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Home My WebLink About1355-zFOIL~ N'O. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY MLa~;ha~ Cemete~_~ent Point conforms substantiolly to the Applicotion for Building Permit horetoforo fil~ in dated ....................... ~....~.0 ....... , 19~..., was issued, and conforms t0 all of t~X~requir~e~f of the opplicoble provisions of the Io~. The occupancy for which this ce~ific~t~ is issued is~.:......~¢ This is issued to of the a,foresaid building. FOI~M NO. 2 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? 1355 Z Date ........................... ~ta~.ck...30. ........ 19...61 Permission is hereby granted to: Ed~i.~..~-.K. In~ ........................................................... ......... O.~.fe.n.t, v.....~., :'ff,. ....................................... to .,.,Mo~re.. a~.. exl, s ~lng... d.~;e.l 1 lng...,..to., new.* ,1.~ a.t l~n ................................................... at premises Iocoted at .8/S...l'4atn..Road ....................................... : ..................................................... .................................................... O~.~,.ex~,¢.,,..., ;% .~, ......................................................................... i .... pursuont to opplic~tion dated .................... Y'~}~,.....~.O ...................... 19.~..., and opproved by the Building Inspector Fee ~...O..,.p..Q ............ Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, 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 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 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-existir~lling or land use 3. Copy of certificate of occupancy [$1_.00_ , $5.00 Date .......................... New Building .. ¥. ¥ ....... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ...... ~ .......................................... House No, . Street Hamlet Owner or Owners of Property ............................... ~t ........................... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... 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~/ermit meets all a.~ppli.~ ble cod, es and regulations. ppHcan[ .... : .',,; ......... ~'.., j .... ~, ...................... ? KING FARMS EDWIN H, KING ORIENT EAST MARION -- GREENPORT POST OFFICE BOX 263 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×omined ............ Approved ........................................ ]9 ........ Permit No ............................... .......... ......................................... (Building Inspector) Application No. [ ~ '~- APPLICATION FOR BUILDING PERMIT I NSTRUCTI ON S a. This application must be completely filled in by typewriter or in ink and su6mitted 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 ar Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ..... ~a~m..2.oad.,...Ox£e~.t.. ~.o.~qt.,..~,1~.I ................................. (Address of oppl~ant) State wheth.er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................... Owne~ , . Name of owner of premises ......... EdwJ-m.H....~: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 will be done. Map No: ..~.,~.: ..~... ...................... Lot No: ...~.../ ............ 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...&.~ ..... 2..s~o~...~l.~..-..unoooup&ed ................................................ b. Intended use and occupancy.....~2~..~ps6s ............................................................................................ 3. Nature of work (check which applicable): New Building .................... Addition .................... Alteration ............ Repair .................... Removal .................... Demolition...' ................. Other Work (Describe) .................... 4. Estimated Cost.....,.~...O.......q ...... .......................... Fee../.0.~ ................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... .o.o,e ................. Number of dwelling units on each floor ............................ If garage, number of cars ....... m3e ............................................................................................................................... 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 ..... ~'.O ................................................................................................. Dimensions of same structure with oIterotians or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ............................Rear ............................ Depth ............................ Height ............................ Mumber of Stories ............................ 9, Size of lot: Front .... L....~... .............. Rear ......J....O..?. .............. Depth~'iT.?. ................ 10. Date of Purchase ........................................................Name,of Former Owner ........................................................ i2. iDoes proposed construction violate any zoning law, ordinance or regulation? ....... ../~....0. ...................................... 13. Name of Owner af premises ...................... I ................. Address ............................................ hone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Nome of Contractor ................... I .................. Address ............................................ Phone 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 names and indicate whether interior or corner IoL STATE OF NE~YC~R.I(,,~J, ) S ~ COUNTY OF ' ~"w'~" '~':"c:~"k"w')/// ,.~,. ,/~,C,,- ' ~ /~-~./...~q .. being duly sworn, deposes and ~oys that he is the applicant, ............... ............ above named. He is the ............................................................................................................................................................ (Contractor, agent, cortDorate officer, etc.) of sa d 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 thl~:~,~,gtion are true to the best of his knowledge and belief; n r se~ ~ he a hcat~on filed therewith and that the work will be performed in the rna r~ f;F~,] ~ pp .... . Sworn to before me this e,~%~ ~e//; ~!~& ?~.~ dav of ' ~ 19 ..... ~/, ~n ~ ~ k'o#. (S~gnature of app leant) ,~ ........................ ~08, I/0 ~ ,~ ~ Notary Public,~..~'''~':'c°unty '~;/~o,~. ~ (~.4..,,_~4-~Z~'£