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Home My WebLink About9793-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No ..... Z']0.I.~4 ...... Date ..... ~op'gel~lbei'. 2.9 ............. 19.8.0 THIS CERTIFIES that the building ................................................ ~600 Nauglcs Dr~.ve Location of Property ... 260..Rosa .Lana..Pv.'~,..Rd~..~23 ......... Mat.ti, rock,..N, ~r.... House No, Street Hamlet County Tax Map No. 1000 Section .... 99 ...... Block ...~ ........... Lot ....... .~.~ ....... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... O'.uric..1.2 ........ , 19.7.8 pursuant to which Building Permit No ..... 97.9.~ ........... dated ..... J. une. 21 .............. 19 ?f3., 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 ......... ......... ~dat~,tio~ .ox.to .a. P~.iva.te .Ona .Family. Dw. ellilxg .................... The certificate is issued to ............ G.~OI'g.e..t'.TM,. ~ .I~.~.a..~: .r.ey. ..................... (owner, ~J~It of the aforesaid building. Suffolk County Department of Health Approval .......... I'J ./[~ ............................. UNDERWRITERS CERTIFICATE NO .................. N..~.8.6..3~./4. ...................... Buikling inspector Rev 4/79 FOR~I NO. ~ TOW~ OF $OUT~OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P'REMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 9793 Z Date ..... ~I'L11'1 ~ ....... 2.'J .............................. , 19...~.8. Permission is hereby granted to: ............. G. eox'ge...F.&.I,,,,t l,.t~.. P~. ey. ..................... to ..add...o~a~..a..P~.:t.v. at, a Oa~ Fea:Lly, dttelllng ...................................................... at premises located at ............... .~..~...~.~.R.~.B...e.~...~...~...~e..-.-?.?..~.Y..~..~.~....~....d.~.~ .................................. .................................................. Y~'l;:b:L:~uck,..Ne~..Xork ................................................................ pursuant to application dated ....~..le~.~......~.2.. ................................. , 19.7...~..., and approved by the Building Inspector. Fee $...~.~..:..0..0.. .......... 1000-99-5-18 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 ali buildings, property lines, streets, and unusual natural or topographic features. 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 requ!rements 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 $5.00 3. Copy of certificate of occupancy $I.00 Date., .5~..~.~. New Building ............. Old or Pre-existing Building ........ Vacant Land ............. Location of Property ...................... .~././~.g. ~.t..~ )'..~.~,.~. C ........... House No. Stre~. Hamlet Owner or Owners of Property . .~. ?.~?~.h~.:. .(..~...~. '~..~....(~..~.'~ ........................... County Tax Map No. 1000 Section ...~. 9.~ .0. O. ..... Block ....0. ~.~. 9 ...... Lot., .~./.o~..0. ~? .0. ..... Subdivision ................................ .Filed Map No~ .......... Lot No .............. Permit No..~..~.9.~. ~-,. Date of Permit ~/.~,,~?.~.Applicant...~..~.°..&.~.~....~.. ?..~.~.'V .......... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... FinaJ Certificate ...... ~ ............ Fee Submitted $ ...... .~.-. ~ .................. Construction on above described building and p~eets a~,~tplicable codes and regulations. Ap p I ic a n t .~,~,~'?~...~c/~.~-P.. 2~. ?",,~ ..................... ~ ...... .~. ~o-~o-7~ / / ~ August 12, 1980 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TE, L. 765-1802 George F. and Lila Frey 260 Rose Lane - Pvt. Rd. #23 Mattituck, New York Dear Mr. and Mrs. Frey: : This is to advise you that the job under Building Permit No, 9793Z issued to G. & L. Frey on June 21, 1978 - for one ~amily dwelli'ng appears to be completed as of our la'~'t inspection. Before you can legally use or occupy this structure a Certificate of Occupancy must be issued. Please fill the above office. of Occupancy out the enclosed form and return same to There is a fee of $5.00 for a Certificate Thank you for your prompt attention. Very truly yours, GEORGE H. FISHER Sr. Building Inspector encl. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~ti 8S JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment os described belo~ and introduced by the applicant ~med on the able application nuo~ber in the premises of C~rge ~ey,N~gles ~i~,off ~se I~e 8-C ~ ~ad,Y~ll ~ad & ~r~k ~a~er i~L in the following location; ~ Baselnent ~i 1st Fl. ~ 2nd Fl. was exatnlned on FIKTOEIE 14 OUTLETS RECEPTACLES J~ly 14, 1980 t009~ Section Block 5 Lot 18 and found to be in co,npliance with the requlre,~er~ts af this Board. SWITCHES FIXTURES RANGES COOKING DECKS OVENS EXHAUST FANS DRYERS FURNACE 3 SYSTEMS E E NO OF CC COND PER ,~ R V I C AWG OF CC COND NO OF HI.LEG uFA Hi. LEGW O NO OF NEUTRALS OF NEUTRAL Maugles Drive, P. 04 ~,~'~f~ g~10 GENERAL MANAOEn r~tt~.t~J% N~Y~ 11952 1t L Per This certificate most not be offered in ~ny ~o,ner; return ~o the office of lhe Boord ff incor~ed. [nspeclor, may be identified by lhelr credenfiols. COPY FOR BUILDING DEPARTMENT, THIS COPY OF CKKiIFICATE MU~ NOT BE ~LT~RE~ IH ANY MANNER. INSp~'r~OPtS~ BEFORE BACKFI~UNG FOUNDA. , ~NAL WHeN JOB ~ETED eOT ~,s~ ~ ~UCTION ERRORS CUSTOMER SERVICE Ol 2040 B 'oad Holl 920 East '!4f~th :~;-,:~:t? Farmin(jdale NY', · ,- ~ (516) ~9,4-,1500,~ Bronx NY 10455 ~ ~CIfton N4 NOTED '.:~y: ~' DEPARTMENT AT to 4PM FOR REQUIR, ~JO:D ~nOllOH elam punos OE pue -OC :s~ooo ~lqm!l P!IOS SMOOO ~OH el!qOl/~ uene'i .~l]aAO l~U!A I eA!le~ooeo A pelelnm!S eH eulnua~ ]AIIVUOOgO ~eeo punos ', ese8 I!eN qe!patujalUl Jeln6aM NOIlVqnSNI ~,maUaA-~ld UOH al!qo~i ®p~oqes.,iaA ~PualqtuM. I ~anql~U!A k poo~pJeH pJeoqp,leH 110¥-!nN¥1~1 Id .iau§!seo · papuaS -' §u!qleaqS gL laUed OOO~J.-IOS :~ue~ o!Isnl::l In'l pelee.LL , ~ saqeq$ '~,,Suotutuoo TOWN OF SOUTHOLD BUILDIN~ DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..........~.u~e.....~-;'i. ........... 19.....'~ Approved ..........~e*..*.~..'J. ...... ;..., 19....r~ Permit No .......~. ................. Disapproved a/c ......................... Z...., ............................................................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .............. ~ ................. INSTRUCTIONS Application No ........9'J~.~ ............... 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. (Address of applicant) 7__ State whether applicont is owner, lessee, ogent, architect, engineer, general contractor, electricion, plumber or builder. ................. ..... ..................................................................... Name of owner of premi~...~.L..~....~...~....~...~.~.....~........?.......~...~...~....~......C."Cc..~.~..j. .................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No, ~7.~ Plumber's License No. -~2~ Electrician's License No .............................. ? Other Trade's License No ............................................... Location of land on which proposed.~york will be done,. MapNo.: ./..O.~)..B.......O..~.].~.....~...§.9. Lot No. ~.!.~..~..O. fl. .......... Street and Number .................... ./.,(/..~.~.[..(~.g..~.,.¢.......~.l~..j..V..~,..~ ................................................. t~..~.~.~.....~...~..'~...(,_ ....... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...... ~-~.~.i.J..~..~.~..~.~...~.... ......................................................................... b. Intended use and occupancy 3. Nature of work (check which applicable): New Building'. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work .................................................... ~F~J~' b00 0 ~o_~ (Description) 4. Estimated Cost ............................................................ 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 ............................ " ................................ Depth ...... .~...~...~. ..... 7. Dimensions of existing structures, if any: Front ......... ...~... ............. Rear ;~,,Z ~ Height ....... /~ ............ Number of Stories ........ .~..~.~..~.. ............................................................................................. Dimensions of same structure with alterations or additions: Front ] ~ i Rear z/~ / . Depth ........... '~:.~.~. ............. Height ........ ./~/. ............. Number of Stories ...... ~.~.:~.~.. ............... 8. Dimensions of entire new construction: Front .......... ~'..~./.,: .................. Rear ........../.,~,.,~. ........... Depth Height ..... .J..~.) ......... Number of Stories &~X'/~.'~.. ............................. 9. Size of lot: Front ........... ~.?..~.,~. .................................. Rear /eel Depth 3 10. Date of Purchase ........ --:~.P..b..~....~......,/..~..0..h/ ................ Name of Former Owner ..... .~.~.¢.4..q.~..~..§.~,..C~ ...................... 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 ......... ...~..0.. ............ Will excess fill ~e removed fram premises: (] ~ -~J )Yes (:~,~ ~N~o / 1~.~..~.....~....~ 14. Name of Owner of premises .,~'..~'T~-..c~.~....~.,~....~..k~..~...'~.~'Address c:.~.:..~..~.~..l.k!.~..~one No. ...... Name of Architect .............................................................. Address ................................,Phone No ....................... ~om~ of Contractor ..A~.:~.....~.'.~..'..~.~..~ ........................... A~dres's~.~.C~.~r.~..~.~.~..~.~ Phon~ Ne.',-.~.~..:./.~... PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and indicate ail 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 'f.~R/./~ ~ .X~ .......... ~..~..~...~ ........................... being duly sworn, deposes and says that he is the appticam (Notate of individual signing c6ntracf) above named. (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 applicetipn are true to the best of his knowledge and belief; and that' the work will be performed in the manner set forth in thej~plication filed therewith. ...... , ........ ........... ...... ........................... / ~ ~ . ~ ~. . ~ ~p,,ca.~/