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Home My WebLink About9666-zTO~N OF SOUTHOLD BurLnlNG DEPARTMENT Town Clerk', Office $outhold, N. ¥. Certificate Of Occupancy ~To .... Z. 9.1~.~.... Date ...A.u.~...~. .... ~ ........... , 19..7.8 THIS CERTIFIES that the building located at ...~.~.~...~.o.~'..o.o~ .L..a~..e. ...... Street Map No ..... ,~l?..' .8... Block No ........... Lot No ............. .~.9 ................... conforms substantially to the Application for Building Permit heretofore filed in t_hi.~ office dated ..F.eh~a~... 2~ ...... , 19..7..8 pursuant to which Building Permit No ..... 9..66..6Z dated . .Apm. l]~ ...... .30. ...... , 19..7.8, was issued, and confor,z,-~ to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ........... P. rl¥~te. 0n~ .Fsmily..Dw.el],l~g ............................ The certificate is issued to ...... .~(;bO. Real.~..Inc. ................................ (owner, ~ of the a~oresaid building. Suffolk County Department o! Health Approval ......... ~.$~1-~3(+ ................... UNDERWRITERS CERTIFICATE No ........ ~ ...... .s~$7.~p.6. ..... .~.~9..so.5~. HOUSE NUMBER ..... 565 ......Street ........ ~qg.d..L..a~.e. ................... .............................................. .~.a.~.~$ .~.u.~,..N..~..~.o.r.k. ........... Building ~--~-tor "PRIVATE WELL WITH HIGH NITRATES SEE HFALTH~DEPARTM]!ITf NOTE ON FINAL SURVEY". FORM NO. 2 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) N? 9666 Z Date Permission is hereby granted to: :: ....... ~.~.~ ......... ~.Z.L&/...Z.).'...... ~.~...c... ...... at premises located at ~ b-~ ..~..~) ~-~ .~..~..(:,'.._/~ ~, ~. ~L~ d ......................... ~ ~ 19~.., and approved by the pursuant to application dated ............................. Building Inspector. Fee .,~ /q~¢-, Z¥ ./...~ Building Inspector FOF, M NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southoid, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions ~u/~/, c ~ /~ A. This opplication must be filled in typewriter OR ink, ond submitted in ~ to the Building Inspector with the following; for new buildings or new use: 1. Finol survey of property with occurate Iocotion of oil buildings, property lines, streets, and unusuol noturol or topogrophic feotures. 2. Finol opproval of Heolth Dept. of wcter supply end sewerege disposcl~(S-9 form or equel). 3. Approwl of electricel instelletion from Boord of Fire Unde~riters. 4. Commercial buildings, Industriol buildings, ~ultiple Residences end similor buildings end instollotions, ~ certificote of Code complience from the Architect or Engineer responsible for the building, 5. Submit Planning Boord opprovol of completed site plen requirements where oppliceble. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings end "pre-existing" lend uses: ~. Accurate su~ey o'f property showing ell property lines, streets, buildings end unusuel noturol or topogrophic lectures. 2. Sworn stotement of owner or previous owner es t~ use, occuponcy end condition of buildings. 3. Dete of eny housing code or sofe~ inspection of buildings or premises, or other pe~inent in- formation required to prepore ~ certificete. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 [~ ~ Date .............................. / New Building ....~. ............ Old or Pre-existing Building ........................... Vacan~ Land ............................ ....................... ................... ......... ........ ..... Owner Or ~ners Of ~ropefly ~.~= .~5~C~7~1 5~]~ ........ Su~ivis,o, .... ~ ............................................. · ............. Lot No..~f:[ ..... Block No ............. House Perm t No t4~Z Dote Of Permit ~ App cant ~ ~~r~ Heo th Dept Approva ~--. ~0 --Z~ .~bor ~ . '~' · ~[~~ ~ .......................... ~- ....... pt. Approval ................................................ ............. Request For Tempora~ Ce~ificate ........................................ Final Ce~ificate~ .......................................... ~.e S~,.~d ~ 6'"'¢..,C~ .................. Construction on above described building on.~J~l~c~..mit ~mee~l~plicable_~ ond_ regulations. Sworn to before me this Appll~~~~ . _. .... 2.~.... ~o,....~~:.L ........ /fTC ~,,~ o~ PARK AVENUE HUNTINGTrlN, N. Y. 11'74:~ June 20, 1978 Mr. Hi~derma~ Southold Bldg. Dept. Main Rd. Southold, NY 11971 Dear Sir: The plywood shipped to CoDe Real~y,,,permit #9666Z, is all agency graded exterior glue sheath~. Sincerely yours, Howard M. [lee% President HK:LO THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~-- BS JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIE..~THAT P ~96662 ~uoe t~aaa, cy,.tnc, els Dog~ooa La. 279 a/ SCan[ay Rd. MattiCuck,L.[. in the following location; ~asement [] 1st Fl. [] 2nd FI. Section Block Lot NXTURE I [ FIXTURES OUTLETS ~EPTAC:LES SWITCHES IHCANDE~ENT FLUORE~ENT 18 38 19 18 a~d found to be in compliance with the requirements of thiz Board. 2 t~ SERVICE DISCONNECT I .O. OF I s METER 1 125 P x 1 OTHRR APPARATUS: RANGES ;PECIAL REC'PT CO(O(ING DECKS OVENS DISH WASHIRS TIME CLOCKS BELL UNIT HEATERS MULT~OUTLmT V I C E *Future Appliance Feede:s: 1-2g14, ~OCors: 1 ~ra~.hp 1 smoke detecto: 1-2#12, A. W.G. NC~ (~= HI-LEG OF CC. COND. 4 1-3~9 EXHAUST FANS Ltghcway Elec. Co. P.O. Box 120 Hedford, L.I. 11763 lic. 1728E 11 This certificate must not be altered in any manner;, return to the office of the Board if incorrect. Inspectors may be __ __ ~t; ~__ BUILDING DBtARTMINi'. THIS COPY OF CERTIFICATI MUST NOT M AL~a~D IN ANY MLKNNER. THE THIS CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK; NEW YORK 10035 on.,,. N397206 P ~9666Z only the electrical equipment as descri~Mt helo~v and introduced by the ap~ica~t named on the abot~ appli~atlon number in the premises of .Cobe Rea.&ty,Inc. e/s Dogwood l~ne,. 279-'a/o StanLey Rd. MlttLtuck,L.I. JOb ~L00/0L in the followlng location; ~ Basement ~ 1st FI. [] 2nd Fl. Section Block Lot was examined on ~b~UgU~ t ~ ~ ~L9~8 and found to be in compliance tvith the requirements of this Board. RXTURE RXTURES RANGES OVENS DISH WASHERS EXHAUST FANS L& 38 19 18 DRYERS FURNACE MOTORS FUTURE APPUAflC$ FEEDERS TIME CLOCKS UNIT HEATERS MULTI,4~JT~ DIMMERS SYSTEMS SERVICE DISCONNECT S E R V I C Motors: 1 free.hp smoke detector 1-2#14, 1-2t12, 1-3t8 Eastbrfd~e Elec. Inc. P.O. Box 2a& Sc.James, L.I. 11780 ltC. 1897E /'" 11 Per. This certificate must not be altered in any mannerr return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDINO DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BI ALTERID IN ANY MANNER. TOWN OF SOUTHOLD TOWN I~.LERK'S OFFICE SOLITHOLD, N. Y. TOWN Elf' SOUTHE)LD I-IFFICE OF BUILDING INSPECTOR TOWN I':LERK'S OFFICE SOUTH~LD, N. Y. 119~71 TEL. March 2, 1978 Cobe Realty Inc. 47 Laurel Street Holbrook, New York 11741 JOY Re:.,~ # 100-OL Dear Sir: I am returning your papers applying for a Building Permit, dated February 25, 1978. We require the original, not a copy of the Health i~Serviee approval. A plot diagram is to be drawn on each copy of the application or attached. You did not give the Plumbers or Electrician's License. If unknown now, please send the information later. We require three sets of identical plans.You have noted in black some changes. We will need a better draw- ing of these changes showing foundation, floor plan and cross section. On the plans you show sizes which may be the over- all frame, not glass or openings. As per State Code you are required window light of at least 10% of the floor area and 5% of open ventilation. In each room you must have one window with 4 square feet and not leas than 16" clear width opening. The bottom of this window opening shall not be over 3'6" off of the floor. Upon return of the information, I'll be glad to issue a Permit. Yours truly, · FISHER Inspector COUNTY ~e attaahed approval ~;as issued sub.%c~ to the notation ~cn~a~d .our approval s~m~o. 7;ould you please t:~e the foz!o~:~ ~ - of approval oH the fLual C of 0 as this ~II ensure that ~ future %.~11 be made aw~e of the nitr~te problem. "Private well with high '~ -~ Hsa±th Da:artmen~ note on final survey". "Thmxk you, Robert A. Villa, P. E. 4 'L TOWN OF SO~T.O£D BUILDfNG DEPARTMENT TOWN CLERK'S OFFICE ,OUT.O,,, N. ,. Examined 7 , 19 ........ ................................~ ~;~" ','7?,e.m,. ~ ~.~. Approved ................. _.7_._ ............. , No. ................................................ ................ (Building Inspector) Application No.....~./...~.....~....~.. ........... APPLICATION FOR BUILDING PERMIT 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 demo t on, as herein descr bed The applicant agrees to comply with all applicable laws ordinances building code, ~ code, aQ~Lregu~ations, and to admit author zed nspectors on premises and in bui dings for necessary inspecti°ns'~l~l~ -~-~n.~.~/% ~'~,~n~ ............................... (S'g ature of applicon, or name, if a corporation) ~2~~..~..:r...... ~..,t~..r..,.~..~...,~. ~. ~,l (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~ll~l~.....ll~-~,~..~'.y. ...... ~'..../?.C.., ............................................... ::::::::::::::::::::::::::::::::: If~pplic~nt j/"a~corpor~ duly authorized officer. ...~~,1~,~/, ~ ........ ,- ....................... v..,.~.... .... (Name and title of corporate officer] Builder's License No Plumber's License No. Electrician's License Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ...~.~..~...tJ~. ................... Lot No...~...~. .............. Street and Number~..~..~.~&..'~.....~.41~.~;.....~..~...~..~....~.~ ...... /]1~..~..~,",~..~..'~....~,~ ...... ~,L..~.~ ........... '~ Municil~'allty State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ....~....~'....~....~...~...~.. ....... ..~....~....~....~. ..................... ~ ........................................................ b. occ,,o, , ......... -- / J 3. Nature of work (check which applicable): New Building~ · ................................... Alteration .............. ~ . Repair .................. Removal .................. Demolitior~ .................... Other Work ................................................ . .... (Description) 4. Estimated Cost dS~.,~:~ ....................................... Fee (to be paid on filing this application) I . u b i 5. If dwelling, number of dwellin units ............................ N m er of dwelling un'ts 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 of Stories ................................ 8. Dimensions ~ entire new construction: Front,.~ .......................... Rear .~ ..................Depth .............. ~.~ Height .~..~. ............. Number of Stories ..... I ............................................................................................................. 9. Size of lot: Front ..... ~.~. ......................................... Rear-.1~.~ .......................... : Depth ~.~ .................... 10. Date of Purchase .~¢.~ ...... ~.~.~ .......................... Name of Former Owner .~.q.~......~.~.~.. 11. Zone or use district in which premises are situated ..................................................................................................... J ]2. Does proposed construction violate any zoning law, ordinance or regulation: ........ ~.~ ...................................... 13. Will lot be regraded ....~.~ ............ Will excess fill be removed from_p[emises: ~ Yes ( ) No ........... 14.Name of Owner of premises(~ ~.~.... Addres ~. .. Phone No. Name of Architec~ .............................................................. Address ................................ Phone No ....................... ? Nome of Contractor ............~ ............................................... Address ................................ Phone No ....................... PLOT DJAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner Id. I I ..... ~. ,~, .~...v~. ........................................ being above (Name of individual sig~ng contract) duly sworn, deposes and says that he is the applicant the ............. fd~., He is ....... ~¥.,. "icer, ............................................................................ 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 ell statements contained in this applicetion are true to the be~/l~f,,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 ~mts~-- ~ \ IA .......... .~..~,~.. day of ..... .~...~ ......................... , 19..~ ~,,~ ,~. Nota .................................................... County ............ ** - ......................... No, 52,4521525 High N trates: Water not to be used f6r preparation of baby formula or cons~Eotion by infants under six (6) months of age. 1 thk residence will ~nform to ~e standa~ ~e Sufldk Co~ty Depa~me~ of fle~ Senic~. r Water suppl~ and, sewage disposal systems ~dence will confo~n to ~e st~rds of ~ County ~pa~m~t of He~h ~ o9. oo (~.~ o~. 0o4 , ?ff~.~., L J 7: $" 7'-b" 7v-5' /1: 4" ,./ .. =__L "'ATB, NOTIFY BUILDING DEPARTMENT AT ~65-2660 gAM to 4PM FO~ REQUIR- rED INSPECTIONS~ ]. ~FORR BACKFILLING FOUNDA- TION OR START FRAMING '2. FRAMING INSPECTION ~. BEFORE COVERING PIPES OF ANY KIND 4. FINAL WHEN -lOB'COMPLETED NOT RESPONSIBLE FOR D~SI~N OR CONSTRUCTION ER~OR~ 5. ALL CONSTRUCTION MUST M~ET ~EQUIREMENT5 OF N.Y. STATE CODE AND TOWN HOUSING COD~ & ZONING ,I _ES'- 0 " , q '..,¢,, T