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Home My WebLink About744-z FOI~M NO. ~ TOWN OF $OUTHOLD 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) 744' Z Permission is hereby granted to: P.O. Box ]East M~ul{ion~ N~v ]fork to eonstruet r~w one ~ily dvelli~ at premises located at $/S Bay ¥iew Drive ~ Oardtne~s Bay Estates~ East Marion~ New York. pursuant to application dated ,T~l'i~ 30 1959 and approved by the Bui}ding Inspector Building Inspector HOWARD M. TE~RY FORM NO, 6 TOWN OF SOUTHOLD 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 featu res. 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 instatla- 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" land 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 New Building ............. Old or Pre-existing Building .., .~, ....... Vacant Land ............. Location of Property ... ;~.Sp..3 .ay.v.~.e..~..~v.e, .~p.e.,...~.a.s.~..l¢.~.~.~o. ,n.,..~.e..w..~..o. ~.~ ............... House No. Street Hamlet Owner or Owners of Property .RQ.tb, .~,. ~.q~':¢ ...... ' ............................... , .... County Tax Map No. 1000 Section .... $? ......... Block .,..~. .......... Lot .... 2. ........... Subdivision, . .G.a..~.cl.,~.qe. ~.s..]~a.. y..~.s.~. ,a..t.e.s. ..... Filed Map No. 275 . .Lot No. 122 Permit No ..... ' ...... Date of Permit .......... Applicant .. ~8~;.a.t.e...o.~..~.u..~.h..~.;..B.u.~.~. ..... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underw}iters Approval ........................ Planning Board Apl?reval ...................... Request for Temporary Certificate ..................... Final Certificate ........ .~, ............. Fee Submitted $ ............................. Construction on above described building andj;~T1;i%'t meets all applicable codes and regulations. ..... App cant ~ , ., C~ Rudolph H. ~' uer, Attorney for Estate of Ruth Rev. 10-10-78 H. Bu;cr 0-¢¢W' c.o. cs--/, )h. TOWN OF SOLITHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ............. ~l ~ Approved ............ No ...... Disapproved a/c ...................... ~ ...................... ~ ............................... ....... ' .................... .......... ........ ..... " (Building I nsp ect o.~'~'~ APPLICATION FOR BUILDING PERMIT Application No ...... . .,,~....~...~..... .... 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 adioining premises or public streets or areas, and giving a detalled 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 o 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 puFpose 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 o Building Permit pursuant to the Building Zone Ordinance of the Town of Sou'thold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or o Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all oppllc.oble laws, ordinances and regulations. .~ot~ure qf.f~p_,lic~ant, or nome, if a corporation) ...... ............................. (Address of apl~/c~nt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of prem.ses....~'.~...~,.~'~,.~l~.~ .................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work wi[I be done. Map No: ............................................Lot No: ..... ?~?. ........ Street and Number ...................................................................................................................................................... Municipality 2. State existing use and occupancy of p~emises and intende~ use and occupancy of proposed construction: o. Existing use and occupancy ................. ~~~ .............................................................................. b. Intended use and tI0~r~tc2 3. Nature of work (check which applicable): New Building ....... ~ .......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition ............. ~j~/.Other Work (Describe) .................... 4. Estimated Cost..~.~..l..0..0...O.~ ........................................... F~e ..... .?~...~..:...~'~.. ............................................................... (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 an~ 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 ................................ ~9 29 6~ 8. ~i~ens~ons o~ en~re ~ew co~t~ct~cn; ~o~ ............................ ~ecr ............................ ~ept~ ............................ He~t ............................ ~5er of 5toiles ........... ~ ............... 9. Size of lot: Front ~ Rear ~ ~ ., ~t ~90 ~t ~ ........................................................ uepm ............................ 10. Date or ~urcnase ...........~ .......~..~.~..~.. .............. ~ame ~t former uwner .............. ;,. ........................................ 11. Zone or uso d~stnct m which premises ore sffuoted ........................................................................... 12. Does proposed construction violate any zonin~ Iow, ordinance or re~ubfion? ~O 13. Nome of Owner of oremisos~,~.~.~ .................. Address ..~.~...~..k~.[.~ ....... Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Dou 1~ ~o~ero r " - ~ ~ 7-068g N~me of Contractor ....... ~ .......................................... Add ess ............................................ Phone HO ..................... PLOT DIAGRAM Locate clearly and distinctly ell 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 NE~/./'~J~J~,_ ~ ) S S / ~ ' ~ COUNTY OF ,~.....) ,' .............. ~...~....'Y:L~...T_..-Z~I........~...:...'~...:~ .......................... being duJy sworn, deposes and says that he is the applicant (Name of individual signing ppplication) above named. He ~s the (Contractor, egent, corporate officer, etc.) of said owner ar owners, and is duly authorized to perform or have perfarmed the said work and to make end file this application; that all statements cont<=ined in this application are true to the best of h~ow}edge and belief; and that the work will be performed in the manner set forth in the application filed,t, ber, ew,[h. Sworn to before me this CORNF-L~ · [4. ................. f. .......... . .