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Home My WebLink About2548-zFOKM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .... ~.J~....~(~:~ehehe,..J~li'cl ...................... Street Map No ......... ~ ........ Block No. ~ ................ Lot No ..... ~ ...... .l~.g.l~l~ ................................. conforms substanhally to the Apphcahon for Building Permit heretofore filed ~n th~s office doted ....................................... · ~G.~.QbJ~'~ .... 9..., 19...~. pursuant to which Bu,lding Permit No...;~.~.. dated ............................. 0a.~;obe[,.....'l O, 19.. (~t., was ~ssued, and conforms to all of the requirements of the apphcable provisions of the law. The occupancy for whmh thzs cerhficate is issued ~s ........ ........ [~i.v.~te.. ~r~..~am~l.~..~.~e3bl~r~ ...................................................................................... The certificate is issued to .... l]~t(~.~e..jl'~tib;~...&. ~;J,£e .......... o~10,e~.ll .......................................... (owner, lessee or tenant) of the aforesaid building H.D.apprOVeA September 8~ ]J96~ by R. Villa Building Inspector FORI~I NO. ~ 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? 2548 z Permission is hereby granted to: ........... G~r~:a..r~.~ ........................................ ... ~9..... ~hor. e .. Ro~d ........................................ ............... · ~.,L~.e~....~,,L ............................ to ....... ]h~Jl~..~e~..aa,..~'aa;t,I~..~e3,:Z~a~[ ............................................................................... at premises located at ..... ~l~...~~L.~.l[.~ .............................................................................. pursuant to application dated ...................................... ~.]~...~ 19...~, end approved by the Building Inspector Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- [802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of properW 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. 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 properW 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: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.Q0, Accessory ,$~0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling ~ IO~_.Q.-O0 3. Copy of certificate of occupancy $ 5.0 0,~5._2Le ~ r ~ $10-~ '7 ~ver 4. Vacant Land C.O. $ 20.00 5. Updated C. O. $ 50.00 Date ......................../..c~f/~..~..?. NewC°nstruc%ion ...... Old or Pre-existing BuHding .~...~.: .... Vacant [and ............. Location of Property,. / q ~} ~ 'No' " Owner or Owners of Property' ~.; .~ .... C~...~ ...... ~ .......... · --~ ,-I County Tax Map No. 1000 Section ..... .~/.'] ..... Block ..... ~'. ...... Lot... ~ ...... Subdivimon ................................. Filed Map No ....... ~.._~L-ot No .............. Perm,t No. ~..¥.~...~:).. Date of Permit ./.~./¢~..-2..Applicant .... ~....~.. ~ ........... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate v/ Fee Submitted $ .... /..~.....~.. ............... Construction on above described building and Applicant Rev 10-10-78 SUFFOLK CODI~F/ DEPARTMENT OF N~,~LT~ Eldg. Permi% No. TO WHOM IT MAY CO~Ib~EI~N: The sewage disposal facilities for a structure located at ..... / ~/ ~ ~? (G~ve deed loc~tion) ~ ' ' - ' have been inspected by this Department amd found to ~e satisfactory. District Engineer FOruM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ~ t D 19..~...~ Approved ........................................ , 19 ........ Permit No ................................. D~sapp roved a/c ................................................................................ APPLICATION FOR BUILDING PERMIT Application No. ~"~'~z~/cF'~' INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets r areas, and gwing a detailed description of layout of propertymust be drawn on the diagram which is part of this opplicatior c. The work covered by this application may not be commenced before ~ssuance of Building Permit. d. Upon approval of this application, the Building Inspector w~ll issue a Building Permit to the applicant. Suc permit shah 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 ~or any purpose whatever until a Certificate of Occupant shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bbdding Permit pursuant to t} Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances , Regulations, for the construction of buildings, addmons or alterations, or for removal or demolition, as herein describe, The apphcant agrees to comply with all applicable laws, ordinances, building code and regulations. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build. Name of owner of premises .~.'.~..~-.9.~.~.e..~F..]r..t~.''z''..'.~'.~...~...r.~..~....%~..~.~.....~'~..~'.~ ..................................................................... If applicant is a corporate, signature of duly outhorized officer, (Name and title of corporate officeH 1. Location of land on which proposed work will be done. Map No,~ ......... ~....... ..................... Lot No: .~.... Street and Number see lilotr, ~lan - other mi(la ....................................................... L '~ ............ : ........ /" ''¢' ~':" ~' '~ ' '~'':'~r' ' ' '¥' ''r~'~--u-~'~'~' ' ''~' ' '''c ' '~r' ' ' ''~' ...... ~. ....... /v~unicipality 2. State ex~shng use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~o~e b. Intended use and occupancy .... 9..~..e.,..~..]-.~.~....°..~..e..,.l..~..°...z~.....z~..~,~.~.e..~.~.e. ........................................................ 3. Nature of work (check which applicable). New Budding .X .............. Addmon .................. Alteration ................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................................... $1o, o00. OO 4. Estimated Cost ............................................................ Fee ........................................................................................ (to be paid on fihng this application) 5. If dwelhng, number of dwelling units ..~a~e. ................... Number of dwelling units on each floor .......................... If garage, number of cars one c~r-c~'Dort 6 If business, commercial or mixed occupancy, specify nature and extent of each type of use .............................. 7. D~mens~ons of exmting structures, if any: Front ..........................Reczr .......................... Depth .......................... Hmght ............................ Number of Stories ............................................................................................................. D~mens~ons of same structure with alterations or additions: Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construchon: Front b~.feet, Rear b,~ feet De-th ~ feet, Height ........ .]..~...~.~.e..¢.. ..... Number of Stories ?.n.~ ....................... S,ze at ~nt 62 feet, r~_ 61 feet, _ _ ~vera. ge 98 feet 9. of ............................. ~.:.. p~uar ............................ L)epTn ................................ . ..... Oct. 10, 1964 ..... Edw&r~ and Sandrm Bagens~ ]0 uaTe at ~urcnose ........................................................ Name at former ~wner ...................................................... 1 1. Zone or use dtstnct m which premtses are situated reatdeJtial 12. Does proposed construction violate any zomng law, ordmancel~ ~gu~ation~ no 3 ~more R6aA ................................................... George Fluhr ~,, 13 Name of Owner of prem,ses ....................::~:~ ............... ^aaress ..~lXaox~e.,..He.~...Ig. rk .....Phone No.~....~.'..]:.O.~.~... Name of Architect ...................................................... Address ............................................ Phone No ................... Name of Contractor .................................................... Address ............................................ Phone No .................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro property hnes. Give street and block numbers or description according to deed, and show street names and in&ca whether interior or corner lot. STATE OF NEW YORK, S.S. COUNTY OF (,..,~,~,r~..~r,~.....~ Mr. Geerge FluOr ................................................................................................. being duly sworn, deposes and says that he is the appHc. (Name of in&vidual signing apphcation) above r;amed. He ~s the owmer (Contractor, agent, corporate officer, etc.) of said owner or owners, and ~s duly authorized to perform or have performed the said work and to make and this application, that all statements contained in this application are true to the best of his knowledge and bel and that the work wdl be performed in the manner set forth ig the application filed therewith. Sworn to before me this - .............. .... ...... ................. .,., ....... Z / ........... County .... app,cant ,~ LIC State o~ ; ............... "~C1"~'~"'"7~'~ .................. No 41-5429'435 - Queen,~ C/o~nt~XI?TARY PUBLIC, State of New York .' (;;l~rtW~cate filed m Noss~..o.u,n.ty~No. _41-5429435 - Queens Count~ \