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Home My WebLink About5312-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.D+..8.~. 9 ....... Date ............ 0et .... 11 ....... , 19 .~'~. THIS CERTIFIES that the building located at .N/S. 14a~.r~ aoaa ........... Street Map No.l~ .......... Block No... ~X ..... Lot No..XZ~ .... 80~tthol. d · 'N:'Y'~ ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. May..1. 9, 19..~2 pursuant to which Building Permit No.. dated ......... lta~.... 19 ..... , 19 72., 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 . I~.siness-~uildi~g'-' i~'°~t' .s.torage..et~-4~;outhela..F.~sh.l.n~. The certificate is issued to . Michael .l~orr. i$ ........ l~mer ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. lt~,.R, ............................. UNDERWRITERS CERTIFICATH No .... ~,Ro .......................................... HOUSE NUMBER...6~.~'0~. .... Street ....l'la.. ~l~.. ,~Oa.. ¢1 .................................. Building Inspector FOI~I~! NO. 2 TOWN O~ SO~THOLD 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? 5312 Z Permission is hereby granted to: ............ ~l~b,~.~2,..i~,:..,~:'.~.:::.~£~ ......... : ................. ................ .~.~, ~,...~:. ............................ ; ................. ................... ~. ~..t..~.~,~ ........................ ~ ................. to ..$.~],~[..~e.~..*,~.i~,,,~..b:~,d:tz~ ............................ ~ ......................................................... .................................................. (,1~e~¢,.-~-~ ,~a ge- - *~it4 i~,~g;) ........................................................ at premises located at ........... ~,~.~..~:f~:T~...~£.'.~ ........................ i ......................................................... ................................................................ ;-~.~:at~ ~,'.~ ....... ~.,~'.~..~ ......................................................... pursuant* to application dated ................................... ;~,~ ........ ~....., 19..~.I~., and approved by the Building Inspector. / 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 requirements where applicable. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-ex~ or land 3. Copy of certificate of occupancy use $5.00 Date ......................... . New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ..... ~\~O~- ~ p~, ,.~ ~of~ House No. ~o Street \ \ Harn/e~ Owner or Owners of Property ....... .~.~,o~> J~ ~,,~ C~c,~-/L ~.~.~ y-~>~,~ L,o=~>, County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No...~..~..~f?... Date of Permit \?\~-/'-.Applicant Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Sa bmitted $..~.~??..~.'~. ~..~.~ .~~. ..... .~/... ./ Construction on above deSCribed building~s~cable codes and rag t~ons. A I~,_~ ~ _--~-"--'x pp icant ............................... ~ ......... Rev. 10-10-78 FORM NO. 6 TOWN OF SOUTHOLD Building Delmrfment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, in triplicate to the Building 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 installations, 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 end "pre-existing" land uses: 1. ,~ccurate 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 in- formation required to prepare a certificate. / Date New Building .................... Old or Pre-existing Building ............................ Vacant Land .......~ ............... Location Of Property ....... ,~....~ .~ ................ ~.~7......~.~..~....~.. .................................. Owner Or Owners Of Property ....... .J~J.....~........~...~...~...][..~ ............................................................. Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No....~.~.~.~.......Z... Date Of Permit ...c~L!..~..~J...Applican, .......................... ~..~.....~../.i~. ............ Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building aqd permit meets ~a~plic~ble codes and regulations. Sw~? to before fm.~h~. ~ "~ ~ ~ ~-~ I ...... [. ....... day o .......................................... ~ (stamper sea ) FOGM NO. 6 TOWN: OF $OUTHOLD Building Delm~tment Town Clerk. Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 installation from Board of Fire Underwriters. 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. 5. Submit Planning Board al~proval 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 in- formation required to prepare a certificate. New Building ...... ~ .........Old or Pre-existing Building ........................... Vacant Land .....~.i ..................... Location Of Property ....~..o...~..~...~.....~.....~..f[ .................................. L.~.~.....~ ................................................... Owner Or Owners Of Property ....~.......~. ...... .~.~.~ L I Subdivision ........................................... \:'"~'~" ........... Lot No ............. ~--\BI°ck No ............. Hou, se Na ............. Permit No..~..~....!...~.....~'~.. Date Of Permit ...~... ~...~.!?.:~/.Applicant ..... .~.~.]~......~..~..~ Health Dept. Approval ............................................ Labor Dept. Approvm~ ............................................... Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submi~ed $ .................................... Notary Public ...... ~.....~..~.~.~..~.... County Construction on above described buildingX~/~Lp,er,rn'~_m~) c~l ~x~able co~es and regulations. Sworn to before me this Examined Approved FORM NO. 1 . TOWN oF SOIJTHOLD BUILDING DEPA R~'MENT TOWN CLERK'S OFFICE $OUTHOLD, N. ¥. 19 ........Pemit No ..................................... Application No ............. Disapproved a/c .......................................................... { (~uildin~ In,per) APPLICATION FOR BUILDING PERMIT 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 ofproperty must be drown 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 hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other app icable 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, housing code, and regulations. (Signature of applicant, or name, if a corporation) Main Read~ Seuthol~ N.Y. .. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.~ Name of owner of premises ~t:~.~...e.~,...~.*.....~...~.~.?...~..S. ............................... " . .:' '~ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done· Map No.: XZ Z3r. ........................................ Lot No ......................... Street and Number .............. ]g./~._-v~.::L~..]~l~&l[ ...... ~R~a~e~ ....... 3[o?_ ............................................................ ~ ~ / c./~._~ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy vacal~; ~a~cl ~usiness buildinz ea~ st a b. Intended use and occupancy ........................................................... .(.~. WT. g.~.). ...................... 3. Nature of work (check which applicable): New Building .....3~;3~... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ...........~.~.~.Q.Q.Q....+.. ........ i~ .................... Fee .....1. .Q A.Q.Q ...................................... (to be paid On filing this application) 5. If dwelling, number of dwelling units ...~'k~. ............... Number of dwelling units on each floor ..... . ...................... If garage, numl~er Of Cars . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..~,..~.~.?.~.e. ......... 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 ...... :[00 ....................... Rear ........... .1.OD. ......... Depth ...... 1.~.~ ........... Height .................... Number of Stories ....~t .............................................................................................. 9. Size of lot: Front ...... 200 ............... Rear ......... .1.9.9 .................... Depth ..... ..... 1 71 ...... ................................. 10. Date of Purchase ..................................................... Name of Former Owner n 11. Zone oF use district in which premises are situated ........... R ....... r];lS.t .......................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .......... 33~ .......... 13. Name of Owner of premises )~x..~.~..~,~.~'J,a ........... Address ............ ~..9.P,.~.q],~ ............. Phone No ..................... Name of Architect St3~all steel er equal ........................................................................................................ Phone No ..................... Name of Contractor ..... s.u~;~liez'...ef...kl~l~ ........Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block number or description according to deed, and ~shOw street names and indicate whether interior or comer lot. -- ~ ~3ot. STATE OF NEW YORK. t.. COUNTY OF ....;~.il~.f~. ......... 13'3 ..:.;......; .............. ;;.J.J.;.;; ....... ~..~..~ .......... ~ing duly ~om, d~es and says t~ he is the applicant (Name of indiyidual signing application) above named. He is the ........................................... ~e~ ................................................................................................. (~ntmctor, ag~t, co~orate officer, ~c.) of said owner or ~ners, and is duly authorized to perform or h~e pe~o~ed the said work and to ~ke and file th[~..gppli~ati~n; that all statements contain~ in this applicati~ am tree to the best of his knowledge and belief; and that the work will be performed in the manner ~t fo~h in the ~plicati~ fil~ ther~i ~ Sworn to ~fore me this ................. ...... ............... No,o~ Public~~~ ...... Coun~~ (~"~;~ ~f ~plicont) '" Te~ ~pires March ~, 19~