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Home My WebLink About3123-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No.Z14102 Date December 18 .................................................. 19...85 THIS CERTIFIES that the building .. Addition and Alteration Location of Property ......2..515..F.i.n.e..T.r.e.e..R.d..~ Cut.ch. ogue .ouse mo. Street Hamlet County Tax Map No. 1000 Section . .1.q4. ...... ;Block .... 3. .......... Lot 4 Subdivision NASSAU .FAR.MS ...Filed Map No. 11 7.9 .Lot No. 14 conforms substantially to the Application for Building Permit heretofore filed in this office dated ....J.u.n.e.. ] .4 ........... 19 .6.6. pursuant to which Building Permit No..3. 1. .2.3~Z. .............. dated .... ~.u.n.e...~ .6 ................ 19 .6.6., 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 ......... ....R.l.t.e. V .a.t.i.o.n..s' .a.n..d..a.d.d. ,i.t.i.o.n...o.n..e..x.i.s. .... dw.e lling. %lng ................................. The certificate is issued to NORMA PORDON of the aforese~d budding. Suffolk County Depaztment of Healtli Approval N / A · N/A UNDERWRITERS CERTIFICAT£ NO .................................................. Building Inspector Rev. 1/81 FO~ NO. 2 TOWN OF SOUTHOLD I~UILDING DEPARTMENT TOWN CLERICS SOUTMOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3i~3 z Permission is hereby granted to: Nox'~a Porden ....~.Q ~et~ .A~ ................. ...... ~'~or. al .. ~.a~k~ ...N.~ ~ ................................. Make alterati.9..n.~ ~ a~ .a.~d.i. tion on ex~.:$t.i.n~ d.w. etli..~.. at premises located at ..~,~..]..t~ ~B~,.~.~,~. ................................................................... ................................................. :...~/.~....,.~.~.e. ~.e.~...~..~ ~ ..i..i.....o.;~.t,; .~k~. .............................. pursuant to application '~'ated .]..i...]...: '...~..~...G...: ...~.~.;..,' ........ 19,~...~.::; o~cl approved by the Building Inspector ' ....... :~56::::~::: ....... ~z::::::~:::':;~ ........ ~ ............. Building inspector ~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m ~mmmmmm 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: I. Accurate survey of pXoperty 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 $15.0 0 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 ._- Date..../.Z'; .-.(~ ~ ?'.~ ............ New Building ............. Old or Pre-existing Building . ...~ ....... Vacant Land .............. Location of Property .......... ~./.~Z,~...~.~ ~. ~..~.'~.~'....~..~ .................. ~. >..~¢-/-J ¢~..¢~L-f~'... House No. Street Ham/et Owner or Owners of Property ........................................... County Tax Map No. 1000 Section ... ~./../.2..~ ...... Block ....... .~. ...... Lot .... .~. .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.-~./?.~..Z,.~... Date of Permit .~/~.~l~.~...Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $.....~...-z~. ..... .~..i .......... Construction on above described building and permit meets all applicable codes and regulations. Applicant..~?x~-...~,.~. ......................... Rev. 10-10-78 NO. I TOWN OF SOUTHOLD BUILDING DEPARTME~IT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .............,, ........ ,, 3 % Approved ........................................ , 19 ........ Permit No ............................. Disapproved a/c .................. ~.~-~ .................. ~;~Y~~ ........................... (Buildin~ Inspector) ~ Application No ............................. APPLICATION FOR BUILDING PERMIT Date .................. ....... :...*. ................. ..... 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 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 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. (Signature of applicant, or name, if a corporation) ............................... ~ ........... ; ............. ~ ................... 9.~. , . (Address of applicant) State whether applicant is owner, lessee, agent, architect, engi'neer, general contractor, electrician, plumber or builder. 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.: .....~.t~ ............... Street and Number .... ..~.k\..x4..~. ...... .k.~..~ ....... .~m~.~......\~.~..~ .......... .~u..~..~ ........ ~k~-~......~:~4~ ........ ' Mun~ipality ~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a, Existing use and occupancy ......... I~,~......~,~,,.~..~.....~,.~.~j~.~.,:~.,, -- -- ........................................................ b. Intended use and occupancy ...... ,~ C~ \~' '~x' ' ~...~m~ .~,.~.,,~....'.~..,,~.~,~k.~,~.~.....~,~,.O~.~...~2.~,.,.~..../~_~.~~..~ -- 4. 5. 6. Not ~re of work (check which applicable): New Building .................. Addition .................. Alteration ..... ~. .... Rep, dr .................. Remo,~.al .................. Demolition .................. Other Work (Describe) Esti~ ~ated Cost ...................... .~...O...O...:....-:: ...................... Fee . (to be paid on filing this application) If dfvelling, number of dwelling units ............................ Number of dwelling units on each floor If g~roge, number of cQrs If ]qusiness, commercial or mixed occupancy, specify nature and extent of each type of use Dimlensions of existing structures, if any: Front ......... ~ .............Rear ........ ~.¢~; ................... Depth ...~.¢J-..]5 ...... Heir}hr ........................ Number of Stories .......... Dim?sions of same structure with alterations or additions: Front ........... ~. Rear ...... :Y.I~....~, ............... Height ............................ Number of Stories ..... .~..~:.~ .................. Dep}h ' " Di ensions of entire new construction: Front ........... I~ ....................... Rear ~ Depth .,,~ Height .......~.~. ......... Number of Stories ................. Sizel of lot' Front ......... 1,.~4...¢/,.%.). Rear ~ ~.. "1 ! ................ Deplh ...... ~7'c"~,"~ .............. I ' ~ ~" ~"'~ r''r° Da~t of Purchase ...?,~,:e .~ ..... ,~,..$,-.. ¢~,-, .1. .............. .........Name~ of Former Owner ' ......... ................ \ Zonle or use district in whicnl~remi~es ~re situated Doe~s proposed construction violate any zoning law, ordinance or regulation~ I ...... No?e. of Owner of premises ................ ~Ovu,k~ ~;~,, ~ fvt~l~.~ ....... Addressbt~ ~5,tt~ kook, .... ¢. Phone No~e of Architect ...................................................... Address ...~,.I;Z::...~,,.,i:::!.~.~:;;..~;j; Phone No. Na~ ~e of Contractor .................................................... Address ' Phone No. Locat property I whether ir PLOT DIAGRAM clearly and distinctly oll buildings, whether existing or proposed, and indicate all set-back dimensions nes. Give street and block number or description according to deed, and show street names and indi~ [erior or corner lot. STATE O~ NEW YORK, COUNTY!OF ................................ ~ .... th.of he is rhea ,(r~ame at inaiviauat signing applicouom abow; nathed. He is the ................. ~ ............. (Contractor, agent, corporate officer, etc.) of said o~,ner or owners, and is duly authorized to perform or hove performed the said work and to make and this oppli.:ation; that oil statements contained in this application are true to the best of his knowledge and belief; that the v ark will be performed in the manner set forth in the application filed therewith. Sworn to I'~ efore me this .............. o, ..... . . ............. : .............. : ................. : ............... .. ........... Notary Pqblic, ...X(~~l[~~~ounty~ (Signature of applicant) NOTARY PUBLIC~at~ CommmsJo. Expires M~rch