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Home My WebLink About5910-zFORM NO. 4 TOWN OF SOUTHOLD BUILI)ING DEPARTMENT Town Clerk's Office $outhold, BI. Y. Certificnte Of Occupnncy No. Z~?S1 Date Feb ~ 19.77. THIS CERTIFIES that the building located at .....Cl~o...1..~...P.l.a.c..e ......... Street Map No. xx Block No. xx .Lot No. xxx conforms substantially to the Application for Building Permit heretofore fried in this office dated ........... . .F~.~,...~.0..., 19.7.2.. pursuant to which Building Permit No. ~.~.~..O.Z.. dated .......... .~a..y. ..... ~.0..., 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 family dwelling The certificate is issued to James F. Bahr Jr Owner (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.R. UNDERWRITERS CERTIFICATE No. Pe]ading HOUSE NUMBER .... 2..7~ ....... Street . .C.h.a.~.~ .1.i.n..P..1.a.e.e. ........................ Building Insp~tor FOI~ NO. ~ TOWN OF $OUTNOL~ 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? 5910 Z Permission is hereby granted to: ~.~J~L1~..~...~.~. ............................................. at premises located at ..... ~ll~..~.~t.....~,~ti&.,~O.~l ....... fl,~:~ijl~..~.~41~ ............................. pursuant to application doted ............................. ~ ......... ~0...., 19...~, and approved by the Building Inspector. FOItM NO. 6 TOWN OF SOUTHOLD Building Depaitment Town Clerics 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 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. 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 ~....~..... /.?....~, ~ NewBu dng ...~......~......~... Old or Pre-exJstlng Building .i.' ......................... Vacant Land (~cna2irO~ r~Ow~ rO~seort~f ~ro~>2/...~.. _ ....~...~ ..~....~..~ c-~,-~ ~"i ......... su~v~sion .............. ~ ..................................... ~o, ~o..~,~ ~o....~... ,o~e ,o ............. erm,t No..~ .............. Date Of Perm,~/~ ........ Apphcant ~ ........... ~.~ ............... ,~,t~ ~,. ~ro~, .......... ~Z.~.~......' ' . .......... ~or ~row, ........ .~...~. ......................... ~ . .....~.:.~ ....................... Unde~rJte~ Approval ........... ~ ............................. Planmng B~rd ~proval Request For Tempom~ Ce~ificate ........................................ Final Ce~ificate .... ~ ............................ Fee Submitted $ .~.~.~ ............. Construction on above described building an~Lm~ee~,~all appli~,bJe~es ~ ~gu Is. Sworn to before me ~-~ ~~ ~ ////7 ~//~. ............. /.. day of .....1 ........... [x.....Z .~...../.... (stamp or ,eo,, ~ Notary Public .................................... COunty Approved TOWN OF $OUTHOLD BmLDING DEPARTMENT TOWN CLERK'S OFFICE ..~,,~w~-z-,~,~.~-'- SOUTHOLD, N.Y~~ ~ ~tl</~. _ 19.~.~. Pemit No. ~.~.~..,~ .............. -~pplication No, , .~..?.[...o. .................. Disapproved a/c ............................................................................................ ................................ i ................................. APPLICATION FOR BUILDING PERMIT Dote ..~..~ ....................... ,19....~...~,- INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildin§ Inspector, 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Pict plan showing location of lot and of buildings on premises, relationship to ad oining premises or public streets or areas aod~ giwng 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 onc~ 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 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, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. State whether applicant is owner, lessee, agent, architect, engineer, general con rac or, eec rician, p umber or bui der Name of owner of premises ...~....~...........~/.~ If applicant is a corporate, signat'crffe of duly authorized officer. (Name and title of corporate officer) 1. Locationof landon which proposed wo[k will be done I~a~ No' ..~..,~l .~. ~ .~, . Lot ~ ............ , ......... ............. Street and Number ...~.Z..~......~...~...~ ............... -- ~7~ ~ ~ v Municipali~ 2. State existing use and occupancy of ~~ i~~ occupancy of propo~d construction: a. Existing u~ and occupancy ....... ~~..~.~.....~-~.~..~ ............. ~-~-~. ~ b. Intended use and occupancy .... ~.:.~....~~.....~.~..~.~.....~~ 3. Na{ure of work (check which applicable): New Building ....................... Addition ..................... Alteration .............. Repair ............. ............ Removal ......................... Demolition ........................ Other Work ......... Fee ,.~,,,5,,~.~ ................................................................................. 4. Estimated Cost .............. ~. · .~....~.....~?.....~... ........ (Description) (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. tf business, commercial or mixed occupancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front .....~c~...~ ..... Rear ...... .~,,,~...~.. ....... Depth ...... .L~....~......~.. 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 ......... '.~,,,~J..[.... Rear ...... ~_,~M:,J..:... ...... Depth ......'~m-O.....w~,~.~ .... Height ...... ~.~.../. ............................... Number of ~tories ......... ~ ~J~ , 9. Size of lot: Front ....... .~....l'...~ ............ Rear .......... ~.....~ .......... ....~. Del~th · ...... ~...~;..~'.. ....................... 10. Date of Purchase ....~...~,.~....~.....~...... Name of Former Owner ......~.~- ............................... 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: (/'~U 13. Will lot be regraded ...........~.~3.. ............. Will excess ~.,be remo/ved/~ro.[n premises: ~,~] ~ [/1] No 14. Name of Owner of premises .,,,~....."J~......~.....~Z'..~-'~,-~,~-~....,J/~.....~J;~..~......: ............... ,// I ,~3 (Address) ~,/ (Phony No.) Name of Architect ............/~.~.~...{~.. ..................................................................................................................... ~ I .~, ~/' ~ (Address) (Phone No.) Name of Contractor ............ ~.JZ..~../.I....V. ................................................................................................................... {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 interiorT~_,~. ~2~/o°r corner Iot.~, STATE OF NEW YOR_~~//~_~ ) COUNTY OF .................~. ........................ ) SS ~ame Ol in ividu signing contract) {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. .......................... ......... ........................ / I Notary Public ...................................................................... County .......... (Signature of applicant)