUBLIC, Sta~e of Hew Yore No. 52.8913915-Suffolk County CeramiC, an Expires Marc~ 30, THE NEW YORK BOARD OF FIRE UNDERWRITERS I ~.k ,, ,f_:'.~ ;, , t BUREAU OF+ELECTRICITY '~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 narc September I3~:t977 ~ppllca,,o,,/~o.a.yU~92 Ix N355G78 THIS CE~IFIE5 THAT only the electrical equipment ~ described below and int~uc~ by t~ applicant ~med on the above application number in the premi~es of M. McKernan, 900 Yennecott Drive, Southold, L.I. i..~/.tt.~.~ to~.t,o~; ~ a~.~t ~ z,t ~. ~ ~.a r~. outside s~ct~o~ ' mo~ ~t w..~.=~.~o~ Septembe~ 8, 1977 and found to be ln complianec wlth the requiremen~s of thiz Board. FIXTURE FIXTURES OUTLETS SWITCHES FLUORESCENT I ,,, 2 1 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS RANGES OVENS EXHAUST FANS TIME CLOCKS MULTI-OUTLET SYSTEMS NO OF FEET SERVICE DISCONNECT S E - ~-- - - E · - .... NO OF CC COND PER ~' A W G NO OF NEUTRALS OF HI LEG.,, A W G J NO OF HI.LEG OF CC COND OTHER APPARATUS: -"(Swimming Pool) This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to have frequent test and/or repairs made by a qualified person. AWG OF NEUTRAL F.T. Electrigs ,, 160 Northern Blvd '- .1 ST. James, L.I. 11780' ~ LI c. 1,l 0 2E OENER~ ,D Per Thru certificate must not be altered [n any manner, return fo the office of the Board if incorrect, Inspectors may be zd~nfified by TOWN OF SOUTHOLD BUILDIHG DEPARTMEHT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi, 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 par~ of this applicatio 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 wdl 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 in whole or in part for any purpose whatever unhl a Certificate of Occupan[ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Budding Permit pursuant to tF 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; admit authorized inspectors on premises and ir~ buildings for necessary inspections. ...... ,..-. .................................. (Signature of applic&nt, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bullde Name of owner of premises ../.u...(°. ..... ¢;..'~.~....,:~.. ..................................................... If apphcant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......... .~..~z.../.~.~ ............................... Plumber's License No ...... .~.../..~. ............................... Electrician's License No .... /.../..~...~,.,..~.~,. ....................... · Other Trade s License No ............................................... Locot,on of :and on wh,ch proposed work be done. Lot No ............. Street and Number .~..(..~...(~..~..~...~..C..q.~..r.?~........~.C:'' -- -- .......... ~.~..C~?~.~..../.~......Z~.: .~.~. ......... ~....~.~....7.~ ......................... Municipality State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction' a Exlsiting use and occupancy .... /..~.~a:..~..: .......................................................................................................... b Intended use and occupancy ....... ..~..?../.......7.y_...c.., ................ ~........~/ ............................................. Nature of work (check which apphcable) New Budding ........... Addition ............. Alteration ............ Repa,r ............... Removal .............. Demohhor ............ Other Work ......... ~.~.../. ........................... (Description) 4 Est,mated Cost ................................................. Fee .... /~---~ (to be pa~d on filing th~s apphcahon) 5 If dwelhng, number of dwelhng umts ................... Number of dwelhng umts on each floor ..................... If garage, number of cars ................................................................................................................... 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use ....................... 7. D~mens~ons of ex,sting structures, ff any Front ....................... Rear ................................ Depth ................... Hmght ........................ Number of Stones ................................................................................................. D~mensions of same structure with olterahons or addmons Front .................................... Rear ........................ Depth .......................... Height ................. Number of Stor~es ....................... 8 D~mens~ons of entire new construction: Front '~ "L_. Rear .. ''~ ~'- Depth '/~ Height ............. Number of Stories .................................................. 9 S~ze of lot' Front ............................................. Rear ......................................... Depth .............................. 10 Date of Purchase ................................................... Name of Former Owner ...................................................... 11 Zone or use d~stnct ,n which premises are s~tuated .............................. ~ ........................................... 12 Does proposed construchon wolate any Tatung 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 ................................ Phone No ..................... Name of Architect .......................... Address ................................ Phone No ..................... Nome of Contractor ................................................. Address ................................ Phone No ..................... PLOT DIAGRAM Locate clearly and d~stmctly all buildings, whether ex,sting or proposed, and red,cate all set-back d~mensions fror propcrty lines Gwe street and block number or description according to deed, and show street names and ind~cat whether mter~or or corner lot ~ ~ ... ~_~ ( STATE OF NEW YORK, COUNTY OF ........................ rS S ....M-. ...................................... being duly sworn, deposes and says that he ,s the apphc~ (Name of individual s~gning contract) above named He ~s the .............................................................................................................................................. (Contractor, agent, corporate off,car, otc of sa~d owner or owners, and ~s duly authorized to oerform or have performed the sa~d work and to make and this apphcohon; that ail statements contained that the work will be performed m the manner set forth in the apphcahon filed therewith Sworn to before me this ....... · .~:..7. ......... day of ~....~.~- ................ , 19 ,ota Pu ,,c, ,'" / ................... ~ -- ~ ,.-"',~' ............ ! ............ ~ ..... t; ................................ //~ q' ~~ NOTARY PUB-JC. :,.,e of New Yo~ gl l ~J J Co~J~J~