HomeMy WebLinkAbout9940-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No. Z10295 Date December q0, 19 80
THIS CERTIFIES that the building ................................................
Location of Property 920 Youngs Road, Orient
House No. Street Hamlet
County Tax Map No. 1000 Section ...1.8. ....... Block ...... '.2 ........ Lot ..... ? .3..+.. ? .6..
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
· .S..op.t.o.m. 1?..er. !, ...... 19 7.8. pursuant to which Building Permit No...9.9../4.0. .Z. ............
dated September 13, 78
............................ 19..., was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
The certificate is issued to Jerie and Kenneth Newman
..................... ~o¥,'o;, ~~ ................
of the aforesaid building.
Suffolk County Department of Health Approval .., ~I./.R. ...................................
UNDERWmTE~S CURTZFm^T~ ua .... .~. 5e. eg.3.7. ....................................
***Board of Appeals Approval #2446 - July 27, .197~(Slde Yard).
............. ~iicii~'~Jc't;~ .............
Rev 4/79
TOWN OF SOUTHOLD
BUILDING DI~PA, RTMI~NT
TOWN CLERK'S OFFICE
SOUTHOLD, N.. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
9940 Z
Permission is hereby granted to:
pursuant to app ~.cahon dated ..................... : .............................. lC).` ., ~. anti approved b~ the
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 approva~ 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 bg~d~!_n, gs 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 inform&
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
c '
Da,e..I. 2= ..... ..........
New Building . . .~.'~. ~ ...... Old or Pre-existing Building ............ Vacant Land .............
Location of Property .......... · .......... ~. ...........................
House No, ~- Street I Hamlet
Owner or Owners of Property ...-~';e~ct,¢...~'...~.-.~.XC.~,~k~ ...... '~ .'~,~.~(~*~ ..............
County Tax Map No. 1000 Section ............... Block ............. Lot .............
Subdivision ................................. Filed Map No ........... Lot No... ............
Permit No~.~J C). ~J~.... Date of Permit ?.~).~.'[~.l.(~pplicant.. l~e~.~.~ ~.~... ,~.~.~),~,~,ld?~. · .
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval .... L.~.~?..~.~X .L-~. ~; ........ Planning Board Approval . H~,~ ...............
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ .... ~-'~ ~') ...................
/
Construction on above described building and perle, e/ts all applicable codes and_
Applicant ...... ' . .//~/~' ..................................
R~. ~o.~0-~8
THE NEW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
~ ES JOHN STREET, NEW YORK, NEW YORK 10038
THIS CERTIFIES THAT
only the electrical equipment as described bel~ and introduced by the applicant named on the above application number in the premises of
in the following location; ~ Basement ~ 1st FI. ~2nd FL
~ Section BIoc~ Lot
was examlaed on ~8~ 4 ~ ~J(J and found to be in compliance wita the requirements of this Board.
FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
~ 13 3
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ~PECIALREC'PT TIMECLOCKS BEt[ UNIT HEATERS MULTI-OUTLET DIMMERS
SERVICE DISCONNECT NO. OF S E R V I C E
~ METER
P~tb~d/~ 1 bc~r~ .d,25~p
(~nt~ NoY~ 11957
Th~s certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspector~ may be identified by ' ~ ir credentials.
S COPY OF CERTIFICATE
BE SLTERED IN ANY
TOWN OF SOUTHOLD
r'IFFIO~' FIF BIiiL. OINr~ INSPEOTOR
TOWN r. LERK'S CIFFIO£
SOUTHOLD, N, Y. llcJ?~
TEL. 765-~-660
Memorandum ~rom....
BUILD1NG~INSP~ECTORS OFFICE
Town HALL, SOUTHOLD, ]~'. Y. 11971
765-1802
OLD PRINTS
AM.ERICANA
PAINTIN08 BEFORE I~90
OLD I~RINTS
HARRY SHAW NEWMAN KENNETH M. NEWMAN
I5o LEXINGTON AVENUE ~T 3OTa ST., NEW YORK, N.Y. IOO16 · ~'zLzPaoNz MURaAr m~L 3'395o
August 13, 1980
Mr. Fisher, Building Inspector
Town of Southold
Southold, New York
'0,
. ear Mr. Fisher:
At long last we are nearing completion
of the greenhouse. I have been working on it all
sQmmer and having great difficulty in installing the
glass. The frame is up so that you can get some
idea as to its size and shape. The ~our Seasons
people tell me they are going to put-the glass in
the 25th or 26th of this month so perhaps you
could check it out later that week.
We will be leaving Orient for Garden
City after Labor Day so the garage will be closed.
Enclosed is a zerox of the fire under-
writers' certificate which we ~ust recently obtained.
Thank you for all your assistance and
unde~ standzng. Do-it-yourself projects sometimes
take longer than the "it is so easy" directions in
the ads. /
Sincere/y yours,
?
K enn)th~. ~e~man
KMN:rhb
Enclosure
Private Road. e/o Youngs Road
Orient, Nevi York
TOWN
BUILDING DEPARTMENT
~UTHOLD, N. Y.
Disapproved a/c ............. ~ .................................................................
.......................................................................... ........
7/~/7[~ (Building Inspecto~
APPLICATION FOR BUILDING PERMIT
Dote ............... , ............
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 m
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 shah 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 Deportment for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New Yprk, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or fc~r removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, bj~4~clir~g code, housing code, and regulations, and to
admit authorized inspectors on premises and in buildings for necessary ~ntec~ons.
(Signature of applicant, or name, if a corporation)
e~.st of Youn~s ~td Orient. N.Y.
(Address of applicant)
State whether applicent is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
......................... O.~ne~. ..............................................................................................................................................................
Name of owner of premises J(~e.lmO.e:~ ~ ~ J.e.~'.J~e ~Btlan. ...........................................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No .....................................................
Plumber's License No .................................................
Electrician's License No .............................................
Other Trade's License No ...............................................
1. Location of land on which proposed work will be done. Map No.: ...~..0...0..0.._.~..8. ..................... Lot No .........................
Street and Number ...~.zl.J.~.a~..J~d .......................................................................................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy .......... l.).~l..g'...cJ....~........~t.F~.; ..............................................................................
b. Intended use and occupancy ......... '..~:......~...qk......~.~Y~q.~
3. Nature of work (check which applicable): New Building' .....~ .......... Addition .................. Alteration ...............
Repair .................. Removal .................. Demolition .................... Other Work ....................................................
(Description)
4. Estimated Cost .~f~.J,t~]....~.[~.O0 .......................... Fee J0
(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 ....2..~G.Z~..P_=r~g~ ............................................................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................
7. Dimensions of existing structures, if any: Front .]~.0....~.1:; ............... Rear ~.Q~.I; ...................... Depth .32...~'.'J; .......
Height ........................ Number of Stories ....... gTI~ ..................................................................................................
Dimensions of same structure with alterations or additions: Front ....................................Rear ............................
Depth ................................ Height ............................ Number of Stories ................................
8. Dimensions of entire new construction: Front .....2..6. ............................ Rear....~ ................... Depth ...~.~ ................
9. Size of I°tOFr°ntHeight .................... ..2..?.. Numbs;...~.f../.~t~ 'r.es . ............................................................................................. ~, Rear r~,/~ ~''? .......... Depth ..... ./.../...~. ................. .z.' ...............
10. Dote of Purchase ...'19,~...o,'1cJ.7.8 .......................... Nome of Former Owner ....}~..L~.C~ar~ ..............................
11. Zone or use district in which premises are situated .....................................................................................................
12, Does proposed construction violate any zoning law, ordinance or regulation: ............. ~ ......................................
13. Will lot be regraded .['LO. ...................... Will excess fill be removed from premises: ( ) Yes (~') No
~rivate rd
14. Nome of Owner of prem ses ..~e~)~.~l..z~e.~l~.-~ ................. Addres~ ..~-~.atcgB...rt~ ........ Phone No. 3~,..3..~92 ....
Name of Architect .............................................................. Address ................................ Phone No .......................
Name of Contractor ....~k)~e .............................................. Address ................................ Phone No .......................
PLOT DIAGRAM
Locate clearly 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 lot.
STATE OF NEW,~YOBK~. ~x. ~ ( ~
COUNTY OE .~..(-.LY.~.C ......... .r"'"'
.............. ./.~..~.~.~.~.....~*'~........~./..-~...~. ~-~;~ ............. being duly sworn, deposes and says that he is the applicon!
(Name of individual signing contracf)
above named.
He is the ............. ~ ~....~....~..~ ..................................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed~he said work and to make and file
th s application; that ali statements contained in this application are true to t~'best of his knowledge and belief; and
that the work will be performed int~e manner set fo~h in the application fi~t~erewith.
Sworn to before me this 7 , ~
............. ........ ............... ....
ic, . ....~~~ ................. .............................
(Si~noture
~ ~ BA~T~ C. Co~OY
NOT~y PUBLIC, Sta[e of
C~on Expires
F
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