The URL can be used to link to this page

Home My WebLink About2549-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy addition THIS CERTIFIES that the building ................................................ Location of Property .. 9.6 O ................. .Pg.q.u.a..s.h. Ay. 9.n.u.e. ............C..u.t.qh.o.g.u.e. House No. Street Hamlet County Tax Map No. 1000 Section .... ~.Q ~ .....Block ... ~.~. ......... Lot . ...0.0.7. .......... Subdivision ...... :~ ........................ Filed Map No...~ ...... Lot No...X. .......... conforms substantially to the Application for Building Permit heretofore fried in this office dated ..... Oc.t. Qber..8 ...... 196z3. pursuant to which Building Permit No .... 2.~ .6~..g....* ........ · dated ...... 9.c.'q.o.b..o.r.. 1..0 .......... 196. 6.., was issued, and conforms to ail of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... The certificate is issued to ... J. QH. I:l..S.... ?.AIq..A.T?.A. .............................. ~.. ..... (owner, of the aforesaid building. Suffolk County Department of Health Approval not. apl~.licable UNDERWRITERS CERTIFICATE NO ........... .N.6.3. ~ ~ 3r~ · Building Permit 2549Z was issued to Eugene Horton A/C C.A. Dalin. Building Inspector Rev. 1/81 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°. :3549 z Date ........... J~.~.t3~....~ ...................... , 19....~.. Permission is hereby granted to: ~a~mu~..t~c~..-~....C.A.~_~-S~ ................. ................ l~le.tt ~,tu~k .......................................... to ........ ~ld.. ~-. ~-.~,~.~.t ~n.. e~. an..ea~t~rk~..~e~ ....................... ct premises located at ..... .~,Jl~l~jlJ~..~J,%te~ ......................................................................................... ................................................... ~teheg~m~ ..... ~,.~, ...................................................................... pursuant to application dated ................................ t~:J~C:II~?.....J~ .... 19.~t~.., and approved by the Budding Inspector Fee $....~.?.,.0~....~ ....... 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. 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. Bo 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/ land use --['~-e-E×±s t,±ng C. 0. $15.00 3. Copy of certificate of occupancy $1.00 Yacant land C.0. $ 5.00 Date . .?L.-..r~,...Z).. fi. C~. ~..,~; ...... New Buildin .(~ ¢>.~.~3.:~ .~'..') Old or Pre-existing Building .~. ......... Vacant Land ............. Location ofProperty . ..~. ~ ..~. .............. . .-?~,;.,".~.~, .Ft.'.>).q.../~..d.¼~ ....... ,~U'~ N'o: steer ....... Owner or Owners of Property . .:.,.r,' lq. .~?,. ~ . .~.~.~..i3..'F~..~3 ................................. County Tax Map No. 1000 Section .... ~.?.q~, ...... Block ... [ ! .......... Lot...~ ............ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. ~--~.~ ~..~-Date of Permit I.ql~.tD. [,~).~t .Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Fee Submitted $ ............................. Construction on above described building and p~rmit meetsFIl applicable codes and regulations. ~-~JL ~ ~O ~ { ~-----------------,~,,D~ Applicant .. 7 .~?'.~7 ~. ~. 1~.~ Q, ~-, ~ ~ ¢~ ....................... , r7,5 ~ BUILDING DEPARTMENT TOWN OF SOUTHOLD, N. Y. Location HOUSING CODE INSPECTION REPORT (number & streW) (Municipalit3~ Subdivision .... Name of Owner(s) oocu~.cy ,,, /~- '/ ..... Key available Suffolk Co. Source of request ~,'~.~ //~.~-z~- Map No. Lo t (s) (owner-~nant) - Accompanied by: ~/t~ T~ No. /~,' ~.-/,/-'~/ D_WELLING: Type of construction ~o~dation Total rooms, let. F1 ~i" 2nd. F1~ 3rd. FI Bathroom(s) / Porch, type. Breezeway. Type Heat Fireplace(s Domestic hotwater Other Deck, typ~ Garage Warm Air No. Exits ~ - Toilet room(s) Patio, type_ .. Utility room Hotwater '~' Airconditioning Type heater ~-~7~/G/~ ACCESSORY STRUCTURES: Garage, type const. Swimming pool Other Storage, type const. Guest, type const. VIOLATIONS: Housing Code, Chapter 52 Location , Descri. ption Art. Sec. Inspected by: Date of Insp. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×am,ned ...... ............ , Approved ............................. ........ Perm,t No. %ZZ-- ............... ....... ................................. ~~h ~ APPLICATION FOR BUILDING PERMIT Applicotion No ..............l' ..... INSTRUCTIONS a. This application must be completely filled in ay y~w ' ' ink n duplicate to the Buildin. Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o areas, and giving a detailed description of layout of propertymust be drawn on the diagram which is port of this applicatior c. The work covered by this apphcation may not be commenced before ~ssuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. SucJ 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-N~,~gy purpose whatever until a Certificate of Occupanc~ shall have be.h~g~,,~4 by *~ ~,,~l~:-g ~ ......... : APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Budding Permit p~rsuant to th, Building Zon~ Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, ~rdinances o Regutahons, )r the construction of buildings, additions or alterations, or for removal or demolition, as her~in described The apphcon agrees to comply with ali applicable laws, ordman~s, budding code and regglahons, j ~ignature of appli~nt, or name, if a (Add~ of applicant) State whether hcant is owner, lessee, agent, architect, engineer, general contra~ tar, :~-~r builder Name of owner of premises ....... : ........ If applicant ~s a corporate, signature of duly authorized officer, (Nome and title of corporate officer) Location of land on whmh proposed work will be done. Map No' Street and Number ....~---~,,~r~-..~. ~ ,~- . ~ -~n~c~Dah~ ' 5tare ex~sting use and occupancy of p~?mises and inte_j:kded use and occul~ncy of proposed construction: b, Intended use and occupancy ..................... ,~,,.~..~,.,, .......................... ~ .............................................. 3 Nature of work (check which applicable). New Building .................. Addition ~ Alteration Repair .................... Removal .................... Demolition .................... Other Work (Describe) ..................................... 4. Estimated Cost ............................................................ Fee ......................................................................................... (to be prod on filing this application) .5. If dwelhng, number of dwelling units ............................ 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. D,mensions of existing structures, if any: Front ...... ,~:~2 .......... Re¢Ir ..... ............ Depth .....~....~.. ................ Height ...... ~...~ ............... Number of Stories ....... /. ........................................................................ ~...~ ...................... Dimensions of same structure with alterations or additions: Front ...... ~..~.'. ................. Rear ............................... /...5. Depth ..~..~... ................... Height ....... ............... Number of Stories .... ./. ................................. 8 Dimensions--of entire new construction: Front ........... .]...~... ......... Rear .......... .]...~.. ........... Depth .../....~... .............. Height ........... /..~"~. .......... 'Number of Stories ..... ./. .................... 9. S,ze of lot: Front ........... ~..:~..~.. ........ Rear .......... .~..,~..~.. ........ Depth ..... 10. Date of Purchase ........................................................ Name of Former Owner .~..~....~....~-~'T~~ 11. Zone or use district in which premises are situated ............................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation:~ ............ ..~...~?. ............................ 13. Name of Owner of premi,ses .~..~..~...: ....... ..... Address ...t.~~ ....... Phone No ................... Name of Architect ...................................................... Address ............................................ Phone No ................... Nome of Contractor ~..~.~....~r:~_~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 ind~cal whether interior or corner lot. ................... ~....~.:.....~ ...................... being duly sworn, deposes and says that he is the applic above named. He is the .................~wr~._..~n~r.-. ...................... ~..~.~ ............................................................................ (Co c r, agent, corporate officer, etc.) of sold owner or owners, and is duly authorized to perform or hove performed the smd work and to make and th~s application; that oil statements contained in this application are true to the best of his knowledge and bel and that the work w~ll be performed in the manner set forth in the application filed therewith. Sworn to before me this ~ .................. ,---- .................. ......... .............. Notary Public~..',~..,...~~/~_ Z7~0~ (~,gnature of applicant) ~ ~o~rv ruhl% ~ate of New York I',o : ' ~3449~3, Suffolk County