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Home My WebLink About9095-zFOR3I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No. Z79.6'~. ...... Date ........... .0qt...1.8. ........ , 19..7.7. THIS CERTIFIES that the building located at . .G.O.l.d..8. p.u?..~..O~.d.. ~.~.c,~c!,!~.; Street Map No.. ~i~.ogc)o~ .¥i~Block No ........... Lot No, .1.2 ..... Cu.tc. hogu.e ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ~::nr.. 1 ?. , 19.7.7. pursuant to which Building Permit No. dated ........... ;:i:-~r...1% ., 19~,~/., was issued, and conforms to all of the require- ments of the applicable prowsions of the law. The occupancy for which this certificate is issued is Pr.i¥~,',t~..o,~:, .~ia,~J.~,.~ .~t:~.e.:!~,i~g..1.at. ;~'~,Q(~r. f, .O~i~..~:~.,..~.. f~.~. ~ ..... The certificate is issued to . (Jhc..~;l,e,~..d~. G~nstaz~.~e. l~ing... ~ziaer ................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . (~ci;.. ]!~...197~...by..R,. Y~.].a.a ..... UNDERWRITERS CERTIFICATE No.ld~?.].~.3....~.~p~c..~9...~.~77 .................. HOUSE NUMBER ...... ].090 .... Street .. ,6oI~1..~]pur..St ......................... Building Inspector [ FORM NO. 2 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°. 9095 Z Permission is hereby granted to: And r ,e. ?...},~.,u..1...l_e...r... ?..,o. ?: p.......A../_ .C... _C.~.r_l.,.e..s....~....C..o...n. s t aha e King Rt 2~A Miller P1 at premises located at .L..o...~...J.~ ....... ,~J.~e..~.o...~...Z.j:.?~.{..i'~..s.~ ................................................................... ............................................. ~..o..Z..~.~...,~:~.u..~..~...0...z..~...~.~.~e....~.~ ....................................................... Cutchogue pursuant to application dated Mar 17 19....2..?., and approved by the Building Inspector. Building Inspector ~OR3,~ ~O. 6 TOWH OF $OUTHOLD Buildi.g Depnrtme.~ Town Clerks Office Southold, N. 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 fallowing; 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 disposol--(S-g 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 $I.00 ! 7 [~lte ............ New tt omg ................ Addition ................ Old or Pre-existing Building ................ Vacant kond .............. Location Of Property . ..~i5~.~.~{,~...~5.~5.~_,**~ ......... ~,=)w.j~. ............... 17 .......................................... Owner Or Owners Of Property ,,0,.4~.~..-~...~d..~.t:k~..&~./~....~...~..'.~.7.....~-..{..~...c?. .......................................... Subdivision O.~..~7.%9.~...~.!,.~..~..'4.....~.%'...'..12...'2..~.?~.. ...... Lot No .....l~. Block No....i:...-:7.... House No Permit Date Of Permit .2.1[Ll2/.,.ap;'ieo,t"-' " Heolth Dept. Approval ............................................ Labor De~t. Approval ................................................ / ----- UnderwritersApproval .............................................. Plonning Boord Approvol ........................................ Request For Temporary Certificate ........................................ Final Certificate ........ ~ ......................... Fee Submitted $ ,.g.,..~.0..O. ...................... Construction on above described building and permit meets all applicable codes end regulations. Applicant .~~ ......................................... Sworn to before me this ......... doy of (stamp or seal)~.~ff, 13go~O i.,"~:THE'~iEW,'YORK BOARD OF FlEE UND ~ ' i' J,i ' ;~ , ~,?*,.. ; _,.85 JOHN STREET. NEWYORK. NEW YORK 1003~ : ' ' - . - ,. 977 . , y e e~ec~r~ca~ equ?men~ ~ ~escribed bel~ and in~rod~c~ by the appllc~ na~ed on ~h~ above apPlica~io~ nu~b~ i~ thepremlses~of "C~a~!e~K!~~ GOld Spur~,i/~Mi~.~West Depo~ Lane~ CUtchogue, .N.y. · ..~.~,,~;,~,~,,~ -- ~ep~emoer ~o, l~yy~ ~ - ~: ~ ~e~o,~ ~ mo~' 5 0akhurst Elec. Constr. Sound'[Beach, N.Yj ./:: 117'89 This certifica[e muff not be altered in any manner; return to the office Lic#822E' of ere ~oorc~ if bcorrect. Inspectors may be their FO~M NO. 1 TOWN OF $OUTHOLD (;/~('/~7 ?~/' ,c ,' Z/ ~ TOWN CLERIC: $ OFFICE ~ / ~ ~ ~, ~'~ ~ THOL , Y. 2 k .................................................... .- .......................... ..... 7 .... APPLICATION FOR BUILDING PERMIT .... ~} .~ INSTRU~IONS .~ a. This application must be compl,tely filled in by typewriter ac in ink and submitted in triplicate to th~ Building Inspector, with ~ sets of plans, accurat~ plot plan to ~ale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ ar~as, and gMng a detail~ description of layout ofproper~ must be drawn on the diagram which is pa~ of this application. c. 7he work cowred by this application may not be commenced be~ore issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building P~rmit to the opplicant. Such permit shall be kept on th~ premises available for inspection throughout th~ work. ~. No building shall be occupied or used in whole or in port for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuanc~ o~ a Building P~rmit pursuant to tha~ BuildMg Zone Ordinance o~ the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the constru~ion of buildings, additions or alterations, or for removal or d~molition, as herein described. The applicant agrees to comply with all applicable ~aws, ordinances, building code, housing code, a~d regulations, and to admit authorized inspectors on pr~mise~ and in buildings for n~essa~ in--ions. ~ '~ ~ ~ State whether oppllcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. ...... ........ (Name and title of corporate officer) Builder's License No ..... ~.,..~....~...~......~...~.. ................... Plumber's License No .... ..4...~.....~......i...~.. ....... ..~.....~.~L~-u~.~ ~A-c.e----"-~O M(~I k~:)d~'kl~( Other Trade's License No ............................................... ~lj~j~ ~ [9 ~ ~ / 1. Location of land on which proposed work will be done. Mop No,:O..r~.~..~...~/.i.~..~.T}.... Lot No.t~...(....~-,.,i ............. Street and Number ..)..~....~_~.~..~'~.....?~ .~.,~....-~.~..~..¢~..~.~.~7......~...,..0.,..~.-..~.....~..L¢~., ."~a~? .................. ~ O 'T'~4.~O C.~O ~-~- N '~"' Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Exisiting use and occupancy .................................................................. ; ............................................................. Intended use and occupancy .............. I...,~...~/~..~.~..~.~f..,*~,,,~.,L..~,...1~,....~.. ................................................... 3. Nature of work (check which applicable): New Building ...... ...~:~......,,. Addition .................. Alteration Repair .................. Removal .................. Demolitior ..................... Other Work .................................................... '-~' ?___~-- (Description) 4. Estimated Cost,~.,..~....~..,..~.~).~.:...O..,.C~.. .................. Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ........... ~. ............ Number of dwelling units on each floor ..~-.,..~..~ .......... If garage, number of cars ~ O~l'~-- ' ~ ~'~ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ....... : .................... if any: F ant "-- Rear "-- Depth 7. Dimensions of existing structures, r ................................................................................ ight He ........................ Number of Stories Dimensions of same structure with alterations or additions: Front ...~ .... Rear ..~ ....... Depth ......... Height .....~.....Numbe, r~,~ ~ of Stories ....~ 8. Dimensions of entire new construction: Front, f/__ ,~,,, r-~ ,~ ~,---,7(''''~:''t''~'''''~'' .............. Rear .....~...~...~....~. ......... Depth ..~f,......-:..C). ...... Height .~...0.~...~.. ...... Number of Stories ..... I./...~...~'~...~~-,..~m~.-. ............................................................... 9. Size of lot: Front ..... L~..I~ ........................................ Rear ....... L~...I. .......................... Depth ..z.,,~.z~.,7~...L.C...,~.,..~,.: 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12, Does proposed construction violate any zoning law, ordinance or regulation: ......... '.~.!....~.. ..................................... 13, Will lot be regraded ......I..~....C,~.. .............. Will excess fill be removed from premises: ( ) Yes ( ~ 14. Name of Owner of premises .C,,~-.~.~-~,.~,....~...\...t~....~. ........ Address .~K~.~.I..~.~'..~...~....L... Phone No.'~'...~.~.....~...'~....~..~ Name of Architect .............................................................. Address ................................ Phone No ....................... of Contractor ^ ress No. 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 description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, / c ¢ COUNTY OF ...:~..(Z....7'~'.~....~......Z~....~....f'~'~, ................ ~..../~,..~..~.../t'~.......~../..~...g.....~Trfffffff,~ ........................ being duly sworn, deposes and says that he is the app[icam (Name of indlv[duaf signing contract) above named. He is the ~ ~~ (Contractor, agent, corporate officer, etc.) of 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 contaiped in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner ~et fo~h in the application filed therewith. Sworn to bef~me~~)/this m / ...... ................................. / ~ARY PUBLIC, Slute of New Yer~ NOTE: · : MONUM£NT THE LOCATION OF WELLS AND CESSPOOLS SHOWN H~REON ARE FROM FIELD THE WATER SUPPLY AND SEWAGE DISPOSAt. SYSTEMS FOR THIS RESIDFNCE WILL CONFORM TO THE STANDARDS OP IHE SUFFOLK COUNTY OF HEALTH SERVICES APPLICANT: ADDRESS ............................. TEL he sewage disposal and water Supply ~eilitles .t'o~., this tScation have been lSpected by th~- ~ be satisfacL~a~yen~and~foand Ch*el Of General ~ginee~ SedUces · SURVEY tOR' ~,.~--~-~ ~ ,ofms,~o,~/*isX~'~f}5'Y;' ' , CHARLES F, KING ~ CONSTANCE M. KING ow.~: ",,:~ ~' ~ . ~ ' ' I = ~0 4U~I6,19Y6 ~ 76 668 THE LOCATION OF WELLS ANO CESSPOOLS SHOWN HEREON ARE FROM FIELD OF HEALTH SERVICES APPLICANT: ADDRESS ..... TEL LOT NO. 12 ' I = 50 J ..... AU~16,1976 76-668 i Nor~; at -- MONI)M~NT THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR FROM DATA OBTAINED FROM OTHERS THE WA~ER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STA~A~ O~TTH~E S~,~F~(v"~OU~TY DEPARTMENT APPLICANT: _ ~ _~ -- ___ SUFFOLK COUNTY DEPARTMENT OF F:r-ALTH SERVICES FOR APPROVAL OF CONSTRUCTION ONLY - APPROV~ - ~ YOUNG & ,U)O OS',RANDER AVFr~iUE, RPv~ RJR A'~), ~JW YORK '57i~vEY FOR. CUTCHOGUE ~ow~ o~ SOUTHOLD