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Home My WebLink About2852-zFOP~I~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY No... Z..~,,,..~[~. .......... Date ..................... ,...J'JO.~.el~,'J).f~'......~6..., 1 c~.... THIS CERTIFIES that the building located at ..~/t/J~..~l.~J.~.~O~..~ .................................Street Map No...X:Y~ ............ Block No..::Yx~,~ ........... Lot No ..... ~ ....... (}~*.~t.~.O.~..~.l~...~.*...~.~. ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ....................................... ~.~1~1~.~ ....... .~ 19...~ pursuant to which Building Permit No..~.~.~,..~. dated .............................. 8ejJt~.....1. ......... , 19.,~,~,, was issued, ond conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ . P.~. i.va.te., one...~mi ly.. d. we.],'l.tn g. ............................................................................................... The certificate is issued to ..[~gF.'~...~.FiF.~..;[~h-~:...~.~..~.e. ............ 0l~e~.S ...................................... (owner, lessee or tenant) of the aforesaid building. B~ilding Inspector FORM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) pursuant to alSpli~otioh dated ................... Building inspector Permission is hereby granted to: .............. ~eeapo~e ................................... ......... to .Htl:l,:Ld..:~z..or~e..£ar~.~y:..~we],~l,r~g .......... , ............ ::....: ........................................................ at premises located at ...[t/~.J].....~t~.~JlDP....~J~ ............................................................. ~ ........................ ..................................... · .................... ~en~...~¢, ~,. .......................................................... ~ .......... 19.~.., and]approved by the Fee $.~LO,.(~O, .......... Building InspectOr / FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, 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. 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.OO Pa e .... ........ New Building ............. Old or Pre-existing Building XX Vacant Land Location of Property 13 ,~.adison Street ...G.~..e.eD~.q~..~., House No, Street Hamlet OwnerorOwnersofPr(~perty Robert and Martha Parrish County Tax Map No. 1000 Section 033 Block 05 Lot. 023 Subdivision ' . ......... . F ed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ......................... Labor Dept. Approval ........................ Underwrite.rs Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....... .X.X .............. Fee Submitted $...1:.5.: 9.0 ..................... Construction on above described building and permit meets all a_pp. Liqable ~pdes and regulations. IrvJ/hg L. Price, J~., Attorney/Agent for Rev. lO-10-78 Robert and Martha Parrish Premises at 13 Madison Street Greenport, New York STATE OF NEW YORK) COUNTY OF SUFFOLK) SS.: I, ROBERT PARRISH, residing at 13 Madison Street, Greenport, New York, being duly sworn, depose and say: That I am one of the present owners of the premises located at 13 Madison Street, Greenport~ New York, and designated on the Suffolk County Tax Map as District 1000, Section 033, Block 05, Lot 023, and am familiar with the condition of same; That the structure situated thereon has been designed, arranged and physically occupied as a single family dwelling; That at this time the premises is occupied by myself and my wife; is good; That the condition of the existing structure on %he premises That I make this affidavit in the knowledge that the Build- ing Department of the Town of Southold will rely on the accuracy thereof in issuing a certificate of occupancy for pre-existing use. Sworn to before me this day of May, 1983. Notary ~Pj~blic DORIS M. GANNON NOTARYPU~LIC, Stateof NY / Surf Co, No, 47015~4 ~ ,./ Term Expires March 30, ]9~,~ FOI~M NO. 1 TOWN OF SOUTHOLD BUILDIbiG DEPARTMEbiT TOWN CLERK'S OFFICE SOUTHOLD, bi. Y. Approved .................................... , 19...~.!...Permit No ................................. Disapproved a/c ..................................................................... . .~,,; r;.~L~ ......................................... .......... .................. ....................... A~PLICATIO~ ~DR ~BUILDIbiG ~ERMIT Application No. c9-d~'5"'2-""'- 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 location. 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 wilJ issue a Building Permit to the applicant. Such permit shall be kept on the premises avc~ilable for inspection throughout the progres~ of the work. e. No building shall be occupied al: used in whale, or in part for any purpose whatever until o 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 ~sgeua~sa~n~argtrhe~sc~nsctr~mc~i~Tw~hb~d~icaa~¢t[~rrc~a~rr~'l~i~?~ or demolition, as herein described ......... : ......... " ~ (Address of applicant) State whether applicc~Js~ · --' .~,,°wner' lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................... ......................................... ........................................................................... Name of owner of prem ses...~.C...~.,. ,~.~,,.._,,.~,,O,,_~_,~,~,,_l~..,_?_..__,,.,~,,,_f~,.,,~.,,,~,..~S..~C ....................................... If applicant is a corporate, signature of duly authorized officer, (Name and title of corporate, officer) Location of land on which proposed work will be done. Map No: ............................................ Lot No: .................... Street and Number ....................... ~_ ..... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: O. Existing use and occupancy ......... .!..~....O,.,.~.,~' .............................................................. b. Intended use and occupancy ....... [.. ...~.. , /. 3. Notc~re of work (check which applicable): New Building .................... Addition .................... Alteration ................ RepcJir ......... ..._,~L. Removal .................... Demolition .............. ~.t... 'Other Work (Describe) .................... 4. Estin~ated Cost~ ..... .~.......~....~?...O..Q.,....C:~...i~. .................. Fee ....~..1..(~..,...4~,.~.. .................................................... ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units .......................... Number of dwelling units on each floor .............................. If girage, number of cars ..........J~..~....~...~JT('..~.--.~...~ .......... ! 6. If bhsiness, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front..~.~:$.1~.~ ...... 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 ....~..(~. ............... Rear ..... (1~.(~. .............. Depth ...~ ........... Height ........ ........... Nu berofS,odes ......... ............... .,,,,' , 9. Sizeiof lot: Front ..... L.t~...(~. ............ Rear ....... I~..~.~::~ ........... Depth .....t..~ ............ 10. Date of Purchase ........................................................ N,~e of Former Owner ................................................... · ' ' r ituated'-:)~ (~ I L.~ T.~ ~ 11. Zone or use district m which premises o e s ........ ~ .................................................................................... 12. Does proposed construction viblat[any zoning la,w, ordinance or regulation? ...... .~.......O.. ................................... 13. Name of Owner of premises..~..:.....~....~.....('~...~.~.S...(~. ...... Address ..C'.'.~....O~....~..../~..~.~.....(~....: ......... Phone NO ................. Na~e of Architect .................................................... Address '.i~~.~.'.' ...... Phone NO .................. No~e of Contractor~..~.....~.l~...~....O...~...~.. .........Address .... ~i~ ...... Phone NC~....r~...~....-~....o.! PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions ftc property lir)es. Give street and block numbers or description according to deed, and show street names and indicc whether interior or corner lot. lOC>, STATE OF: NEW YORK ) COUNTY OF .......................... ) IOO.88 .~ ............................................. ; ...................... , ......... being duly sworn, deposes and says that he is the applic, (Name of individual signing application) above na~ed. 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 ' this application; that all statements contained in this appl caliph are true to the best of his knowledge and bell and that the work will be performed in the manner set forth in the application filed therewith. S to "efore me thi MILDI,t.u bi ,~rl,~ I ~ ~ ;* r ~ ; . 52-061 0~b ~OU~ y ~ , ............ f..., ...... r Notary Pu~lic,~ounty~,' (Sigma;: of applicant,