HomeMy WebLinkAbout2105-zFOR~ 1V'O. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES that the building located at ..C~l.v. es...Neck.~ad ............................. Street
Mop No ..... HJ.'I1 ........ Block No ......~ ............ Lot No.~ ...... ~U.~ho.l.d,..i~,.~t., ........................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
............................. 3'.,~,e ......... 26 ............. , 196.~... pursuant to which Building Permit No...Z210~..
dated ............................. ~T.~a ....... ~......, t 9...~3, 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 ........
..... P~.l.v.~.t.e....o.n.e...~'~tlr...d.~.el~m~. ...........................................................................................
The certificate is issued to .I/~.~],$.8$0,.~J~E..t~.~ ....................................... .0.I~jk~'~' ........ i ..................
(owner, lessee or tenant)
of the aforesaid building.
H.D, Approval Oct.
1963
by R, Villa
........... ....... .............
Building J nspe[:'~'~ /
FOI~I NO. 2
TOWN OF SOUTHOLD
BUILDI~qG DEPARTMENT
TOW14 CLERK'S OFFICE
SOUTHOLD, 14. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 2105, z
Dote ..................... ~t~.~ ....... ~ ............... 19'63"
Permission is hereby granted to:
"~ t;'~'"'~e~e~ ........................................................
to ..... B~i'td.. ~-. ~ · ' f ~i'ty · '~et'ti~qg .................................................................................
at premises located at ..W./~.....~re~,.~k..~ ...................... '('"~"(~i.']~'~'~") .....................
............................................. ~out~ol~;"~;~Z;; .................................................................................
pursuant to application dated ............................... .~.....;~ .............. ~9.~.., and approved by the
Building Inspector
Fee $'~O/,'00 ...........
FORM NO. 6
TOWN OF SOUTHOLD
Building Dapar1~nent
Town Hall
· ~outhold, N.Y. 11B71
APPLICATIDN FOR CERTIFICA'I'E OF OCCUPANCY
submltted~a:~, ..... atp the Building Inq~-
A. This application must be filled in ~pewriter OR ink, and ' ' - ~ .....
~or with the following: for new buildings ar new u~:
1. Final ~mey of property with acetate I~afion of all buildlno% propa~y lines, ~raats, and unu~al
namrat er topographic fea~ra& ~
2 F hal approval of Health Dept. of water ~pply and ~weraga dispo~l-[S-9 form er equal).
3. Approval of electrical installation from Board of F re Unclear ~ur~ ·
4. Commercial buildings, Industrial buildings, Multiple Resida~es and ~imilar ~ildinas and install~
5. Submit Planning Board approval el completed site plan requirements where applicable.
B. For existing building~ lprior'io April ig57), Non-conforming u~s, or buildings and "pre-existing"
land u~:
1. Accurate ~eV of peope~y ~howing all property lines, ~raets, buildings and unu~al neural or
topographic features. . '
2. Sworn s[asamen[ of owner or previouS, owner as ~o u~, occupancy and condition of building~ ,
3. Dale of any housing code or ~feW in~[ion of buildings or premix% or other pu~inun[ informa-
tion required [o prepare a oa~ificasa. "-
C. Fees:'
1. Certificate of occupancy , $5.00. '. /
2. Certificate of ,.occupancy on pre-existing dwelling / land usa
.. 3. Copy of carijfmate of occupancy . $1.00 . /
--P~e-Exia:ing C.O. $15.00
Vacan: land C.O. $ 5.00
Date September 16, 1986
New Building Old or Pre-existing Building ¥~ Vacant Land
Locationof P~opany ' Calves Neck Road Southold
., ,,.~ Hou~ Nh Strut Hamlet
Ownar or Owners of Pfope~y Estate of Viola C. Bartlett
CountyTax Map No. 1000 Section...............063 . Block ..... ~ Lot 023
Subdivision ' Filed Map No Lot No
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approve ' Planning Board Approval '
Request for Temporary Certificate ............... ' ......F~nal Certificate . .~.x. .................. ~2078
Fee Submitted $ 1.~ Q.0 ·
WILLIAM H. PRICE, JR., ESQ.
ri,w, t0'sa. Ta
S-9
SUFFOLK COUNTY DEPARTMENT OF HEALTH
Date , 10/8/6~ ,
Building Permit No. Z2105
TO WHOM IT MAY CONCERN:
The sewage disposal facilities for a structure located at
Neck Road, So?hold
Calv?s, ,, (Give deed location)
have been inspected by this Department and found to be satisfactory.
District Engineer
District Engineer
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. ¥.
Exa mined ..ii,,~ .......... ~,-Z '~] 19.. !~
Approved ....... ~ ................................ , 19 ........ Permit No .................................
Disapproved a/c ....... >,~.~.. ........... : ....... } ............ ~.y~...~.~ · ...........
............. '...
..... ...... . ........................................
-- (Building Inspector)
Application No .............................
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application equst be completely filled in by typewriter or Jn ink and submitted in duplicate to the Building
Inspector.
b. Plot plan showing location of lot and o~ buildings on premises, relationship to adjoining premises or public streets or
areas, and giving o detailed description of layout of property must be drawn on the diagram which is part of this application.
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 pa rt for any purpose whatever until a Certificate of Occupancy
shall have been g~anted by the Building Inspector.
APPLICATION 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 a'lterations, or for removal or demolition, as herein described.
The applicant agrees to comply with ail applicable laws, ordinances and regulations.
NEW ENGLAND HOMES,INa.
.......... .........
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
........................................................................ ...........................................................................................................
Name of owner of premises William Ba~"blett ~
If applicant is o corporate, signature of duty authorized officer.
(Name and title of corporate officer)
1. Location o~ 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:
o. Existing use and occupancy ...................................................................................................................................
b. Intended use and occupancy ........... ..c~...e.~.]:~..t~ .............................. . ....
3. Nature of work (check which applicable): New Building ..... .~.. .......... Addition .................. Alteration ..............
Rep?ir .................... Removal .................... Demolition .................... Other Work (Describe) ........................
4. Estij'nated Cost .~.,..~...~ ............................................. Fee ......................................................................................
(to be paid on filing this application)
5. If dwelling, numbe~r*of dwelling umts .............................. Number of dwelling units on each floor ........................
If garage, number of cars one
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 .........................................................................................................
Dirr},'ensions of same structure with alterations or additions: Front ................................ Rear ............................
Dep[th ............................ Height ................................ Number of Stories ........................................
8. Dimensions of entire new construction: Front ................................ Rear 62 1 Depth ~[91
Height .....]~...I. ................... Number of Stories.....]'. ............................
9. Size of lot: Front 20~e2~! Rear ~'~01 Depth~0*3,~t ]~ & ]J~)*00! ~
10. Datb of Purchase Jttne *1~63 .. Name of Former Owner L.~t'r~n }{~.].'1 & &d~l~.l~e ]
11. Zode or use district in which premises are situated .....
12. Doe~s proposed construction violate any zoning law, ordinance or regulation?
William Bar%le%% --- ]7 W.Edsall ~lvd.
13. Name of Owner of premises ........................................ ^aaress~t..li~S..~...M~ ........ Phone:
Name of Architect ...................................................... Address ............................................ Phone No.
Name of Contractor .~..~....~..~.~:~..~...~..~...~.e.?......Address ~.?.~.~.~...~.~L~.~.~.~ Phone No.
PLOT DIAGRAM
Locatf clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr~
property lihes. Give street and block numbers or description according to deed, and show street names and indic
whether interior or corner lot.
~ ..... ! '
COUNTySTAT O ,oFNI S.S.
~-4~ being duly sworn, deposes and says that he is the applica t
(Name of individual signing application) / ,~ ~ , / ~
above nam'ed. He is the ..~E~~2.....~C~.~-~..~~..,~,. -- __ ...............
' (Contrac~r, agent, corporate officer, etc.)
of said owner or owners, and is duly ~r~z~ perform or have performed the said work and to make and {
this application; that all stotem~y~y~<~i~ ~r~pplication are true to the best of his knowledge and bell
and that the work will be perfor~J~~ in t~e application filed therewith.
Sworn to bbf~e me this COl~,~:,ss~0~, ~xp,res ~arc. , ~ ; ~ ~ ~ _ _ ~ ~ ~x
~ ~oyof ~ ,19 ~ ~~A~'>~
........... ,,....~, ~.~...~_.~.....~:~:_~_._, ~ ........ . ........ ~.. ...~,..~.: ....... ,....~.,~
,o ory .....................