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HomeMy WebLinkAbout9711-zTOWN OF $OUTHOLD B[rrLr~ING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z9287 Date November 2 19.78 THIS CERTIFIES that the building located at . .~.5.~....C.e.d..a.~i .D.r.; .......... Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore fried in this office dated . .. k~gril...2~ ........ , 19 .?@. pursuant to which Building Permit No.. dated ... May ..... ~ .......... , 19.7@., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ....... ~..r.s.v.p..~..~. ~.~.~× .~.¥7%~ ................................. The certificate is issued to .......... ~Tg..rr~..e~.~ .~.. l.~.a.r.e..n..R.e.:L.c.h. ...................... ( owner, ~l~s~ ,~z~-a ) of the aforesaid building. Suffolk County Department of Health Approval ..... .8.~$Q.-~!{ ...................... UNDERWRITERS CERTIFICATE No ...... ~.:.~.0.~..~ ...................... HOUSE NUMBER .... 6..~.~ .......Street ......... .C.e.d..a~...D.r..i.v.e. ................... E~s?, l'~er±on New York '1000-22-2-4'1 Building Inspector FOENI NO. ~ TOWN OP 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) Permission is hereby granted to: ....... ~'. .............. - ............................ :...Z ................................................................................................... at premises located et ....................... ,~,~,...~.2~ ...... ..~,.~...~..~...¢~ ....... ..~...?..~i!.~'~/'.~. ...................................... Building Inspector. Fee $..../...~.....~: .......... ............................ r.. .............................. :.:L....'. ....... Building Inspector FOR~I NO. 6 TOWN OF SOUTHOLD Building Deimltmeut Town Clerks Office $outhold, H. Yo 11971 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 ail buildings, property fines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 farm or equal). 3. Approval 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), Nan-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey o~ 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 formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 // 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 ,/* /, ,~ j 3. Copy of certificate of occupancy $1.00 ~;~//~//~/'~ Date .......... ............. New Building .... ~ ........ Old or Pre-exi ting Building .............. t ............. Vacant/-and ............................ Location Of Pioperty .......................... ~'~ ..~.......~{~-.-~.~ ........ /~/~ '~'"'~/~'~'~"v o, ............. ......... ................ ................ .... Subdivision ................................................................ Lot No..,.L~.../.. Blqc~ No...2~ ......Hoyse No.~:~. ...... ..~..../~././~,~.. Date Of Permit'~//~....:....Applican, .........h~.~...~TT.~,~.~.~..'~ ........... Permit / Health Dept, Approval ............................................ Labor Dept. Approval ................................................ Undel~r~ters Approval .............................................. Planmng Board Approval ........................................ Req~s~ For Tempora,!~ Certificate .............................. Final Certificate .......................................... Fa;' ~;;~m~tted ~ .......d...:..~.62.. ............. Construction on above described building and e i odes and regulations. Applicant ......... ."~".~'~...~'~.,. ~ · -~ · .................................................. Sworn to before me this ~.,~.~, day of Public nty Notary ~!u NOTARY FU~;LIC, ~TAI'L' (?F NEW YORK S~Ffo~k Cc~mty No. 5 '-464/,944 Term Expires March 30, 1979 (stamp or seal) THE NEW YORK BOARD OF FIRE UNDERWRITERS [1 fi, BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the el~ctrlcal mlu~prnent as described below and introduced b~ the apl~lica~t named o.n the above qpplica~ion ~umber in the prem/ses of florman R, Re'l'ch, 6.55 Cedar' in the followlng location; ~Basement ~ 1st ~l. [] 2nd FI. Section Block Lot wazexarninedon O~ObFJf* J~.~ [~7~ andfoundtobelncompliancewiththerequlrernentsofshi~Board. RXTURE ~ECEPTA LEI ] RXTURES ':* / '" I" 1 I ~'ER,'.w' I o,, '"R.,,AC' ~,,,'ORS .. ,. 2 F RANGES COOKING DECKS OVENS INSH WASHERS A~AT. K. AAtiT. K.W. ,*aT. K.W. TIMECLOCKS BELL UNIT HEATERS MULTI-OUTLE ,,,,,T. ,,,,,,,. ,,,,.S. ".'. ~:~,;,'%"L' EXHAUST FAN~ DIMMERS SERVICE DISCONNECT I NO. OF A,,T. ,.,,,. ,,,,, ~f,". I !00 CB OTHER APPARATUS: :',~or/~: I-F -S~oke S E R V I C OF CC. COND. NO. OF HI-LEG Of NEUTRAL 4 lei Prato Wl~lns Lane ~reenport, t.,I. ~ MAN,~ Per ,. This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by the.' credenhals. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~OUTHOLD, N. Y. Examined ,?~//,.~,,/¥ ~ "~ '~ .............. ~ .,~ ....... ,......;; ..... 19:...~... Approved .............. 7// Application No. ' Disapproved a/c ..... " ....... ; ...... %....,.'; ....................................... ~ .................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .............. , ................. , o. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the BuildinmW 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 of property 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. h APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances 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 insp/ections. APPROVED AS NOTED ...,~..~ .L~....~~ DATE: ~'- a~ - '7 ~7 FEE~ /~ BY: -4~-~ (Signature of applicant, or ~ame, if a corporation) ?b_~ NOTIFY ,UILDI,G DFDARTMENT .A.¥ ...~'.~..../~'~'~".....~.l.~.'.~..~...~?...~ ...~...~....'/.L.u...~... ~.~'/,~ .~.<7-6~26'60 9AM to 4PM FOR REa,.;.:.,- (Address of appl cant) 1 ( ~' ~;'~;¢' ''/''" I~D INSPECTIONS: 1. BEFORE BACKFILLiNg State[j~jtJ~R ~c~/~j~n~.f~?p'v~q~:T, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 2. FRAMING INSPZ,,Ci',~t: /~'~) )/,/v~,,,~/-'" .... 3..-. BE FORt? .CO VRr( l ~?~ ..p~!~.;'.~ ..O~...A.N y. ~q~.,,.~ :?. x ..: ..~..~ ...................... ~...~..., ......................................................................... ........ ............................................................... If ap~dF~l}~sS'~qcL~'~re,E'~na~r,e of duly authorized officer. 5. ALL CON,~IRU.,~[O,I~ M~, M,,J ........ ~QUI~.D,~.~..~.;;..u,,~...~T.~L¢.~.~ ................... AND ~ ~tJti~ ~B~O~ t ~icer) Builder's License No ..................................................... Plumber's License No .... .h~../i~..::...,../~... ........................ E_,ectr,c,ons, ,cense ...................... Other Trade s License No .......................................... Location of land on which prf~psed work will 1~ done, Map No.: J~./.~'~....../. ....... .~..~..~...~.. Lot No ~ / Street and Number ....... ~O'~.~.~.. ....... /~....JrD..;~.~..~:... .............................. ~ ..~.... ~'.~.~.'~'" ~ O~ 5 Municipality '" State existing use and occupancy of premises a~d_d_d~ntende~/r/,~ccupancy of proposed construction: a, Exisiting use and occupancy ....... ~...~'~.../~../~./ ........... ,/../:.~ ........................................ ~..,, ................................ b. Intended use and occupancy ...... ~../..¢...~.......'7.~.~.¢¢.¢//..'-¢.'/~ f ......... ..~.;~Zf....~./:.r-: .~..~../ ....... ~..~,..~..~.././../...~..~..¢'.,7..// ........................ / / 3. Nature of work (check which applicable): New Baildmg.. ................. Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... O,~ther Work ~4~.~.~'.~S..~.~..~.~-,~'l~5~(Desc.~i ii~)'''~''' 4. Estimated Cost~.?. /~'~.(-,~).:~...O... .................. Fee .......... (~ ............................................. i~.i ................... (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 stractures, if any: F~ont ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................ Dimensions of some structure with alterations or eddilions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .......................... Rear ..'Depth ................... ' / Height .../,.~. ........... Number of Stories ................................................................................................................... 9. Size of lot: Front ........... ~./.O..~.. ............... : ................. Rear. ....... ./'~,;~) ......................... Depth ./.,~ ..................... 10. Date of Purchase ~.,¢.,¢%.Z....~...,..L~.,.7.~.... ......... Name of Former Owner/~.~ .~ .~.~...~,~...~. ....... 11. Zone or use district in which premises are situated .)'~..,~.S¢../..~...~?..~.. ............. ,~..~...~..~ ........... ' .... 12. Does proposed construction violate any zoning law, 'ordinance or regulation: ............. /~/~:~ .................... 13. Will lot be regraded ...... /~/.~. ............... Will exce&s fill be removed from premises: ()(') Yes ' ( ) No 14. Name of Owner of premises .~.V~.~*~'~%~..~.'.~¢¢~, ..... Address .~...1~..I.¢....~...../t~.¢~:. Phone No~'~ Name of Architect' . ............................................................. Address ................................ Phone No ....................... Nome of Contractor ............ ~.'~ ....................... 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. S1-A'TE OF NEW 1~DR~¢.~¢ /~"~- /¢, ................ ~O. Fm~.-..~..~'~ ............................... being duly sworn, deposes and soys that he is the opplicam (No f individual signing contract) 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 that the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this * / ~ ..... / ...... .......... ....... S~ffo]k O:u:.iy No. 52-4644944 Term Expires M~Fch 30, 1979 TITLE TO THIS SURVEY IS A VIOLATION OF TI~IIT HOLE SUF~'. CO DEPT OF HEALT~ $t~R¥1CdI~I ' ~ATEMENT OF INTENT J '-~" /' FOR APPRovaL O~, CONSTRO~iO~, ONLY, .......... ~ ~,]g' OATK: ......... ~ OlS~AL SYSTEMS ~R THIS R~{. '; DeNCE WILL CONFORM TO THE ..... $TA~D~D$ O~ SUffOLK CO. D[PT. SUFF ¢0. H~ALTH D£1~I', APPROVAL I N. S. NO. ~ / 0 // 0 :: ~' ' i ~o.,~ ... ~ - i2o.o Tow~ o~ ~o~ ,N.~ ' TE.~r HOL.; SU~'F. CO. O~l~l', OF H~'AL?H ~I~R¥!GII~ ' ~AT~ENT OF INTENT .. __ _ _ ..w... I loam I [ DEN~ WILL CONFORM TO THE ~ H, 8. REF. NO.: ,,, ; 7 . 8TAND~ OF SUFFOLK CO. D[PT.