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Home My WebLink About9641-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificale Of Occupancy No. Z9290 Date November 6 78 THIS CERTIFIES that the building located at .. 3~5. Windja~aler. D.r. ive., ~ Map No .... ~.62 .... Block No ........... Lot No, 29 conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .M.a.r..c.h .... .2~ ......, 19..7..8 pursuant to which Building Permit No ...... .9.6.4'1Z dated .... M.a.~.q.h .... .2~ ......., 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 ......... Pr, tv.~t.e..0~. ~.~il~..]~e~-l~,~g ............................... The certificate is issued to ........... G~.egor~ .R.oa.e .............................. (owner, ~~ of the aforesaid building. Suffolk County Department of Health Approval ............ .8.-.S..0.-.~:5. ............... UNDERWRITERS CERTIFICATE No. N405,~67 HOUSE NUMBER ..... ~.5.5 ......Street .......... .~.l.n..d~p.m.T .er..D.r..1y.e. ............ Southold, N,Y. ...IV'--IF wi, . Building Inspector County Tax Map # 1000-79-4-40 TOWN OF S6UT:HOLII~:' I~UlLDING DEpARTMEIqT TOWN CLERK'S oFFIC:E SOUTHOLD, N~. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P'~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9641 Z Date :' / \~ /-~ ] c) Permission is hereby granted to: ........... /.:F.:.:'./?..'.C..~!'.::":..!,:.:..,,.::....C.....~..!;.(.~...... ('''~ . ~"" W/.i ' C '-' c.,- ,¢ C_> ~ ot premises Ioeoted at ...: ............ ...... pursuant to appl,cat,on dated .................................... /...~../:..:!....~:'.~"19..:.~:'., and approved by the Building Inspector. ~ee ,....~.~...::Z- ; Building' n~Pector TOWN OF $OUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application fnust be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the fallowing; 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 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 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 Date ......... .~'~ .C~.¥., ~ .................. New Building v~ Addition Old or Pre-existing Building Vacant Land Location Of Property-,.....k,,,'~.~..~..~(~m'~t.~,~...l~.~..~.., ........ ~:~.~.?t'..,~..O.~m~ .............................. Subdivision ...~.~.~..(~r~.~.....~.~..c~,~.~, .,.~. ............... Lot No....~..~... Block No House No Permit No ..................... Date Of Permit .................... Applicant .................................................................. Health Dept. Approval .... ./.~/Z,,~, .................. Lobar Dept. Approval ................................................ Underwriters Approval ............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permi]>-)meets all~l~cpdes j~nd regulations· pp ~., · · .~,~~. ....... .,/'n,.~,~-f~..~,~¢f,. ~ ................... Sworn to before me this day of ................................. /.......?/ No,ary Pub,,c ......... Coun (stamp or seal) ELIZABETH ANN ~RVILL~ ,~C ~ /'-~/') NOTARY pUB[1O, State of New yor~ No 52-8125850, Sufiolk Couaty ~ ~ Term Expires March 30. 19~O ~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 8'K JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT P- ~96~Z inthefollo~ingl~ation; ~ e~ement ~ lstrL ~ 2~ FL S~tion ~e~M ~t2~ wm erami~ on OC ~ Ob e ~ ~ ~ 19 7 8 and found to be iff compl~a~e ~ith the requlremen~ of thh S~rd. ' RXTURE ~.~....~. I t RXTU~ES ~AN(~S ~OKiNG ~KS 23 23 23 23 1 14.~ DRYERS I mRNA~ ~TO~ I ~TURE A~A~ m~ ~RK'K T~C~ I ~ ~ ~ ~ ~ 3o ~E~ ~N~ I~.~ ~ S ~ ~ V I, Motor8: l- 3/~hp ~-~.F.C.I. 1-Smoke Deteoto~ ¢ E EXHAUST FANS i~ ~UU TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. praved ..................................... ,gZ Perm,t No. ....... .................... (B- ........................... APPLICATION FOR BUILDING PERMIT Application No..' .............................. 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 o~ 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. (Signature of applicant, or name, if a corporation) ..... %.~::D ....... ~ ...............................(Address of applicant)~ ......... i'~'~"~' ................... ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................... .................................................................................................................. Name of owner of premises ..... ~.~...~...~...%......~....C~..~..~ ................................................................................................. If applic~is a corporate, sign~f duty authorized officer. (Name and title of corporate officer) Builder's License No ......... ~ ...................................... Plumber's License No ........ ~. ..q. ~ Other Trade's License No ............................................... 1. Location of land on which proposed work wi be done. Mop No ~..,~ .~....~. ......... Lot No.......c~....~ Street and Number ........ .~..~,,~.'~.'..~l~.~....~....~...~......~....~.,.\..~.~.~ .............................................. i. XiXiill ~OO,.~'~,CD~x~2) , ~..~.~y~ , , , Municipality 2. State existing use and occupancy of premises and i~ntendec~use aha occupancy or proposea construction: a. I~xisiting use and occupancy ......... .~-~).C~..~...~.. ................................................................................................. b. Intended useandoccupancy ......... ..~.~..,.~..k...3.~¥:x.?-~...~..~ik...~....¥......~.q~..~h..~-~ ................................. ¥ 3. Nature of work (check which applicable): New Building, .....Z~ .......... Addition .................. Alteration ................ Repair .................. Removal .................. Demolittor ..................... Other Work ................................................... (Description) 4. Estimated Cost .......... .~..C)..~..~...~,.~......-.~.,.-L?.....-Fee .......................................................................................... (to be paicl on filing this application) 5. If dwelling, number o~ dwelling units ........... .J .............. Nurnhcr of dwelling units on each floor ..... , ...................... If garage, number of curs ................. i .................................................................................................... 6. If business, commercial u~ nrtxed occupancy, speci[y ,m~ture and extent of each type of use ............................ 7. Dirnensions of existing structares, Jf any: F~o~,t ........................... Rear ................................Depth .................... Height ........................ Number of Stories ................................................................................................................ Dimensions of same structure with olle~a~tons or ~]ddiiion:~: I lunt ................................... Rear ............................ Depth ................................Height .......................... i',lu,-nbcr af Stories ................., .............. 8. Dimensions of entire new construction: Front ....... .,~.-..q~-~. .............Rear ....f..~....~.~.; ............. Depth .....C:~.....~...i .......... .....~_..~- ....... Number of Stories ......... ~" ~ ....... .......... , ................................... X"X ...... i ............... 9. SizeHeightof lot: Front .......... ~fZ)..~.i ................................. I~c<, .......... S'..C).._.C~... ..................... Depth ..~c~.~:k.(~. ................. 10. Date of Purchase ....................................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .......... ...~.~..~..~....~.-.~-..~...~....~...~.~-~ ........................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............. .~...C~ ................................ 13. Will lot be regroded ..... "~""~-'~__ __r'bWill excess fill be removed from premises: ( ) Yes (V~'No 14. Nome of Owner of premises ....... ~....~..~....~..~....~.r~.q~...~..~. ..... Address .~...~.~..~.~..~.'..C~)..~.. Phon~ No ....................... Nome Architect No ....................... Nome of Contractor ..... ~'Z\~,~...~'~..~..~.~,D.~2, ...... ,^,ddress .~D::~%,~..~. ~:~rx% Phone No.~...~..~,,~.,,~.. ~c~.,..~:Z PLO'[ DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines, Give street and black number or description according to deed, and show street names and indicate ~vhether interior or corner Io~. S1-A'TE OF NEW YORK. ~ c c COUNTY OF ................................ fo"~ ........................................................................................... beM!j club/ sworn, deposes and says that he is the applicant (Name of individual signing contract) above named, ~, ~,j/,~ .. Fie is the ....... ~~ ......................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hava performed the said work and to make ~nd file this application; that all statements contained in this application ore true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........ -~/~'/~L (Signature of applicant) F ~y ~. DAWSON ~OTARY PUBLIC. Stale of Hew York No. 52.4643721. Su[foll~ County~ Term ~xp~res March 30, 19~ ? APPROVED AS NOTED NOTIFY BUILDING D£PARTMENT AT ).~765-2660 9AM'to 4PM FO~ 4. FINAL WNEN JO3 COMPLETED 01 Ii , f