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Home My WebLink About666-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-18924 Date MARCH 28~ 1990 THIS CERTIFIES that the building. ONE FAMILY DWELLING Location of Property 670 SMITH DRIVE NORTH SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 76 Block 2 Lot 14 Subdivision Filed Map No. Lot No. conforms substantially fo the Application for Building Permit heretofore filed in this office dated MAY 6, 1959 ~ursuant to which Building Permit No. 666-Z dated MAY 7, 1959 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 ONE FAMILY DWELLING WITH ENCLOSED SCREENED PORCH. * The certificate is issued to (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED *NOTE: THIS UPDATES CO Z-349. DATED JDL¥ ]5, Rev. 1/81 CHARLES GILLESPIE N/a 1959. ~uilding Inspector FOI~M NO. 4 TOWN O~: $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at..8~,t,J~.,1)~.:LY.~..~g.~.t~J~ ................................ Street Map No.q.o.9.~C....~..e..q~f...~..~lock No ......................... Lot No.....~..4:...~......8~_~.f4..~..o.~.~.~...~?,.~.:. .................... conforms substantially to the Application for Building Permit heretofore filed in this office doted .............................. .~.~.....~ .............. , 19~.C)...., pursuant to which Building Permit No.....~.6..6..6. ................ dated ..................................... ~.~.~.....~....., 19.~..., 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 .............. ................. ........................................................................................ This certificate is issued to ....O.b.8,1C.~CL...q~,~,¢P..~g~k~. .................. (.¢~'.~.) ............................................. (owner, lessee or tenant) of the aforesaid building. ............ : .................... - ............. ; ....... ::;.:;...'.'; * ~ .......... Building Inspector / FOI~FI NO. :2 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? 666 Z Permission is hereby granted to: G.~.Smith & $on,~ A/O Charles Gillespte ~ai~ St Souf, hoid, ~.Y. to to build new onef,~mity d~elling Smith Drive ]Jorth Goose Nemk Est~%e~ lot # 94 & 95 at premises located at ................................................................... pursuant to application dated ]~ay 6 1~59 ................................................................. y ........ , and approved by the Building Inspector Fee $ ~d~),O0 TO~N OF SOfT,OLD BUILDING DEPART}IE~T TO~N HALL SOUTHOLD~ RE~ YOR~ 765 - 1802 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY NEI~ CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING.~...VACANT LAND ........ ~TREET Owner or Owners of Property.. .. ith pt App Hen De . royal .................. Underwriters Approval ........... Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate .............. Fee Submitted: $.., ., .......... FORM NO. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN IIALL 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY INSTRUCTIONS A. l~is application must be filed in typewriter OR ink and submitted to the Building Inspector with the following; for new buildings or new use: ]. 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). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that solder used in system contains less' than 2/10 of IZ lead. 5. 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. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (Prior to April 9, 1957] non-conforming uses, or buildings and "pre-existing" land uses: i. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. A properly completed application, a consent to inspect signed by the applicant and a certified abstract of title issued by a title company which shall show single and separate ownership of the entire lot prior to April 9, ]957. . If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent information required to prepare a certificate. C. For Vacant Land Certificate of Occupancy: I. An application for vacant land Certificate of Occupancy shall be submitted, and a certified abstract of title issued by a title company showing single and separate ownership of the entire 10t prior to April 9, 1957 shall also accompany the application. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. D. FEES: 3. CERTIFICATE OF OCCUPANCY - New Dwelling $25.00, Additions to Dwelling $25.00, Alteration td Dwelliug $25.00, Swimming Pool, $25.00. Accessory building $25.00 Addition to Accessory buildings, $25.00 - Businesses $50.00. 2. Certificate of Occupancy on pre-existing dwelling - $100.00. 3. Copy of Certificate of Occupancy - $5.00 - over 5 years - $10.00 &. Vacant Land Certificate of Occupancy - $20.00 5. Updated Certificate of Occupancy - $50.00 6. Temporary Certificate of Occupancy -$]5.00 Residential Commercial ev. I0/14/88 D~1¥£ NO.TN d MAP OE PF~OPEi?.TY 21CIqAED ~ t'qAI'~tAN SALEF2NO BAYV~ E'v~' GUAI?JkN~'EED TO 'T T'~' ICOt~ I~ _E G~AP-:A~'EE GO f'ZO~t2i(~ VAil TUYL, RC, NO. 1 TOWN al: SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFPlC[ SOUTHOLD, Examined ............ ~..:Z. !..C:../.. .... /.. . .. 19. ~..~. , - ,, ..~.L kc Approved ...................... : ........... ' ...... 19 ........ Permit No .................... Disapproved a/c ....... yl'""/'l' ........ >']"'"' ~ ........ z~""~% ...... ~ ....... m,' ....... ........................... ::..!:% r' (Building Inspector) l' Application No .........~....~....~. ........... APPLICATION FOR BUILDING PERMIT .. ............................ .... INSTRUCTIONS a, This application must be completely filled in by typewriter or. in ink and sut)mitted in duplicate to the Building Inspect'or. 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 location. 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 progress of 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 tS HEREBY MADE to the Building Department for the issuanc,e of a Budding 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 ail applicable laws', ordinances ~d regulations. ¢,/ ~' .~(Signatufe of applicant, or naht~, if a corpora,tion) ........... (A tess o opp icant) State whether applicant is owner, lessee, agent, architect, engineer, ge,.neral contractor, electrician, plumber or builder. ............... C,::~.~, .;~¢~~....G,...:.:~× ~.:_ .......................... k>' ........... :...I ............................... : .............................................. If applicant is a corporate signature/of duly-a~horized officer.' .... -.- ;/¥>., ..,, . (Name and title of corporate officer) ,;, , StreetondNumber~~~Z~' ' "' ' -- ~~" "~7'"'" ......... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............................................................... : ..................................................................... b. Intended use and occupancy .......... ~~4-,K~r,~.~,~,~ .......................................................................... 3. Nature of work (check which applicable): New Building.....~. .......... Addition .................... Alteration .................... Repair .............. ..~Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ...... "'¢'.~..~:;.-~__ ................................ 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 ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent o~ 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 .....'~....~.. ................ Height ..... ~.~... .............. Number of Stories ....~,¢~,,~,-, .......... 9. Size of lot: Front ...... .~...~...~¢~. ........ Rear ..... j...~ ........... Depth ..J...~..'~..~. .............. 10. Date of Purchase ....J...~..,.~.~... ................................ Nome of Former Owner .~.~..~..~./..<:~~ ....... 11. Zone or use district in which premises ore situated ......... ~.~/,~,-~.~l¢,~l~r¢.~. .................................................. 12. Does proposed construction violat, e any zoning law, ordinance or regulation? ...... ~ ...................................... 13. Name of Owner of premises..~~C.~.Address ............................................ Phone NO ..................... Name of Architect ................ -- ----'""'~' ........... ~, ................... Address ........................................... ~..~..~. Phone NO ..................... Name of Controctor~..,.~..-...~.fYrf~.~.,~;..t-~:~...: ....... Address .~~..~..' ............. Phone NO. PLOT DIAGRAM Locate dearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ) S S ' COUNTY OF ............................ .................... ~, .,.~,~.%~../;-..~ . , · ....... y (Name of indiviaum si~.ing oppHcohon) obove homed. He is the ............ ~ ...................................................................................................... (Contractor, agent, corporate officer, etc.) o{ said owner or owners, ond is duly authorized to perform or h~ve per~ormed the soid work ond to m~ke ond file this application; that oll statements contained in this application ore true to the best o~ his knowledge ond belie~; ~nd that the work will be performed in the manner set forth in the opplic~.t~n filed therewith. Sworn to befor~ me this ........... ~ ..........aay or ....................... ~,¢.~.~.. m~....,.~..,. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD', N. Y. Exam,ned ......... ,,, ,, ,, ....... Approved ........................................ 19 ........ Permit No .................. Disapproved a/c .................... ~, ~'~N,~i_.~~5 ................................ ?'~JJ~,7 ................... ....... .............. ............................ Application No ........~.....~.. ~ ........... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving o detailed description of layout of property must be drawn on the diagram which is part of this location. 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 l~ept on the premises available for inspection throughout the progress of 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applioable laws, ordinances Apd regulations. ,/ ..... (Signotuf~ of app,'canL or na/n~ if a corpo~Jior ~ (Add ssa appica j State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signatur,~dof duly a~orized officer. ...... ~z,.~.~/c... :/.... :..:.....~, ~... ~ .~.. :: ................... : ......... (Name and title of corporate officer) 1. kocation of land on which~roposed work will be done. MapNo:~.~...~ ...... LotNo: .~....~.~.....~..~.....~''~:;~- Street and Numbe~.~.,~ ....... ~.'~'~'.y ......... 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... , ........................................................................................................................... b. Intended use and occupancy .......... (,~..~...~......~..~./. · .. '' .......................................................................... 3. Nature of work (check which applicable): Ne~¢ Build,ng.....~. ........... Addition ....................Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost.....'~.¢4'...~;,~--..~ ................................. 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 ............................................................................................................................................ 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 a/tera~ions or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ....... .~...~1!~.-- ........... Rear ...... .~....~.. ............ Depth .....~..~... ................ Height ..... .~'~.. ............... Number of Stories ....~t.'t¢,,~,, .......... 9. Size of lot: Front ...... ..~..~.42 ......... Rear ..... ~......~... ........... Depth .../..~)..~..~. .............. 10. Dote of Purchase ..,..~...~...~"..,."~'.,. ................................ Nome of Former Owner ...-~..,,.,.¢~.,:.~~ ......... 11.. Zone or use district in which premises are situated ........ ~~ .................................................. 121' "Does proposed construction viblate'ony zoning law, ordinance or regulation? ...... ~ ........................... .......... , 13. Name of Owner of premises.;~..~.Address ............................................ Phone NO ..................... Name of Architect .................. ...~,.,__..,..~ ................... Address .._......~~ .............. Phone NO ..................... Name of Contractor.,,~...~..,c¢.Cf~i,,l~/l~,~..~/~t~¢~/~--"~'~" ....... Address .~.?m....-r~.(m' ~*~"'21~ ................ Phone NO. PLOT DIAGRAM Lac.ate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. 4'(,0 STATE OF NEW YORK, ) ,¢ ¢ . COUNTY OF._ ....................... ~....) ............... ~'~;'"'~/~'"'V'"being duly sworn,' deposes and says that he ,s the applicant above named· He is the .................. ~r..~,r ........................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work end to make and fife this application; that all statements contained in this application are true to the best of his knowledge and belief; end that the work will be performed in the manne, r set foFt, h in the application filed therewith· Sworn to before~me this ~ , ' - ,,',m~ '~. sOo~'~ '~.~.,