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Home My WebLink About9834-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No....Z.9.3 .~.0 .... Date . .De.c.e.~l~.er..6 .............. , 19.7.9. THIS CERTIFIES that the building located at .500..S. tSt~uy.a~..d.c..Rd., ....... ~ Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...July. .... .7. ........, 19. ?.8 pursuant to which Building Permit No ...... 98~/4Z dated ...JuLy. .... .18 ........ , 19..7.8, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is Private One Fami.ly Dwelling issued is ...................................................................... The certificate is issued to ...... TI~.~.d. or.e..&..C.o.l~..e.e~. ~.~.r..t.nge. v .................. (owner, ~ of the aforesaid building. Suffolk County Department o~ Health Approval ........ . .ST.S..0.-.7.6.....N. qv..e.m.b.e.T' .2.2.:. 1978 UNDERWRITERS CERTIFICATE No. N412416 HOUSE NUMBER .. 5.0.0 ........ Street ..... .S..mu?..y.s.l.d.e...R.o?.d. .................... Southold, N.Y. Building Inspector County Tax Map Number 1000-63-l-Part of 3 FO~M NO. ~ TOWN OF SOUTHOI~D BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 9834 Z Permission is hereby granted to: pursuant to application ~ated Building Inspector,, pERMiT INCLUDES TO REMOVE EXCES~ !~1[~ ,FROM ABOVE PREMISES' BY Fee ~ ...... (~r'~;;.'~O....~ REGRADING EOT "DRIVEWAy coNsTi~UC~ION · · C~$SPOOL CONSTRUCTION ~ELbAR CONSTR~, OTHER ~ "~ ...... 'l~6}-l,Part of Z~' _H* S, , 8..80-76 TOWN OF $OUTHOI. D Building Dep~rtrnent Town Clerks Office Sou~hold, N. Y. 11971 6 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 disposai--(S-9 form or equal). 3. Approvat 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelHng or land use 3. Copy of certificate of occupancy $1.00 $5.00 - ...................... New Building ..... ~ ........ ,Old or Pre-existing Building ..._. .............. ./..-.~.. Vaca,n,t Land ...... ? .......... :t ...... Loca,,on o, Proper, . ...... Owner O, Owner, Of P.rope,y ................................ '. Subdivision ............................................. ',i .......... ,.....Lot No ............. Block No ............. House No ............. Permit "o..~...-~....~.!ZDate Of Permit ..7.~...,Applicant .................................................................. Health Dept. Appr~vat ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ....... ~./ ....................... Request For Temporary Certificate ........................................ Final Certificate .......... ~ .............................. Fee Submitted $ .................................... o~rmit ~e~e~ all applica,bl~ codes and regulations. Construction on above described building ..................................... Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or seal) TOWN 0~- SOUTHOLO OFFICE CF I=IUILDING INSPECTOR TOWN CLERK'S OFFICE SOUTHDLD, N. Y. 11~71 TEL. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY I~e ES JOHN NEW NEW YORK 10038 STREET, YORK, r THIS CERTIFIES THAT only ~ ~rlcal ~iu~ment as describ~l b~low and introduced by tl~ appllclmt ~ on t~ Isbot~ appllcati4m number in tim premis~ of S~rln~er,n/w End Sunny Side Dr.,l~O0t w/O ~-~,ar~'ons L~.,Soufhold,L.I. BYERS [] 2nd Fl. Seetion Block Lot and.found to be in compliance with the requirementa of this Board. RANGES OVENS DISH WASHERS EXHAUST FANS $~RVIC~ DI$CONNECI' I-Sr~oke !:e ~recl'or S E R V I C E Snud5 Elect. Serv!c~, Inc. 175 3rd St. Sf. James~N.Y. I1'7~0 LIc, 10?E PM II This ce~ificme mud not be ahered in any manner~ return to the office of fhe Board if incorrect. In~p~dor~ m~ be identified by their credentials. .... C _ DEPARTMENT. THIS COPY OF CERTIFICATE~MM~TBBIO ~AHY~ ~ Examined ....... Approved ....... ~'~5' ........ $~-~- ........... 19.,?'4;~.. Permit No..'.~.~l~ ..................... Disapproved a/c FORM ~qO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Application No ..... 5}t~f .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .......... :~.t,~?,~... jZ ........................ ] 9...~.,., ..... INSTRUCTIONS 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 plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part 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 issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessa~ inspections. ~, ---. ...................... ............................................. (Signature of applicant, or name, if a corporation) .............................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premlse~ "~'""¢.~"',~e~a~;t...~...~.~]~..~¥.~[.~.~[~$~.~. ....................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~- Builder's Lic~se No ...................................................... Plumber's License No. ~.~.~....~.C~../ ~~ .o ............................................. 1. kecotion o{ Iond on which proposed work will bo done. ~op . Stroet ond ~umbor iql~;~J~ Ig ~[. ~ . ~g~tO~ ................................................... Municipali~ 2. State exisfJng use and occupancy of premises and in~ended use and occupancy of proposed construction: a. Exisiting use and occupancy ~,~ ~(~ ................................. b. Intended use and occupancy ................... .(~,~;~.~...m~..~,~..~L~.~;. ...................................... 3. Nature of work (check which applicable): New Building' ....3~ ........... Addition .................. Alteration ................. Repair .................. Removal .................. Demolitior .....................Other Work .................................................... ..~... {Description) 4. Estimated Cost ............ $.3:~,}~)0 ............................... Fee ......... .~...Z.../..~. ............................................................ (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 ........ (,~..~3f.~.~..~.t~:~,a~¢~¢] .............................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ....... z~C~).~ ...........Rear ................................Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... P, ear ............................ Depth ................................Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ....... ~7.~....., ................ Rear...,/~,7.] .................. Depth ..... ~g.I. ............ Height ...:;~,,,?. ..........Number of Stories .................... ~ ............................................................................................... 9. Size of lot: Front ............ ~/;~.o.~.~ ............................. Rear .........].3.~,~.~ ...................Depth ...... ~./'~;~i~.~ ............ 10. Date of Purchase ............... :~..~..~.~....~.l....~.r~]~ ............ 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: .......... ~i~..O. ......................................... 13. Will lot be regraded .....~.~.~..~ ............ W, ill excess, fill be removed from premises: (~) Yes ( ) No 1 4. Nome of Owner of premises ..~,;~(~,~ .............................. Address .,.V3[~J'~J;...~,~e.. Phone No..Zw.;~,.,,,l].%.. PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-lmack 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 NE~/Y~,~ ~~...~.....~:~.. .............................. being duly sworn, deposes and says that he is the applicani ....... "~SZ~' 'L~J(; ~'' 'o f individual above named. He is the ........................... ~ ....................................................................................................... (Controclor~ ogen~, corporo~e officer, etc.) of sold o~ner or owners, ond is duly ou~horized 1o perform or have performed 1he soid ~ork ond 1o ~oke ond file this opplicotion~ thor oil s~o~emems contoined in this opplicotion ore true to the best o~ his knowledge ond belief; ond that' the work will be performed i~he manner set fo~h in the ~plicotion filed therewith. Sworn to ~e this / / .......................................... Notaw Public, . .......... ~~CounW r ......... ~l ................ ;~':'""? ........ Y ....... ;:';'":~' ............................. I ' ~ ~~ (~ ~lgno~ure o~ appI,con~l Now 0,~ I -n facIlitie~ for this inmr~';.~ havo been Chief of Goneral Engineering 5uRVEYI[O FOR T~EOOO~E 4 Cozztg~ $ITUATEO~ At SCALE 1~ ~ ~' DATE I1-1~-Iq78 RLED M~P NO: DATE BOOK NO; ~GE ' HAROLD g TRAN~HON JRJP. C. LAND SURVEYOR SUCCESSOR TO WILLIAM G. METER NORTH COUNTRY ROAD- WADING RIVER NEW YORK 11792 (51G;)~29- 469~ A~T. 473-3626 "Th~ water supp3.y ~nd s~wzge disposal systems for this residence will conform to the standards of the Suffolk County DeDzrtment Service ". the New Y~r~ 3t~e Ed~.:a .on L~v/. shall ~ot ~ consdered ~O'be a valid tru~ ~Wch~s,;N, Y. 11934 Bren Stakes Shown Thus -I ~J APPROVED AS NOTED/ D^rE..__._ Z--fZ- NOTIFy DUILDING DEPARTMENT AT ED INSPECTIONS: 1. BEFORE BACKFILLING FOUNDA. TION OR START F~AMING DATE PROJECT N~ 825 East Jericho Turnpike ri; Huntington Sta., N,Y. 11746 (516) 4 2 1 - 2 2 4 4 REVISIONS --t 2,. 12, 13. 14. t6. )3, 19. 20. agrae Wi~h S~. , ' - ' Contr~or or o~er shall obtain ~ ~butl~img p~r~ fr~ ~he t~i T~ or V~ll~ prior co starting any work, , , Comtractor shall obtain all required app~ov~ls~ ~:~lt~ in~pec~on approvaI~, e~c, for w~k perfumed f~om a~nctes having thereof. All work shall conform to the New York $~ate Buit~tng Co~ and all rui aaa regula.tibns of the To~ or Vtll~e Should ~ fall to foll~ ~is pr~ce.d~e and` eontinu~ wf~h the ~rk, h~ assu~ all resp~ibility a~d ltabilit~ ~isimg ~herefr~. . Provide tin. proofing with trollied on maS~tc 0n ail ~o~daci~ waltz, Roof a 2~ fl-30~/sq. ~.~. live load All headers to be (2) 2 x 6 Up, eSS motgd Otherwise, , r desi~, & lnj~allation, Syst~ ~o' ~ 900 ga1. rain,, e6pti~ tank ~d 300: ~:. ,ft,,,""J wall ~ea Leaching ~ol. - . ; ,, F~nish a~d install a ~ngle ~tati~ a~o~ detaating at~m Ivic~ ~e~e 'indicated on plan. Device shalt c0nform .tO seC.{on ~01 of N.-Y,S; ~ch$~ecc has not' been reCaine~ foW,i~spectto~ and/or obs~vacim of Do no~ scale ~a~ngs. ~ri~eu di~nsio&S supercede J I ' J DATE SCA£E PROJECT N-° Philip. C. Pan d o I f i SHEET N°-. A R C H I T E C T 825 East Jericho Turnpike Huntinjton Sra., N.Y, 11746 (511) 4 2 1 ' 2 2 4 4 REVISIONS SCA[.E DRAW~ Alt Philip C. Paod o Ill ~l~ SHEET A R C H I T E C T 825 East Jerichn Turnpike HuntinBton Sta., N.Y. 11746 2 ~ - 2 2 4 4 OF~ 4 REVISIONS