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Home My WebLink About10087-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No .... Z96OD ....... Date ,Tu,%]r. R~ ........................ 19..T.9 THIS CERTIFIES that the building ................................................ Location of Property .... ~I~Z.~ ..... ~VOfL'~ Hous~ No. S~r~t H~nl~t County Tax Map No. 1000 Section ...51 ....... Block . 6...~. ........ Lot.. 22 ............ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ........ Deo....~8 ..... ,19 ?R pursuant to which Bufldin~ Permit No .... 'IC)OB'~..Z .......... dated ...... ~D®o.. 29 ............. 19.7~ was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is i~ued is ......... ......... priva:e..one, em=l.].y..c~ellJa=$ ...................................... The certificate is issued to . 14~¢the~ .&. J'oael~o~~ ...................... of the aforesaid building. Suffolk County Department of Health Approval ....... ~/~ ............................... UNDERWRITERS CERTIFICATE NO .................. ~/~-Tt/~ ....................... R~ 4/79 Building Inspector 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) ~-0087 Z Date ~......~....~....., 19..7....~. Permission is hereby granted to: ............. ...~z~.z..z.~.~....~../~... ~ ..~...~c. "~'""~"~ ........... ,.r . ot pr~m,~s ,o~ed at .~...~....~..:...~...4.~.~',z.~.........'....~ ...... .;.;../.. Building Inspector. ~ee ~./.~. ....... .~ ~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 Inspec- tor 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 featu res. 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 installa- tions, 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 peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 informa- tion required to prepare a certificate, 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 New Building ... ~ ........ Old or Pre-existing Building $5.00 Date May 21, 1981 X× ............ Vacant Land ............. Location of Property 1775 West Mill Creek Drive Southold House No, Street Ham/et Owner or Owners of Property Matthew & Josephine McKiernan County Tax Map No. 1000 Section 051. O0 Block 06. O0 Lot .... 032. 000 Subdivision ............................ Filed Map No ..... Lot No. Permit No. [~¢P.~?:~.~.. Date of Permitt~z~.~' (. 7¢~,..Applicant ./.~..,/,(ff..~..~/.z~../~,¢-2.- ............ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Cert f cate ......... Fna Cert f ~t~ XX .......................... Fee Submitted $. ,5...0.0. ....................... ~ Construction on above described building and permit meets all appli a i odes and regulations. ~ - Applicant, ~: ......................... ~) WILLIAM H.~ ~RICE, JR., ESQ. Attorney/Agent Rev. 10-10-?8 for Matthew & Josephine McKiernan FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor 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 installa- tions, 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 informa- tion required to prepare a certificate. 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 Date .~-~,/~/. c~.-~,. ~'~.~. ....... New Building ............. Old or Pre-existing Building '~" Vacant Land Location of Property ,/'..2,2~:...~;c~...~.,//.., (~,~.¢~./~..~?.....~. d.~, ~'~d. ,/o/~....~. ~../../~. ?/... House No. Street Hamlet Owner or Owners of Property ~. ~?.~: ./~./~r~..~..~-d~/,~/~.-~'~./~',~.~/. Cji. ~;~'/~:.~/. ........... County Tax Map No. 1000 Section . .~'.~./. ......... Block .. ~. ........... Lot...~?.~.. .......... Subdivision ................................. Map No ............... Lot No ............... Permit No.~.~...~-. Date of Permit .~'.~/.~.~/.~. ~Applicant. Health Dept. Approval ...xCel././.), ............... Labor Dept. Approval . .~/.4~. .................. Underwriters Approval ~?.~.~-~.'/~, ......... Planning Board Approval .,f~/-/~... ~ ............ Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ..... ~. ,.. ~.. ................ Construction on above described building and p?mit meets all applicablejco~s and regulations. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ..o-, l~?~ "' Jo.. ST.ET..EW YO..,~.,..,.~,~" ,oo~E June THIS CE~IFIES THAT o~y t~ e~t~ ~u~t ~ ~scdb~ ~ ~ int~u~ ~ t~ ~pli~nt ~ on t~ a~ ~t~n numar ~ t~ p~ of FIXTURE FIXTURES OUTLETS SWITCHES 24 6,9 22 24 RANGES OVENS DISH WASHERS EXHAUST FANS DRYERS FURNACE MOTORS FEEDERS TIME CLOCKS MULTI-OUTLET DIMMERS SYSTEMS SERVICE DISCONNECT S E R No. OF CCCOND. A.W.G. ¢ Elec. ~oomhea~e~s: 1-L.5, 3-1.25, I GFCI, 2 smoke ctetectors, Hot water heater: l-4.5kw. 4'[.0, 6-.65, 7-.36510g F. Tabacco-F.~.. ELec. 160 ~orthern Blvd. St. James,N.Y. 11780 lic.ll02~ [his certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be 1l COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN MANNER. 'I'OWN CL~R.~'$ QFFICE $OUTHOLD, N. )isopproved a/c .............. ~ ............ ,~ ............................................ ......................... 5 .......... :...ZZ ......... ......................... .... ~.~ ...... .~L...~- .............. (Building lns~etar) APPLICATION FOR ~UILDING ~t~2MIT a. Th s ~pplicotlon mu~t be completely ill!ed in by b/pewriter or in ink and submitted in triplicate to ~the' Building Inspector, w~th 3 sets o~ plans, ~¢~r~e plot pl~n to ~le. Fee ~:cordlng to schedule. :' "-': '- _. .............. ~ ......... =' ~ ~-~n ~n the dianrom which is p~ of this apphcotion. ; ~ ~e work ¢~ered by ~is ~ppllc~tion m~y not be commenced before iszuance of Building rerm~t. : ';.. ' .-5 .- ,.-. eke , on the ~rem~s~ ~ailc~le for inspection throughout the work. ' haUpan~ppr~al of ~is application, ~e Building Inspector will i~ue ¢ Building Permit to the ¢~plMant. Such permit b , ? .... . , - ~ ' --~ ,- -.,~ -- :- ~ f~r an~ ~u~ase whatever until o Ce~ifica~e of Occupancy ~h~fl h~e been ~rant~ by the Buildln~ l~pa~oc ' ' APPLICATION S HEREBY ~DE ~ the Building Dep~eat for the i~uance of 9 Build{ne P~rmit pursuant to the ]uitding Zone Ordinance of the Town of ~outhold, Suffolk ~==n~, New York, and other oppdccbL Laws, Ordinances or ~egut~dons, far the cabin,lan a~ buildin~s, additions or rtt~r~ions, or far removal or demolition, as herein described. ' ' (Signmmre of applic~t, or ~me, if o'co~orati~n) . ¢~e .~r.~,.~.~.ce..~..~c:....O~/z~.Z~.~z~:/:....,..~. i...,~.~..c~. ..................................... : ................................................................... ; ......................................... : ........ .~, ~ ~¢ ~ e ~ .~ ~.~¢ ............................................................................. Nome ~ owner e~ p~mizes ............................... ~ IN,me ~nd title cf ca~o~te officer) ~uilder's Lic~se No ........ ~¢.L~ ................................ Plumber'S License No ..... ~/-~ ................................. ~lectricla~'s License Ns...~,~. ......................... Clair Trade = License No. ~ / ~ ~ 1: ~ac~dan a~ land on which proposed work will be dc~. Mop N~.: ~..~[~ZZ(~.~.~... Let No ........................ Srre~r a~d Number..,...-....- ~e~..., ..... . ....... X~//....~C.¢.~....~,. ....... ~ ~.~ ~.../~ ~../Z.~ ZZ .............................. 5ta~e existing use ~nd accup~n~ of premises cad in~e~ged use c~d cccup~r~ of proposed cons~c/i~n: ~. ~isiting use end ~cupancy ..,~e~z.~g~gg .................................................................................................... b. Inl~4 u~ ~ ~uP~n~Y .~z.~.C{..;;...~,~,~.~.~.~,,M ....... ~Z~..~...M...,.C...~ ................ ~,.. (cn.~c,.. wh;ch op,o~icobl~)' New Bui!ding .................. Add,tion ..... ~ .........~t~r~on .............. ~. N~tur~ of ~rk 4. Esdmoted C~s~ ~.~--~-¢-¢"¢'"~& ................ : .............. ~ee ........................................................................ (to be paid on filing this ~ppllcotion) .... ~. Ii d.,velHng, number o¢ dwelling units ........ Z .......... Number o~ dwelling units on each fl~r ....... Z ................. If garage, number of ~rs ............ -~ ....................... : ' .............................................. Ii bus]ness, commercial or mlx~ occup3ncy, speoF/ n'sture 6nd extent or each l~e o¢ use . ................ 7. Dimensions of exlstin~ strustures, i¢ any: Front ........ ~.~..-~ ........... Rear ~¢ ........ Depth Stories ............................................. ' ............................................. He[gk~ ..... ~--¢ ......... Number 0¢ ~Iterat,ons or ~d.J,h~¢~ Front ......... ~-~ ...... Rear . ~¢ / .......... Dimens]cns of same structure with ~ / · ¢ .... / Helgh~ ........~ .............Ndmber o¢ S~ones Depth .........~.~ .................. . .... ¢¢ / D~th ....¢. ............... 8. Dimensions of enHre new consfructlor,: Front ............ ~ / ....... Rear .................... H~.hr ~ / / Number o¢ Stories ....... ~ ................................... ~"~ ................................................... - = '": ............... ~/ Rear ~ .. Depth ..~..~ 9. Size ef !or' Fro~t ....... .Z~. ................................................................................. . ' i0. Dc:re o¢ Purchase .... ~. ............... Nome o¢ Former C~ner ..... ~4¢~.z~.-~ ~ 1. Zone or use district in which premises are situated .....~¢~ z.¢~¢.~.~.~ 12. Does proposed construction violote ~ny zoning I~w, etd[nonce or regulation: ................................ · , '~ .......... W H excess fill be removed from premises: ( ~e~ ' - ~ ~¢~., ~.~E~¢~ Address ..~2~.~..l~ ..... Phone ~o. N~me o¢ Architect ........ ~-/-~ .......................................... Address ............................ ~... ~hone No %,E .............. N~me o~ Contractor ...... ; j, .......~ ................................... Address ............... P~on~ No ~LOT DIAG~M '' e~ I ~nd ~istin~ly ~11 buildings, whether existin~ or proposed, end indicote oi1 set. ok , . .- z~ove ~med. ~ · ~ forth in tke .*pnHcoHon filed therewith. :h~ ~he w,z~j will be peaFgraed ,n the manne~r se ~ . ~wom to~o¢~e this ~/IJ / ~ ~/ APPRO,~,T~E), AS NOTED DATE,, ~ ~/'~,~/7 ~ 765-2660 9AM fo 4P~ FOR REQU R- r ED. INSPECTIONS: 1. BEFOR~ BAC~(FIL%I~G FOUNDA- TiON O~ START FRAMING 3. BEFOR~ COVERING P~S' OP ANY KND S. ALL CONSTRUCTIO~ MUSt ME~T REQUIREMENTS OF N,?, ~TATE CODE AND TOWN HO~ING ~D~ · ZONI~G ,o.ff/ ,. . rI.