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Home My WebLink About2745-zFO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPArTmeNT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No..~...a.3..6! ............. Dote .................... armatta.~..~....a.% ......... , i966... T~q[S CERTIFIES that the building located at ....................................................................... Street MPeq~nie Bay Oal¢~ , , ap I'~o ....................... BLOCK NO ......... ~ ...... Lot No...1~, .......... ~.e~,O~O.~......H.,.'~r4 .................. conforms substantially to the Application for Building Permit heretofore filed Jn this office dated ................................... K~. .......... 12 ......... , 19.{~... pursuant to which Building Permit No..2~.J.~.~...~. dated ............................ ~Y......~,.~ ............ , 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 ........ ............. l~.iv.a~te...orze..f, amlls~..rlw~.ll.i~lg ................................................................................... The certificate is issued to ..D....~.~atale~...Eldl~d.g~ ....................... Owtla~. ................................... (owner, lessee or tena,nt) of the aforesaid building. H. D. Approval Ja~. 19,'66 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) N? 2745 Z Date Permission is hereby granted to: 0o Stanley ~dx. edg® ............ ~3.~......~.~ ~..~.e..k....~ ........................... ................ ..If~..t.~.o. ~s.....~.,. ~ :. ...................... to ....~...~... ~....n.e. ~....o..n.e...~'.~.~;I,~...~..~ .%~.~ ................................................................................... at premises located at ....[.Q.~..~.i.....,~.~.~.~,.~...~I~....OIJ~I~I .............................................................. .... ~.e...q .o..n. ~ .e.k.. ~... ~, ...................................................................... pursuant to application dated ............................ ~ ....... ~2 .............. 19..~;~., and approved by the Building Inspector Fee $..~.O..e...O~.. ......... Building Inspector SUFFOLK COU~TT DEPAHTME~T OF HEALTH Da%e~ Permit TO WHOM 1T NAY CONCERN: The sewage disposal facilities for a structure located at have been inspected by this Department and found to be satisfactory. District Engineer - s r c Eng _eer 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. Approva~ of e~ectrica~ 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, B. 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 or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date. 2.~.., ,~../.~..~'.,. 2~- .... New Building ....~'.~'/-. ..... Old or Pre-existing Building ............ Vacant Land ............. / Location of Property .......... /~ ~.. ~. ,~.'~/q.. ~-~.~.~-~ ~ ¢. ..... .x'~x ~. House No. Street Hamlet Owner or Owners of Property . · ~.. · · .~.~ .~..~ · ~/~.~~'. · .e~' ~' ............... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision., .~.~r;~./.)?¢;,.. ~2.~,,. ¢~.~.~¢_~.,~..,..Map No..~. ~./¢/~. ,z~., ..... Lot No..~.-¢~ .,,. ....... Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ./(..d..~.. ,'. ................. Construction on above described building and permit meets all applicable codes and regulations. FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .................. .,.....! ...................... Approved ........................................ , 19 ........ Permit No ................................. Disopp rov~d o/c ..... //~ ......... ......... ....................................... APPLICATION FOR BUILDING PERMIT Date ............~..~,2,. ................................, 19(],5 ........ INSTRUCTIONS a. This application~' must be' completely'filled in by typewriter or in ink and suJ~mitt]ed 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 shah 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 port far 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, building code and regulations. ............... (S~gnature/o'f applicant, or ndme, if a corporation) , (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................................. O~ne.~. .................................................... , ..................................................................... Name of owner of premises ...... O.,,..S.~i~.~T..~EI~P.~.d~e.~...J~ ..................................................................................... 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: .[.~...dz..,O.../~,.!....L~......~...//..~...,~..~Lot No: ....~.,,2. ............ Street and Number R;ob£ns ar~ .L~ne. ..~....~...c.-..a....~'...! ..c;:.......~ ................. ] :. ,: ....... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................ ~'.~,9~h...~1~%~1~ ........................................................................ b. Intended use and occupancy .................... s.tD.~.].~..~'.am.~.~..~:..d, we.l, lSnE.,~z~si.~e~l ........................... 3. Natlure of work (check which applicable): New Building ...... ;r. ......... Addition .................. Alteration .............. Repbir .................... Removal .................... Demolition .................... Other Work (Describe) .................................. 4. Estimated Cost ....... ,~'I~O,QO,..OD. ............................ Fee ...,~..,0.,..~ ............................................................... (to be paid on filing this application) .5. If dwelling, number of dwelling units ..... ..o,?..e....~ ............ Number of dwelling units on each floor ........................ If g,'aroge, number of cars .............................. .~,O ................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ........................... 7, Dimensions of existing structures, if any: Front ....~g~e ............. Rear .......................... Depth ....................... Height ............................ Number of Stories .......................................................................................................... Dimensions of same structure with alterations or additions: Front ................................ Rear ........................... Depth .............................. H,eight .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ....~..,~ ..................... Rear .......... ~..,5. ............. Depth .... Height ......~,~ ................. Number of Stories ........ ~;~.o ............. 9. Siz(~ of lot: Front ..... l~ ............... Rear ........ '13~. ............ Depth ....ft.~....~L~.6 ......... 10. Do(e of Purchase ...Zft~.u~m~...19.65 ........................ Name of Former Owner ...~,...~.....~m:[.~t ..................... 11. Zor~e or use district in which premises ore situated...~.e~.~e. Tt~,:[Ci~.../~'tcl...f~'t,~O.~.~l~..~,~ ..................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............. ~o ............................... 13. Name of Owner of premises ..O....~.....~3,~=.ec~de..~c, Address].~.~..~,~c,~..~ct.-...~t,t~fi~hone NoJ[e,...~....q~ Na~e of Architect ~.....,]'.,..~ea,e,e~. ...................Address .~w..,~;.....~tz~.t~.~[.~.ozz Phone No,~,~...?...D.S No,ne of Contractor ..Q,..~L...~-'l-clm. ec~e...~z:..., ....... Address].3,~..~l/.,~'.c]c..~41,....~[~; ,Phone PLOT DIAGRAM Loca~e 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 lot. ire STATE O? NEW YORK, 1 S.S. COUNTY' OF ................................ . . .O.~. '~.^..~Z.~.~g.e..~Tm.., .............................................. being duly ..... ~(Name of individua signing opp cat on) / sworn, deposes and says that he is the appl above nabbed. He is the (Contractor, agent, corporate officer, etc.) of said o~vner or owners, and is duly authorized to perform or have performed the said work and to make this app !cation that a statements contained in this application are true to the best of his knowledge and b and thatithe work will be performed Jn the manner set forth in the application filed therewith. Sworn to!before me this L ~ ~ , , /,Z~ dayof , ~.~A-~- , 19.(,~ /r'r) . ~/ / ~/ -/ ~ ..................... . ................. ~ ~ ~.~ ~ ~ , ,, , - -- .... ..... .................. Nntnrv P~ubiic ~,~k~~' County ~ ~ (~noture of opp~ant) No. 52-0618100 Suffolk Count/ ' ///V' I C EL'LA ~. } [ , D [.M 'oi 7 P-.O Ri T -E LF_V~,T ~.CO ~q D VLO0~ P P