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Home My WebLink About5460-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. UPDATED C.O. Certificate Of Occupancy THIS CERTIFIES that the bmlding .... .P.r.i.v.a..t.e. ,qn..e..f.a.m..i.ly..d..w.e.l.l.i..n9 ............ Location of Property ..... 7.5..0...T.r..u.m.a.n.s..P.a.t.h. ...............E.a.s..t..M.a.r..i.o.n. .......... House No. Street Hamlet County Tax Map No. 1000 Section ...3 .~ ........ Block ..... ~.2. ....... Lot .... .3 ............ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated ...A.u.~. :..1..2 .......... ,19.7. 3:. pursuant to which Building Permit No...5.~.6.0. g. .............. dated .... .3t.u. qt :..1. 2. ...............19.7.1., 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 ......... ..... ~ri-v-a~e. one. f~mily..dwelling..~ith. ~etac2aed. g~rag~ .................. The certificate is issued to ....B.E.C.K.Y...J.O.H.I~..S?.O~ ....................................... (owner, of the aforesaid building. Suffolk County Department of Health Approval ..... I~/.R ................................. UNDERWRITERS CERTIFICATE NO ............. R/.R ................................. Update of C.O. #Z4779 Building Inspector Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~?~c) . Date THIS CERTIFIES that the building located at Map No. Bayl~ke Pk Block No ..... Lot No. · .. Aw4~ 30 , 19 T~aman' a Path P~.t Rd Street East Ma~'ien conforms substantially to the Application for Building Permit heretofore filed in this office dated Allguat; 1319 ~rl pursuant to which Building Permit No. 51+6(1~ dated ... .~llg .~.~ .... , 19..~.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is. Private one famtl~ .dwe.tiing .................. The certificate is issued to FF, Kh~K. Kniep . · · O~me~ ................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . l~',R,, ............... UNDERWRITERS CERTIFICATE No. . .~,,~, . ItOUSE NUMBER 7~0 Street Tmumalt Pa, th Building Insl)cctor ~/ I~ORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF: THE WORK AUTHORIZED) N.o 546O z Permission is hereby granted to: premises located at .......... ~//~..'..~.,~t~....~j~l~..~mll~l~..~l~ ....................................... ....................................................... ~u~.t,....~t~ ........... ~.:. ........................................................ pursuc~t to application dated .................................. ~ ....... ~ ......, 19.~.~.., and approved by the Building Inspector. ~ee ,..~....~. ............ 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 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 reqgirements where applicable. For existing buddings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, ~treets, 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 requi~ed to prepare a certificate. ,~ C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date .. May.2.7, 1986 .. New Building ......... ~.... OId~_or Pre-existing Buddlng(l~ ~ ..... a IVacant Land ~ ........... Location of Property...i/~.~C~,.. [.~.../~.~.~.d ..... ~ ...... ~ .~_s..t.. ~.~?o..~.. House No. Street Hamlet Becky Johnsl:on Owner or Owners of Property ................. - ..................................... County Tax Map No. 1000 Section .... 73.1 ........ Block .. 1.2 ........... Lot. 003 Subdiwsion ................................. Filed Map No ........... Lot No .............. Permit No..~. ~.~.~..Z-... Date of Permit ?'./( ~.7./...App licant .................................. Health Dept. Approval ........................ Labor Dept. Approval ...................... ~.. Underwriters Approval ........................ Planning Board Approval .................. ~ . · ~ Request for Temporary Certificate ..................... Final Certificate ........ ° ......... - Fee ~ubmitted $. 15.00 Construction on above described building and permit'meets all app~cable,,co,des and regulations. Michael J. Hall Applicant ...... ,~ ........... ........ ~./~ .............................. Rev. 10-10-78 · , ~ ,, _.,,..~, , TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLE~,K'S OFFICE SOUTHOLD, N. Y. ...... ........ , 1'~_ 19"~1 Pemit No...~..../~..~.. ~. ~-~-.~- Approved ........................................ , ......................................... Disapproved a/c ...................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS 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 o 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 a~teratJons, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................... ............ ........ ;' ........ ................................................................. i .................... Name of owner of premises ......~..~..~.~ .................................................................................. If applicant is a corporate, signature of duly authorized officer. .................. ......... I. Location of land on which p~pose~work~Maap No.:..~.....~.~.w?...~.l~....~..[~ot/No./~ Street and Number .......... ..S~li~......~.~...~..~ .................. .~....~ ...... ./..~.~-~ ............................. 2. State existing use and occupancy of premises and inten' ' ' -- ded use and occupancy of proposed construction: a. Exisiting use and occupancy ........ ,~...?; ...................... i ......... b. Intended use and occupancy ............... .~..'. .............................. ~..... ................................... 3. Nature of work (check which applicable): New Building .................. ,~clition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ........... .~. ...................................... Fee ....... ~..~ .................................................................. (to be paid on filing this application) 5. tf dwelling, number of dwelling units ...... I~ ................... 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 t~/pe of use ............................ 7. Dimensions of existing structures, if any: Front ..........t..;;~-~ .......... 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 ...................................................................................................................... 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ] 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............................................................ 13. Name of Owner of premises ........................................ Address ............................................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-b~ck 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 N EW~.OP~,, j~- I. S S COUNTY OF .~.~....~' ' ....... ~ ................. --~?..;.........~?~--....~ ....... being duly sworn, deposes and says that he is the applicant (Name/of individual signtng application) above named. He is the .............................. ~ ............................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to rn~ke and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth Jn the applicatio~ filed therewith. Sworn to before me this ................ day of ............. .......... , Notary Public,. . aunty · State of New York NO. 52-8]25890, Suffolk Term Expires Ma~ch 30.