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Home My WebLink About9607-zTOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z90.~.7. ..... Date ...MaY .... ~7 ................ ,19..7.8 THIS CERTIFIES that the building located at . J.~.0 .... B.ay..A.y.e. ......... Street Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .. J'anua:c~r... ~ ...... , 19 .?7. pursuant to which Building Permit No....9.6.0.7.Z. dated .. ~m~ua~.... ~ ....... , 1977.., 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 ... ACCESSORY..USE. ~0. TI'~.0NE. FAMIL~ .D~I~N~.....* ............... '.' The certificate is issued to .... .George.Sntder .................................... (owner, ~ ) of the aforesaid building. Suffolk County Department of Health Approval ...... N/R, .......................... UNDERWRITERS CERTIFICATE No....N.~..~9.7. ..... ~a.y.. ?.0.,. J.9.7.8 ............ HOUSE NUMBER . .. $~Q ...... Street ........ .B.a.y..A.v.e. ......................... ........................... Maitliuok, New York ....... Building Inspector * NOTE .... NO KITCHEN OR COOKING FACILITIES TOWN BUILDING TOWN · SOUTHOre, N, ¥. ~ BUILDING ~P~RAAIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 96O7 Z Permission is hereby granted fo: ~,,~_:~.......~::??.~. ....... ~......,.c...~.~. ...... <~O'/TA~.E-. .. .. ............................. . . .... ...,................................................,.... at premises located at Building Inspector. Fee $.../..?... .............. : : , Building {n~peCtor FORM NO. S TOWN OF $OUTHOLD , Building Deportment Town Clerks Office 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 Inspector 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 features. 2. Final approval of Health Dept. of water supply and sewerage disp0sol--(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 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), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey.of 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 in- 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 3. Copy of certificate of occupancy $1.00 Dot ~ay 16, 1978 New Building ................ Addition ................ Old or Pre-existing Building...............,X Vacant Land .............. Location Of Property ~v Avenue l~a~t.l, tuc~, N.~. Owner Or Owners Of Property .......... .G..e...o...z~.e....,S.,~.~,e.r.. ............................................................................. Subdivision ................................................................ Lot No ............. Block No ............. House No ............. .................... 1/4/78 ~ugene Horton & Sons Inc. Permit No. 9607Z Date Of Permit .................... Applicant .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval X .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate X Fee Submitted $ .5.00 Construction on above ' described building, arid permit meets ol.I ppplic, able codes and regulations. Sworn to before me this Applicant~....~._.._,.~[~...~, ......~~0/'V~ A ................ day of ............................................ Notary Public .................................... County (stamp or seal) zg-- rT- 75~ '7~_ / ~'~.E / TOWN OF SOUTHOLD Building Inspectot"s Office Town Clerk Building Southold, N.Y. 765-20§0 THE NEW YORK BOARD OF FIRE UNDERWRITERS P'~' BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT ~ly the e~t~l ~u~nt ~ ~db~ ~ ~ i~t~ b~ t~ ~l~ ~ ~ g~ ~ ~pl~um~r in t~ pMm~ of inthefollowlr~gloeatlon; [] Besem~t ~ :.~n. [] ;.d n. outside s~tlo, mo~k Lot was .xamin~d on May 8, 197. and found to be in eompliance wlth the requirements of this Board. fiXTURE ~ EPTACLES SWITCHES FIXTURES OUTLETS DRYERS I FURNACE MOTORS FUTURE APFtJANCE FEEDERS AMT. K.W. OIL H.P. GAS H.P. AMT. NO. A.W.G. SERVICE DISCONNECT I NO. OF I S I IO RANGES COOKING D~S I OVENS DISH WASHERS SPECIAL REC'PT I ~0 TIMECLOCKS RELL UNITHEATRES MULTI-OUTLET E R V I C E EXHAUST FANS DIMMERS 3 T~le¢. Room Hee. ters: 3-1.5kW,l-,75KW 7.-a.~. I. ~.-~I,SKW }lot WateP Hea~er Dettne~' E.1. ee. Co. Box ~{iverhead, L.I. Per t This certificate must not be altered in any manner~ return to the office of the Board if incorrect. Inspectors may be identified COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT B! ALTERED IN ANY MAHH'~q~. · ~0 ~,.~ '/ i APPROVED, AS NOTED . ~ ~¢- ~ 9~-330 9AM to 4PM FO~ R~QUIR, ~Z ~l~~ ED INSP~CTIONS: ' /~ ~ ' BEFORE BACK~ILL!N~ F~dHDA' ~ TION OR. START F~/ 3. B~O~ COVE~ING P~?~:~ OF ANY KIND NOT RESPONSI~L~ OR CONST~cUCTjON J, ALL CONST~UCT~QN MU5¥ ~T REQUJREM~::~-' L ,: N,Y. STATE CODE TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ................. ...~...~...~........~....., 19.7......~.. Application No....~.....~..E.7.. ............. · '7 C) foOTZ---- Approved ............... ~T...../......, 19....~... Permit No ..................................... .......................................................... ........... ..... ........................ APPLIGATION FOR BUILDING PERMIT Date ...... .~..].~ ............................... , ~9.~.. INSTRUCTIONS a. This application must be completely filled in by typewriter or 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. + (Signa~re of a'~'l~¥i'c~;~"~" ~;~';~'~TiF~"~:'~';~'g;~;ii;;,'i ........ .~.~..~......~..~.~..~.~..,.......~.,.?..[., ........................... · (',~ddress ~f applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................ c~.o.~..h..~.~.~.o..~ .......................................................................................................................................... Name of owner of premises ...... ..~...~. ~ ......... ...~.....k. .~.... ............................................................................... (ff-xap~icant is a,co~rat~, signat~c of duty ~uthorized officer. ......... Builder's License No .............,/,.. .................................. Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on whi~ proposed work will be done. Map No.: ........................................ Lot No ......................... Street and Number ...'.~...~......l'.~.V....~w..'~ ~' ................................................................. ~..~...~..x..,~..~...~....~.. .............. ~-J Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ..~..&v~'~.~..~.. b. Intended use and occupancy ....... ..~.~....~......~... ....... .~. · .~...?..?-..~. · .'~. · · .......................................................................... .......... ;m ................. ,.~.,-a ~ No...~ ......... ~ ................ a. This a~licati~ m~ ~ compl~ly fill~ in ~ ~ewHter ~.in i~ a~ s~i~ in triplicate ~ ~e Bul~i~ n~tor, with 3 ~ of pl~s, ~cu~ plm plan ~ ~le. F~ a~o~ ~ ~h~ule. b. Plot plan shying I~ation of lot and of buildings areas, and givi~ a ~all~ ~rJptJ~ of I~ ofp~ must c. ~e wo~ c~er~ ~ th~ a~li~atlon ~ n~ d. Up~ appeal of ~is applic~i~, ~e Buildi~ Im~tor will i~e a Building Pe~it to the a~lJcant. Such permit shall ~ kept ~ the pmmi~ ~ilable for in~i~ e. No building shall be ~cupi~ or u~ in whole or in ~ for any pu~e whirr until a Ce~if~ate of ~cu~ncy shall have been granted ~ the Building Ink,tar. .^,P,.PLIC, ATIO_.N,IS HEREB. Y MADE to the Building Department for the ssuance of a Building Permit oursuont to the u~a~n.g. ~on.e ~r.ainonce at the Town of Southold, Suffolk County, New York, and other anplic-able Lav~. Ordinances or ,egu~a~i,o. ns, ?r the construct!on of buildings, additions or alterations, or for removal or de~olition, as h~rein described..~~ ne applicant agrees to comply with all applicable laws, ordinances, bulldJng code, housing code, and regulations, and to--~ admit authorized inspectors on premises and in buikllng~ for necessary ir-~oections..~_- ........ ....... ............. (Signattire of applicant, or name, if o corporation) { (^ddress 6f applicontJ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................ ~_~.~ ,.A,.:. ..~oL~...~. ~.)..~T.. ......................... . ............. Gtc> C~r. ~ ' ,\,. ([~ Name of owner of premises .................. ~.~ ........... ~.~.., ...... ~,~..~_v. .................................................................................. If app!icant is a corporate, signature of duly authorized officer. · , , , ( \ · ..~:;, ....... (~:[~'"'me ............. and title~'""~'""~""~"J"~'"~of corpor9te offic~ ............. Builders License No .............../.... ................................. Plumber% License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on whi~h~ proposed work will be done. Map No.: ........................................ Lot No ......................... Street and Number ..~.'.¥.~L...;~.....I~.~.~..~ ................................................................. i~..~..,~.~...~'..~..k....~.~.!..~. .............. ~-~ Municipality 2. State existing use and occupancy of premises ond intended use and occupancy of proposed construction: a. Exisiting use and occupancy ............. ~ ............. ,~.~..~ .............................................................. ', ~Q~ \'~ '~ ~- C~- .............. b. Intended use and occupancy ........... ~ .................................... ~ ............................................................................. 3. Nature of work (check which applicable): New Building'. ................. Addition .................. Alteration ............... Repair .................. Removal .................. Demolilior, .................... Other Work ................................................... z¢ Fe (Descript on) 4. Estimated Cost ...... ...}..t.~...u...~ ................................... e .......................................................................................... (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 curs .............................................................................................................................. 6. If business, commercial or mixed occupancy, specify n~ture and extent of each type of use ............................ 7. Dimensions of existing slructures, if any: F~o~,t ...... ~ .... Rear .............~ ........... Depth .~ ............. Height ........ .t~. ......... Number of Stories ........ I ................................................................................................. Dimensions of same struclure with alterations or additioos: Front ............ ~ ................ Rear ..... ~ ............... Depth ............. ~ ............ Height ........ k~ ............ Ffu,"nber of Stories ....1 ........................... 8. Dimensioas of entire new construction: Front .................... . ............... Rear ............................ Depth ........................ Height .................... Number of Stories ............................................................................................................. 9. Size of lot: Front ................. ~..~ ............................... I{('~w . ........ ~..~ ......................Depth ................................ 10. Date of Purchase ........................................................Name et Former Owner ........................................................ 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 ............................ Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner ofpremisesS$ . I~I~1~I. I~mZ;iA$~'C'~ ' Address .~.~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. I ..z..O~ ~OIdv~T~T- -C-° GU ~T STATE OF NEW Y~!(~//,/~' COUN'FY..OF ...~.)' ""~ ............... (~.~'..~..LC[~C~.... ....................... beiag duly sworn, deposes and says that he is the applicant (Nome ~ individual signing contract) above named. He is the ~0~ ~cdd~ .... (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 [he best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn tp before me this ~ ~ '~ J JD~ T. 1ERRY LSSignature of applicant) ~o~'~ P:~;~;c. S~:~'.~ o~ Now York Commission Expires Marcl] I/