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Home My WebLink About994-zFO,I~M: NfO. 4 TOWI~' OF $OUTHOLD BUiLDInG D~PARTM'~-NT SOII'TI-IOLD, I~I, OF' OCCUPABICY THIS CERTIFIES that the building located al ....E/.~3...Blll~.se.t..Ay¢o. ............................... Street Map No.... ~ .......... Block No....~:~ ........ Lot No... ~.....~.OOlrt~Ot~l~......l~.,.~,. ...................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..............~l&l~tl.....~l,.~ ........ , 19...6.0 pursuant to whiel~ Building Permit No.....~...~l+ ....... ~lated .................... i..~.~..~..¢.~.....~1 ~....., 19....6.0 w.as 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 .....A~LbeJe.t..Dintzio ............ (omlel,.)....., .......................................... (owner, lessee or tenant) of the aforesaid building. Building inspector TOWlq OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, lq. Y. BUILDING PERMIT (THIS PERMIT MUST,BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 99i Z ~rch 15 60 Date .......................................................... 19 ........ Permission is hereby granted to: .... ~.z.~.e.~..~,....~...~..~.~0. .................................. 400 8:L~h ~t:reet bUild new one ~y ~ll~g .Building Inspector pursuant to applieaHen d~ted ................................................................ ~ ........ , ~nd appreYed by the Building Inspector TOWN OF SOUTHOLD 0 Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This opplicat[ar~ must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building inspector 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 disposol--(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 instollatlons, o certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Plann{ng Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate 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 any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare o 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 .... .D...e ,c..e,m..b.e. ,~.....Z,, .3./.,., .Z..9,7.,8..,. New Building ...... ..~. ....... Addition ...... .X.. ....... Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ...4...4....S...q.~...s..e..~.....~.~.e..~....~TD..e.D.D.9~.~.,...~W...~,Q~ .............................................. Owner Or Owners Of Property ~?~d`~`¥~D~j;~j;~.~ ................................................... ision ............................... , ............................... Lot No ............. Block No ............. House No ............. %~e'l~it No ..................... Dote Of Permit .~./.~'./...'~.'~/...Applioant .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fincd Certificate ~ Fee Submitted $ 2.0 0 Applicant ,...~.~ f~ ........................................... ~ha~d F. L-arK&- Sworn to before me this Notary Public ....... .S. ,~ ~,~, ,o. 1.,~ ............ County (stamp or seal) BARBARA DIACHUN No~a~ Publ c, State ~f New york 52-4635190 Smfolk County FOlt~l NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Examined ...... ~.¢.¢.,~..-/.~.i '-19.~.~? Approved ..... ~'.,~.~?,c,...~.~.4~, 19.~(.~.Permit No ....... ...~..?,¢.~/. ............. Disapproved a/c ........................................................................................... Application No ......... ~ .~..'?../../... .... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ........ .......... 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 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 inspe.ction 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 hove 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 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ......... ............................ ........... ;Z ............ State whether applicant is owner, lessee, agent, architect, engineer, genera[ contractor, electrician, plumber or builder. owner of premises ......... ........................................................................................... Name of If applicant is a corporate, signature of duly authorized officer, (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No . r...~rr=... ...... Lot No: .................... ~ cZ ~ ~'.~, ,/ .~,~.c ~..~,~(~,~.? ........................................... Street and Number ............. ~. ..................... / ' Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy :,.¢. .r.~:<. ............................................................. b. Intended use and occupancy ......... ,(.~.~-~.;~.;. ~,-~ ................................. property lines. Give street and block numbers or description according whether interior or corner lot. 3. Nature of work (check which applicable): New Building ....... ~...... ...... Addition .................... Alteration .................... Repair .................... I~.emoval .................... Demolition .................... Other Work (Describe) .................... (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 ................ Y.~./.~..?.~ ............................................................................................................. 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 ...... t~..,,r.... ........... Depth .;.....;.,¢¢...~.4.~< ...... Height ............................ Number of Stories ........ ./. ..................... 9. S,ze of lot: Front ............. j.-,~. ........ Rear .......... ..........Depth .................. 12. Does proposed construction violate any zoning law, ordinance or,regulation? ...... , ................................................. P.LOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from to deed, and show street names and indicate STATE OF NEW/'XORK /" )S S COUNTY 0 F ~..'?~¢~I-6¢--~. ~ ,, ) .:...' ......................... ~;/~...:~if¢~..9,~c.¢¢ ................... being duly sworn, deposes a4d says that he is the applicant (Name of individual signing operation) above named. He is the ........... .~--~.~'4~. ..................................................................... ; .................................................. (Contractor, agent, corporate, 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 all 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. Sworn to b.e.~ me this ........... .~..~.~....~.... doy of ........... ~,,, ,~,.,~ .... 19...~,,.~., Notory Public, . ......................................................... C, ounty