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HomeMy WebLinkAbout3521-zTOWI~ OF SOUTHOLD BUILDING D~.PARTM~--NT TOWN CLERK*S OFFICE SOUTHOLD, N. Y, OEi;tTIFIOATE OF OEIOUPANOY THIS CERTIFIES that the building located at . .t~/.~...,;OO1~0~..]ha..l~O~.ttl~.. Street . Easter Shor~ Map mo ............. DIOCK ISo ............. Lot No..]02 ...... ~e~.nl)o.<~..}j~.7~, .... conforms substantially $o the Applicati.on for Building Permit heretof~e filed in this office dated ......... ~¢...~2. ...... 196.~. pursuant to which Building Permit No. 3~. ~. dated ............ .~k~.. 29.., 19.~, was issued, and conforms to all of the require- ments .of the .applicable provisions of the law. The .occupancy got which this certificate is issued is .... P~'~¥~. PJ~..;~]~!~ .~W~$~i~g ....................................... The certificate is issued t.o .Gll~.~00~iO..~rgB01 ...... ~>lgOR .......................... (owner, lessee or tenant) of the aforesaid building. .Suffolk County Department of Health Approval .... ~.a~.,..~..t9.68...bY..~..VilSa .... 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? 3521 Z Permission is hereby granted to: l~...l~e~....~/C..au~tod~..l~az~IL ......... at premises located at ..,1,og,..lL~'.,,;.....ci&s:t~r'/.l..,,.b. oz'.as...'l"t' ............................................................ ........................ ~S*..*.llooree..Le..llo~h ......... . ....... ~eape~t .................. :.:~.~ ....... ~ ................ pursua:n4' to application doted ................................. 41~.....~, ....... , 19.6~/..., and approved by the Building Inspector. Fee $.~)~.G(~ .......... Building Inspector ~ OWNER TOWN FORMER OWNER LAND Ilo© IMP. OF SOUTHOLD PROPERTY STREEI' N S FARM TOTAL /DATE ' z~ 0'-% ,, ~ 1~ ! 'o ? '~..-... /, / I:: .3 AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre VILLAGE 'L/i, E W RECORD CARD DI~T. SUB. ~/" 1 ,:. : , ACR. TYPE OF BUILDING Value Per Value Acre Fotol ~eadowland DEPTH -louse Plot BULKHEAD COMM. CB. MICS. Mkt. Value REMARKS _. tillable FRONTAGE ON WATER /Voodland ~ FRONTAGE ON ROAD ) / DOCK OWN ER ~OWN !STREET OF $OUTHOLD PROPERTY RECORD CARD · : ' ~ ' ~i .~i~ //,z FORMER OWNER '~ ! N ! VILLAGE SEAS. LAND IMP. ~W VL.l' FARM j COMM. CB. D ST i SUB. TYPE OF BUILDING AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per V¢lue Ac re FRONTAGE ON WATER Ti~[ab~e Woodland FRONTAGE ON ROAD Meadowbnd House Plot Total DEPTH J BULKHEAD DOCK Extension ~xtension Porch Porch Breezewoy Garage ~ ~ ¢ ~.~._ -_ ~.,. ~ ~ Patio Foundation Ext. Walls Fire PJace ;-- '~ ype Roof Recreotion Room Dormer / Bath Floors Interior Finish k{eot Rooms 1st Floor Rooms 2nd Floor ~'- ' ¢- CDrJvewey Total BR. B FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~m ~ll~fll~ 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 featu res. 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 pZt)perty 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 3. Copy of certificate of occupancy $1,00 4.Vacant Land C.O. $5.00 $15.00 Date .... .3 .1.9.8.5 ........ ,D, sc, em,b,e,r, ,,, New Building . .~( .......... Old or Pre-existing Building ............ Vacant Land ............. New York Location of Property .Moor{~:% I~i~p.e. bl.qr, th.,, .Qr.e.e.r)p. 0.rt., .... ~ ............................... House No, Street Hamlet Owner or Owners of PropertyCus.todjo I~r~la¢. ~0¢1 I~J~z~l~th B, randi - County Tax Map No. 1000 Section ,035 ........... Block . .;~ ............ Lot..~,0. ............ Subdivision .Easte~'o.$bpr.e,s .................. Filed Map No, .8.q7.5. ...... Lot No. ,102 Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ......................... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....... X. ............... Fee Submitted $ .? ~, I~. ..................... Construction on above described building and permit meets all applicable codes and regulations. Rev, 10-10-78 Applicant .................... S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Da.re 1~ ~ ~ Bldg, Permit No. ~-~/ ~-- TO WHOM IT MAY CONCERN: The sewage disposa~ facilities for a (Give /deed locati/on) structure located have been inspected by this department and found to be satisfactory. District Engineer District Enginee r.<,,~> FO~M NO. 1 Examined .................................. , 19~ ~7 Approved t L c~ ~.. 19.~.~ ..... Permit No. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No. Disapproved a/c .............................. ~..~?. ............... _ ~ctor)~ APPLICATION FOR BUILDING PERMIT Date .................................. .J....g~...e. ,......2..2. ....... , 19...6.7 ...... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and subntitted 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. Wm. Beebe (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................................... ..Q .0.~ ?..~ .q..¢..O. ~. ............................................................................................................................ Name of owner of premises ...... .O...~..~.~..O..~..~g....~...Z'.~.?...~ .......................................................................................................... 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.: ....~..~fi.t2~D...~...o..z/..e..s....~_ot No.: ....... .]=...0..2. .......... Street and Number ~./..~......~.o..o..[.e..$....~..~..[.o...z'.~.~.. ....... .G..z'...e..e.~..o..~.~.. ........................................................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .y.~.~.~.~...~,~D.~t, ................................................................................................... b. Intended use and occupancy .......... ..o..~..e.....~...~..~..~.];.~....~...w..e...Z.~.$..~.J~. ........................................................................ 3. Nature of work (check which applicable): New Building ..~ ....... Addition .................. Alteration .................. Repair .................. Removal ..................Demolition .................. Other Work (Describe) ........................................ o- o ? zo.oo 4. Estimated Cost ..... .~e~..~..~. ............................................ tee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... OI~e ................. Number of dwelling units on each floor ............................ If garage, number of cars two 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 ......... .1~.~. ............. Depth ...... ..,~0..~.~.l~L Height .................... Number of Stories ..... .o...n..~ .......................................................................................................... 9. Size of lot: Front ....... 1.~.0 .............. Rear ....... ,],~.Q ..................... Depth .1,~Q ........................ 10. Date of Purchase ........................................................ Name of Former Owner Eastern Shores Inc "A" Di 11.. Zone or use district in which premises are situated ............. m~,. ............................... 12. Does proposed construction violate any zoning law, ordinance or regulationP no 13. Name of Owner of premises ..C.~.t...o..d..i.o.....~.l?.~..rt.d..~,...Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ...~r~3.o...~.e. eb.e ........................... Address .......... Q.u.~.g..h...o..g.~..e. ............ 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 interior or corner lot. STATE OF NEW, q~I~,-] 1,. '~ ¢ ¢ COUNTY OF ................................ ................................................................................................. being duly sworn, deposes ond soys thor he is the opplicant (Name of individual signing applical'i.o~X..~_,~ above named. He is the .................. ~~...~4. ........................................................................... (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 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 I ................ ................... ................ ~L,..,.--~ ~ - Notary Public, ~"'~'"'~~gf~lx':. ~qqnty ............................. / ~ NOTARY PUBLIC, State ol New Yor~ No. 52-3233120 Suffolk County ~erm Expires ~arch