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Home My WebLink About2201-zFOI~M NO. 4 TOWN OFSOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ...~/.~..~f~.~Q~...]~...,~.~ ................... Street Map No. ~ ............ Block No .......... .~...'~... ...... Lot No...~ ........ .~..~.~i~.~.~..L..~.?..¥.t. ............... conforms substantially to the Applic6tion for Building Permit heretofore filed in this office dated ............................................ .1~..~.~.......~ ....... , 19.~]... pursuant to which Building Permit No....~;~,0.~..~.. dated ............................ C~.~. ....... ~ ........... , 19..~.., 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 ........ ...... ~.~.v..~.C...e.....q~.~....C.~...~,l~....~..z..~ ........................................................................................... The certificate is issued to ...~.~..O..~...~'~.'~ ................................... ~/'D..e.~' ........................................ (owner, lessee or tena:nt) of the aforesaid building. H,D. Approval June 11, 196~ by R.Villa ............. Building Inspector FORM 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? 2201, Z Permission is hereby granted to: Edw..... Ab~t~.... A~.C.....Audr. e~... Abi.tz .............. .................. ~i~k ........................................ to ...... ]~ul~d.. ne.~., one...£amil~...d~el&t~.: .............................................................................. at premises located at ,..,..~.~,~O~[G.,.]~'..-/~.~ ................................................................................. ................................................... ~t,t~t,i+.~ ....................................................................................... pursuant to cpplicotion dated ......................... 0~; ......... ,1. .................... I91~.~..., and approved by the Building Inspector SUFFOLK COUNTY DEPARTMENT OF HEALTH Date june 11, 1962 Building Permit No. TO WHOM IT MkY CONCERN: The sewage disposal facilities for a structure located at 300' west Bay View Aven/s Peconic Bay Blvd.~ Mattiteck (Give deed lo~ation) 22012 have been inspected by this Department and found to be satisfactory. District Enginee~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, 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. Fi,nal 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. C, Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date . .O..c,t~o]~.e.~. ~.~J,~,. ~.9,~Q ,.. New Building ............. Old or Pre-existing Building ...X ........ Vacant:Land ............. Location of Property .......... PeC. G]3~¢. ~.~. ~].¥d...~..~a.~.~;.J,t,~t¢~ ~. ]~je.t,~ .¥O~, .......... Hou~ No. Street Hamlet Owner or Owners of Property ... DairtJ. e]L. ~,. $.t.e~;]3¢~¢..&. Hia~.J,J,¥rt .Le¢7-¢~,3]¢ ............... County Tax Map No. 1000 Section . ,],z[400. ....... Block ... 0.~Q0 ....... Lot. 0,[.~..Q00 ........ 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 $.. ~L...O.0 ...................... Construction on above described building and permit meets all applicable cp.,des and regulations. Applicant ....... .~~~~. ~-,~ ........... Rev, 10-10-7a BERNARD BRAUN, P.C. ,ATTORNEY AT 4AW 6080 JERICHO 11JRNIR~¢25 COMMACK, NEW YORK I FOI~,M NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined /~?./.I , 19 Application No.....C~...~....~.. ,~'... APPLICATION FOR BUILDING PERMIT Dote ............. 0~:.'b G'b e.~.....~. ................... , 19.63 .......... 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 Iodation of lot and of buildings on p remises, 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 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 gronted 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 alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) ........... ~t¢&t~aek. ................................................................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................... ~o~t~.~o.%o~ ....................................................................................................................................... Name of owner of premises ..~'t~'~r~'......~'b~.t~: .................................................................................................................... If applicant is a corporate, sign'ature of duly authorized officer. (Name and title df corporate officer) Location of land on.~vhl.ch proposed work will be done. Map No: ....... ~ ............................ Lot No: ...;XX~,~ ...... Street and Numbe.r ......... Pe'eonte.'"B~7"B[Lv~l ....... ............................................................................. State existing usg and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use,,and occupancy .......... .vaoa~'l~.-.~.o% ............................................................................................... b. Intended us~!and occupancy ............. tln. o..~.~ll~:..l::t.w~'J.l..~lg .......................................... 3, Naiure of work (check which applicable): New Building .,]QF.3Q~ ...... Addition .................. Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ........ .14~O00..~./(.M ........................... Fee ..,.10. (to be paid on filing this application) 5. If dwelling, number of dwelling units .On~ ..................... Number of dwelling units on each floor If garage, number of cars .......................... 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. Dirr{ensions of entire new construction: Front...,..~ ..................... Rear ........ .60. ..............Depth ...... ~.)t'..~..~. ........ Height ............................Number of Stories ...... Om ..................... 9. Size of lot: Front ....... 3,00 .................. Rear ...........]..00 ..........Depth ..... ~3,~' ............................ 10. Date of Purchase ................. ~l¢)~.~ ............................. Name of Former Owner ..... B.e....l~i,J,,~ ................ 11, Zone or use district in which premises are situated ................... .1.1.~,1.~....~;].~ ............... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............. 140. 13. Name of Owner of premises ...... ,il,l~¢lZ'.e~...A'~i.~.....Address .......... ~.{~1,.~;~.'~ ............ Phone No. Name of Archit,ect ...................................................... Address ............................................ Phone No. Name of Contractor ........... ~(I,'b/.....~.~,~ .................Address ........... .]~....~..~.~.~.~...O..~.'. ........... Phone No. PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions fr property lines. Give street and block numbers or description according to deed, and show street names and indi whether interior or corner lot. STA'I"E OF, NEW YORK · ) COUNTY OF ...~.~['~3,.~ ....... ) S,S. ....................... :~C].~.~,.At)~ ................................................. being duly sworn, deposes and says that he is the applic (Na:me of individual signing application) above named. He is the ..,i...OO~;Z'.ft~l.~O~ ......................... (Contractor, agent, corporate officer, etc.) of said owner or owners, bnd is duly authorized to perform or have performed the said work and to make and ' this application; that all ~statemeo.t~c~fned in this application are true to the best of his knowledge and beli and that the work will be, per[6~t~}~ ~ner set forth in the application filed therewith. ............... Z ...... davof ........ ~ ................ ~.~r,..., 19..~3. ,~,~-~M/ - /~ ~ ') -,,/ ~:~,/ /~ ..... ~,.~CM..~4/~4.. ; .~ ............ Notary Public, .~.;~.,..~:(~(..~.~.....~.....~.J.~..~Lf.,v~.. C~t~/ ./ (Signature of ~lican~) '