The URL can be used to link to this page

Home My WebLink About9632-zNO. ~ TOWN OF $OUTHOLD BUll.DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ..... .2.2.5...M..a~..l.o.n..L..a~..e. .... Street Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....M.a?.c.h. .... 17. ...... , 19..7.8. pursuant to which Building Permit No. ..... 9632Z... dated .... .M.a?.c.h. .... 1.6. ......., 19..7.8., was issued, and conforms to an of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private Ore Family Dwelling ..... Th ' ' ' d t George Long e cert~hcate ~s issue o .................................................. · ...... (owner, of the aforesaid building. ~uffolk County Department of Health Approval ....... 6/.2.1./.7.8. .... .8.-.S..0.-.1.7. ....... UNDERWRITERS CERTIFICATE No. N392901 6/29f78 HOUSE NUMBER 225 Street Marion Lane East Marion, N.Y. Building Inspector ONE UNFINIS~ BATHROOM THAT WILL REQUIRE A BUILDING PERMIT TO FINISH, OF $-~)UTHOLD B, uILDING DI~PARTMENT?~ Tow~ C~E~K'S OFFIC= ~ SOUTHOLD, N,. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~ N? 9632 Z Permission is hereby granted to: ...-;Z;.....~ ...................... :.; ........................................... ..... .~ ........ ~/:~?:i:~.:~ ...... ..z..~.~ .................. Building Inspector. '""LI lb Fee $...../..~...~. TOWN OF $OUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLIGATION FOR GERTIFIC:ATE OF OC:GUPANGY 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 disposal--(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwritersl 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 July 13, 1978 New Building ....x...x~... ...... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property 225 Marion Lane~ ]Sas'l: Marion~ N,Y, Owner Or Owners Of Property George Long Subdivision ................................................................ Lot No ............. Block No ............. House No 225 i 9632Z Perm t No ..................... Date Of Permit ...3..,/,.,1.,G,,,/.?..8...Applicant Inland Holl~es Inc, 6/21/7'8 8-SO-17 , , Health Dept. Approval ............................................ uaoor Dept. Approval ..;....~./..a. .................................. N392901 6/29/78 · yes . . Underwriters Approval .............................................. Planning BoGrd ApproYal ...................................... Request For Temporary Certificate ......... ..~..o. .......................... Fin~J Certificate ...... .¥..e..s.. ............................ Fee Submitted $ ..S..:..O...O. ......................... Sworn to before me this ..... .z..3.. ...... day of ................................ Notary Public ..... .S. ~ .f..f.9~..k. .............. County Construction on above described building ~,~..~licoble codes and regulations. Applicant ............... (stamP or seal) THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 10038 THIS CE~IFIES THAT teez examined on and found to be in compliance with the requirements of th~s Board. I I RXTURES RXTURE IEC~PTACLES SWITCHES INCANDESCENT [ FLUC~E$.CENT I 2~ S6 26 2~ DRYERS I FURNACE MOTORS I FUTURE AFFIANCE ~ SERV~E DISCONNECT I HO. OF I ' S I 1 O0 C 8 x ~. ~'~'. ~'~ mu,,. ~..2w ,..~w s.~3w 3..~w .0.0~ cc. co.o. ! Smoke detectors Notors! I-F hp MT. K.W. iPEa&L REC'PT COOKING DKO(S OVENS DISH WASHBIS I I V I EXHAUST FANS Richard ~. Relye8 Delmar Dc. P.O.Box Laurel, L.I. 4 ! 4 372 Per · This certificate must not be altered in any monner~ return to the office of the Board if incorrect. Inspectors may be identified by their credentials. __ ~COPY FOR BUILDING DEPARTMENT. THI~E~MUST NOT BIi ALTERED IN ANY MANN; .~ ~ BUILDING DEPARTMENT l//~ ~//~ ~/,,(.:' s,i'~,~)J'~ TOWN CLERK'S OFFICE ~UTHOLD, N. Y. ................... ........ . ........ Disopproved ~/c .......................................................................... {Buildino Inspector) APPLICATION FOR BUILDING PERMIT Date ..~t%N.g.b...~.~ ....................... , 19...7..~. ..... INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ink and sul~mitted 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 befores ssuence of B_uilding 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 o 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 fo comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and ir~ buildings for. necessary inSPections. (Signature of applicant, or name, if a corporefion) BOX 117s Mattitucks N.Y. 11952 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. General Contz~ctor Name of owner of premises .~..or~e Long If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ....... .5...1..7..-..p. .............................. 2148-E Electrician's License No ............................................. /~O O Other Trade's License No ............................................... - ,~Locat on qf and on whic,h~proposed worl~will be done Map No D$~i: I~O.Q..~..e..o~_.o. 31 Lot No Stree~nd Number ~ ~e ~S~d ~% Of B~ Avenue, Eas~ ~ZZO~ State existing use and occupancy o~ premises ond intend~ us~ 6~ o~cuponcy of proposed construction: Vacan~ o. Exisiting use and occupancy b. ~ntended use and occup~.cy ................................................................................................................................ 3. Nature of work (check which applicable): New Building...X, SQO( ...... Addition Alteration ' · Repair .................. Removal .................. Demolition .................... Other Work..: ........ !'~ ................................... . .... '--"]/~ 1~ j'~ (Description) ................ Z..7.. ............. .._:.2 ....................................... · ...... 4. Estimated Cost ...~..~.O..~..O...O..O..~..O..O.. ............................. ....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 '1 ........... 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 of entire new construction: Front .......... 6.0. ..................... Rear ......¢~.0. ................. Depth .,..3..~ ................. Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front 2¢.3.. ........................................ Rear .......~.~...2. ............................ Depth .2...]:.3. ........................ 10, Date of Purchase . . ~ .............................................. Name of Former Owner ........................................................ 11. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ........................................................ 13. Will lot be regraded . ......... ~...~. ........... Will excess fill be removed from premises: ( ) Yes (x) No 14. Norne of Owner of premises ..... IG~l~g~..~-On~l .................... Address ................................Phone No ....................... Nome of Architect .............................................................. Address ................................Phone No ....................... Nome of Contractor ~:~&9.a....~q.mg..s.~....]:.~.°..®. .................. AddressB....~.....~.l...?...~.~..$.~..1;~l~e No..2'.?..8.7..~.6..~.. ~b&~ /}~,x, ~oo ~ PLOT DIAGRAM Locate clearl¢ and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from and show street names and indicate property lines· Give street and block number or description according to deed, whether interior or corner Iot.,~_~:~¢' ¢/,~ ~4:~ ~]A]E OF NEW ~Q.~(,.. tSc Al~..o/.2 ~..~ ~.~ COUNTY ............... ~.~wrF...er~.._~.~ ................ being duly sworn, deposes and says that he is the applicam (Name of individual signing c~tfac~) above named, He is the ~ ................................. S9F~.~.9~. ........................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized ~o 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 th, ar the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ...... /~.~. ...... day of ....... .~ ~.~ ........................ , S~olk oun Nora Pub' . ................................................. C ~ ......... ~~~ ................................ 5 -c~ ,,,, ~...t,. "' ~-.. 5~'~v~yr~ ~ " , .. ~,_.~ , .. t ,-'~,/,.~, .--~ ~ ,~. ' TOwN o~ ~U~O, N.~ '* ZO' ,/~ 315 Westphalia Rd. ,~ 'n Box 117 · Mattituck, N. Y. 11952 . ' ; i~ ~ ~2.9~ ~ ~ ....... ~ ...... ~. t .'!-:, '" ' ' :,F! I --'l ,,I