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Home My WebLink About9893-zTO~I OF $OUTHOLD B~.nlNG DEPARTM6~IT Town Clerk'~ O~iee $omhold, N. Y. Certificate Of Occupancy No....Z73.5.9 .... Date . .D..e.c.e.m.b..e¥ .... 2.7 ........... ,19..7..8 THIS CERTIFIES that the building located at ~.&..0..B.e.y...H.ay.e..n..L..s~..e ...... Map No... ~9.3~ .....Block No ...........Lot No ........~? ........................ conforms substantially to the Application for Building Permit heretofore filed in this office dated .. Auguat .9 .........., 19.7/1 pursuant to which Building Permit No .... dated .. August .9 ........... , 19...7.Swas issued, and conforms to all of the require- mants of the applicable provisions of the law. The occupancy for which this certificate is issued is .......... 9~£vate. One. Family. I~ellin/f .............................. The cort~icate is ~ued to ........... ~e..%o~e.z)..s~ .~..~.d.e ............................ (owner, o! the aforesaid buildi~. Suffolk County Department of Health Approval D.e.c.e.m.~..e?..~.2. ,. ?.~?.8 ..... .~-..~.0..-9.zt.. Robert A. m~ERwarrERs ¢~FZCATE Zgo .... .~h~..~?.~ ................................ HOUSE ~E2 ... ~.~.. ....... Street ............~.ay..ff..ay.e?....~A~... .............. ................................................. .S.o.u.t;~..oLd. ,..K.X.. .............. .... . .~....-~..~.,'....~.Z., .~.~. ~.~.... Building Inspector Cou~'L'F Tax Numbe~ 1000-088-4-24 · 'ORM NO. 3 TOWN OF' $OUTHOLD BUILDING, DEPARi~ENT TOWN CLERK'S OFFICE SOUTHOLD~ N~ Y. · BUILDING PERMIT (THIS PERMIT MUST, BE KEPT' ON THE PREMISESJIJN~I'IL FULL COMPLETION OF THE WORK ^UTHOR ZED) N? 9893 Z Permission is hereby gronted tO: Dat~ at premises pursudnt t? application: Building Inspector. :Fee 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 Buirding 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 Ptanning 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 build'ings. 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./.Z:/.~,, .~. / .~.~ ............ New Building .... ~ ...... Old or Pre-existing Building ............ Vacant Land ............. Hou~ ~o. S~reet Owner or Owners of Property ...~./,~ ~. ~,...~'; .~ ~ { ~.~ .............................. County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision..~1~ ~ .A.~ ~.../~'. ~.¢~y.~. (.~. '.v~./, '.Map No ............... Lot No ............... Permit No.~.~. ?.~. ~... Date of Permit ~/.~/'2 ~...Applicant, ./~.. /~¢./.L;..C.~,. ~ .7,~.~.J.. .... /.~.~..~,, Health Dept. Approval .i.'~.l .t-,~. j .~.~ ............ Labor Dept. Approval ........................ Underwriters Approval..~ .Z:/./.,V. ( .~.j ............ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................ Construction on above described building and permit meets all applicable codes and regulations. Applicant .... .~., , ,d~-~.., ~ .~!: , .~,: , ~ Rev. lO-10-7e /, (.(~ ~{.~'/ BUREAU OF ELECTRICITY ES,JOHN STREET, NEW YORK, NEW YORK 10058 o,.. December 19, 197~ THIS CERTIFIES THAT in the f~lowin8 ~t~n; ~ B~e~e~z ~ lsLFI. ~ 2nd Fl. S~tion Bilk ~m~o. ~cember A~, ~9~ a~fou~wbeincom~iance~iththe~uire~ntsofth~. RXTURE ~E~EPTA I WIT I RXTURES I ~AN~SS 15o CB 1-~.~ Hot Wa~er Heater OF CC. COND. 1/0 TIME CLOCKS / BELL UNIT H~ATEIS MULTI-OUTLIT I EXHAUST FANS JoEeph D. Mazzonl 22 Waver_ly ~e Me'ford, L.I. ~1763 Llc. 482 E ema~A aA~Aeea , 11 Ptr ' This certificate must not be altered in any manner;, return to the office of the Board if incorrect. Impectors may be identified by their credentials. I :: __ C J~I~I~.,_TH~IS COP~Y_O~I_ ~UST NOT B! ALT~JO iN ANY MANNER. TEL. ~6S-266C TOWN OF SnUTHOLD nFFICE OF BUILDIN[~ INSPECTOR TOWN {~LERK'S OFFICE SOUTHCLD, N. Y. 11971 FORM lqO, 1 ~ · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .... ~,~. ',~...~.. .............. , 19~Z..~. Approved ..... ~......~. ............... , 19Z~ Permit No...~.Z.~...,~.~....~.... ........... APPLICATION FOR BUILDING PERMIT Application No...~.~.../.:~). ................ INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ 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 or 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 necessary inspections. .... ./'Z2... ' ,~.'z-z-~ Tu c/,~ ..W...'V' ................. 'i~'~;'~'~"~ii~'~'~i ........... z..-. ........... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................... .............................. , .......................................................................... Name of owner of premises ............. ~.~....J~....~.-./~. ....... ~¢..::;./~.. 0 T-- if applicant is a corporate, sianature of duly authorized officer. ....... .......... >/, :o-?sT (Name and title or corporate offic~l') Builders License No .......... 1.3. ................................... ~'d- /"~-~'/¢~////~OO --(~6~- ~Y~ -- Z~7~ Plumber's License No ...... /~.0..~...~...t~. ......... .~...?../~.J~. Electrician's License No ...... ..'.~....~.....~....~.~....'~..J. ........ Other Trode's License No ............................................... ~ ~' ~/'~ 1. Location of land on wh ch proposed work w be done Map No ~.~/~J.~J?~..~...~'./?.~.1~.. Lot No ..... f~.....~. .......... Street and Number ...J~.~.....~.~...~...V..~..~. ....... ..~....J~..._~.....(~. ........... .~...~...~....~...J..~ g.~.~..-J). ~ .V.-. .......... /~(~Z~r~Z'~ ~J~unicipaii~ ........ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy //f,x~)T' .~...~./~)~ v b. Intended use and occupancy ................ E .................... ~.. .......... ~ ...................... L..d .......................... 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ................................................. ... 7~) S,~'- (Description) 4. Estimated Cost ~l~Ii , O ~ .~. ..... 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 ............................................................................................................................................. 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 bf Stories ................................ 8, Dimensions of entire new construction: Front ................. ~ ................. Rear ............................ Depth ..... .'~..,~ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ............ .~....~.....~. ................................ Rear ......... /..~...?. ....................... Depth ....~...:.~:.....~.. ............... 10. Date of Purchase ......... ~.'~...~. ...................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ......... .~1. ...................................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ..... .~...~. .......................................... 13. Will lot be regraded . ....... ~..O.. ........... Will e~cess fill be removed from premises: ( ) Yes (x~ No 14. Name of Owner of premises ...,.~......~....~.'./~..../~....l..~......~... ........ Address ................................ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Nem of Contractor ....... Phone No. PLOT DIAGRAM Locate dearly 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 STATE OF NEW Yf~RK,,i ~ ~ /t,- [¢ c COUNTY OF ..... ~~... f-~'~ _ .......... ~..~...~.~. ~.:_./~/.;...'....'..~'.~..'.....'~..[...~..Z..~z.....Z~...~.,...beJng duly sworn, deposes and says that he is the applicam ~ ~Name o~ indivJdua~ 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 contained in this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set fo~h in the application filed therewith. Sworn t~efore me this ~ ........... .......................... .............. ........... HOLE , SU,,F. C: . DI[pT. OF HEALTH:,, , t~lrR~l: · ; ~ i*: : STATEMENT OF tNT~NT *' ,, : ; : DI~$A~ SYSTEM~ FOR THIS RESI- OWNER: 7-~ / . "' ' · ., ~, .-4::'I ~ ~' ~' ~ i r~, , ~D~CK V~N TUYC, p* C. SUF~ CO, DEPT OF HEACTH ~RVIC~ STAteMENT OF IN~E~ ' DIg~L ~Y~TEM~ FOR THI8 ~ ~ ~, DATE: ~ ' ] ~ 0 ~ :; ~TAN~DS' OF SUFFOLK CO. DEPT. ~ OF H~L~, SERVI~E5. 6PPUCA~ . I 'i ~ 'z-4- 'T G APPROVED AS NOTED NO'FY ~u,~m,~ 765-2660 9AM to 4PM FOR REQUIR. ED INSPECTIONS: ~ BEFORE BACKFILLING FOUNDA- TION OR START FRAMING 2. FRAMING INSPECTION HOT RESPONSIgLE FOR DESIGN OR CONSTRUCTION ERRORS 5. ALL CONSTRUCTION MUST MEET REQUIREMENTS OF N.Y, STATE CODE T RE. NO. ~4' ¢ 4- ~" ]