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Home My WebLink About9317-zTOWN OF $OUTHOI.r~ BUII,DING DEPARTME, NT Town Clerk's Office Southold, N. Y. Certificate Of Occupency No...~. 9~1 · · · Date ........... Auq.ust. 9., ..... , 197 8.. THIS CERTIFIES that the building located at . 3575. Hor.~;on6 .Lane ...... ~]/I]~g~iX Map No .... X.Y,X ..... Block No ...... .xxxLot No ..... xxxx .XX ...................... confo~-i~s substantially to the Application for Building Permit heretofore fi/ed in this office dated ........ June. 20., .... , 19.77. pursuant to which Building Permit No. 93.175.. dated ........ June. 2D.r ..... , 19~7.., was issued, and confox-ins to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .PR.IVATE .ONE. FAMILY/.DW~-?.LING ..................................... 'I"ne certificate is issued to . WVV.LIAM .F .. S2J.~4Olq ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval luly..3, 197.8 ...... 7.-S.~-.83 ....... UNDERWRITERS CERTIFICATE No .... N37~1680 ................................. HOUSE NUMBER . .3575 ...... Street . . Ho~:~6~/..Lan~.,..SoRth~rl~ .Ne~..York . TOWN OF $OUTHOLD Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY I n structions A. This application must be fdled in typewriter OR ink., and submitted in triplicate to the Building Inspector w~th the following, for new buildings or new use: I. 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 cerhficate of Code comphance from the Architect or Engineer responsible for the building. §. Submit Planmng Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to Aprd 1957), Non-conforming uses, or buddings 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 inspechon 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 ..... . ..~... ........ Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ..~.~..~..~...~./~9~ ....... ..//~..~.~..~..~.~....,~....~......~..~..~..~....~..£.../,.~.. ........................................ Owner Or Owners Of Property ...... ~...42... ........ .~.......~..~.....,..~...(..~...~.. ........ .....~./~../.../~....o....~.. ......................................... Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No...~.../.~..~... ..... Date Of Permit ~'..'.~..0...'.~.7.....Applicant ....~'..,~.~.~.. ............................................... Health Dept. Approval ................ ~ ....................... Labor Dept. Approval ................................................ Underwriters Approval .............. .../... .......................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ................ .~ ................... Fee Submitted $ ...... ...~. ;...e.~./..x..~. ............... Construction on above described building and permit meets all applicable codes and regulations. · ................................... Sworn to before me this ................ dayof ............................................ (stamporseal) ///~ Notary Public .................................... County TOWN OF SOUTHOLD Building Inspector's Office Town Clerk Building Southold, N, Y. 765-2660 TOWN OF SOUTHOLD Building Inspector's Office Town Clerk Building Southold, N.Y. 765-2660 !//~'/7 ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ! 85 JOHN STREET. NEW YORK. NEW YORK 10038 ,a,.. Ja,uary 30, w978 ~,,~.,,~.,o.~¢,,~ ~,~ :~N 373880 THIS CERTIFIES THAT William Salmon, Horton's Lane, North Road & Soundview Ave.,South~ld,- L.I. m thefoltowmg location; ~ Basement ~ Ist FI. ~ 2nd Fl. 0 U t S I d e ~t~,,, at~ was examined on January 26. 1978 and found to be ln coznptlnnce with the requlremenrz of th~ H~rd. nXTURE LE~..T .....I ...~T .... I eXTURES i eAN~Es iCOOK,~OOECKS f OVE.~S . JmS~ WASa~RSl EXHaU~ ~A~ DRYERS FURNACE ~O~O~S mTU.~ a~mA~C~ ~O~.S S.~*~[.tC'~*j ~C[OC~S i ~tt U~* HEATERS 1 gUL/I-OUTtET ~ DIMMERS -- '[ [ I' ' ~j ~TRANS ~~ ~STE~S ~ * I ~l ~ ].~ ~' [ SERVICE DISCONNE~ ~NO. OF I S E , R V I C ~ 'E ....... I OTHER APPARATUS: I G.FoC. ! . i 10 AMP Vacuum Unit Richard D. Gwydir Vanston Road 1Ths Cutchogue, N.Y. 11935 Lie. 2002 GI~NERAL/V~N~ cerhflcote must not be oltered in any manner, return to the of{ice of the ~oard ,f incorrect Inspectors may be ,dentff~ed by~e~r credentlols. TOWN OF SOUTHOLD /,~ BUILDING DEPARTMENT_,~j~ _ TOWN CLERK'S OFFICE (/"~ $OUTHOLD, H. Y.,,~"~' .... .................. ........ , ~oprovec~ ........................................ , I'~ ........ ~errntt r~o ........................ .~ ......... D,sapproved a/c ............... ..~.-~.,.a.~ ............................. ~ ............ ;..?.~5~ ......................... (Building nspector) / Date 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 Iocahon of lot and of braidings on premises, relationship to adloining premises or pubhc streets, areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this applicatio. c. The work covered by this apphcation may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will ~ssue 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 Jn part for any purpose whatever until a Certificate of Occupan, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to t} Budding 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 in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) ..... (Address or appdcantI State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electricmn, plumber or bu,lde .......... ................................................................................................................................................. Name of owner of premises ..~. ~.:..~....~..Z.:~ ..... ..~.......~./~.....~...~..(:...'~.....~.......~..r~......~....,~?..~.~ .............................. If applicant ~s a co~orate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License ~ro..g....?~..~.~...: .................... Other Trade's License No ............................................... Location of land an which proposed work will be done. M~p No .................................... Lot No ...................... Street and Number ...................,Z~..~..~...~....O....~:~.....~.....~--~.~...~T... ....................... ..'~....~....q~..~..~....d..C<. .................... Municipality State existing use and occupanc~ of premises and intended use and occupancy of proposed construction: a Exisiting use and occupancy ....... ~..~.~...7..¢...~...../.. (. ( ..c.;~.. ~'.~. ~Z.~ .................. b. Intended use and occupancy 3 Nature of work (check which oppllcable) New Building ..... .V........ Addition ................. Alteration ............... Repair ................ Removal .................. Demohhor ............ Other Work ................................................. ~...~....~.~ (_.ac( 7cO~ (Description) 4 Estimated Cost ..................... .~....~....(~).. ................... Fee ................................................................................... (to be prod on fihng th~s applicahon) 5 If dwelling, number of dwelhng units . .~2...~...~_.. .... Number of dwelling umts on each floor .......................... If garage, number of cars .... ~ ............. 6. If bus~ness, commercial or m~xed occupancy, specify nature and extent of each type of use .......................... 7 D~mens~ons of ex~stmg structures, ~f any Front ...................... Rear ................................Depth .................... Height ....................... Number of Stones ............................................................................................................ D,mens,ons of same structure w,th alterat,ons or add,r,ons Front ........ ..'~JJ~...~. .......... Rear ....-~.....~. .... Depth .- ~-'~ ~.~ .... Height ....................... Number of Stories ............................... - i I i~lj 8 D,mens,ons of entire new construct,on Front ....... .~..~... .................. Rear ...... ~.~.-. ........... Depth.."~...~.....~..[ .... Height ............... Number of Stories ...... /. ................................................ d ................................ ~ ............... 9. S,ze of lot Front .... ../..~.~.....f. ......................... Rear .../...~...~...~..~.~.. ............ Depth .?.....'-~..~... .~ c,J ~ ~-c,' ~ ,~.' ~ c'g';g'L~';~' ..... 10 Date of Purchase ..~.....~...~.., .... ../.c~.. ...... ~. .............. Name of Former Owner ..z.,,J ..... ~.~../r..c,.,zl.m-......~..o.~.M...~. 11. Zone or use d,str,ct in which prem,ses are s,tuated . ./.~...~....~..,~.~.~rT....~.....~...~.'...~..~.. ........................................ 12 Does proposed construchon wolate any zoning law, ordinance or regulation ..... ~ ........................................ 13. Wdl lot be regraded ...,(:~-~.. .......... Will excess fill be removed from premises: (v-')~Yes ( ) No 14 Name of Owner of prem,ses L~., ..~..C..,..,¢?:..¢/!....k..~...~.K.~,...~..-¢. ...... Address ../..~/°.....-~--Fe....~.~..~.../...~...'?....~?. Phone No. Name of Architect ................................. Address ................................Phone No ...................... Na~e of Contractor ......................................... Address ................................Phone No ...................... PLOT DIAGRAM Locate clearly and dmtmctly all buddings, whether ex~stmg or proposed, and indicate oil set-back d~mens~ons fror property hnes Give street and block number or description according to deed, and show street names and indicat whether interior or corner lot STATE OF NEW....YOR, K/* IJ IS,. COUNTYk%OF./¥___,,~. -~ , ~ ..... ~,.'v...~..4~-~..2,~.¢~¢~.....~,..~z. 4C-/.c-'~.c.;~..z'../7-?~...'-~... ................ be,ng duly sworn, deposes and says that he is the apphca (Name of indiwdual s~gnlng contract) above named He ~s the ............ (Contractor, agent, corporate officer, etc ) of sa~d owner or owners, and is duly authonzed to perform or have performed the said work and to make and this apphcahon, that that the work will be performed m the manner set forth m the apphcahon filed therewith. Sworn to before me th,s (/~ // .... day ........... Cou. .... ..... ................... (~ature of applicant) ~//~ ]~//~/~ ~ ~/~ NOTAAY PUBLIC, Stale of New York [-AND Services j ~- O-O /9"