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HomeMy WebLinkAbout5705-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. 7 939. ...... Date ............ Dee... 7. ....... , 19.7~ THIS CERTIFIES that the building located at p~t. Roed. ~. 1~. (14tmn. Ia.). Street Map No.. ~ ....... Block No...x~ ...... Lot No.. ~r~.. Ox, ien. t ~ .}Lo.Y.o ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... .Feb ..... 1..., 19.72. pursuant to which Building Permit No. ~?O~Z.. dated ........... Feb .... 1 ...., 19.72., was issued, and conforms to ail of the require- ments of the applicable provisions .of the law. The occupancy for which this certificate is issued is . PrS, vate..ot~e. :ami:Ly..clve3,1~ng ....................................... The certificate is issued to . .0co, ge. D.ow. & .W~,fe ....... 0~mex'm .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approvai UNDERWRITERS CERTIFICATE No .... ,.q. ~6.3OI4. HOUSE NUM BER....~,~ ...... Street... Pv.'b .B. oaCl..~. 14...- .~ .~ .................... Building Inspector ro~mvi ~o. ~ 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? 5705 Z Permission is hereby gronted to: ~ · ..ai~t,e~..lt~,..I~l~r~!.~e..~:Gee!~v, · et premises located at .......... p~.,~,,~ ............ ]ll/~,,~Jk~i,~l~ ...................... : ........................ ............................... Ol'&~l~ ............ ~,~. ................... ; ......... :'"'i .......................... · .............................. pursua~ to application dated ........................ ;.;..~t~l~ ...... ~ .............. , Building Inspector., 19.~.., and approved by the Building Insp~tor : ~ S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date NOV ~ Bldg. Permit No. TO WHOM IT MAY CONCERN: The sewage disposal faciliti~es for a structure located (Give deed Iocat have been inspected by this department and found to be satisfactory. ~ ~ 197;~ NOV © FORM lqO. ~ TOWN OF Building Department Town Clerk~ Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE ~F OCCUPANCY Instructions A. This application must be filled in typewriter aP, ink, and i~submitted in triplicate to the Building Inspector with the following; for new buildings or new ruse: 1. Final survey of property with accurate location of al(' 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 Bo~rd of Fire ~nderwriters. 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-conformingl uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing oil property lines, streets, buildings and unusual natural or topographic features, 2. Sworn statement of owner or previous owner as to use, l accupancy 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 3, Copy of certificate of occupancy $I.00 New Building .........X. .......... Old or Pre-existing Building .............. $5,00 Dote ....~,.~'....~../....2~ ...................... .............. Vacant Land X H~, & Ms~ George H. Dau IILJDD Subdivision ................................................................ Lot No ........ ~, ..... Bbck No ............. Mouse No [nc. Health Dept. Approval ..... ~.~/.~/..2~ ...................... Labor Dept. ~pprovol ................................................ Request For Temporary Certificate ........................................ Finat Certificate ........X. ................................. Fee Submitted $ ....~.,.~ ........................ Construction on above described building on~ermit me~li/c~:l~le ¢~e~,¥_and regulations. Ernes~ F. ~ichter, ~ Sworn to before me this da'of ............. y ....... 1.~......~,, Pub,,c ...... Nolary Public, S~a~e of New York No, 52-2225313 Suffolk Ceunty (stamp or seal) APPLICATION FORM ~0. 6 TOWhi OF SOUTHOL~ Building Department~ Town ¢lerk~ Office South'old, hi. ¥. 11971~ FOR GERTIFICAT£ ~ 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 Lisa: 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 dispcsal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire ~nderwriters. 4. Commercial buildings, Industrial buildings, Multiple J~esidences and similar buildings and installations, o certificate of Code compliance from t~e Architect or Engineer responsible for the building. ~ 5. Submit Planning Board approval of completed site pla~ requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses; ]. Accurate survey af property showing all property lines, istreets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, ~ccupancy and condition of buildings. 3. Date af any housing code or safety inspection of build!ngs 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 u~e 3. Copy of certificate of occupancy $1.00 $5.00 Date ....I.. ~/., ..~ ,, ./. ,, ?., .2. ...................... New Building X Old or Pre-existing Building .............. I' ............ Vacant Land Location Of Property ................................................ ~;S~.;~;~.a~..~..D~~% , "~ ......... ; ....................... ~.~___. ..................................................... 'T ................................................... [Z~]~b' Subdivision ................................................................ Lot No ........ ¢,... Block N0 ............. House No ............. 2/I/92 H o ,h App o o ....................... rapt. ppro om ................................................ Underwriters Approvol .............................................. vmnnmg B~rd Approv0l ........................................ Request For Temporary Ce~ificate ........................................ Final Certificate X Fee Submitted $ Cons,ruction on obove described building an~mit m.~a~oble ~d ,egulati~s. .................................. Swo~o before me this ........... ....... ..... ....... ~.~ ........ County Nota~ Public FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT Tow SOUTHOLD, N. Y. Ex,mined ........ , 1~..~ Appli¢~ti~ N~ ................................. Apprawd ........................................ , 19 ........ Pemit No .................................. Disapproved a/c ............................ ........... APPLICATION FOR BUILDING ~ERMIT Dote Feb INSTRUCTIONS a. This application must be completely filled in by typewriter or in i~k and submitted in duplicate to the Buildi~ Inspector. b. Plot plan showing location of lot and of buildings on premises, relatignship to ~djoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn c. The work covered by this application may not be commenced befor~ issuance of Building Permit. d. Upon approva of this application, the Bu Iding Inspector wi issue 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 [i,ssuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New ~ork, 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. Richter ;iome lm'nrovemer~t Co (Signature of applicant, or name, if a corporation) 7th [St Greemoort (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Co~itrac~oAl , . Name of owner of premises ......... .O.~o.r. 6a..D.o~,Z..d..i't&~'$ .................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work ~i/ll be do, ne. Mop No.: ...i...~%X. .......................... Lot No ...... .~.~ .............. State existing use and occupancy of premises and in,e ~d use a~ occupancy of proposed construction: a. Exisiting use and occupancy ...... ~M~.%~-.9...~-.~ ............................................................................................... b. Intended use and occupancy ozle 3. Nature of work (check which applicable): New Building .....~.~ ....... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ........... .LL~.~.D0©...~ .............................. Fee .0.,q,.8.0 .............................................................................. (to be paid on filing this application) ,5. If dwelling, number of dwelling units ..oZ¢4~ ................... Number of dwelling units on each floor ............................ If garage, number of c,:rs ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, Jf 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 ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ......... $c~LI, ............ Rear .......... ~6X;)..,~* .............. Depth ...... 8,~.0 ................... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ............. ~!..A.~!....d..::k.s.J;;. .................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ........... BO. ............................................ 13. Name of Owner of premises .G....e..o....T~..o..~. ....................... Address ..[L.~.g~..J;~pD.:R.~ .................... Phone No ..................... Name of Architect ..~e~..~;g~,o,§ .............................. Address .....~.O. Zt.t~D~.¢, .................... Phone No ..................... Name of Contractor ...t.~.g.}).~fl~...~.Q~.~...~[~.~..C......Address ......... .Qz'.ee~.t. ............ Phone No ..................... PLOT DIAGRAM L.ocote clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from prope~¢y lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. See filed plans STATE OF NEW YORK, 1S.S COUNTY OF ...£zc£2~Z.~. ........... ................. %:; .......... F:...~.~-~,.¢...~..j:e~c,,~, .......................... being duly sworn, deposes and soys that he is the applicant u~ame at ma~waual signing apphcation) above named. He is the ............................. .~o~&z.~g.~o~ ................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and t~and file this application; that all statements contained in this application are t~ the b~i~wled~e ~d belief; and that the work will be performed in the manner set forth in the applicat~le~ ther~it~//~ /~ ~. , Sworn to before me this ................... ~-~.ofz-j~...~'.ehu~'~-- .............. , 19.~2.. NatoW PubJi~~~. County~~[~'~ .............................. ~/ ELIZABETH ANN N~ . Term Expires Marc~ 30, 19~ f ~, E)ow I % ~ % % (,--/ *~-ASSCMI~ L¥ .15AS~Z J ~¢ e..PH 3T.C-R.k3 PLO'T pLkN $C.&L~.,. t~l= I00~ "LS R'~, OF WA~..' ' -', ~ · .:)NI . \, NOTES: ocr, 1t, l~Tt ~t~, IO/Iq/tqTI ,~ ¢' o' / e? ',