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Home My WebLink About5998-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z~990 ...... Date ........... Jail-. · 30 ....... , 19.73 THIS CERTIFIES that the building located at .. Oak. Dr,.ye ............... Street Map No. Reydon. 8holl~ll~ck No ........... Lot No. ~.~-~0 ..... Southo.lct .. N~,.~.. ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... July' '.' tO, 19 '72' pursuant to which Building Permit No.. '~998~, dated ............ gu:].~' ' · 'lO, 19. F2, 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 . Pr:hr&re..one..fand..l~r .d~tetling ....................................... The certificate is issued to .. Lavr. ence .pre.sby ........ OYner ...................... (owner, lessee or tenant) of the aforesaid building. (NOTE I one room to be $~.n[shed tr:Lm) Suffolk County Department of Health Approval .lq .R., .............................. UNDERWRITERS CERTIFICATE No.. P~nd~.n~ ... (b.y..Kuback~) ...................... HOUSE NUMBER.. 620 ....... Street ......Oak. D~. .................................... tiding Inspector FO'tZM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT 'TOWN CLERK'S OFFICE SOUTHOLD, N, Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5998 z Date ........................ ~!~ ....... J.0 .......... , 19...~.2. Permission is hereby granted to: Jo4u~.. ,'. ~£ ~:~,~.~r~. '~ ~q;.. L ... ~.r~sh~.. &. ¥.if~ ............. ~o~tl~l~ ............................................... to .~tl~.~d.. ~..a~d.:L ~$~z~ .~..~a~..a.~-t ~:pat.:L~s.. ~1.- ~a;$a~..4vot~.~ ................. at premises located at ..... ~t~2~--~(~....~e~t;~o~ .............. Ji, e.)~..~ll~Z~e~ ............................. ....................................... ~.....{3e.~.J~=;L~.e .............. ~e~,t~c~l~....~Lok.. ....................................... pursuant to application dated .......................~ .......... ?..0.. ........ , 19..5.2..., and approved by the Building Inspector. Fee $..1.~,8 D,Q .......... t Building Inspector ~rol~! NO. 6 TOWN OF $OUTHOLD Building Dep~r~ment Town Clerk* Office Southold, N. ¥. 11971 APPUGATION FOR CERTIFICATE OF OGGUPANGY Instructions 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 dispasal--(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. 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 3. Copy of certificate of occupancy $1.00 $5.00 January ~0, 197~ Date ................................................ New Building.............~ ....... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property .....................................0a~ Drive Re~.d~n..........................Shores,.................................................................S~uth~ld N.¥ .. Owner Or Owners Of Property Lawrence....P..re...s..b.~... . ................. Subdivision Re~.don ..~..~..o..~.e...s. ........................ Lot No. ~.~/~Q Block No ............. House No ............. Permit No...~c~9.~ ...... Date Of Permit ..~,,/.~[0~/.~.2.Applicant .... ~O~LT~..~0,?.L~:~13. .............................. Health Dept. Approval ...... ..~..*...~..'. ............................ Labor Dept. Approval .......... ..~..'...~..*. ............................ Underwriters Approval ...~f~D.d,,~Tt$ ......................... Planning Board Approval ..... .~...*.~.: .......................... Request For Temporary Certificate ........................................ Final Certificate ....... ~ .............................. Fee Submitted $ .~....0...0. ......................... Construction on above described building and permit_meets all applicgble codes and regulations. Applicant ~.......2~¢,Z~....~....~...~ ..................... Sworn '0 before me this ~/ ........ 3.0.... day of ....,,T..aA~.L~.Z~......1.~).~.,~ ......... (stamp or seal) ~/~/-/ Notary Public .................................... County r~ LOT-'~ 29 LOT~=~30 -*-.%' 70' 30 'AZ, toY#S/ /eec/ Approved ........................................ , TOWN OF SOUTHOLD BUILDING DEPAF. TMEN'~'-~ ' TOWN CLERK'S Disapproved o/c ........ ~ .................................. .,~__~. APPLICATION FOR BUILDING PERMIT ~ ',~,,,,/ Date .~ /...~..... '/-//'/~:/'~'~INSTRU~IONS ...~ ............................... , 19.Z~.~ a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with~ 3 sets of plans, accurate plot plan to scale. Fee according to schedule. ,~w b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, ancl~ 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 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. (Address of applicant) ~ State ~,,hether appJi~a~t,~~agent, architect, engineer, general contractor, electrician, plumber or builder', Name of owner of premises ..~..-:~....~Z.~..;...~.,.4......~~ ............................................................... If applicant is a corporate, signature of duly authorized officer. 1. Location of land on which propo~_d work will be done. Map No.: ..... ~.~../.. .................................... Lot No ............. Street and N~um~r ..~..~........~..z ............................................................... .-~..~ ......................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...~.~ .................................................................................................. b. Intended use and occupancy ......... .~../. .............................................................................................................. 3. Nature of work (check which applicable): New Building ....................... Addition .....~ ....... Alteration.~ .... Repair ............. . ............ Removal ......................... Demolition ........................ Other Work .................................... 4. Estimated Cost ...~/~o~.~..~. ............................ Fee ...~..-~...; ........ , ........... .~.....~. ................................ .I..D..es.c.~!.p.t.i..o.n.! .......... {t° be paid on fili.ng this application) 5. If dwe~ing, number of dwelling units ................. Number of dwelling units on eact~ floor ......................................... If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of usa ................. ._. .................. .... / 7. D~mens~ons of ex~sting structures, ~f any: Front ...~....-~.. ........... Rear ......-~....,~.. ............... Depth ..,,~o.,*¢.~.,,~, ................. Height ....~...~. ................................................ Number of Stories ...../. ...................................................................... Dimensions of same structure with alterations or additions: Front ...... ~ .............. Rear ...~r~...~, ................................ $9.~'S . f . Depth ...~1^,~ .............................. Hmght ....~..~. .............................. Number of Storms ...../. .................................. / w/ ...,,~..e./.. .................... 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 ............................................................................ 11. Zone or usa district in which premisas are situated ..................................................................................................... 12. Does proposad construction violate any zoning law, ordinance or regulation: ............................................................ regraded ______'~_ ~ .................. Will excess fill be removed from premises: [Y,] Yes [ ] 13. Will lot be No 14. Name of Owner of pre misas '7,~,~u..~..;.)'.~,~.,....~..:..... ~~.,....(~.~..........~..~.r.~ '~ ....... ffAddress) (Phone No.) Name of Architect ....................................................................................................................... i;'"~'"~' .................. fl ~ ~1 ·1 .,~-- ~Address~-~ ~ _ · ( ho e o.) ,, Name of Contractor ~l(4'Jf~.~4.~ ........ .~..~....~...,...&~ ............. '~..~.~....~..~...~...~... ~/ ' I f'/ (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinc~iy all buildings, whether existing or proposad, and indicate all sat-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 YORI~ ,~///~__~,/~ ) SS ' COUNTY OF ........... .~..~..~.~..~.., .'~,~...~ .......~.....,.. ) ...................................... ~.~...:~~ ...... ~ing duly s~rn de~, and says tha~ he is the ,ppli~n, above named. of said owner or owners, and is ~f~o ~rform or have ~or~d the said work and to make and file this appli~tion; that all s~temen~ contained in this ~,~ ~st,of his knowled~ and ~lief; and that the work will ~ ~orm~ in the ~n~r ~ ~or~ ~n ~be ~.~c.~ o.~'~1~~ s~o~ ............................ ....... .................... _ ,. ......... ........................ 'ti, ,I