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Home My WebLink About9122-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office South&d, N. Y. Certificnte Of Occupnncy No. Z..9.086 ..... Date .Jun~ .27.~..1 ............... , 19.78. THIS CERTIFIES that the building located at ~/.s.B.~r!.ey..L~.n.e. .......... Green fields Map No..63!3 ....... Block No ........... Lot No, .~7 .............................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .~arch..~..14 ....... , 197.7.. pursuant to which Building Permit No. ~t~h..25, .................. , 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 Rriva.te. one.. family. ~lwell£ng ...................................... The certificate is issued to . .c~.rW~L.t.~. ~. ~.a~.t~t; .................................. (owner, ~~) of the aforesaid building. Suffolk County Department of Health Approval .J.u.n.e...2.7.,.. ~:9.7.8. .................... UNDERWRITERS CERTIFICATE No. N374902 HOUSE NUMBER . 5 .6.0 .......... Street...~or~l, ey. I~ne, ........ ../ BulldOg 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 CQMPLETION OF THE WORK AUTHORIZED) N? 9122 Z Permission is hereby granted to: F~'a~---~n-.-..~..C.-.f,~.~%~ ..& .. ~l'~t.~ ......... .......... ~0~;...~.~:L.... ~ :1 ....... ~l..v e ~.he. ad ........... ~o ..b..u:..i..1..d.....n...e.~ ...o. ~ .e....f...0~Z...~L .Z..l..n..g ................................................ : .................................... at premises located at ..~,o.t,...1.~. .......... (~;r~e~l~',~a~L4s ....................................................................... ................................................ ~ar~e~...La~e ......... ~,~tho,ld ......................................................... pursuant to application dated ...................... ~a~.....l~. ................ , 19.~..., and approved by the Building Inspector. Fee $.~3,~0 ........... ~ , ~ ~u~aing inspecrlr FORM. NO. 6 TOWN OF SOUTHOLD Building Deportment Town Glerks Office Southoid, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate 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 Aprll 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey o'f 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 3. Copy of certificate of occupancy $1.00 $5.00 O te .... J.2.7. ............. New Building ...¥.e,s .......... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ..... I~QJI;...~.J.~. ........ I~t~/7..J..~.y,...[,flJ~....q. .............. .~.~.tl.tc.h.q.!.~. ....... .(.~..e...e..n.?...i..e..!..d...s.).... Owner Or Owners Of Property .......... .~.q,.~.~/.i..~..z....~l/~...d....~§.~.n.,~..~..~. ............................................................... Subdivision ...G.~..e...e..n..~,.i..e..!..d...s...,E..,s.~.a.~..e..s. ............... Lot No...~.,!,~,,,, Block No ............. House No.....,,~.6,~. Permit No..~.~2~C¢~.,, Date Of Permit .~L~,.~J,~.7,...Applicant ........ .F,~.,a.,n,,.k,..B,o,l?.n,. .................................. Health Dept, Approval 6/,2,~./,2S.,,;E....~;LZ, la~,,.,.Labor Dept. Approval ................................................ Underwriters Approval ...N..~...~..0...2. ........................... Planning Board Approval ..... . ................................... Request For Temporary Certificate ........................................ Final Certificate ......~,.e,s ............................. Fee Submitted $ .~[~.0.~. .......................... Construction on above described building and permit meets a~l~ applicable codes and regulations. Applicant .............................................................. Sworn to before me this ................ day of ............................................ (stamp or seal) Notary Public .................................... County ~ THE -NEW YORK BOARD- OF FIRE, UNDERWRITERS t ~' : ',; L, BUREAU OF ELECTRICITY ,, . %".1 .L' '' : ~ JOI'~N~TREET NE~V YORK NEW YORK 10038 ,; ~, ;.};?' 560 Bailey Lane, Southoldr L.I. ,- :,3o f . ,:m: ;_ ~OUrtET$ '.~ ~WI'/CHr::S ' ~LOO~eSCeN, T ::Lfi:38~ 27 '" '- ,.,'~- SERV!~E. DISCONNECT RANGES: ."OOKING DECKS OVENS DISH WASHERS JNIT HEATERS DIMMERS ' ,..:~ ",,:-:~<:,~ .~., 'Cen:er M0ri~heS 11934 ... ::~,, _.,,: ,. ..... , , , i:.' ;~,' : : ' '"' This certi~icat~ ~bst not be'altered ' ~ in ~ny manner~ return t~ the bffice of the ~oa~d if ihcorr~ct. Inspbctors may or ¢oW THE LOCATION OF WELLS AND .CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR FROM DATA OBTAINED FROM OTHERS THE WATER SUPPLY AND SEWAGE OISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF T E SUFFOLK COUNTY DEPARTMENT APPLICANT:__ ADDRESS .%!~~ CF-~I _'Z~.__~__ oA~ JUN 271878 facilities fo~' t'e~; ]ocat!on ]~av8 been bof of ) ( vD¢° NOTE: m:MONUMENT SUBDIVISION MAP FILED IN THE OFF[CE OF THE CLERK OF SUFFOLK COUNTY ON NO~ 10,[975 AS FILE N0.6~13 REVISIONS APR. 27,1978 JUNE S, 1978 YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: GORWIT, Z & BARNETT ~' LOT 17,'IGREENFIELDS AT SOUTHOLD" AT GUARANTEED TO: SOUTHOLD :rOwN of ~'SOUTHOLD SUFFOLK.CO., N.Y. SCALE: 1"=40', [DATE: MAR, 9,1977 -I O~ O0W .rnerlY J' J* fO~(vd¢OCf) .[ ~I,IFFOLK coUNTY DEPARTMENT. OF I~IEA~-~'F ?-?.'""' FOR APPROVAL OF CONSTRUCTIOi'~ ,9 'of 18 ,~ v~dcont ) NOTE: al=MONUMENT SUBDIVISION MAP FILED iN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON NOV. 10,1975 AS FiLE NO. 6313 YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. 'YOUNG HOWARD W. YOUNG SURVEY FOR: GORWITZ 8 BARNETT LOT 17, "GREENFIELDS AT SOt ,,'r SOUTHOLD TOWN oF X3OUTHOLD SUFFOLK CO., N.Y. ] ,i =¢tO' DATE: MAR. 9, 1977 mE,LOCATION 'OF WSLLS A~O,~.E~SPOOL$ SHOWN HEREON ARE~'~OM FREI.o OBSERVATIONS ~AND OR FROM DATA OBTaiNED ~0~ O~HERS THE WATER SUPPLY AND ~EWAGE DISPOSAL S~STEMS FOR TH~S RESIDENCE / "~UFFOLK COUNTY DEPARTMENT OF HEAt?:* '.'g~',""' FOR APPROVAL OF CONSTRUCTIC DATE HS REF; NO.~, pOV,I OF .rnerd J' J' D°n°l~ue '°f 18 .,( v~cont ) NOTE: ~: MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE[ CLERK OF SUFFOLK COUNTY ON NOV. I0, 1975 AS FILE. NO, 6'51'~ EE¥1SIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG; SURVEY FOR: 'GORWITZ ~ BARNETT LOT 17,"GREENFIELDS AT AT SOUTHOLD TOWN OF ~OUTHOLD : SUFFOLK CO,, N.Y. ;CALE: ~,l :40' DATE' MAR, 9, I977 i !<,:. NO. 4. ,o.. / I 'L _ ,. ~.,.~-~- .. , I ............................... J_' ....... ~ ~ .'~: ........................................................, '1