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Home My WebLink About6168-zNO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.. ~.~.(~82 ..... Date ........ .D.e.~....6.. , 19.73. THIS CERTIFIES that the building located at .. Farmir~g. R.o~[ ........... Street Map No...~. ........ Block No....~... Lot No x..x~....h.'.e¥..S..u.ffoLk.. ?. :.~.o ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... .0.c~ ...6 ...... , 19..7.2. pursuant to which Building Permit No...61682~ dated .......... .0.~.t.....6. .... , 19.7..2., 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..P..r.i.v.a.~..e..(.A.e..e.e.s.s.q.r.y).' .~.t.o?.a.g.e., .b.u%.l..d.~.~.g ........................... The certificate is issued to Salvator Sposato Ownel. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N .R. UNDERWRITERS CERTIFICATE No. N oR · HOUSE NUMBER ~50 Street ?arming Road Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6168 Z Permission is hereby granted to: at premises Io~ated at ......................................................... .................................................... ~/,~ w' ._5 ~ E.E.a..~.~ pursuant to application doted ~ ~! r 1~.....~..., ond approved by the Building Inspector. Fee $ ........................ Building Inspector FOR2~ NO. 6 TOWN: OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLIGATION FOR GERTIFIGATE OF OGGUPANG¥ Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE 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, /~Aultiple 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 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. 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 ......................... : ................. ........ .~... Additi~0n ......... : ...... Old or Pre-existing Building ................ Vocant~a~d ..~ .......... New Building Location Of Propert~y ..... .~~-~ ........ ~..c~.... ............ ...~....~.~~('~ ~///~ ........... Owner Or Owners C~f Property ..~.....~.~ ...... ./..C ............... SubdiviSion .................. ~ ................................. Lot No..-:....~.. Block No..~ ..... House No"~".?...O....~ Permit N,o..i..~.../...~....~.& Date Of Permit ~..~......~...Applicant ..~..~i ........................ I-lealth Dept. Approval ....... .(..~..;.....~.. ...................... Labor Dept. Approval .......... i ....... (....~:~... ...................... Underwriters Approval ........./~/'j.:. ............ i ................... planning Board Approval ..~...~ ........... Y ~e~eUej~mF~t~e~esm...~.~..m...~..~.~i. ii~t.~.iiillI .................................. Final Certificate ...yz~.. .............................. Sworn to before me thi,s .......... .~... day of ...~.....~...~. ................. (stamp Notary Public .................................... County TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~OUTHOLD, No Y. Examined ........................................ , 19 ........ roved....... ..... .......'.....' · ' 19 ........ Pemit No ..................................... Disapproved a/c ......... Application No ....... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ''- / ' ................................................ , 19 ............ INSTRUCTIONS a. This applicetion must be completely filled in by typewriter or n ink end submitted n triplicate to the Building Inspector, with.\ 3 sets of plans, accurate plot plan to scale. Fee according to schedu e b. Plot plan showing location of lot and of bud ngs on premises, relationship to adjoining premises or public streets or areas, and~ giving a detailed description of layout of property must be drawn on 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 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 beene, 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, Suffotk 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, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (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, If applicant is a corporate, signature of duly auth' ' Jz~d officer. ' .......................................................................................... (Name and title of corporate officer) ~, 1. Location of land on which proposed work will,be done. Map No.: .................... Lot No ...... ~ ....................................... Streetand Number ~....~'...0.....~...~. ~. '~u~_~~ ......................... .................................................... .......... 2. State existing use and occupancy of prem~ded~ and~ oc/cu,pancy of proposed construction: a. Existing use and occupancy ................................. ~ b. Intended use and occupancy .......... ~.....~..~(~ ................................................................................. ~ 3.' Nat'bre of work (check which applicable): New Building ....................... Addition ..................... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work ................................. (Description) 4. Estimated Cost ...... J.~.M..,.~.l.,.r. ..................... 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 wpe 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 ....... L....; ........... Rear ..... ~....-)~.. .............. Depth .....~. .......................... Height ....... .~. ....................................... Number of Stories ........................................................................................ 9. Size of lot: Front ...................................... Rear .......................................... Depth .................................................. Height .................................................... Number of Stories ...................................................................................... 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 11. Zone or use district Jn which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............ ~¢~ ...................................... Will lot be regraded --.---.~......, ............... Will excess fill be removed from pre~mises: [ ]~"~- ] No, 13. ,,m. o, Own.r o, ,,em,., · · · 14. 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-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. STATE OF NEW Y~.K.~ ~ l ) COUN~r~ ~_~ ............ ) "~'~~'/'~'[~i~'~'~)~' .................... being du ¥ sworn, deposes and says that he is the applicant above named. He is the ................................................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform orjL~ge.l~erfqrrned the said work and to make and file this application; that all the bl~g;~ ~bl~.nH~/~[]~)~eE~en~,d~ief;. -- ------,~.. and that the work will be performed in the manner statements contained in this application are true to No 52 0344 set forth in the ~pplication filed therewith. . - 963 Suffolk County_ -- .~' /-,~ .~. ~. Com~,,~o. E~,~o,~ 30, .......... ......... day of ....... ......... ~ - {Signature Ol appncantJ