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Home My WebLink About718-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CI~ERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No..Z..Z~0~ ............. Date ............................ ~D%~be'~'. · ~. ......19.~... THIS CERTIFIES that the building located at..~/(.D..Sc~d..~&ew..~a&d ............................ Street Map No. Ozz~.f,..B~..B~Block No. one .................. Lot No. ~C~ .......... 0z?~,en~,~....}I,~, ........................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................ ,]'~e....l~ ........... ~ 19.~9..., pursuant to which Building Permit No...D..7~,8 ................ dated ............................. ~'~m~....~.9. ........ , 19.5~i..., 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 .............. ....................... ~z'..1,w.t~.. ~,~. ,t'~£~ · .~e]b ~ ~.~ .............................................................................. ' .... This certificate is issued to .J~DJ.~....~chr.~..¢~,e~ ........ (~.~e~ ....................................... : ..................... (owner, lessee or tenant} of the aforesaid building. ~ Building Inspector 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? 718 Z Date Permission is hereby granted to: Walter Uhl, Inc.~ a/e Joseph Schneider Syo~sett~ L.I.~ New York to at premises ocated at Soundview Avenue~ Orient~ New York pursuant to app cat on dated J~e 16 t9 ........................................................................ , and approved Dy rne Building Inspector 10.00 paid Fee $ ........................ FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 , 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~m~ to,the Building Inspec- tor with the following; for new buildings or new use: i : 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 f~m 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 building~iand "pre-existing" land uses: 1. Accurat~ 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 ~ny housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 ..l~Certificate of occupancy New Dwelling $25.00, Accessory '$10.00 Business $50.00 ~2_:,;Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00. 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... New C on 8 t r u c % i on Old or Pre-existing Build, ing Vacant Land 5;, o,?' ' Location of Property . ' ~ ~'~ ' z Owner or Owners of Property t ......................................................... County Tax Map No. 1000 Section .. 0 [ ~' Block ~ ..... Lot .... S divi io... .... No. 4 X?.7..Lot No. Permit No ........... Date qf Permit .......... Applicant .................................. Health Dept, Approval ....... ' ................. Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate.. ...................... Fee Submitted $ .............................. Construction on above de,.ri?ed_ b,~l/.d [,n/g and permit m, eets all applicable codes and regulations. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........ Disappraved.c~/c .......................... ~:c:...~.. ..................... ~ .......................... .......... ....... ....... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be cqmpletely 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 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 IS HEREBY MADE to the Building Department for the issuanoe 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 applicable laws, ordinances and regulations. ..... ......... (Address of applicant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~,//.~.< ''Y' c. ,~' _ , .~ J'~ (? If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed workwill be done. Map, Nc~)~.t.(~ .......... .~.~',/...~ .~..~:.'..~....~ot No: .................... Street and Number ............. ..~..~.~.~.~(`~..~..~!~t'~.~...~`~.~.~. ~.~`(~..~...~?f~'~.T~ ....................................... Municipality 2. State existing use and occupancy of pr,emises and intended use and occupancy of proposed construction: o. Existinguseandoceupancy ........ ........................................................... b. Intended use and occuponcy....~./~L~?....~..~.~.~.. ..~.['.~Z4 ...... ~..~=~.....~... L. ...................... ~//~ t 3. Nature of work (check which applicable): New Building .................... Addi ion ....................Alteration .................... Repair .................:~.Removal .................... Demolition ....................Other Work (Describe) .................... 4. Esti mated Cost.....<~..../..~..~....¢...~...~...,......~... ......................... Fee ........¢~'.-/...~.~.:...~.'~(..~. ............................................................... (to be paid on filing this application) S. If dwelling, number of dwelling units ................ ./. ............. Number of dwelling units on each floor ......... .~.. ............... If garage, number of cars ................ ~ ........................................................................................................................ 6. If business, commercial ar 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 ~'/~/l/ ~ ,4~--~ ~-" / * /'/ 8. Dimensions of entire new construction: Front ...... ~... ../~.. I/ Rear ....... /...../~2 ........... Depth Height ............................ Number of Stories ...... Z ................... 9. Size of lot: Front ...../..,~.'.~....: ......... Rear ....... /.r..~.~.~..: ..... Depth .~...- ........ A//.../.' 10. Date of Purchase ........................................................ Name of Former Owner .................. ii. Zone or use district in which premises are situated ............... ,.~.. .......... ../I-~¢.~'..,'~--'--z~;......~,.././~). ..................................... ]2. Does proposed construction violate any zoning law, ordinance or regulation? ,~.........~....~....~...: ............................ 13. Name of Owner of premise~'..~.~..~.~r~..~.~.f~.f.?......~ddress ....................... Phone NO ..................... of Architect ........................................................ Address ........................................... Phone NO ..................... Name ~'~;?~/~/'/~.} " ' .~'.~ .~..7~. (./.. ~i~..~..'~:..,..Phone NO. Name of Controctor.......~--.~..~..--~-.~ ...... ;_..~......Address ..... . ................... / PLOT DIAGRAM Locate clearly 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 cc~r~n~r lot. ~_ ~,,.¢c~><~ I ~ 7 STATE OF NEW~¢O~,I~, -,// ) S S COLJNTY OF ~~.*-) ' ~~i ................ being duly sworn, deposes and says that he is the applicant ('Name of indivld~ ~g ' g 'PP' ' above named. He the ........ .......................................... : ........................................ ,~/ cz// (Contractor, agent, corlborote officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that afl statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. JUDITH T I~0KEf~ Sworn to befo~ me this ~ota p ' "/'- ~ ' ' (~7~"" ¢ ~9 t,,~,z~,, No 52-8344963, s.fM$ianntu~e, of applicant)