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Home My WebLink About3268-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z h967... Date ....... Jan .5 ., 1973. THIS CERTIFIES that the building located at l~rt lqoad OSf Peo o Bay B~4leet Map NoEd~emero ~ Block No ...... Lot No.11 & pt 12 Laurel N .Y ~. conforms substantially to the Application for Build~ng Permit heretofore fred in this office dated 8ap~ .22 , 19 ~6 pursuant to which Building Permit No. dated . .. 0~...13 ..... , 196~., was issued, ~d conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Pr. ivate one family, dwelling · · (Approv~ b~..~ Appeal~ .0ct 6, The certificate is issued to Al tee. Dawo .... ~er .............. (owner, lessee or tenant) of the aforesaid building. HOTEl Orig~al house b~It before April 23~ 1957 Suffolk County Department of Health Approval Pre- .existing .. UNDHRWRITERS CERTIFICATH No P~e-. exist~g .............. HOUSI: NUMBt~ b60 Street Private Road ~ 2. (l. icDo~ld Cross.g) Bu~Idmg Inspector 1966 FOR~ 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? 3268 Z Permission is hereby granted to: Alice L. ~awe ................. La~als...N,,,¥.. .................................. ................ .&~.c.g.e. ~..o..~.3'...~ 1.~ g, ............................................................................................................. ~t premises located at ....2g.t,..3J,...~..l~.t,..A,?,t ....... ~d~.e...~ar.~. ............................................ ................... ~:t,...~.~.¢.... ~l~..... ~.e.c.o.~t.c....I~a~...~l.~, ....... ~1 ,...~.,.~... ............................ pursuan,t to application dated .......................... P,~t,.....~ .............. , 19.66.., and approved by the Building Inspector. ]Jotel Approved by Bd of Appeals Fee $...~..... ,0~,. ............. FOI~M NO. 6 TOWN OF SOUTHOLD Building Department Town Clerki Office Southold, N. Y. 11971 --rr- I ^PPUC^TmON FO. CE. :.C^TE OF OCCUP^NC / Ins~ructionl A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector 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 ~nstallation from Board of Fire Underwrmters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. ,~o5. Submit Planning Board approval of completed site plan requirements where applicable. Eg~existing buildings (prior to April 1957), blah-conforming uses, or buildings and "pre-existing" land uses: ' 1. Accurate survey of property 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 inspechon of buildings or premises, or other pertinent in- rmation required to prepare a certificate. C. Fees: J. Certificate of occupancy $5.00 k" 2. Certificate of occupancy on pre-existing dwelling or land use (, $5.00 ~ 3. Copy of certificate of occupancy $1.00 ~ ~'~-m-- _, _ New Building ...... ~ .......... Old or Pre-ex~shng Building~..J~..: ............. Vacant Land ........... ..~T.. ............. Location Of Property~.'...'Z:..~'.~r~T~:~L~l~-~..~'~..~..~..:~?.(.~.z5~`~'~.~..'~..~.~.~..~..~c~/~/ Owner Or Owners Of Property ,~<f..;~.-~..../.(~.'.~ ....... ~"-" '-~'" '~'"'/'£;'~'-'-':z~ ........................................... Subdivision .¢.~..~.~:.¢...m~...(.~..~....../....~...-~...,~..., ...... Lot No ............. Block No ............. House No ............. / ' . /. Permit bio .................... Date Of Pertain, ..~..~.......Apphcant,/4.{../.x..~'..e ....... ./........~..~.~.../.,..~. ........ Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Sub mitred, ~_.,~..QZ.~..~x~.,4:.,: ~x~,/j~, ~' ~,) Construction on above described building and permit meets all app~able c~es and regulations. ~plicant ................................................................................................... Sw~o before me?~is ..~...T... day of .,¢'.~~, /¢~.. ~ (stamp or seal) BAR'EARA M. H^URLI',~ I~otary Pubhc ~n the State o[ New Ybr~ No. 52-6806770 Residing in Su,ff~lk County Cumrm~slon ExpireS'March 30, FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. INSTRUCTIONS a. Thru applicahon must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giwng a detaded description of layout of propertymust be drawn on the d~agram which is part of this applicatio, c The work covered by th~s application may not be commenced before issuance of Budding Permit d Upon approval of th~s opphcation, the Budding Inspector wffl cssue a Budding Permit to the applicant. permit shall be kept on the premises available for ~nspection throughout the progress of the work. e No budding shQIl be occupied or used in whole or m part For any purpose whatever unbl a Certificate of Occupan, shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Budding Permit pursuant to ti~ Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances , Regulat,ons, for the construction of buddings, additions or alterQhons, or for removal or demolition, as herein describe, The apphcant agrees to comply with all applicable laws, ordinances, building code and regulahons._ ..... .................. ......... (Signature of apphcant, or name, cf a corporahon) ......r ......... ............... State whether a phcant is owner, lesse.e, agent, architect,,gng~neer, general contractor, electrician, plumber or build; If apphcant cs a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on whmh proposed work will be done Map No ............ ..~........~....'~... ............... Lot No:/~.....'Zt:....~....~Z:. Street and Numbe~c~..~.,~"~. ~.-.~r. ~./.~..~ ~'~'~'~ ..~.,~....'~.., .~..~...~.~... Mumcipality 2 State ex~sting use and occupancy of prem,ses and intend~ed use and occupancy of proposed construction: a. Existing use and occupancy ..... ~,.r....~.....,~...~ .~ ~..(.......' .......................................................................... b. Intended use ond occuponcy . ..~.,~?.~.~...~....eS..., .................................................................................. 3. Nature of work (check which apphcable). New Budding .................. Addition.......J ......... .. Alteration .. ............... Repair .................... Removal ............... Z'" Demohbon ................... ._~ther VYork (Describe) .................................... 4 Eshmated CasCO.......~.......?.....~...~ .............................. Fee ........................................................................................ (to be pa~d on filing th~s apphcabon) 5 If dwelhng, number of dwelling units ...~ .......... Number of dwelling umts on each floor .......................... If garage, number of cars .................. ~.~ ......................................................................................................... 6. If business, commercial or~ed occupancy, speci~ ~ature and ext~t of e~ch ~pe of use ...... ~ ..... ~.~ ........... 7 Dm~ens~ons of ex~shng structures, ffany: Front ..~ ................. Rear ~ .................. Depth ..~ ................ Height ..... ~..~ ~. Number of Stories .... ~.~ ........................ ~..~'~ ........................................ ~..~... D~men~Ds~e structure w~th alterabons or a~dmons: Front ..... ~.~ ................Rear~ ........................ Depth .~X.~ ............ Height ..~..~;~....~.Number of Stones ..... ~.~..~.~. .................... 8 D~mensions of enbre new construction' Front ............................ Rear ............................ Depth .......................... Height ............................ Number of Stones 9 S,ze of lot. Front ......... ~ ............... ' Rear ..... ~ .......... Depth ....... ~o~ ' , 10 Date of Purchase ~~..~.~./ ....... ~.¢.~. ...... Name of .~rmer~ ~~--/~ner ..~..~....~C.~/ ..... 11. Zone or use distr,ct m~hich prem,ses are s,tuated ....... ~ ....... ~~.~.~ ............. ~..... ..... 12 Does proposed construction wolate any zoning law, ordinance or regulation? .................................................... 13 Nome of ~ner of prem,se~..~.~.~¢....Address~ ~.~<<.~.~ ......... ~ Phone ¢..~:~.~ Name of Architect ~~.. ........................... Address ( Phone No .................. Name of Contracto~..~.~.~.C .......... Addres~.~.~.~.~ .............. ~one ~ PLOT DIAG~M Locate clearly and d,stinctly all existing or ~bsed,;an~'~ndiCa}e all ~et-b6CE 8iF ensions fr property hnes. Gwe street and block numbers accorCng to deed, and shgw steer names and ~ndic whether interior or corner lot. ~ J ~ ~ ~~-"(~me o{ individual s~nin~ opphc~tion) obo~ named. He ,s the ........ [ ....................................... ] ......................................................................................... 1 I t(Con~~nt, ~0'~orate affiX-' of sa~ owner or owners, andls d~zed to r r orme~e s~ wo~ an~o make and this Cpphcot~on; th~~ue to the best of hi~owledge and beli and hat work ~~ apB~ filed there,. ~ ~t,~ filed t~,~ Notary Pubhc, .. , ~unty ~ (_Signature of applicant) Notary ,ubhc,