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Home My WebLink About10320-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. g.lA 1.13 .......... Date ....... .~g&u.q .~..~ ................. 19 .~..~ THIS CERTIFIES that the building ................................................ Location of Property .455 ................ Fl'.e.c[. $~'.e.e t, ............ }l.e?.. $.u.f.~q~.k ..... House No. Street Hamlet County Tax Map No. 1000 Section . ,1 1 7 ....... Block . .0.z} ........... Lot .... 0.1.4. ......... Subdivision ..... .X ......................... Filed Map No..X. ...... Lot No...X ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. tJ.uno. P-~t ......... 19.7.9 pursuant to which Building Permit No.. 103~.1~. Z ............ dated ....~.u.~.y..1 B. ................ 19 7.9., 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 ......... .............. a..prJ.~ate, one-. family..c[~e~l.J, rig, .............................. The certificate is issued to .......... lrI.e.~.l~OTl..& . ~ .v.e.J:.Y..13...D.~a..k.:L.ll. ...................... (owner, I~ of the aforesaid building. Suffolk County Department of Health Approval .9.-.~..0.-.6.7. ~. ,.. ?. UNDERWRITERS CERTIFICATE NO ........ ~l.. 4. ~1.3.2.2. ~. ................................ Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to:~_Z,,//~ ~-..~ . ........ ..n~. ~/.4~ ~.... ~ ~/.<...,..~ ....... ...... ~....,.c.....~...~.~//.~.....~....~ ........... ..... Z'Z'~...,.z~...~.~.~.,,.:.~...:.~: ........ .,:.../.7 ~ ~o ....... .(.~..~...~ r.-..~.~....o.~..~......~.,~./.~..4...~......~.~~ ................... et premises Iocoted ot ?/ Building Inspector. Fee $ ...... /... ............ ~ Buildlng Inspector FORM NO, 6 TOWN OF $OUTHOLD 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 all buildings, property lines, streets, and unusual natura~ 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 requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" ~and 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 $1.00 Date ..... (~ ~/' '~ / ~> ~)'- .. New Building.............~ O~d or Pre-existing Building(Z,) ........ ~ rVacant Land ' Location of Property ..... ~.--~. ....... .~.¢'. ?~ .... ~' ....... N~... ~ .~.([~ t ~ ....... Hou~ No. Street Hamlet Owner or Owners of Property · ~¢~'~ -~: .~..~, ..... D~'~ ................. County Tax Map No. 1000 Section .............. Block ............. Lot ............ Subdiws~on ................................. Filed Map No ........... Lot No .............. Permit No..~.~O,. Date of Permit ~..Applicant ........ ~e~ .... ~ .... Health Dept. Approval .... ~ ..... Labor Dept. Approval .................... ,.. Unde~riters A~provat ........ ' ........... Plannin~ Board Approval .................. ~ , .~ Request for Temporary Certificate ..................... Final Certificate ........ - ......... Fee~ubmitted$ .... ~.....~....?-....'~.>../(.~.~-:.~..~./~hr~ ~n,..~_~ ~ Construction on above described building and permirmee~s all app~cable~,co,de~s and regulations. Applicant ....... ,, ........ .~ ....... ~ ............ ~)Ot_~ Ft FP~AI~,'~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY~ ~, 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT only the electrical equipment as described below and irttroduced by the applicant nam~ on the aboVe application number irt the premises of }~r~ Daskin,w/e ~%~kl i~. ,.500' s/o C~or~e P,d. ,New in the following location; ~] Basement [~, 1st FI. w.~ex~,nlnedo,, 8ept;m~aber 11, 1980 FIXTURE OUTLETS i6 F~ECEPTACLES 23 SWITCHES FIXTURES INCANOESCENT FLUORESCENT 18 16 DRYERS FURNACE [] 2nd FI. Section Block Lot and found ~o be in compliat~ce wtth the requirements of this Board. RANGES OVENS DISH WASHERS EXHAUST SYSTEMS NO OF FEET OTHER APPARATUS: 1-(~£ 1-~3ke D~tec~or E AWG OF CC COND 2/o NO OF HI tEO AWG OF HI LEG '~O OF NEUTRALS AWG OF NEUTRAL 2/0 Rvland ~lec. /Jo. P.Oo Box 163 Mat~ic~a~k, N, Yo 11952 FOR THIS of th¢~ Board if OF L~¢.242 Per 11 ~Ol~ NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ..................... ~ ................ , '~....~... '~ ^ppHcation No/...~??-) <~(J ~ Approved ...Z.~.~.. ........... ,19~. Permit No. ~.~.~ ....... /// Disapprov~ a,: ..................... -~.;:zz.....z~ ........................ ..~ .................. ........ , (Building Inspector) APPLICATION FOR SUILDING PERMIT ' ~'~ ~ Date .................... : ........................... , . INSTRUCTIONS a. This application must be completely filled m 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, relat~dnship to adjoining premmes or pubhc streets or areas, and giwng 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 apphcation, the Building Inspector will ~ssue 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 pa rt 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 Budding Permit pursuant to the Building Zone Ordinance of the Town of South~l~; £~ffolk ,Co~inty~N~w York, and other apphcable Laws, Ord nonces or Regulatzons, for the construction of buildings, additions or a[terations, or for removal or demolition, as herein described The applicant agrees to comply with all '6ppllcabl~ laws; ordlhbnce'~;~ buH~Ji~g cbde, hb~%ihg code, and regulations and to admit authorized inspectors on premises~ and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) 5 Swallow Lane, Levittown, NY 11756 ............................... Z, 'f i i :d ............................... State whether applicant is lessee, owner, agent, architect, engineer, general contractor, electnc~an~/plumber or builder. owner Herman Daskin & 'Wife Nome of owner of premises .................... ; ........................ .. If apphcant is a corporate, signature of'duly authoriz'ed officer. (Name and title of corporate officer) Builder's bcense No ..................................................... Plumber's License No ................ : ................................ Electrician's License No ............. · .............................. 2 Other Trade's License No ............................................... kocat on of and on wh ch proposed work w be done Map No ' Lr, t kl Street and Numb~.~..~...~....F~.e~l...~O~,d. ................................................................ ~i}i~'~...Murficlpahty .......... State existing use and occupancy of premises and inCended use and occupancy of proposed construction: o. Exisiting use and occupancy ....~.~i~,1:1.~...~.9.~ .......... b Intended use and occupancy one family residence Natd're Of v~ork (check whichiapplicable): New Building..................XX Ad Repair .................. Removal '. ............... ;. Demolition....).;, ........... Othm 4. Est.mated' Cost ............................................................ 23 sO00 ' Fee~....~...~.. i (to be 5. If dwelling, number of dwelling units ............................ Number of dwel If garage, number of cars ..... ~ ..................................................................... 6. If business, commercial or mixed occupancy, specify nature and extE 7. Dimensions of exmtmg structures, ~f any: Front. ..~..~. ............... Rear ..i Height ...... ~.~. ............. Number of Stories ............................................... Dimensions of same structure with alterations or additions: Front ......... Depth ................................ Height ............................ Number of Storie~ 8. Dimensions of entire new codstruction: Front ................................... Rec Height 22 I_O. Numberj of Stories 1½ 9. Size of lot: Front ......... .~..0...0..i ...................................... Rear 100.86 10. Date of Purchase ....................................................... Name of Former 1 1. Zone or use district in which premises are situated" .............................. 12. Does proposed construction viblate any zoning law, ordinance or regul 13, Will lot be regraded, ...,,~, ,,~,,~,,: ............. Will excess fill be removed from H~rman Daskin & Wilde_.. ,5. 14, Name of Owner of premises .................................................... ^aaress ..... Name of Architect ........................................................... Address ...... Name of Contractor : ............. i .............................................. Address ...... PLOT DIAGRAM Locate clearly and distinctly al! buildings wheiher existing or proposed, property lines. Give street and bldck number or descriphon according to d, whether interior or corner lot. titian .................. Alteration ............... Work .................................... , ................ (Description) aid on filing this application) lng units on each floor ......................... nt of each type of use ........................... ............................ Depth .................... .......................... Rear .......................... ...................... Depth ................................ don: ....~.0 ............................................... )remises: ( ) Yes (,~) No ~allow ~,~, Phone No ....................... ......................... Phone No ....................... ......................... Phone No ....................... nd indicate all set-back dimensions from ~ed, and show street names and indicate STATE OF NEW YORK, I,¢ ¢ COUNTY OF ......... ~assau ........ ~' ~"'~ ',, ~ ,' ~ Herm,a..~ Daskin . ......... ~ .' ................................... De ng duly sworn, (Name of individual sigding contract) above named. owner , He is the ......................................... ~ .................................................................... (Contractor, agent, corporate officer,~ et of said owner or owners, and is duly authorized to perform, or have perform~ this applicqtion; that all statements contained in this apphcation are'true to th6~ the work will be performed in tt3e manner set forth in the application filed Sworn to be'fore me this .a.,8..,: ,, d- 79 Notary Public, ...~.... County .............. WARR'~A. SAMBACH JR, HDtary Pubhc, Statb of New York No. 30-4516792 Quahfied in Nassau CounW Oornrnlss~on Expires March 30, eposes and says that he is the apphcanl :.) d the said work and to make and file :he best of his knowledge and belief; and therewith, Signature of applicant) ~ENT OF HEALTH SERVICES CONSTRUCTION Ohq. Y ~..o.~'- g~- ~,7 ~'OR APPROVAL TO CONSTRUCT SURVEY FOR HERMAN DASKIN ~, EVELYN DASKIN AT NEW SUFFOLK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK DATE ,JULY lO, 1979 SCALE I"= 40' NO. 79-5'/9 N LINAUTHOR1ZEO ALTERATION OR ADDITION TO THiS SURVEY I~ A VIOLATION OF SECTION 7209 OF THE TEST HOLE Daffx ~ gO ,~2 e. 9. ~. ~~7 HERMAN DASKIN 8 EVELYN DASKIN " dULY 23~ 1982 AT HEW SUFFOLK DATE~ dULY I0, 1979 ~e sewage ~1~po~1 e~A ~a~e: ~pply ~WN OF SOUTHOLD SCALE. 1".40' ~aeiltties ~o~ t~Is locat!o~ have bee~ inspeoted by this departmen~ and found ~FOEK CO~TY, NEW YORK NO. 7~-37g ~e~B NOYBE CO~SIDEREDTO~EAVALID TRUE COPY HLAL~ OEPARTM/NT-DATA FOR ~PPROVAL TO C~STRUCT T~ ~R WHOM THE SU~EY IS PR[PARED I RIVER~AD~ NEW YOR~ MONUMENT AL~E~ W, YOUNG, PROFESSIONAL STAKE AND LAND SURVEYOR H.Y.S. UCENSE NO. IE845 HOWARO W, YOUNG~ LAND SURVEYOR c~T~ ~ w~c(wj, sgPnC T*~KiST)~ CES~OCS(CP) SH~N HgRJ~ N,Y S, LICENSE NO 45893 sua~Y' FOR HERMAN DASKIN & EVELYN DASKIN ~UFFOLK COUN~ DEPARTMENT OF H~LTH SERVICES AT NEw SUFFOLK DATE ,JULY I0, 1979 FOR APPROVAL OF CONSTRUCTION Ob.~Y ~N ~SOUTHOLD SCALE 1"=40' APPROVED ~ ~ ~eo~es o THIS SURVE~ NOT BEAR~G THE LARD HEALTH DEPARTMENT-DATA FOR APPROVAL TO C~STRUCT aaO ~HIS FO~ WHOM T E Su~EY IS PREPAREO 3F H~LTH $~VlCES PUREO~E ~0 ARE NOT ~0 BE USEp TO ESTABLISH ' 1'"" YOUNG YOUNG , ~ ~ ~ ~ ,~ , RIVER~AD~ NEW YORK ALDEN W YOUNG~ PROFESSIONAL ENGINEER D= STAKE AND~ND SURVEYOR N Y.S UCENSE NO 12845 HOWARD W, YOUNG~ LAND SURVEYOR ~ L~1~ OFW~L(~).SEPTIC TANK(St~a:EI~OLS(CP) ~N ~ERE~ N Yg LICENSE NO 4589~ 1