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Home My WebLink About2386-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No Z-22818 Date DECEMBER 28~ 1993 THIS CERTIFIES that the building. DWELLING Location of Propert~ 1370 PRIVATE RD. ~9 SOUTHOLD~ N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 87 Block 1 Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 24~ 1964 pursuant to which Building Permit No. 2386-Z dated MAY 8~ 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 WITH ATTACHED ONE CAR GARAGE The certificate is issued to ALAN HORNE (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMBNT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED NOTE: THIS UPDATES CO Z-2046 DATED NOV. 23, Building Inspector NOV. 23, 1964-R. VILLA N/A 1964. Rev. 1/81 FOI~M 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) . Ne 2386 Z Date ............... , ................. l~' ....... ~ .......... , 19(~1~... Permission is hereby gronted to: F,a~.e..~u~.Coam.t~..¢~.J~¢.....;~im~jr..l;~Fa~i& & Wife ......... 161.....~r~..Ave ..................................... .................... ~,l~r~oa,...~,.Z, ............................ to .~.~[;[A. · ae.~,, e~.e · .~'ma.i.:~ ~-. · .d,~e t.~- ~g ............................................................... ~i .................... et premises Iocoted at ..... ~,.O,~.....O~'~...~/~.....~tt~r~...[,]a.~i~l~,..~O~ ........................................ ......................................................... Soat, bo-l~t ~..... g~..Y.~- ..................................................................... ....... Aeees · ..a~p~ed...bg...B~A~te...a~b.~e.~-. ~o.- g~a~ Sag.-.amd--brus~ ..¢~ea~ing ete pursuant to application dated ............................. ~....~ .......... 19.6~,.., and approved by the Building Inspector Fee $'10,00' .......... FOI~M NO. 4 TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...;~..201+6 ........... Date ................................. THIS CERTIFIES that the building located at .~t.~....~.,.O.,.W.~...O.~..~.~...~,,/~.....~ott¢.h..~az,~j3~-etRoad Map No ..... ]~¢~.d ......... Block No .......... ~ ........Lot No. ,3t~ .......... ~)t%$~ot~.~......~T.,.~.~ ................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...................................... ~i~.oh. ....... 2¥.., 19..6.~.. pursuant to which Building Permit No ..... -~.,~8~..~ dated ............................... }~r .......... ~. ...... 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 ........ P. ~-.tv~;e.. erie..~.e~.t.ty...~1 ,~J ~..t .i~l~. ................................................................ : ............................... The certificate is issued to .~z'...&~..J~.s.....~'.~t..~e~a~'..~.e, ................ .0w~'le~.s ............................. (owner, lessee or ter~.nt) of the aforesaid building. H.D.aPproYa1 Nov. 23, 196~ by R. Villa ....... ~.~,L.~,.~,~...~ ( ' Building Inspector Form No. 6 TOWN OF SOUTtlOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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. Submit 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 o~ 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. i. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming 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 /..~-~..~ .~. ~.~Z ................ New Construction ........... Old Or Pre-existing BuiiJlng..i..~.. ...... i.. ' '' ' Location of Property .......... House No. Street Hamlet 0nwer or Owners of Property...~).~.....~f~.~.. . . ......... . . County Tax Map No 1000, Section..~...~.~. .... Block ....... /. ........ Lot .... ./..~. .............. Subdivision .................................... Filed Map ........ · . · .Lot.. Permit No, .~..%~.¥.~..~...?~.?~a ~e~e Of Permit. ~./..~.~.~.~....Applicant ii..~.?~.~..~.~.? Health Dept. Approval .......................... Underwriters Approval ......................... Planning ~oard Approval ........................ Request for: Temporary Certificate ........... Final Certicate ........... ?ce Submitted: $ ............................. / q 03 s-9 SUFFOLK COUNTY DEPARTMENT OF HEALTH Building Permit TO WHOM IT I~Y CONCERN: The sewage disposal facilities for a structure located at (G~ve deed locati°n) ....... have been inspected by this Department and found to be satisfactory. NOV g ~ 19641 District Engineer TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved .....~..~..~......~.... '.,A~:~'... .............. , lC)~/...~...Perm,t No. :'.~...' .......................... Disapproved a/c ..'~...~....C~:...q...~.....~......?..~....q:~...~ ........ ........ ....................................................... 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 adioining premises or public streets or ureas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this applicution. c. The work covered by this application muy not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue o 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 constructisn of buildings, additions or alterations, or for removal or demolition, es herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ............................. (Signature of applicant, or name, if a corporation) · ........................ (Address 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. Location of land on which proposed work will be done. Map No: .................. ~ ................ Lot No: .....~ ..... Street and Number ..~.~.~...]~..~.~A/~*....~.~.~]~Z~q.~.~.~.g~.~..~:/~'..~.~~~.q.a.~...~.~ ........................... Municipality 2. State existing use and occupancy of premises end intended use and occupancy of proposed construction: a. Existing use and occupancy vaaan~ ~land b. Intended use and occupancy ....../:...~..t?.~..~..~.. ......................................................................................................... 3. Nature of work (check which New Building b-~ Addition Alteration RelSair .................... Removal .................... Demolition .................... Other Work (Describe) ........................ 4. Estimated Cost ...~.~/..~?...~..,.m:q. ............................... Fee ....~,0,00 ..................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .............. J.'. ............. Number of dwelling units on each floor ........................ ~ If g~rage, 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 ............................ Numbe~ of Stories ....................................... . ............... : .................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ............................ Depth ............................ Height ................................ Number of Stories ........................................ 8.. Dimensions of entire new construction: Front ....... .~..~2 .................. Rear ......~...~2. ................. Depth ...'..Z.~...~. ............... Height ......... /..~..~C... .......... Number of Stories ........... ./. ..................... 9. Size of lot: Front ........ ,Z:...~.. ............... Rear ....7...~.?. ................. Depth ...,.J..~'.z~... .......................... 10. Date of Purchase ................ J].e~t, em~e~......?l.~6~.... Name of Former Owner ......... ]~,t,/~l,rd...F~rd ............... 11. Zone or use district in which premises are situated ..................... !!~,~..~,~t, .................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation~ 13. Name of Owner of premises/~,/~.~.¢/~.~.~'...~.~.'/~..~.~,~/'t...Address .../.~.Zz.~.~/.~.(:.~~ '~ ............... Phone No ................ ~ ~ ~al* ~ ~alrlO Arlrtress ............... Name of Architect ..,~ ........................................................................................... Phone No. Name of Contractor ...~¢,~.,z~..~'~.~.~f~.../"/~ ............... Addre~ .Z..C .................... ~ ......... Phone · 2'~,~)~ 9- c-~ ~-~ ....... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions property lines. Give street and block numbers or description according to deed, and show street names and indic whether interior or corner lat. STATE OF NEW YORK, ) COUNTY OF ...J~.t~.~]J~ ........ ) S.S. ............................ I~.l,l~,.~.O.....J~J. lt.~O ................................. being duly sworn, deposes and says that he is the applicc (No,me 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 t this o.pplication; that oil stotement~ con{~EBd~.i~ application are true to the best of his knowledge and bell and that the work will be performe~: ~h,.,~c.~?~Y~&rth in the application filed therewith. Sworn to be~e this t,,,,,,',,/~r '~J'~;~s ~',;~r'~'~ ~;'~ ~ r