The URL can be used to link to this page

Home My WebLink About2283-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPAI~TMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20779 Date JUNE 9, 1992 THIS CERTIFIES that the building. NEW DWELLING Location of Property 855 GAGENS LANDING RD. SOUTHOLD~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 70 Block 10 Lot 31 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 18~ 1964 pursuant to which Building Permit No. 2283-Z dated JANUARY 18, 1964 was issued, and conforms to all of the recfuirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWRLLfNG WITH ATTACHED GARAGE The certificate is issued to (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED GEORGE V. & ELIZABETH M. DICKERSON N/A N-436535 - MAY 12~ 1965 N/A ' / B~ding Inspector Rev. 1/81 FOI~M NO, 4 TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. TEF/P01~AI~' CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located atGEt~J~..J~E/Jtl~t.~rl,~.,ROiJ.~....l~.~.~.tr~.q.~..~.... Stre'et Map No ...... ~ ......... Block No .....~Z~D~ ........ Lot No ........ conforms substantially to the Application for Building Permit heretofore filed in this office dat~ed dated ......................... :~r~irll,l.~...,~.l~ ...... , 1~.. 6...4..., was issued, and conforms to all of the requiremer~ts of the applicable provisions of the law. The occupancy for which this certificate is issued is .,..i.!~ The certificate is issued to ................. .~Jf~.Q~C~,,,D,~C,].J;,~,~,Qrt (owner, lessee or tena.t) of the aforesaid building. Budding Inspectc 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) No. 2283 Z Permission is herel~y granted to: -!~.ge.,~.,. Itt.eke~ .............. : ................ ......... .....8~h0;3~,....., ................... ,...,, ............. pursuant to 'application dated .............. t.,...;:;~.....~.~...i~...~.., 19.~., arid 'approyed by the Building Inspector - 'BbiJding Inspector f /~,~ '-._'/~ld' For~ No. 6 ~C~ TO~ 0~ $OUTHO~D BUILDING DEPARTMENT TOWN HALL 765-1g02 t · APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building 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 from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6, Sobmit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9 1957) non-conforming uses or buildings and pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. ~ Fees i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swinging pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2.Certificate of Occupancy on Pre-existing Building - $100.00 3.Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4.Updated Certificate of Occupancy - $50.00 5.Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date .. ~J .~.~ -~ ~ ~ew Construction ........... Old Or Pre-existing Building..~~'~y~ ,ocation of Property ...... e~ House No. Street Hamlet nwer or Owners of Property ............ ~ ~ , ounty Tax Map No 1000, Section .......... Block ............ Lot ................... ]bdivision ........... i ................... Filed Map ........... Lot . ...................... ,,~, ~o,~~, ~ ...... p~, ............................. ~alth Dept. Approval .... ~ ............... Underwriters royal ......................... · - App arming Board Approval ...... ~. .. quest for: Temporary Certificate.~ ...... Final Certicata ........... ~' ~°S/ . s ..... ' m ......... ~0 E4011 ~ v ~c~ ........... ............. ~ ........ BUREAU OF ELECTRICITY- .... t.:.- ...... ~ ......... , .............. ............. ~ ..... , ..... ,--~ ~ ................ 85 JOHN STREET .,. ................ :~, . '. ........ . NEW- YORK,- NEW YORK 1~38~,.:~ ..... ~ ......: .... :.,,, ~ ; .......... Date May 12, 1965 . " ApplicationNo.:7; .... ~I[~[~fl,That ~he Eleclrlc Equi~ent ~ :' ~ ' ' ":; as.described below and Donald E.' Tuthill ~ in premises o{ .~;Oeor~e Dickerson .... toot o[ ~o :'~'e/s:'~gons ' Banding ........... ........................ ~.~ ........... Southold HEATING APPARATUS --g--~-- _anw.r ....... ; .... -- ' 1-~.8kw dryer ~;':~'~' :; ~:' ~ 1-1.2kw dishwasher ' 2-150W.inc~:: 7~[,h' , ,. 1-12.5kw range Service,~l. phase 2~2'& .l~g.: 1-100~p.~C.B, -~- :: , . ;, - ~;. , and.ou~dlobe2nc~,..pliance ~t.¢l,.e.equir~,i~n,~oy.,sisBoar~as o/ this date. t 'i 8. 87' 58 IO"W. I+0.0 AV~. .'GEOi~GE. V. ~ ELI ZABETH AT SOUTH'OLD M. DICKE~$ON TOWN OF $OUTMOLO . N.~<. 4,. Ir'~t p~p~ C~, as sorv~ed June VAN TUYL I SON FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .........~......C~..~ .t...~., 19...~....~. Approved ................ ~' ................ t.:,......, 19.....!'..Permit No...~......~.....~.....~......~..... Disapproved a/c ........ Appl ca.on .......... APPLICATION FOR BUILDING PERMIT 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 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 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 granted 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. · G.e.o ~g.e.. Diaka~.a~ ................................................. (Signature of applicant, or name, if a corporation) S OtZtb-al~L ~ N, Z .......................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner Name of owner of premises ...... G.aor~e...Dicker.aon If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work wilt be done. Map No: ....).~Q~.?~(..~. .......................... Lot No: .....~.'~ ....... Street and Number ...g. ag.e.~..~a~&n~...~a,~,,.....~.a~t~al~..z.,~ ................................................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy 0~ proposed construction: a. Existing use and occupancy ..... .~'aaan.t...!anc] .................................................................................................... b. Intended use and occupancy ........ .o. kq, g....~f~Rl$~y_..d.W. Ctl,li~.g ........................................................................... 3. Nature of work (check which applicable): New Building ...~f~/~/,~... Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ....'1.9.~.0.0.0..~./..~[ ............................... Fee ...],.C},.0.0 ........................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... QD.~ .................. Number of dwelling units on each floor ............................ If garage, number of cars .........o,~.e .............................................................................................................................. 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. Dimensions of entire new construction: Front.....6~ ....................... Rear .......... 6,R .............. Depth ....... ~.~./....~, ...... Height ............................ Number of Stones.....g,~. ........................ 9. Size of lot: Front ...~.0 ...................... Rear ....... ~L.0. ............. Depth .~-..bc.0. ............................... 10~ Date of Purchase .................. .~..~ ............................ Name of Former Owner ........ ..g..~..~.?.~..~.~ .......................... 11. Zone or use district in which premises are situated ................ ~.~..~..~.~...~.~.S..~ .............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ........... ..~..O. ...................................... 13. Name of Owner of premises ~.e...o....g...J:..c..~?~.~..o..t? ......... Address ........... :.~..o...~.~.~...o..];...~. ............. Phone No ..................... Name of Architect ..]~.,...~,~.¢.W.O.~]...~...,~,~q ........... Address ......... ~M..¢.T.~,I~.~ ............. Phone No ..................... Name of Contractor ~a'l.~,2t~J-.~.b-..~.q],~..~ ~,~C4Jdress ....... ~.9.~,~]),f?.~.(;], .................. 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 lot. STATE OF NEW ~ORK, ) COUNTY OF ....~[~ ....... ) S.S. Geo gickerson ........ ..... ....................................................................................... being duly sworn, deposes and Says that he is the applicant (Name of individual signing application) above named. He is the ......... (Contractor, agent, corporate officer, etc.) of said 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 JhL~.,~plication are true to the best of his knowledge and belief; and that the work will be performed in_the ~e~in the application filed therewith. Sworn to before me this ................ ~.... day, of .................. .~.~,~ .......... , 19...~ff. /I