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HomeMy WebLinkAbout9086-z WOM NO. TOWN OF SOUTHOLD BURDING DEPARTMENT Town Clerk's OHiee Southold, N. Y. Certificate CSF Occupancy No. MA7 . . . . . Date . . . . . . . . . . . . . Sept. . .14. . . . .,119-77 THIS CERTIFIES that the,building located at . & Tr UPLA .Ngek .14fte , , Street Map No. . M . . . . . . . . Block No. . . . . . . . .Lot No. . .3p;. . , Peconic, , .N*Y., , . _ , , , , , conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . . . ?fir . . 14, 19.77., pursuant to which Building Permit No. 90862 dated . . . . . . . . . . . . . yar. . . ! , 19. 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 isPrioate one family dwelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . .Ndmund Bauman. . . . . . .dwr.er . . . . . . . . . . . . . . . . . . . . . . . . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ,Sept 13 1977 by R. Yilla UNDERWRITERS CERTIFICATE No. . . N3.53757 . . .P..$ . .?9 . .197.7, , , , , , , , , , , , , , , HOUSE NUMBER . . . . . . 325, , , . Street . , , . ,Wood .Lane . . . . . .Peconic. . , . . _ . . . _ , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector ~Ol~I NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9086 Z Date ...................... 5Iai. ............ 1.~ ......... , 19...~.7. Permission is hereby granted to: ... 3.~.t..o......~.!......~.t...q z.c..z..e.... ~..a..t..h ....... h.'..e.;~.e~ ...... to ~.~.~ .z. ~....z.Le.~....o. ~.e....~.t..z..~:.. ~.~.~..z...t.~ ....................................................................................... at premises located at ..~../.~....Z..~.~...~.~.~.....~.?.~.~....~.o.~.~.. ........................................................................... ................................................... P..~..e..o.~ ~,.c ....... ~.,.~L~ ............................................................................ pursuant to application dated ...................... }4a~......1)~ ................ , IC)..~.~..., and approved by the Building Inspector. Fee $.~.~...,20 ........... ~t~m~--J -g :: := ' il',- h~-q =~ -- FX~RES-' ; ~{ RANGES:][~ C~KNGDECKSIJ~VENS'Z~itLDSHWASHERS EXHAUST;FA~S ]~ ~::~:~j~t~ll~ll~ ~E iE[~ttI~t~ ~ll~t = =l=!l;~jE~lll~t I= =t1~II1~11~ I~ t~l ~ ~ l~ti~ll~ll~ hsll~]~ ~ ~ t~ ~ I~1 =I1~ I~1~1 ~ I~1 El .~1 ~li:;~lll~tit~lll~tlE~lll~:ijl;elli~ I~Itl;~IIt=iII=III=IIF:tiI=ltl: ~=ltl~it!=lli=tll~i=ii~lq=lq=-, ,Ihs ce~fc6te,md~t'Hdf ~e-6lfere~ n any maHheP*PefUrfi,,to the ottte otthe ~c ~correct IhS~elto~s ~ ~ aenltea Dy~p~r~eaentas TOWN OF $OUTHOLD , Building Depmtment Town Clerks Office Southold, FI. 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: ]. 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 ]957), Non-conforming uses, or buildings and "pre-existing" land uses: ]. 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-existir~j dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 ....... ........... New Building.....,.......,..//' Addition .........,.,.... Old or Pre-existing Building ................ Vacant Land .............. Locotion Of Property Owner Or Owners Of Property ..................................................................... Subdivision ................................................................ Lot No ............. Block No ............. House N~ ............. Permit ,o..~...~...~..~....~.~. Date Of Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fin~ Certificate ....... ..~...... ......................... Fee Submitted $ ...~.~...~... ............... w - .._.. —._, _ _ I. __. _ _ -.. S.:_. ..T_ >... .�.-.... r -,W7n,ol C" /Ofi[ 110 1 I ftJ77 TOWN OF 901047~ t/ t7T RiA-L we �,..✓ +� `,l K1 kY f Y...., ,9 Applitnttion No. .20 �V C y , 777g .................Approved ..............u........... 19` Permit No. f � 9� Disapproveda/c ....... .......... ..................................................... ................................................................................ . .. --h-✓O �-�- "� i3ii ' ........ / 7 (Building ep: rodda . Zb C.G ;50 APPLICATION FOR BUILDING FERMIT W Dote ...e&� ...../�K................. 19.12.... iNsrRl�cfwNs o 0 a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building inspector, with 3 sets of plains, accuratelat pplan to.se* Fee according to schedule. b. Plat plan showing location of lot and of buildings ori premises, relationship to-adjaning promises or public streets or areas,and giving a detailed description of layout of pr*"must be drawn on the diagram which is port,of this application. Z c. The.work covered by this application may not be commenced before,issuance of Building permit. d. Upon approval of this application, the Building spctill issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughoutthe work. e. No building stall be occupied or used in whole or in part for any purpose whatever until a C:entificate of OccuponcyQN shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the BiriWirg I>,porbnesnt for the issuance of'a Sutfding Permit pursuortt to the Building Zone Ordinance of the Town of Soulhokl, Suffolk 'Ctxwnty, New York, and other applicable Laws,.Ordirnornces or Regulations, for the construction of buildings, additions alterations, or for removal or demolitbn, os honeir► daserlbed. The applicant agrees to epmply with afl applicable ktws, ordirrnrnces, building code, housing code, mrd regulotbro, and to admit authorized inspectors on premises and in btdWirgs for necessary irgpectiorw 4 (Signature of applicant, or name, if a corporation) 3i/® moo. BZc_ 4/C RAW A* � ............;S �:f,. ..y. ..ZKZY.r.................................... (Adllress of applicant) -A State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................... . ................. .,,1.»............. .. ...................................................................................................... Name of owner of premises ...ti.I .�'�.GL ..................................... If apph nt is ar tem, s'igvnature of ddjlI uthorized officer. 7�.TaiR' !AYTi.I�.... .�.lf� '.'.............. / (Name and title of corporote officer) Builder's License No. ....................... ................ Z Plumber's License No. .. . .. .. ....................... r , Electrician's License No. .................?........................ r Other Trade's License No. ............ 1. Location of land on which pra�osed work will be done. Map No.: ........... .... ... ...... Lot No 'J Street and Number ;5n?..��?G�ri��..�1�.� !!i?/✓ fes.. ...... ...�.......r�A`�L��Murilclowi�....... 2. State existing use-and,occuponcy of premises and intended use and occupancy of proposed construction:a. Exisiting use and occupancy .................C!'rcY.G /!f ........................................... b. Intended use and occupancy ........../.... l�� r�c.... .lnC .1. r! .................................................... `,1 1. Nature of work (check which applicable): New Building• . ...I ....... Addition ............... Alteration ................ Repair .................. Removal .................. Demolition.:.......:.......... Other Work ................................................ ..... Q _XXI (Description) 4. Estimated Cost ................. Q'.. � .....................Fee .... ../7............................................................................. (to be paid on filing this application))) 5. If dwelling; number of dwelling units .......... /...............Number of dwelling units on each floor ...... ................... Ifgarage, number of cars .....................9.................................................................................................................. 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 ................................................................................................................. Dimensions of some structure with alterations or.odditions: Front.................................... Rear ............................ Depth ............................... Height ............................Number gf Stories ................................ 8. Dimensions of entire new construction: Front ............7Q................... Rear ........7P............. Depth ....✓;.d............. Height .....21 ..... Number of Stories .............I?2..................................................................................................... 9. . Size of lot: Front .......... . ..................................... Rear ...... ......................... Depth ... lE{�................... 10. Date of Purchase' ........ ..................................Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .............AeAr'g........................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .....A a........................./................... 13. Will lot be regraded ........,�4es........... Will excess fill be removed from premises. ( ).Yes (Y) No 14. Name of Owner of premises/Atn.t�'f 4.A*.,Ve1K... ................. Phone No. dxi-7.4.0t Name of Architect .........C.G. 'l.! 1!rr /..`/.7AOAddress Phone No. ................ ...................... Name of Contractor .dry t N Address ................................ Phone No. lM910. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or tlertco'ption according to deed, and show street names and indicate whether interior or corner lot. I A a3 1,9 r STATE OF NEW YORK, I S S COUNTY OF ................ ' f !a 3 / ..cfa/laSN........:...:.......... ....................being duly sworn; deposes and says that he is the applicant (Nome of individual signing contract) above named. �J A He is the ...........T.2�� r ........rJ ....�./r? le, ...................................... (Contractor, agent, corporate officer, etc.) —Rf said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this oppficafion.ore true to the best of his knowledge and belief; and than the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this :;...,f 1..... day of ............ .. .. 197.x... Notary Public. .......................... k ..IX... County .4; ...�(�� .................................. (Signature of applicant) IZABETH ANN NEVILLE NOTA Y PUBLIC, State of New Vnrr AM No. 52.8125850, Suffolk coypI NOTARY pus ie state of k l ,, Term Expires March 30, 19/6 NO.Ter 818125850 Setlotk.F,00 Term F ' .rnMe2 LYiFA.-- ._ SIT. I 1 \ 111 � L NO"") II r F 1 1 ti s DATE: � =,.t.C'- NOTtP! JU';1.. �'.d" 7`` G�� REOUiR• 765-266© 9,' r.5 4a 4PfA Fd J F)CFORE rAr rt 11 -- - - - _ TION OR 59 r "1 r Ov B.NY KIND - 2 pR?.MItJG E 3. 6EFOP'F C07 ETED - - _- - - - - - - - - i 4. FINAL W,P 1 JO= !F :e J SIGN - - - NOT f c PC1N - - - - - - - - OR CONST 0,.T E r�CR5 - - Ipl, orV J1U56 M�15 Jy 57A1C CODE I 5. ALL CO - ___ - REctL5 EM LL ANp 1OVJn L! j,3 CODC { _ I Ilt � I I � � �� I ISI scALM -- �" AR111.1V. Dr DRAWN sr I I, l l onr= 10 - � V RLv�sm f1� l ' ' OPAWING NtIM6Cfl •...�.«..+.��e._-v�.�.0 - — �u���va.r�r+�nvv'i�v ..n.w.ane.mum...i."�a_�v.__.".vw.�.�r.vnr�nv.��..�.. �- .��_.v..�mn.r�v��.�s_r..J � '` ,1 '._ 1 I j I FLdj L SCALL S APPROVF.O MY' DRAWN BY OATS: li_ _ PCVI6L0 DRAWING NUM.R. - I - II I I nqll "11 v II T Q pF 1 Iz 47 _ c II I 1-� UAi6 A � � � - HLVI�F Lt — mYv awIXT[o ox Mo �aaoM CLPLXPIXNT 5 I la •', ti v NO 1 II „ ityv�' L�ti I Dow of � I r � a � II � l'q L -11, 4y ► �1 I APPR.V90 BYI DRAWN BY IA, DATE: Q — j REVISED DRAWING NUMBQR :u%a• ¢RlNrzo oM NO. IooJX CL¢ARIRINT I 35�IL `aS 45�1'z <� N v� , y - m Q LO ry I Nl , 4 F SCALL: ,Y - I APPROVED By. BRAWN BY 14 BATE; 10— � REVIBED DRAWING NBMBER uaa. nIRNS1R on xe. ,eeox cueenmxr C CRON MARTIN HUGHF.5 ',1I � I FT3 RIGHT OF G WAV N.79 571501E. - a ... 310.59 72,48 �. p 110.59 100.0 100.0 Fy m � WELL / ul l J / to SUFFOLK COUNTY HEALTH DEFARTb1ENT e~ } DATE-SEP—' 31911H. D. REF. 7 5 / 3 # 8 _ LL 4 The sewage disposal anal water supo_y pa H9 1 Z- at"Y, �p p facillti ea for this' locati On have bean Inspected by thll department and found —� to be satlsYsctory, 2' Chief of General Engineering �, F. O servi/ccs � ���I"m" J f✓L• vth>�-i:+' Inti fuo..5 � .� � Ln l S 11 I In Z Eu m s.7eq }1�11W _ /salsr ,Q z SCALE •I" []]MONUMENT , O.I20NPIPE a / GI C NANO W CZ N UNAUTHOPRED ALTLRA➢ON OP ADDITION TO THIS SURVEY IS A V N OF 1 SECTION]]DG OF TME NEW EW to YOPR STATE I F UR UCAiION UW. / COPIES OF ik15 SURVEY MAP NOT EEANNG I�'./\ �//''��)) PLOD (�^` THE LAND SUFVEYOR3 UIGLU SEAL OR MAI OF PLOD E 11-1 T Y EMBOSSED SEAL SHALL NOT IF CONSIDEIIED (- _ I TO RE A VALID TALE COZY JUI(�N L/[���_� �� RX, / GUARANTEES INDICATED HER ENALL RUN _ T _ / ONLY FO NE JE SCI!iOR y,Om iHF SUfvVfY ''n�'',�tI ��I(((���\\\ 1(/ J¢^.\{ 5�{/�1 A',,If y (1J'' y 1 1 R )}(�,y 1 t\}f 15 FAEFAf,LD, A,D Ou 113 OHILI EO IHE I I 1 U N J. 91 `vl 1I 1��1 I N ��t�V `[ J \I I I , 1 � TREP COMPANY, GUIUEVO•.IIAL AG211CI AW ! I LENDING 1141UEi1C. "`L 1-1.p ,AND 1 IO INE ACS,GNESS OF a,Lw,DING 1N5$ ATTUVON.OIIAPANIEES ACE kOT TRutSEiuW TO ADDITIONAL INSTRUiIONS OR SWSfGUE1R PECONIC ar % GUARAN'fEE D TO T HE AMERI CAN TITLE INSVRANC TOWN OF ,>UUTHC?L[ NY / 2 COMPANY AN D TP THE SOUTHOLP' W iNG5 % NK A55UPVEYEDccn / //, 7- �/i X7,.+1—Z5#7 INDIAN NECK ROAD P-DDE ICk VAN I U f L ,PC, �� . va------ LICEN5ED LANDSUIZVEYDLtS GREENPORTFN_Y. - _ -