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Home My WebLink About9653-zI~OI~,M NO. 4 TOW~ OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupnncy No. Z9205 Date September 12 78 ........................................ , 19 .... THIS CERTIFIES that the building located at . ~'~330...M..a.~.n..R..o.~ ....... Street Map No ............. Block No ...........Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ... ApriL..4 ........., 19 .?8. pursuant to which Building Permit No ...... .9.~.5~Z dated ... April ~.~ .......... , 19. ?~, was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is ............ .P~.l.v.a. ~.e..O.n. 9..F..~..~Ly...D~.9.1.1!~g ............................ The certificate is issued to .... S.t~he.r~. $....&...S.u.~ .aA1...L:..K.a..e.l.i.n. .................. (owner,~~c of the aforesaid building. Suffolk County Department of Health Approval .............. N/.R. .................. UNDERWRITERS CERTIFICATE No .......... .~.~.9.~..~.'1.~. .......................... HOUSE NUMBER... 2~.~50 ..... Street ............ M.a.:~..Rg.a.d. ................... .................................................. Cutchogue,. ~ew. y.o.r.1; ....... Building Inspector ~ NO. ~ BUILDING 'DEPARTMENT sotn'ffOLO, N. Y. BUILDING PEr, MIT (THIS PERMIT MUST BE KEPT ON THE PkEMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9653 Z Permissio~ is hereby granted to: .... :~,~ ......... :~.i'..{ .......... .~.~..L'...~.! .......... OMTO tOT at premL~es located at E q ~ 3 D H /'~ i h! ('u/7/' tie 0..~., to ,,,~,i~,,,r, ~ ..................................... ~ ,.............., Building Inq:mctor. Fee $....L .................. Building Inspector APPLICATION TOWN OF SOUTHOLD ~ Building Depe~tment Town Clerks Officn Southold, N. ¥. 11971 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 fallowing; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, end unusual natural or topographic features. 9. Final approval of Health Dept. of water supply and sewerage disP0sal--(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 September 7, 1978 New Building ................ Addition ................ Old or Pre-existing Building .....,X, ......... Vacant Land .............. Location Of Property ~..~..?.~..~.~..~.~C~?..~?.~.~g~.e~r~?"w~.~ ................................................ Stephen A. Kaelin and Susan L. Kaelin Owner Or Owners Of Property ....................................................................................................................... Country Club Estates . . Subdivision .............................................................. uor No..,3..,0. ...... Block No ............. House No ............. Permit No ..................... Date Of Permit .................... Applicant .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ X Request For Temporary Certificate ........................................ Fined Certifiqote .......................................... 5.00 Fee Submitted $ .................................... Sworn to before me this 8th September ................ day of ............................................ Suffolk Notary Public .................................... County (stamg or seal) ?/ BARBARA DIACHUN No~a~ Public, Sta~e of New York No. 52-4635190 Suffolk Count~ Commissmn Expires March 301 FROM: RICHARD F. LARK DATE: · septembe~ 8, ATTENTION: · 1978 TO: Town of Southold Building Department Town Clerk's Office Southold, New York 11971 MESSAGE Gentlemen: Enclosed is an original and copy of an application for a Certificate of Occupancy for Stephen A. & Susan L. Kaelin. The Kaelin's home phone number is 765-2743 and Mr. Kaelin works at The North Fork Country Club whose telephone number is 734-6338. REPLY~ DATE: Very trul~ur , SIGNED: ~IGNED: Richard F. ~9~k . (bcti THE I$ ~,t. July ! I. THIS CERTIFIES THAT NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 only the ~ectri~d equipme~t as describ~d belo~ gnd lntroduced by Steve Keelln.s/s Rt. 2~ .Hain Rd,, Cu~'chopue, in the following location; [] Basement [] I~t FI. [] 2nd FI. Seetion Block Lot was examined on Jui~ (~m I (') 7 J~ a~d found to be in complian~e with the requirements o~ thi~ ~mrd. SERVICE EMSCONNECT NO. OF S MI&'TER PAW R EXHAUST FANS Peter [~oporrl~ ~~ "'~/ Hain Rd. Southol d, N.Y. 11971 LIc. 137£ OeNm~ ~A~I~ ~11 This ce~ificate mud not be alter~ in any man~rr return to t~ office of the ~ard if incor~. Ifl~o~ may ~ i~f~ ~ ~r credentials. copy FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATI MUST NOT BE ALTIRID IN ~ MANNER. '11 I '\ \ \ xxooO Examined .................... ~.~: ...... ~./,~./. ~.. ....... ~'~'-~ ..... Application No ................................ ~r~ ................. .~ ............... 7... ,,..7.~ ,-,,,t ~o .......................... ~ _ ~'- ................. (B-'"'"-' "'"';i'l'~lir~ Im43~,~ctor'"" '""'"'"i ............................... ~' ~ APPLIGATION FOR BUILDING PERMIT ~,,e ..... ~.~:':.~ ............. . ,~:!~.~.'.. INSTRUCTIONS a. This .a..ppljcation mu. st be completely filled in by typewriter o~ in ink. and submitted in triplicate to th~ Building~ nspoctor, w,th 3 set~ of p4ans, accurate plat plan to acale. Fee according to schedule. b. Plot plan showing location, of lot and of buildings on premises, relationship to odjo n ng premises or public streets areas, and giving a detailed descnption of layout ofpraperty must be drawn on the diagram which is port of this application. L~j c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this appl!cation, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises avadable for inspection throughout the work. e. No building shall be occupied or used in whole or in pert for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. ^PPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pu~rSUant to the ~BeU,ld;n.g' Zon.e O.,ndmance of .t. he T. ,o~m.,o,f. Southold,. Suffolk .Cou.n. ty, New York, and ..other applicable Laws, Ordnances or~ .~gu at~,o, ns, .tor me c.onstrucr!on o..t, ou~,lamg~,., ,c~d. it~ons or alterat,ons, or for removal or demolition, as herein described. · app,canr agrees to comply w~tn a, app,lcaote taws, ord nonces, buildlna code housin~ code and -~--.I,~w,~- m~l admit authorized ,nspectors on premises and In buildings for necessary ir~-tion~. '~ ' '~' ..... ' --- .............. L.i.~..~..~T...~.. ~ ..................................... (Signature of applicant, or name, if a c°q3oration) ' ........................ , ...... ~n..~..~.~.~ .................... (Address of applicant) ~ State whether applicant is owner, lessee, agent, amhitect, engineer, general contractor, electrician, plumber or builder. ............................................ q.~...~..~.,~.L..C~.~.L.~..~_%~. .......................................................................... Name of owner of premises .....I.......~..~..~.~.~......~'~..r~..~iL.~. ........................................................... If applic,ant is a corporate, signature...of duly authorized officer. ~'~'o~ ' ~'~'''-- (Name-and tFtl -~'~ ~J~~ (.4J~ 'f~" corporate officer) - Builder's Liconse No .............. ~.~ ............................... ~ y~_ ~.~,. ~.._.. P~mber's License ~o ................................................. .~,~. U-,,~ Electrician'~ License No ............................................. ' ~ '~ /~oo--- /~ ~- ~ Other Trade's License No ............................................... 1. ocation of land on which proposed work will be done Map No ~-~ ~ ..,n~y--~l.. L~ot No '~ .. · ~ .......... -;~. ~.' ....... Street and Number L~Z%. ~ b...%. ~...~"~ ......... 6~.....-'*- ---...~-~ .... '~' ~"/Y:' 'F . I~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ~ "T~' ...... : ....... ...... ...... 3. Nature of work (check which applicable)' New Building- , ....... Addition .....~..,,...j.....~Alte£atiqnl ..... ._..;,.._~. Repair ...... Removal .................. Demolition.....~ .......... ..... Other Work ........ ..~. ............ ..~ .......................... ,---- ., ..~ C3 e=. ~ ~ ' ~ (D~cription) 4. Estimated Cost ~.~..~.'..Z~.Z.~.'.~....~ ........ .~ee ..::..:..'..Z...... ......... ; ................ ~. .......................................... ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ [ Number of dwelling units on e~ch floor ............................ If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occupancy, s~a~e'and ext~~ e of use ..... ~.; ............ 7. DJmensions~f existing structures, if any'. Front ......~.~.4~.....~../' . 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 .................................... Rear ............................ Depth ........................ Height .................... Number of Stories .................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ N~me of Fprmer ~er ..... w' ........................................... 11. Zone or use district, in which premises are situated ...... .~.~.~.~.~..~.~..'..~.:Z ...~ ................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ..................................................... 13. Will lot be regraded ...~.~.~..: ......... W~l exq~s fill be removed fro~ p~ses: ( ) Yes ( 14. ~ame o~ ~ner o[ premises .................................................... ~aa e~ ................... ~ ....................... Name of Architect ................ .............................................. A~re~ ..~.~.~ .~hone No ............... Name of Contractor .....~.~..~.~.~.~ ................ A~ro** .......................... ---- '~. ['~h°~ ~o~'. ............... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate a I ~t-~k dimensions from prope~y lines. Give street and block number or description accordin~ to de~ and show street names and indicate whether interior or co~~ STATE OF N~ YORK, ~ ¢ c ' COUNW OF ~~u~~~'~~~ontrac[) be,rig duly sworn, deposes and ~ys that he is the applicam He is the ....... ~.~-~..~ ........................................................................................................................................... (Controctor~ ~nt, corporoto officer~ etc.) of soid owner or owners, ond is duly outhorized to per{orm or h~o performed the sold ~rork ~nd to mko ond file this ~pplicotion; that o1~ st~t~monts cont~inod in this opplicotion ore truo to tho host o{ hi~ knowledge and belie{~ thor the work will bo porformod in tho mannor set {o~h in the opplicotion fllod therewith. Sworn ta before me this ~ '. ~ ....... ..... ......................... ......... ~oto~ P~lic, . ............. ~ .................................. Coun~ ~...~&-:~..-: ~....~ applicont) ~OlgR~ p~tl~, State oI ~ "~'~'~ ROAD ( N.Y.$. Rte. 25) MAIN , nOV~ or formerly \ ---~,___ F/i/Horn Wicl~hom ~ 2o ~. ~ ' .-.- I ~, '~t 30 -F. ~'// "~' I' / ~ L.o I ¢ / ' ~ ~" I ' NOTRE: ~ ~ · -' MONUMENT [3 = ~ ~ LOT NUII~BER$ ,R, EF_E_R TO/~AP OF "COUNTrRY ~ ~ CLUB ESTrATr~S~ PROPOSED TO BEFIL~D IN ~ ~HE OFF/CE OF TrHE CLERKOFSUFFOLK CO. SURVEY, FOI~ · STEPHEIV KAELIIV 8 SUSAIV KAELIAI SEPI: 1,1978 JUNE $0, 197~ AT CUTCHOGUE DATE JUNE 2G, 1978 TOWN OF SOUT/'IOLD SCALE, I"=~0' SUFFOLK COUNTY~, NEW YORK NO. NEW ¥OR~ STATE £DUC~r~O~ LAW .COPIES OF TH tS SURVEy NOT BEARINS THE LAND YOunG YOUNG ALDEN W, YOUNG~PROFESSIONAL ENGINEER AND LAND SURVEYOR N,Y.S. LICENSE N0.12845 AR,,E,FROMr, FIELD OBSERVAT,I,ONS ANO OR DATA OBTAINEO FROM OTHE RS. i01