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Home My WebLink About10145-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No.. Z.963. 4 .......... Date ........ Aucj.u. st. 1.5. .............. 19.7.9. THIS CERTIFIES that the building ................................................ Location of Property ... 505..~ 5.aR3~aw$. J~a~¢ .................... .q~ .~.h.o. c3u. ,.~ .......... House No. Street Hem/et County Tax Map No. 1000 Section . .Q ~ 4 ....... Block ...0.],. .......... Lot ...q~ .7 ........... Subdivision. ~orth.w. oodr, .................. Filed Map No..7.5."7~.3.Lot No..4. ........... conforms substantially to the Application for Building Permit heretofore fried in this office dated .... .t4a.~c1'~ .30 ....... , 19 :l.q pursuant to which Building Permit No...~..0.1.4.~. ~ ........... dated ........... ?4areal ~. 3 O ....... 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 ......... ........ ~)~.QV.~.~. :4.~O~.~.d, .~v.r~4¥'~t.i. r3cJ..p, qo. ~L ......................................... The certificate is issued to ........ l~;'gp~.L. ~. ~qi..~. 3q.a.n..dO.~.~. .......................... (owner, of the aforesaid building. Suffolk County Department of Health Approval ........... ~../.R. ........................... UNDERWRITERS CERTIFICATE NO ......... .44475).3. ................................. ng Inspector Rev 4/79 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10145 Z Date ....... .,.~,...:..~, .......................... , ~9..7...~ Permission is hereby granted to: ~ ...~.:~....~~~...~.~...i....~... ,o ....~~~....~.~..~:~~....~.~i~~. ......................................................... :...Z..:~ ............... ................................................. z~ ~, ' ' 19~., and approved by the pursuant to application dated ............. ~......~.~< ...................... Building 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 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 installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approva~ of completed site plan requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing alt property lines, streets, buildings and unusual natural or topographic featu res. 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 .., f.~,o ?.~-.... Old or Pre-existing Building ...... ".-. .... Vacant Land ...... ~ ...... Location of Property ~'-()~- ..~..).~-,z,.x- A/~-r~? ~c~'7/~_'/~.~,~o ~ Owner or Owners of Property . ~L~. ¢~. ?... ¢..~..o?.;:, ./~.~ .,~.~./?~/_. ......................... County Tax Map No. 100(~ Section ............... Block ............... Lot ...... /.. ........ Subd v s on. ,~..~/~. ?~, .~ .2.~..~ .............. F..ed Map No.J~..~-~..~..~..Lot No .... ~ ....... PermitNo../.~/.z~.-?..~ DateofPermit..~?~.'.0~. ,~.~Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ ? .~.,....'.:. ' ·~ ~ Underwriters Approval. ~.i,..:.>'..~.' ' .Planning Board Approval .............. ........ Request for Temporary Certificate ..................... Final Certificate ....................... Construction on above described building and permit r~e~ll~le codes and regulations. Applicant ..... ~'~./~" ,eL_ ~/' .~ .~.~..,,~ .... .~:, .................... THE NEW YORK BOARD OF FIRE UNDERWRITERS gf BUREAU OF ELECTRIC;ITY BP JOHN STREET. NEW YORK, NEW YORK 1OO3B THIS CE~IFIES THAT ~eas an~l/, ~u3 ~a~news ~a., CU~Ohogue, in the following location; [] Basement [] 1st FI. [] 2nd FI. O~S~ de Section Block Lot was examined on ~ U~ U ~ ~ ~ ~ 1~ 7 ~ and found to be in compliance with the requirements of thls Board. FIXTURE fiXTURES RANGES OVENS D~SH WASHERS EXHAUST FANS OUTLETS SWITCHES 1 DRYERS FURNACE MOTORS FUTURE APPUANCE F~EDERS TIME CLOCKS UNIT HEATERS MULTI-OUTLET DIMMERS SYSTFJAS SERVICE DISCONNECT S E R V I C ~O.O{=CC. COND. A.W.G. NO.OF HI-LEG A.W.G. (Sw~mlng Pool) This certificate covers compliance aS the date of lnspeoSlon only, Because of unusual envlronmenSs It Is advl~aole to have f~equent tess and/or repall~ made by a qualified pe~sono NO. OFNEUTRALS A.W,G. OF NEUTRAL ~mnes t Randall ;.]:3~j !~athewm La. CutchogueR N.Y. 11935 11 This certificote must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their COPY FOR BUILDING DEPARTMENT. THIS ¢OP~/ OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. Examined , ~>/...-~. ~ .... Approved . 7. ~C.d ..... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLO, N.Y. 11971 TEL.: 765-1803 ., 19~. Permit No.../..r.,.:d...r,/.~.,...) ~ Application No./~/." ./SfZ'. ..... Disapproved a/c ...... -YT-.-~ .~. '..~. ............... ../ (B~iilding Inspector) APPLICATION FOR BUILDING PERMIT ~./~)..~ ? Date ....... .~. ....... , 19 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 of property must be drawn on the diagram which is part of this appli- cation. 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. ~, ~ature o~ applicant, os,.~ame, if a corporation) (Mailing address of app~j~nt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder .............. v ...... 12 ............ If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .... ./.q. ,/~.~'~. Plumber's License No ............... ~. ........ Electrician's License No./~'...~.~z. Other Trade's License No ...................... 1. Location of land on whic,h .p~9~ed work will be d ............... ~ ............................. House Number Street Hamlet (Name) 2. State existing use and occupancy of premises and intended use and occ. upancy of proposed construc~tion: b. Intended use and occupancy 3o Nature' of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work .?.~ o--*,~ . .~./._..~.. ? . (Des~liiptior0J Estimated Cost .... 0..0... .......................... Fee ................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units... 7-.T ......... Number of dwelling units on each floor ................ If garage, number of cars .......... 'vT.; ........................................................... 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 ............... Rear ............... Depth ............... I-[eight ........... : ... NjuCber of Stories ........ ~ ..... ~ .......................... /., ......... 9. Size of lot' Front /,-~ .~ ./CA~.2 .~ · Rear /..~. --,~-. ........... Del~h . ./.~...°7-- .,ff~. ~//2d~.. · .af-~-/.' 10. Date of Purchase ....... ~_,07/_~.4~ .............. Name~JfFormerOwner~,_ (,/ .-~?. .............. 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 ..... /¢.q./'-o ................. Will excess f~l b~ r~move4 from premises: ~_ 14. Name of Owner of premises . ./7.%~.o..~...o~...~ ...... Address ~2~5~...Zo-?~. Phone No./,;~.. 7-~5'/'o.~. g.. blame of Architect .......... ~/ ................ Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from propeIly lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW~J)~ICd, n ~.~/ COUNTY OF. ~~..C~-~T du y and ,a,* (Name of individual signing contract) above named. , He is the .................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e ~d file this application;that all statements contained N this application am true to the best of his knowledge and belief; and that the work w~l be perfo~ed in the manner set forth N the application filed therewith. Sworn to befor~ this ...... ..... No ' Public, . .... ........ County (Signature Of applicant) u juHU THE ~'OCATION OF Y?E~r,$ AI~D CESSPOOL~' NOTE: m _- MONUbfENT SU~DIVISION ,~4~.P FiLE'D IIV T.¥E OFF/CE 0t~ THE CLERK OF' ~UFFO/LK COUrtV/ ON /dAY 3t, 19701)S FIL~- £J~ 54G~ REViS)ONS .4UG 1`9. 1.975 ,YOUNG & Y( 400 OSTRANDER AVENUE, SURVEY FOR: "<s~ / LOT &U. ~ NO~TH~/OODS ...... F ~ I HOl~ TITLE D/VISIO 1 OF CH/CACO S~THOZD J TITLE/rvsu~'c~co