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Home My WebLink About1000-zFO'R~ NO. 4 TOWN OF SOUT~-IOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTNOLD, lq. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located al ~...¥..i.~p..r...i.~..~l'.,.i.y..e. ........................ Street Nidd~ Map No ....................... Block No ................................................................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ................ ~?..a...~.?...h........1.? ........ 19..~0. pursuant to which Building Permit No. ~. ,1. . .0. 9. . .0. ........... ~ax'eh 19 19...~(~, was issued, and conforms to all of the requirements 4areal ................................................. of the appiicable provisions of the law. The occupancy for which this certificate is issued is Private one f~.ii~ d~e~:~i~g .... This ¢ortifio~te is issued to (owner, lessee or tenant) of the aforesaid building. .... Building Inspector FOI~B/I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS ~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1000 Z Permission is hereby granted to: to ........ Build..new...one.. £amil~... dw.etting .............................................................................. pursuant to application dated ............... ' .......... ~1.....,~ ................. 19.6Q.., and approved by the Building Inspector Fee $1Q,~O0 ............ FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971~ APPLICATION FOR CERTIFICATE OF OCCUPANCY S application must be tilhM ill Iyin'vvrflel ()It ink, dntl ',,uhltfill['d ul IhtIH~C,lln to Iht; []uilding Inspec- W/th the folJowirEI; Io~ nuw buHduhj:; *~ new u,,e' Final suwey of I)ronerty with ac('urdt(~ location Ot all huihlil)qs, l)rope~ly lines, streets, and unusual ural or topographic lC,]lures. Final approval of t iealth Dept. of water supply and sewerage disposal-(S-9 form or equal), ~roval of electrical installation from Board of Fire Und~,rwriters. buildings, Industrial buihJinfls, Multiple ResMences and similar buildings and installa- dons, a certifica[e of CocJe compliance frorn the Arc[utect or Engineer responsible for the building. )mit Planning ~oard approval of completed s~te plan requiruments where applicable. r'existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" survey of peoperty showing all prbperty lines, streets, buildings and unusual natu(a or )graphic features. statement of owner or previous owner as to use, occupancy and condition of buildings. of any housing code or safety inspection of buildings or premises, or other pertinent informa- required to prepare a certificate. occupancy $5.00 of occ~?ancy on pro ux~sting dwellinq ~r ,of certificate of occupancy $1.00 ' land use 1; I'~'/$5.00 Dau; ,.January 10, ]98i~ ............. Old of' P~r existing lhlihlir~q(X) . X ..... ~ ~ zV,mnnt Land ............ ... Southold NY (Reydton Heights) ,petty . ..V]~c~0.r'i~ Rd, ................................................ of Property Raymond J. Conn. 9];].~ ................................. !Tax Map No. 1000 Secnon . 78 .......... BIocl< . .9 ............. Lot...5.9 ............ ............................ Fih:d M,ip No ........... Lot No .............. .......... Date of Permit .......... Applicant .Ga~.y..F. la.n~e.r. O~.sen.,. Fsq ........... Approval ........................ Labor Dept. Approval ...... ~...I. ~ ........... ,.. pproval . .' ........ ~St for Temporary C,,rt,fie~le .................. I00 ~ I00 FOI~M NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT.OLD, ,. v. Examined ..... ~ .6...~....~..¥... !..~...., 19.~?... Approved ................. ~.(\ ................ , 19..L:,.~.. Permit No....~.. :J...°..Z..°Z..°. .......... v (Building Inspt~ctor) Application No. APPLICATION FOR BUILDING PERMIT Date ........................... Ua .el ..18, ....... , 19.60_ 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 ava.liable for inspection throughout the progress of the work. e. No building ~hall 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 issua.nce 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ~ _ ............. (Signatbre of ?/j~licant, or name, if o corpora~tion) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................................................... .................................................. ........................................................ Name of owner of premises .................~,,..~.~..~.,~.~ .............................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate, officer) Location of land on which proposed work will be done. Map No: ................... ..u' ..................... Lot No: .................... Street and Number .~./~.~ .~.~..~.~.~.~..~ ~.~..~.~ ~.~0..!....~.../..0.....~..~.~..~..~.~.Vt~/ ~Oad Municipality B~t ~/'V teW- 8 ollChl! O]..d State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......................~..~.~.t¢ ............................................................................................ b, Intended use and occupancy ............ ~...~....,1~...:~.],.~...~..~...~,.~/..~..~...0,.~. .................................................................... 10. 11. 12. ]3. Nature of work (check Which applicable): New Building ......... ~. ......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... Estimated Cost ........................ .~-...~.l~'0'rO..0..'..'0~'''.... ....... Fee ...'!..~ .................................................................................. (to be paid on filing this applica~on) If dwelling, number of dwelling units ............... ~ ......... Number of dwelling units on each floor .........."~ ....................... If garage, number of cars ............................................................................................................................................. If business, commercial or mixed occupancy, specify nature and extent of each type of use ................................ Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth ................................ Height ............................ Numbe~' of Stories ............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth ................................ Height ................................ Number of Stories ................................ Dimensions of entire new construction: Front .......... ..~.9..? ........... Rear ..... .~'...~..! ................ Depth .......... .~..~.!. ........... Height ~""6 t Number of Stories ............ ,It. .................. Size of lot: ...........................Rear ............................ ......................... Date of Purchase ............... ..~....~..~../~,0. ....................... Name of Former Owner ....N.~..I~....~...~, ................................... Zone or use district in which premises are situated ................................................................................................ Does proposed construction violate any zoning law, ordinance or regulation? ............. ..~..~. ...................................... Name of Owner of premises..~.,..T,~,.?.~-,~,,~.~..~,,,..,Address .......................................... Phone NO...J~/.....2..'...8..0..?.? Nome of Architect .................................................... ~aaress .......................................... Name of Contractor ........... .?..~...~.,J.,F. ........................... Address ...... .~....l~....~. .......................... Phone NO ..................... P'LOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set*back dimensions from property lines. Give street end block numbers or, description according to deed, and show street names and indicate whether interior or corner tot. ale att. STATE OF NEW~ORJ~////] S S COUNTY OF /'~.£~) ' ' ........ ~~ ......................... ;..being duly sworn, deposes and says that he is the applicant ~ame of individual signing application) above named. He is the ............................. ~~ ....................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and fiJe this application; that all statements contaJ~d in this application are true to the best of his knowledge and belief; and that the work will be performed in ~ manner se~orth in/the a~lication filed therewith.~ Sworn to before me this/ , /~' ~ ~ ~~ , /~ ~ ~ /< day ~.-. ~'~ NOT~C, Stat~ ~ yO* ]~ ~~ ......... r ............. ,~//_.. '2)'"~'"" ~ ............... ~,0. *:~0~'4~0~ ~ s.~fo,k co~.~ ~. // ~ Notary Pub[ c, .~~ ............... ~}~arc (S,gnaturh ~0, .19~ ,e:_.ff .....e of applicant)