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Home My WebLink About2423-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. U ~ D A T E D Certificate C~ Occupancy THIS CERTIFIES that tile buildings.-.~ cl..w.e.]..1..ipg..&., g.a.r.a.g.e ......................... Loc~ofPtol~ .560 . Youngs Avenue Southold County Tax ~ No. I000 Section .. 9.6.~. ...... Binck ... 9J .......... Lot .. 99.3. ........... Subdivision..~ ............................ Filed Map No. X .Lot No. X coefo~m$ substantially to the Application for Building Permit heretofore fried in this office dated .... ~.u..ng..1. Q ......... ,19.6..4pursuanttowhichBuildingPermitNo.. 2423 Z dated ..... J..u .n.e.. 1. .0 ...............19.6. 4., was issued, and conforms to all of the requirements of ~he applicable provisions of the law. The occupancy for which this certificate is issued is ......... a private one-family, dwelling & detached garage. The certificate is issued to ............. Ill. .I.~ ................. .DR.ZD w~.~a~D ....................... of the aforesaid building. Suffolk County Department of Health Approval ...~ .e ~o. t:.....1.5... ! .9 6 4..b ~'..R. :..V.i. 1..1 .a ......... N/A UNDERWRITERS CERTIFICATE NO .................................................. I~. 1,11 + FOI~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? 2 23 z Permission is hereby granted to: ttm, R,.. B~.t,h....A/C ......... ~e3~ .............................. ........ SavJ~ho3.d .................................................... to ..... ~..z~e~z..o~e...£~,.1¥..~l~l.t~ ................................................................................. at premises located at ..... .l~.~.....~o~rlff. l~..~Ve .................................................................................... ...................................................... ~u.t,h~d ......................................................................................... pursuant to application dated .................................. ~ ....... ~0 .....19~3l~.., and approved by the Building Inspector Fee $... ~.'I'.C~ ......... Building Inspector 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. 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 Eries, streets, buildings and unusua~ naturat 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling/ land use 3. Copy of certificate of occupancy $1.00 --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date ...... --~/.~. ~./..~..~% ............. New Building .~/. ,~,~, ,, .~.,. Old or Pre-existing Building ............ Vacant Land ............. Location of Property . '~' .................. Hamlet House No. t' ' Owner or Owners of Property ................ J ................. County Tax Map No, 1000 Section ...~ ~ .Lj~. ..... Block ...... 0. (' ...... Lot.....~...~. ....... Subdivision .... ~ .............. Filed Map No. /~ .Lot No. Permit No ...... .~. Date of Permit . ..~. . .Applicant ..... ~ .' .......... ~//.3.~/~.. ~. Lb Dept App I Health Dept. Approval .............. a or . rova ........................ Underwriters Approval ........................ Planning Board Approval ...................... Bequest for Temporary Certificate ..................... Finat Certificate . · Fee Submitted $ ............................. above described building an er it meets all applicable codes and r,e~u lations¢ / Construction on Applicant ...... TOWN OF $OUTHOLD Building Depar~men~ 'fawn Hall ~outho~d, ,~.Y. 1 APPLICATION FOR C~RTIF]CATE OF OCCUPANCY Instructions This application must be filled in typewrhar OR ink, and subr~itted in duplicate to the Building Inspee tar with me following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusua ' natur21 or tooograohic features. 2. Fina~ approval of Health Deer. of water su0ply 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 buildJ.ng~ and install~ tlons, a certificate of Code compliance from the Architect or Engineer responsible for the buildin.c 5. Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings (prior to ,~pril 1957), Non-conforming uses, or buildings and "pre-existing' land uses: 1. Accurate ~Jrvey of peaperty showing all property lines, .stre.-ts, buildings and unusum natural o topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy an~ condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinem, informa tion required to prepare a certificate. Fees.' 1. Certificate of occupancy $5.00 2. Cerdflcate of occupancy on pre-existing dwelling or land use 3. Co~y of certificate of occupancy $1.00 $5.00 Date 12/19/83 New Building ............. Old or Pre-existing Sui[ding(X), -. ;x;._ .. = ZVacant Land ............ Location o~ Property ~.q ~ ~z.o.t~Og~ Ave: Southold Hou~ No. S~ree ~ Hamie Owner or Owners of Property Mildred A. ~nd County Tax Map No..1000 Sectlon ....64. ......... Block ....1 ........... Lot...,3 Subdivision Filed Map NO ' Lot No ' ' P it NO Ote of Per it ^ --~ :-- - M.i..1.d~r.e.d.A. Wi~ga'n eri~ ........... a ~ .......... .,'*.~..,l,u~n~. ... . .. d ' Health Dept. Approval ........................ Labor Dept. Approval ...................... Underwriters Approval ........................ Planning Board Approval .................. Request for Temporary Certificate .............. , ...... Final Certificate' ...~...- ......... _ Fee Submitted $ ..... ~ ...................... U .., - C~ _ . ._ 3o7o Monstruction on above de..6bed building a~~Ty~¢~/odes and regularJons. · ' ............... FO~M TOWN OF SOUTHOLD BUILDING DEPART/~,Et, IT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. C£RTIFICATE OP' OCCUPANCY No...Z.'1.92.3 .............. Dote .................. THIS CERTIFIES that the building located at ........ .~/~.....~ro%~rt~,S,..A¥.e ......................... Street Map No....,1¢~ ........... Block No ..... ,:~ .......... Lot No. ,..~..]r~"..~ ....... ~ot~l~fto'~ ............................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .................................... J"~ ....... "&O ........ , 10..61+.. pursuant to which Building Permit No ..... Pt~.'~"'Z dated ............................... ~.a/te.....tO....., 19...64-, was issued, and conforms to all of the requirements of the applicable provisions of the Iow, The occupancy for which this certificate is issued is ........ ....... P~. f.V.a.te.. 4~ne ..£am&l~ ..d.we3..1.&.n§ .......................................................................................... The certificate is issued to .Wm....;Bo..~tr¢~[~;~ .......................... O1.~'~ ................................................. (owner, lessee or teno~t) of the aforesaid building. H.D. ApprovaZ Se~t. 15, 196~ by R. Villa ............... t · :4'E'-" · '~. ~"~' ', ;' '". · .' ;%,t ....... ('..~ · .~;. · '~;'. · · :. er ......... Building Inspector FOR~ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..... .~.~::,,..b,O. ........ Approved ........................................ , 19.....!..Permit No .......... Disapproved a/c ................................... ~:~,~--~ ............................................ (Buildin~ Inspector) APPLICATION FOR BUILDING PERMIT /// ,, . o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plat 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 tS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Buitding 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 oil applicable laws, ord, jnance?, building code and regulate, ns.. /~ /(,) (Signature of applicant, or na]~¢~, if a corp//oration~ ......... ' ....... (Address of applicant) ~ State whether applicant is owner, lessee, agent, architect, er~gineer, general contractor, electrician, plumber or builder. Name of owner of premises .Z'.~Gr/~.~ ........ .~.~'~ · "-'" ........................................................... 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. Mop No: ............................................ Lot No: .................... S, ree, and bar ......... ..................................... 2.Stot~ 'e~istin~ uso-~n~occupanc9 o~ises ond intendod use and occuponcg of proposod construction: a. Existing use and occupancy ..:...~~:Z: ......... '..; .............. :;..' .................................................. b. Intonded uso ~nd occuponcg ........................................................................................ 3. Nature of work (check which applicable): New Building ..7,~.. ...... Addition .................. Alteration ............... Repair .................... Removal .................... Demolition ................... , ~ther Work (Describe) 4. Estimated Cost ............. ../..~.~......~...~. .............. Fee ................. .~....~.....~. .................................................... (to be paid on filing this application) 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 addJtians: Front ................................ Rear ............................ Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ~ ~-~ Rear ...~...~. .............. Depth .?....~... Height ....~.....~. ................ Number of Stories ........... .~. .............. 9. Size of lot: Front ...~.~../~ ............Rear ..... ~ ............. Depth ,..~...~ 10. Date of Purchase ....~ .......... ~ ........... Name of Forme, r Owner~--,Z.~/,~-~......6~..~..¢~.. ...... 11. Zone or use distr~ which premises ore situated.,...~ ........................ ~ .............. 12. Does proposed construction violate any ~on, Jng law, ordinance or, regulation? ~,~. ................................... Name of Architect ...................................................... Address ~ Phone No ................. Name of Contractor ......................... ~ ........................ Address .............. ~ ........................... Phone No .........?z ..... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-back dimensions fr~ property lines. Give street and block numbers or description according to deed, and show street names and indk whether interior or corner lot. STATE OF'NEW YORK, }- S COUNTY OF .............................. ..~.~,~f,¢¢.....~....,...~ ....................... being duly sworn, deposes and says that he is the applic (Name of individual signing above named. He is the ......................z:...~.~...~ ........................ (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 f this applic6tion; that a I statements contained in this application are true to the best of his knowledge and bali, and that the work will be performed in the manner set forth in the application filed therewith. Sworn to bbfore me this ~ /~ .............. ....... ........... ............... ~ . .. ~ ~ ~.~ .......... ~ ..... ~...~..~.~.~.~..~ .......... Notary Public_~(L~.....E.:..,~~r. County~¢~e~ (Signature of a~pllcant) No. 52-323~20 Sulfmk Comity Term Expires ~arch 30, 19~