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Home My WebLink About1036-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z16244 Date October 2, 1987 THIS CERTIFIES that the building One family dwelling Location of Property 870 North Parish Dr. & 360 Dayton Rd. Southold County Tax Map No. 1000 Section ...7.1 ........ Block I ..... Lot 30 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... A.p.r.i.1.. 1.4.,.. 1.9.6.0. .... pursuant to which Building Permit No... 1.0.3.6.z. .............. dated.............April 14, 1960 ..... .... ...... . 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 ......... .... O. qe..f.a.m.i.l.y..d.w.e.l.l.i.n.~ with attached two car garage. The certificate is issued to OTIS WHITE & JUNE BUCKLEY of the aforesaid building. Suffolk County Department of Health Approval .... c...0.....Z. 8.0.4..8./. !7./.6.0. .................... UNDERWRITERS CERTIFICATE NO.. N/A PLUMBERS CERTIFICATION DATED: N/A Update of C.0. #z804 8/17/60 ...~.~ ~..~...~... Building Inspector Rev. 1/81 FO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. CERTIFICA'~E OF OCCUPA~{CY THIS CERTIFIES that the building located at l~l!.P, arl~.iSh...D~...&..~a~..~o~_Ro.a~t... Street Map No. ~.~Y~'.~ ......... Block No....~ ......... Lot No.X.Y~ ..........~.O~..h.Q~..~.~......~, ...................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. Ap.~.i~.....],~. .......... l~fa0..., pursuant to which Building Permit No...~_.~.O~.~. ..... ~]ated ....... ............ .A...p.~..1..1.......~.~......., 19..6..0...., 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 (owner, lessee or tenant) of the aforesaid building. Building Inspector FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT N? THISPERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLET,ION OF THE ,WORK AUTHORIZED) ' Permission is hereby gragted to: ' pursuant to application dated ........ i ...... , ................. ~1~.~,~.....~.~ .......... 19...60, and approved by the Building Inspector Fee$[O.GO..~d~check Budding Inspector FORM NO. 6 TOWN OF SOUTHOLD 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 i6k, and submitted m~ to the Building Inspec- tor with the following; for now buildings or new use: 1. Final survey of property with accurate location of alt 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 et~ 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 from the Architect or Engineer responsible for the building. 5. Submit Planning 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 or any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 1. Certificate of occupancy New I)we]~{rlg $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 5oUpdated C.O. $ 50.00 Date ~ ............... New Cons tr uc L i on ...... Old or Pre-existing BuUding ............ Vacant Land ............ Location of Property...~...?.~.... /~/~.~....~....~.~ House No. ~ tree t~ /-- - ~ Hamlet O ner or O ners .... County 'l'ax Map No. 1000 Section ,'~/. .......... Block .... / .......... Lot. ~i~...// ........ Subdivision .......................... , ....... Filed Map No ........... Lot No .............. Permit No~../.Q .~.~ Date ofPermit~./.c~./.~.0 Applicant ................ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .~..~....~... .................. Construction on above described building an~mit meets all ap~PJicabLeoed se~s and r,¥ulati°ns' App c~nt .... L,~..~/-~-4.... ~ .... ~,~: . .~ff).~~. ........... 333/7 / FO~I NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×am,n d .......... Approved .................................... , 'i 9 ........ Permit Na ................................. Disapproved a/c ..... ~.~~ ~ ............. ...... (~ildi~ Inspector) Application No....'./...~....~....g.~ .............. APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application mu~t 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 Bu. ilding 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. APPblCATION 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 alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ..... ature ~.pplicant, or nam/, ~f a cor~ration) (Add'ss of apron ) State whether applicant is owner, lessee, agent, architect, engineer general contractor, electrician, plumber or buiJde.r. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate, officer) Location of land on ' ' ' ' ' ' which proposed work wlll~,be done. Map k)~ .............. '/m ......................... Lot Kip ............. ~ ....... St re et and N umber...~'//.¢~. ~ .~....~-~..Ct.:;.' '~'"~'~'Municipality ~ ~'~ 1''~' '~''' ''''~''''~'' :''' ''~''' ~-~'~' '~'' State existing use and occupancy of premisx~ and intende~d/~use and occupancy of proposed construction: a. Existing use and occupancy ........... .~..~..~...~....~?..~..~..~....~ ..................................................................... b. Intended use and occupancy ........ ...~...~.~,~.).L'~-~/.~../7~.~.~Z'.~...~.~.~.~....j.~~'~/~ ................................. 3. Nature of work (check which applicable): New Building ...... /(X'............ Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 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 .............. ~.....f,~"4,~..r~t.....~'~6~.~ ..................................................... 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 some structure with alterations or additions: Front ................................ Rear ................................ Depth ................................ Height ............................... Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ L..:.~... ......... Rear ...... '...cX.~.~... .......... Depth ....~....~.. .............. Height ............................ Number of Stories ........... '/."'""~,,4 9. Size of lot: Front ..... ./...~.O.. ............ Rear ....... ..,~...~.-....~. ........ Depth ....... ./...~..~...67. ........ 10. Dote of Purchase ...v,.~'ZZ.......x..7../,~...~ ............... Nome of Former Owner ....~ .......... ~~ 11. Zone or use district in which premises are situated ............................. ,&~.......?..C.~....~ ........ ~ ................................ 12. Does proposed construction violate any zoning law, ordinance, or regulation .~ ........... ~ .................. Name of Owner f r ' ~-~Z,~/-~'/~ ~,,J/_~, .6~-Z~'/~4~"T~---%x/~,,~, ,,~/Z ,,~/ .... 13. o p em.ses,¢~'~.~.-:4'..<~.=...:.c~,~.....;c~,^claress ............ ~o~'~h~,~ r~ .................... Name of Architect ~ddress ~o/K~,<,_~ ,'~ · · .......................................... ,'~ ................................... rnone~O ..................... Name of Controctor~.~...c~....8.~].:...~..~Addre~f:.~'~.'~.~.'...~.-.~one NO ..................... 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 na~.es and indicate whether interior or corner lot. , /V STATE OF NEW../YO. RI.(~ ~...~ ) S S COUNW ' ' ............................ :~..f~.~~~ ................... being duly sworn, deposes and says that he is the applicant o .n (~ame;[siZid~al..s~~ ab w, am d. H ' . ..................... ~. ........................................................................................................... (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. IUDITH T, BOKEN ~otary Pubhc, ~tate of Now York Sworn to befor~ me this No. 52-0344963, Suffolk County ./ ........ of .., ........ Notary Public, ~~,~..~..~,<.~.~.L.....~ (Signature of applicant)