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HomeMy WebLinkAbout3480-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN QLERt~'$ SOUTHOLD, N. E:Et~TIFIE:ATE ElF E]E:r":UPANE:Y No..Z. 2.806 .... Date ........... THIS CEBTIFIES tha~ the building located at ~8~d-& .1~%e.~ · ~O~-~treet ~ E~te~ Shore~, ap l~o ........... miocr l~o ............. Lot No. 8~' · G~onpo~-~' .~,~., ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... ~y. ·. 8- · , 19 6~' pursuant to which Building Permit No...~$80 Z dated ............ ~y' · ~0 · ', 19 ~,, was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private ~¢. f~iI~, dw~l.~i}~g ....................................... The certificate is issued to ...JOSeph. SO~llSdog' ......... ~ .................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .AUg,, · ! ' Buildin~ Insp~tor FORM NOo ~ 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? 3~80 Z Permission is hereby gronted to: .................. 0~.i~, ............................................... to ...~..u..~...,a?.~...?..r~...~.~...~.~.~..~.~ ................................................................................ at premises located at ..~,~.~...~.....t~:~t...~;~.....~.n.~.t)~.LV~...'~i'3~l~l~ ................................................. .................................... ~e~.t~,..& ..;aa~ ~.. i~oz~t ..~;,~ ....... ~'~ ..................................... pursucm¢ to application dated .................................... ~. ....... ~ ...... , 10.1~.., and opproved by the Building Inspector. ~e. ~.'.~ ............. Building Inspector ~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter~'R ink, and submitted m ~ to the Building Inmec- tor with the following; for new buildings or new use: 1. Final ~urvey of prol~erty with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water ~upply 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 in~alla- 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 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 inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $25.00 -- BUSINESS $50.00 ACCESSORY $10.00 2. Certificate of-occupancy on pre-existing dwelling ~ 3. Copy of certificate of occupancy $ 5 O0,(.over ~ years $I0 O0' ~'~ / 4oVacant Land C.O $ on ~ ' ~--- ' 5 o Updatec~ NewCOns ttuc t i on ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ..... Hour~e N'o: ..................................... ~ ...................... Owner or Owners of Property ...~~. ..... .~.....Lzf~.. ~ ~L County Tax Ma9 No. 1000 Section,.....~...~ ..... Block ..... :?. ....... Lot.../.(~. ....... ..... Permit N°' :;~ (/~Y0 Date °f Permit '~/~/'O/~ 7 Applicant ~i'~ ............ Health Dept. Approval ..... . ................... Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate . ~. .................. Fee Subm tted $. l.~., .~.. Construction on above described building and l~..r,~it meets all appl[cable~odes and regulations. R,,~. 10-10-78 ~.~ /r v . /~) o50~7 OWNER ~t~oI~ER OWNER j N s s. LAND IMP. STREET VILLAGE DIST.~ SUB. AGE NEW VL . FARM TOTAL DATE BUILDING CONDITION NORMAL BELOW ABOVE FARM Acre Volue Per Acre Tillable Woodland Meadowland House Plot Tot(~l 'W' TYPE OF BUILDING COMM. CB. MICS. Mkt. Value FRONTAGE ON WATER FRONTAGE ON ROAD BULKHEAD DOCK COLOR Extension ~¢fensJoD Porch Porch Breezeway Garage Patio- O, Bo To~al tFoundotion ,~ 0 !Basement iExt. U/ails iFire Place ,Type Roof RecreafJon Room Bath : ~ i Dinette [ Flaor~ ] .7t2.~ · iK' Interior Finish , Heat Rooms ]st 'Floor Rooms 2r~d Floor Dormer Driveway : FIN. B S-9 SCHD TO WHOM IT at SUFFOLK COUNTY DEPARTMENT Da~e Bldg. OF HEALTH Permit No. MAY CONCERN: The sewage disposal facilities Eas%ern Shores: Sec. 3: Lo% #82 - Oreenport (Give deed location) for a structure located have been inspected by this department and found to be satisfactory. District Eng'ineer District Engineer . ~ FOBM NO. ! TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved /I 19...~..( Permit No. ~-~'/7/0~--~ ~ Di~spproved a/c .~ .... APplication No. .~ C( ~ APPLICATION FOR BUILDING PERMIT Dote ...................... ~,~.,..,.,~. ,......~ ....... 19..~..~ ..... INSTRUCTIONS o. 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 o detailed description of layout of property must be drown on the diagram which is I~rt 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 o 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 sh~ll be occupied or used in whole or in port 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 o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with oil applicable lows, ordinances, building code and regulations. of a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber Or builder. Name of owner of premises ................................................................................ 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.: ...... ~..~.......~... ..... Lot No.: ~K,?..- Street and Number ...~..~~-.! ~ ..~..~....~....~ ~ ....~...~ ~ ~:~17~ Municil~li't~' ~' ..... :' ................ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy ..... ~,:. ........................................................................................................ 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .............. .... Other Work (Describe) ........................................ 4. Estimated Cost ..................................................................................................................................................... Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ~. ................... Number of dwelling units on each floor .../.. ...................... If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ 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.....~.../ ................. Depth ..... ~...~. ............. Height .... ....... Number of Stories ...... ./.. ............................................................................................................. ' ..... I 9. Size of lot: Front ...... /..~...~.~.. ........... Rear ........ /~...~. .................... Depth ........................... 10. Date of Purchase ................. .......................... Name of Former Owner .~....~..~ ............. 1 1 Zone or use district in which premises are situated ..<~...~' 12. Does proposed construction violate any~zoning law, ordinance or regulation? ..... ..'~...4~... ............................................. 13. Name of Owner of pre.~nise~.,..~.~ ...... Address ........ ...~.~: ..>~ Phone No Name of Architect .~~~..d~ddress ......~.~..~.~.. Phone No Name of Contractor .~./...~...~.~ Address .....~...~ ....... ...... Phone No ~...~. ]~-~ ~/'~'/ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether i'nterior or corner lot. STATE OF NEW YORK, 1, c c COUNTY OF ....d~.~..~.'.Z/~.. ............ .f .... .................... '.~-J../~....~......~..~.~r'~.~.L.~..~.. ..................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ......................................... ~...~.~..~..~..A..~..7'..J..~. ................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ma:ke and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ..... ........ Notary Public,~.~...~....-:~--~x?/f.~...~A.~ ., ...... :.... (~o~ty /// (Signature of applicant) -- ~-,- */ -b'[~£1C, SEam of New Yor~ ;~ ~,~'~' No. 52-7267800 Suffolk County ~/ ~l'ernl Expires March 30. 19t'~ ~q' .0s II .'I'~.IZ. IA]:2~,,/_oOO~LF:"_£[)L.JC .. t-,'zz,,l,,JC:~ _~.OLO[--.I IA L,.. ..... =,'= P. 1347-4 ~qO~OT,~. HO~b~.$, ~o. ~ REVIS'ION$ · .~.,.,. I .o~.,. · ,-,,o, COPYRIGHT BYSCHOI. ZHOMES. INC. C O N S U I. '1' I N O A R C H I T E ¢ T :'OL.X. o ,r&A~C !.--: ,~ COL. O~ /A, L_.,, ~'4 ° ,~ o .-..,- . 1,c r'-o' o~!GM'T' O[ DC=.., ~-L~X,/,A', I / © k--L' '~4'' o, L F IL o E OLD k_J OL'x-T -F LOC-) L,,OO 7~-JOb'.b-'To LAc?Ob-F° E-LEXY o'~4o oF LBV - LC)O ~ 30( 0 ;- LA~O0 I,, / ] ~4. ~z" I~z:o" 1.2's'<l 2o:0' F~A~4. COL.* S Ec ° FLOOD- JOISZ, LA'ROd'fo SO. COL '~ 9_ , lC) E. IA ~',,vo o O -7 I'- cO" / NOTICe, _q~.,~ t,.~,.~ s~.t~ la~ ~y and ~ ~ ~ ~ alte~ ~ ~.*~, SOHOLZ HOMES, Ino. COPYRIGHT BY 5CHOLZ HOMES, INC. DAT£ DATE */I/*~ Plato and specificatior~ as drawn meet general F. H. ^. and code requirements, but Scholz Hames, Inc., can not guarantee individual interpr~atlon on such requim- me~t~ In eve~-y are~. Any modlficotiom or changes which may be necessary t~ meet such requirements are at tim h~llders respo~ibility and