The URL can be used to link to this page

Home My WebLink About2624-zFOF, dI~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ....~.../..~.....O.~.~...~....~..O..~..~...~.~.....C[.~.?..e...~.....~3treet Map No ...~ .......... Block No .........~ ...... Lot No ....... ~ ......... ..~..O...~..t...~..O.~ ...................... conforms substantially to the Apphcahon for Building Permit heretofore filed ~n th~s office dated ....................................... J~l~.13.~,~ ...~, 19 ....~' pursuant to which Budding Perm,t No...~...~..~...~.....~. dated ................................... ~ .......... ~.., 19......~..,~wos issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which thru cerhficate ..... ~.zl~a, te...or~e..f.~m~,~.., dwe.3,1i~g. ................................................................................. The cerhficote is issued to .~:~.,...~..O~,Q...~B,~.~.S ......... ~e~. ....................................................... (owner, lessee or tenant) of the aforesmd buHdlng H.D ,Approval July 22, FORM 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? 2624 z Permission is hereby granted to: I~ .W. ~t~..&..ScmJ.. ;Ina ..... Jluf. C~..Dr.... ~ohrL.Gr aves ............ ~uthel~ ................................................ to BuJ.:l~.. ,,,ex..cma..£~ir...d~e:Ltt~ ..................................................................................... ct premises located at ....... ~,~..~.,llrm.~l~.. ~;~,..;J~J. ................................................................. ................................................. Bo~th~::Ldt ..... ]l.~:.. ........................................................................... pursuant to application dated ........................ ~T-~LI~_~a. ~r ....... ~ .......... 19..J~J~, and opproved by the Budding Inspector Fee $""].'0'~'00 ........ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions TOWN OF SOUT~OLD 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 Aprd 19/57), Nonconforming uses, or buildings and "pre-existing" land uses: 1, Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topograph ic featu res. 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 --?z~e-E×~_s ting C.O. $15 · 00 3. Copy of certificate of occupancy $1.00 Vacan~ :Land C.0. $ 5.00 Date .......................... New Building ............. Old or Pre-existing Building zX ........... Vacant Land ............. Location of Property .. I PP. ~f). ~]p~:J(.ey. Cr~.eK pr.iy.e.,..S.o.u.th.ql.d.,. J~...Y .......................... House No. Street Ham/et Owner or Owners of Property ...~.o.h.rl..Hz..G?.a.v.e.s..a.R.d. ~.a?,~.o?.i.e. ?....G??l.v.e.s. .................... County Tax Map No. 1000 Section ... 7.0.. ......... Block ...2 ............ Lot...2,8... .......... Subdivision ................................. Filed Map No ........... 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 $ . .[:.0.0 .... . .v~....l .[.C~ .~...---~. ...... Construction on above described building and permit meets all applicable codes and regulations. '/'1 app,can t ....... Ll. aag .al. aaa ....................... P. O. 8ox 706 a~.ao-~o~a Cutchogue, N.Y. 11935 SUFFOLK COUNTY DEPARTMENT OF HEALTH Bldg. Permit No. , . The sewage disposal facilities for a structure located at have been inspected by this Department and found to be satisfactory. District Engineer FOIMI~ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. xomin d ........t"'/" ......................... 19 ........ Approved ................. I\ 19 ...... Permit No ' Application No..,.%~....~...'~,...~,. ..... 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 adloining premises or public streets or areas, and giwng a detailed description of layout of property must be drawn on the d~agram which ~s part of th~s location c The work covered by this application may nat 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 orem~ses 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 asuance 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 apphcable laws, ordinances and regulations j (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electncan, plumber or builder blame of owner of premis~..~ ...................................................................................... If applicant ~s a corporate, s~gnature of duly authorized officer. State existing use and occupancy of;~'eses and intended use and occupancy of proposed construction o Existing use and occupancy ...~'..~ ........................................................................... b. [ntended use and occupancy. .~ ................................. 3 Nature of work (check which applicable) New Building J ...Addition · ..Alterahon ................ Repmr ....................Removal ............. Derhohtion ................. Other Work (Describe) .................. 4 Estimated Cost ..~....~. ~...~....~... ~ ~ ...................... Fee · ...~..~...~....~ .............. (to be paid on fihng th~s apphcation) FEES- If dwelling, number of dwelhng umts .... ~ ......... Nurnber of dwelling units on each floor ......................... If garage, number of cars .... ~ ............................................................................................................. If business, commerical or mixed occupancy, specify nature and extent of each type of use ............................ Dimensions of existing structures, if any' Front ......................... Rear .............. Depth ......................... Height ....................... Number of Stories ..................................................................................................... Dimensions of same structure with alterations or additions' Front ..................... Rear .......................... Depth ...................... Hmght ...................... Number of Stories ............... 8 Dimensions of entire new construction' Front...~..~....~'....~... ........ Rear ....~....~.... .............. Depth ....'~.....?. ............... Height ..~....~...~ ....... Number of Stones .... ~ ................. 9 Size oF lot Front ...~....~....O. ..... Rear ......................... Depth ,/'~."~..~. ......... 10 Zone or use d~strict m which premises are s~tuated ...... Z~. .................................................................................. 11. Does proposed construct,o~ wolate any zoning Iow, ordinance or re~aulahon~....~ ........................... 12 Name of Owner of premis~ ~~ ...Address ~ ........ Phone NO .................. Name of Architect ......... //--~ .............. ,/'. ......... ~. ..... Address ....... .,, ........................ Phone NO ................... Name of Contracto, r~./~:('~-.. ~...~Address ~ ........... Phone NO .................. PLOT DIAGRAM Locate clearly and d~stmctly all buildings, whether existing or proposed, and indicate all set-back d~mensions fro~ property lines Give street and block numbers or description according to deed, and show street names and indicat whether interior or corner Io~ STATE OF NFW YORK, SS. COUNTY OF .......................... ) ........................................ being duly sworn, deposes and says that he is the opptlcan (Name of individual s~gnlng apphcation) above named· He is the ................ ~~ ........................................................................................ (Contractor, agent, corporate officer, etc) of said owner or owners, and ~s duly authorized to perform or hove performed the sa~d work and to make and fd this opplicohon, that oil statements contained, tn this application ore true to the best of his knowledge and beliel and that the work will be performed in the manner set forth in the apphcohon filed therewith ..v f (Singature of applicant~ Notary Pub I ic, ~..).b.¢~ .~-*~¢~. ........ ' ..... m...~CCounty No 52 323Jl~J ,Term Expires NLarch 30, ~9_/~_.~