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Home My WebLink About2350-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-17663 Date JANUARY 9, 1989 THIS CERTIFIES that the buildin~ ONE F~2~ILY DWELLING Location of Property 250 WILLIAMSBURG DRIVE SOUTHOLD, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 78 Block 5 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 14, 1964 pursuant to which Building Permit No. 2350-Z dated APRIL 14, 1964 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 ONE FAMILY DWELLING *THIS UPDATED CO Z-3257 DATED 9/6/68. The certificate is issued to of the aforesaid building. BDB PROPERTIES (owner) XXX~ SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL AUGUST 27, 1968-R. Villa UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED Bull~' ng Inspector Rev. 1/81 FOI~M NO. 4 TOWN OF $OUTHO~..D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, bi. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at .?.~...~..~.t.~.;.~.~i.'....~ ./.~..~§ .~.'..~.~.~.....l.~..O..~..~..... Street Map No.~..e...~..~...O.~.... Block No. :Y~ ................. Lot No. ~ .......... ~o.t,t.~o,],(:], .................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............................ ..A.D.~..~,,1, .......... ."t.~. ........... , 19¢~..~..... pursuant to which Building Permit No..2.;~.~.~. .... doted ........................... ~,~EI,.....~.I+....., 19...~.1~, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ...... ~.~ ~..v.~ ~.,e....o..n..~... f....e.~.$ ~. y... ~e..Z. ~.$.v. ~ ........................................................................................ The certificate is issued to ...~.O..~.~....~..O.~;E~$c~.~9. .................... ~.~¥~.~.~. ........................................... (owner, lessee or tenant) of the aforesaiid building. ~'i,D,~]p~Z'OV~I. /Yum, 27 1968 by P~. Y~L~ Building Inspector FORM NO. 2 TOWN OF $OuTHOL. BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. lluILoING PERMIT .(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 2350 Per,mission is hereby granted to: purs~aht to al~plicatian dated , ................... ,......,~,p;D~,~..:..~L~.-.,:... ..... 19~..., :and approved by the Building Inspector Fee $~.~ ~.~.~ .......... .... ;~.*). ....... ;...: ........................ ....:l ............... , BUilding Inspector TOWN OF SOUTHOLD ~a~'~ Building Depar~ent ~: [~[ Town Hall ~ Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF O~CUPANCY Instructions ,,. A. This application must be filled in ~pewriter OR ink, and submi~ed ~ ~ to the Building In~ec- tor with the following; for new buildings or new u~: 1. Final ~ey of properW with accurate location of all buildings, prope~y lines, ~reets, and unumal natural or topographic fea~res. 2.Final approval of Health Dept. of water mpply and sewerage disposal--(S-9 form or equal). 3.Approval of e~ectrical installation from Board of Fire Unde~riters. 4. Commercial buildings, Indu~rial buildings, Multipte Residences and similar buildings and in~alla- tions, a certificate of Code compliance from the Archit~t 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), Nonconforming u~s, or buildings and "pr~exi~ing" land u~s: 1. Accurate ~ey of p~pe~y showing all proper~ lines, ~ree~s, buildings and unumal na~ral 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 safe~ inspection of buildings or premiss, or other pe~inent informa- tion required to prepare a ce~ificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 ]. Ce~if[cate of occupancy New Dwelling $25.00, Access6ry ,$10.00 Business $50.00 2. Ce~ificate of occupancy on pre-existing dwelling ~ I00. O0 - 3. Copy of certificate of occup~ncy $ 5 00, over 5 years $]0.00 / 4.Vacant Land ~_0,~- $_.~.Q~ ,` /,/ /~ ~pd~ '~ $$ 50.00 ~ . Date .... /.~J!~/.Uo ........... ... NewC°nstructi°n . . OIdo[Pre-exstngBuilding .~ ...... Vacant Land . l, '. -_ " ' .... ..... ....ocatonofPro' perWQ~0~ ......... __'.~~ ........... ~~... Owner or Owners of Properw ... ~. ~. ~~~ ..... - .......... ] ............. SuDd~ision ........................ File0 ~a0 ~o ........... Cot ~o Permit ~o.. ~a'. ~.~-.. ~ate of Permit .......... ~001icant ................ Health De0t. Ao~roval ........................ labor Dept. Ap0roval ........................ Hnde~dters A~proval ........................ Plannin~ goard ApCroval ...................... ~equest for Tem~orarg Certificate ..................... Final Certificate ~. ................... ,.. ................ Construction on above described building and pgx-~nit meets all applicable cod~.es and regulations. ^pp.cant / g' Rev, 10-10.7a S-9 SCHD SUFFOLK COUNTY DEPARTMENT Date Bldg. CONCERN: The sewage disposal facilities for a structure located (Give deed location) have been inspected by this department and found to be satisfactory. Dis'~r~ ot k~C~r District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ I 19 ........Permit No ............................... Application No. Disapproved a/c ........................................................... ......................... .................................... (Building Insp~:tor) 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 propertymust 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 part 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 o 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, building code and regulations. ~/(Signature of applicant, or name, if a corporation) ......... ......................... (Add?ess of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .............. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Locat on of land on which proposed work will be done. Map No~ ~,.:.D.:~: ........ Lot No.. ....... Street and Number ~...~..~.~..: ~. ~~~.~ .,~ Z ~~... ,.,~ ~ ~)~ U'd~/,~,~, b~x~[ ~,¢ Munlclpahty 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy .......................... :.~...C~...~.....~ .............................................................. 3. Nature of work (check which applicable): New Building ...,( ............. Addition .................. Alteration .............. Repbir .................... Removal ... ................. Demolition .................... Other Work (Describe) .................................. 4. Estimated Cost ............ }...; ................ Fee ...I..~...X~ ...................................................................... , (to be pa~d on fihng th~s' opphcabon) 5. If dwelling, 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. Dimensions of existing structures, if any: Front .......................... Rear .......................... Depth ........................ Height ............................ Number of Stories ........................................................................................................... Dimensions of same structure with alterations or aad't'ons: Front ................................ Rear ............................ Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ...~y.~ ............... Rear .,~..~ .................. Depth ..~ ............. Height ......... ~.~ ............. Number of Stories ..... ~ ........... 9. Size of lot: Front ..... /.~.J ................ Rear ..... /.6J ............ ..~ Depth ../..~.~ ................... 10. Dee of Purchase ..... .~'...~.,t:~.~ .................... Name of Former ~ner ....~. ~~. ~1. ~one or ~se d~strict in w~ic~ premises ore sit~te~ ........... ~.....~ ........................................................... 12. Does proposed construction violate any zoning law, ordinance,,,°r reg~ation? ,.~ ...................................... 13. Name of Owner of p~s ~~.~Address~>~.~ ....................... Phone No ............... . Name of Architect .................. Address ~ .............. ~hone No ................ Name of Contractor ...... ~.'. ................................... Phone No ................ .................................................... Address ' PLOT DIAG~M L.oc~t& dearly and distinctly alt buildings, whether existing or proposed, and indicate all set-back dimensions fr, property 10es. Give street and block numbers or description according to deed, and show street names and india whether interior ar corner [ , STATE OF NEW y~/ .... ~...~~ bein~ duly sworn, deposes ~nd s~ys that he is the opplicc ................ ~'~'~"individu~l si~ni~o ~opplicatlon) ~bove named. Ho is the or, ooont, corporoto officor, otc.) of said owner or owners ond is duly ~uthorizod to perform or h~ve performed the soid work ond to m~ke ~nd this ,pplic~tion~ thor * statements contoinod in this application *re true to tho best o{ his knowlod~o ond ond thor the work will be performed in tho m~nner set forth in the opplic~t~o~ filed therowith. Sworn to b~fo this 19~... Notary Public, JUOtTU (Sig ,licant) Fotary Puhhc, State of New Y~