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Home My WebLink About9864-zTOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No... Z9337 .... Date ....D.e.c..e?.b.e.r...~.~. .......... , 19...7.8 THIS CERTIFIES that the building located at ...~ }.~.0. ..... Dp.n.n.a...DF.iXe.... ~ Map No. /*256 Block No ..... Lot No, 32 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .J'.u.~y. .... 1,7. ......., 19..7.8. pursuant to which Building Permit No .... .9,06~Z dated .... .~.u.l.y....2.5. ........ , 19...7,Nwas 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 Private One Family Dwelling Rev. Charles Bell & wf. The certificate is issued to ........................................................ (owner, t~ of the aforesaid building. Suffolk County Department of Health Approval .~. $...09. .Deo.e~lber..7., .1.97.8.. UNDERWRITERS CERTIFICATE No ..... P..e.n.d.~n.g ................................ HOUSE NUMBER ... ? .~Q ...... Street ...... 79..n~..a. ?.rfl.¥.e. ......... ..f Building Inspector County Tax Map Number 1000-115-15-15 FO~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N..Y. BUILDING PERMIT .,~THIS PERMIT MUST BE KEPT ON THE P'REMiSES UNTIL FULL COMPLETION OF THE WORK AUTHORIZEO) ~o. os~ z Permission is hereby granted to; .... ~.~...~~-'~ ~ at premises located at ...... 'pu~subn'f 'to application dated ,BUilding Inspector. 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 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 informa- tion 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 Date .. ,~,°c:.~.~. .'./..~,J../,~'.7 .~. ....... New Building ............. Old or Pre-existing Building ............Vacant Land ............. Location of Property ............................................. House No, Street Hamlet Owner or Owners of Property ...~. ,~. ,'..~/...~/~... ~/~, ,/-~..~....~. · ,~./~. ..................... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ,~.~2.. J-~/~..L/~....~/~¢~:~-~.....~.~.~...Map No ............... Lot No.. ~..~. ......... Permit No..~.~. ~.~./...~'. Date of Permit JU.~.~..~..~, .7~.Appticant..~)~..~.0.f.~.. ~/~gT~..C~J'..//~'/2.,, ....... Health Dept. Approval . .~...-' ..... : ............ Labor Dept, Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ~ Fee Submitted $.. ,~.,..O.~. ..................... Construction on above described building and p~rmit meets all applicable cod~s and regulations. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 .JOHN STREET. NEW YORK. NEW YORK 10038 o~t~ December 12, ~ ,,~ ~ept~t~o,~o.o~ft~ 9~1~9 · .,~ ~,.....~ ?. ~ ~,~ ~ N 4 [ 3 8 7 ~ o~y the e~t~ ~u~nt ~ ~s~d~ ~ ~ int~ ~ t~ ~p~t ~ o~ t~ ~ ~l~t~ ~um~r ~n t~ ~m~s of Rev. C~.r~ ~e~l~/~ Do~ I)~.,~O0'a/o ~eP~3~ ~ ~ ~ and found to be in compliance with the requirements of this Board. tvas examined on D~,c~b~r ~ ~ ~ 0 fiXTURE FIXTURES OUTL_b'TS tEC~TACLES SWITCHES ,NCANDESCENT I FLU~eESCENT t ~v~C~ ~ /''~ ~ ~-' I I SERVICE DISCONNECT I NO. OF ~ ~0 C~ METER l-q.~.I, l-/h.oke D~ rector RANGES LoECI AL REC'FI 1 30 $ R OF CC. COND. ICOOKING DECKS I OVENS leaSH WAS~RS TIME CLOCKS BELL,,}j~UNIT HEATERS MULTI-OUTLETsYsTEMS i A,V~T. AMP~.Te~q$. H.P. NO. OF ~ V .t C EXHAUST FANS AMT. H.P. Brook Elect. Juniper Ave. Sm!thrown,N. ¥. ]T787 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by thei~'~eclentials. __ cop ABTMEHT.. TIffS C~)PY~OF .CERT!FI_CAT_E M.U. ST .NOT ~l ALTERID~ iN .AFl J~_NNER. _ TOWN OF SOUTHOLD ~ ~,~ ~ BUILDING DEPARTMENT~' ~ .' - '~ TOWN CLERK'S OFFICE~/~ ~~ S T.OLO, ,. y. ................................................................. ................ ...Z .......................... .......... D. July 17, 1978 a~e .................... . ................. a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to odioining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. 'l'he work covered by this application may not be commenced' before issuonce 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 progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shell 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. Clarendon Homes, Inc. (Signature of applicant, or name, if a corporation) (Address of applicant) 11776 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contractor Name of owner of premises Rev. a~d Mrs. Charles Bell If aC~lico~t i~,~ corporate signature of duly authorized officer, f co triter) ~ ~' Deep Hole Creek F. states ]. Loc~tion o~ land on which proposed work will be done. ~ap No.: ..~.~ ............................. Lot No.: ..... ~ ............... Street end Number W~s Donna Drive, 2000' N~o Theresa Drive Munici~li~ 2. State existing use end ~cupancy of premises and intended use and occupancy o~ proposed construction: a. Existing use and ~cupancy .~/ b. Intended use end ~cupancy .......... 9~...~.~.$.~Y....~.~$.~.~.~ ...................................................................... 3. Nature of war (check which applicable): New Building X Addition Alteration Repair .................. Removal .................. Demolitian .................. Otl~e~/'o rk (Describe) ........................................ · 45,000.00 4. Estimated Cost ............................................................ Fee .,.L,K.~.~ ................................................................. (IG be paid on filing this application) 5. If dwelling, number of dwelling units ....... .o.~..e. .............. Number of dwelling units on each floor ............................ two If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories .................................................................. . ............................................... Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ......... .8..0. ....................... Rear ....... 3.0. ................ Depth ...... ,~.6 ............. Height ..~..8. ............. Number of Stories ....... g..~,.~ ........................................................................................................ 9. Size of lot: Front ....~-.~.O.,..O.7. .......... Rear ..... 1B~.,1.9. ................. Depth ...~.,~.7..,.~.2...[~Qr.t~-) 90.00 (south) 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ] 1. Zone or use district in which premises are situated ........................... ~...: ................................................................. 12. Does proposed construction violate any zoning law, ordinance o~.,rAjg~Jatif~? ... ~!rt..9. ...................................... 13, Name of Owner of premisesR.?..v..'.....C~...a.r..1..e-s...B..e..1..1. ....... Address .aiv~z~,ead~.~l.¥ ............. Phone No. ~23.~$$~4 ..... ~ F;ezel Lane Name of A ch,t ct ......................... ^d ress ............. Pho,e No. ..... 12Pt o e Name of Contractor ..C..1...8~..?..l}.,,,~.....H...(~l...e..s.m...I.~.c..: ......... Address ..~.OICIL.~uI1.R.~d~.... Phone No. 4.7..3..c.~.%.~Q ..... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil 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, ~ e ¢ COUNTY OF ..... S:Lt~foik ............ ~o.o. ....................... .J..o...J~.....J..:...~...d~_..~.....ty. ........................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the Contractor (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 contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith· Sworn to before me this (~ (-~ · 17th day of ..d..t~..~. ,19 78 ...~x',~,~ /, ~'~~.~.~!.~.:..~..~.~._/..... Notary Publi,~c, . .......... ....~....,,~,~...x~.. ........................ ~C~o~ir~~~ ~p'l'i'~ a n t) ................ pubhe, BT~'~°fJ~-~'"r~m~lr~ / / ...................... CO, BUFF. CO. DEPT. OF HFALTH FOR APPROVAL OF GON~'r~uc'rION ONLY DATE: H. I. RL~'. NO.: APPROVED: THE WA?ER SUPPLY AND Is'WAGE DIIPOSAL IYITE141 FOR THI8 RE~I- DENCIr WILL CONFORM TO THE ETANDMD~ OF SUFFOLK CO. DEPT. OF HIbI~LTH. BBRVIOE~. 1 /V. ~?o/~'..7__0"1~. -90.0 t° I~14:W, JIICK YAN Tt,IYI- P. C. ..... ~ULL APPROVED AS .OTED 765-2660 9AM to 4PM FOR REQUIR- ED INSPECTIONS= 1. BEFORE BACKFILLING FOUNDA- TION OR START FRAMING 2. FRAMING INSPECTION 3. BEFORE COVERING PlPZS OF ANY KIND ~. FINAL WHEN JOB COMPLETED NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ~RRORS ~. ALL CONSTRUCTION MUST MEET REQUIREMENTS OF N.Y. STATE CODE [ ~N~ ~0WN HOUSING CODE & ZONING ~ . i L. ,G 't N f