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Home My WebLink About6013-zTOWN OF $OUTHOLD BUILDING DEPARTME, NT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy No. iI~?07. ..... Date ............. .D.e.c ..... .~....., 19..7.3 THIS CERTIFIES that the building located at .P..~..e..3.t. ................... Street Map No. xxx ........ Block No..zzx ..... Lot No. XXZ .... He.t.t.l.~..o.k....N.,.Y... ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... ,TILly.....13, 19.72. pursuant to which Building Permit No. 6..0.1.3.Z... dated .......J.~..~. ..... ~..~ ..... , 19.7.~.., 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 . Pl'.tvat~. (&~cesso~y). lw! .m.~ .P001 .~..e. ql~ .t~ ...................... The certificate is issued to G~.o.f:['l'.ey..&....Lq.l~l~i~.~.e .H.a.l.l. qn..b.e.qi~. ....... . .~..e..~.s ..... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval I~oRo UNDERWRITERS CERTIFICATE No.. ~ .129.1.7.9 ..... ~?...2.6...1.~)?~. ............ HOUSE NUMBER .. 1 ~.60 ....... Street..Pike..~.t ................................ ... .......... Building Inspectc~ FOI~ NO. 2 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°. 6013 Z Date .................. ....~......k.~...., 19...~...)~ Permission is hereby granted to: ............ '; ........ ':'~?i ............................... ,o...~,:~.~ ........ ~..~ ........ i;.~..~.;Li.....~~,....g~ .... ~~......~'.....~...~ ...... ~.~.z,~ ....... ~......~..: ............................ at premises I~ated at ..........~...~..'...:~...:v. ............ ~....~ ....... : .................................................................. .......................................................... 2 .......................................................... ~ .................................. pursuant to application dated ................ ~,~ ......... t,~-~. ...... , 19..~....?~., and approved by the Building Inspector. Building Inspector THE NEW YORK BOARD OF FIRE UNDERWRITERS p.~ BUREAU OF ELECTRICITY ~ B$ JOHN STREET. NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT Geoffrey Hallenbeck, s/~ 1500 Pi~e Street, Mattituck, L.I. ~n the following location; ~ B~ement ~ lst FI. ~ ~.d F~. outside ~t~o. mo~ w~ exami~d on ~iO verb e r 19, 197 ~ and found to be iff compliance with the requirements of this Board. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT DRYERS FEEDERS UNIT HEATERS MULTI-OUTLET SYSTEMS NO. OF FEET OTHER APPARATUS: E R V I C NO, OFCC. COND. A, W,G, NO. OF HI-LEG OF CC. COND. 3 OF Hi-LEG NO OF NEUTRALS OF NEUTRAL Per COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FORM NO. 6 TOWN OF SOUTHOLD Building Department 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 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 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. 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 formation required to prepare a certificate. C. Fees: l. Certificate of occupancy $.5.00 2. Certificate of occupancy on pre-existing dwelling or land use $§.00 3. Copy of certificate of occupancy $1.00 Date ..~'.~ ............. z......~...~.. ..... New Building ................ Addition .~.i;!.!....~..... Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ....... .~......:~...~..O.. ....... .~..(.i..~....¢.:....~.../. ......... ~/~/.//.'.../..L/..i~...c.L<'.' .................................. Owner Or Owners Of Property ....~."...~. ...... ~ .................... .//..CZL.~. .......... .~ ..................................................... Subdivision ................................................................ Lot No ............. Block No. House No./..~...~'~D Permit No....~./',~./.~...Z:_.. Date Of Permit ...~x/./.~'.~/.71..&:..-..Applicant ...~...:..~...!/...,('.~.d~k.~i.~..Lj..~ ...................... Heath Dept Approva '7_,' Labor Dept Approval Underwriters Approval .... ~.;f:{'...~.c;..i~.~..D. ................. Planning Board Approval '."7 ................................. Request For Temporary Cert f cate ........................................ F hal Cert ficate ...~ ..................................... Fee Submitted $ ........;$..~...L..,. .............. Construction on above described building and permit meets all applicable codes and regulations. App,icant ..................... Sworn to before me this ~'/~c- /~' ~ :7 o '7 ..... of or Notaw Public .................................... Coun~ Examined ..~...~..~ ~¥.. ....... Approved .................................... i FOt~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19..?.....~ 19 ........ Pemif No..~....~.../..~..~ .......... Appli¢Ofion No.. ~ 0 / ~ ~J~ Disapproved a/c ....~.....~ ........ ~ ...... APPLICATION FOR BUILDING PERMI.T~ a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector. wit~ 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relation'ship 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 applicatibn. 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 u~ed in whole or in part for any purpose ~hatever 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 Count~; 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 il~spections. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · ................................................................... .. ¥-:;:' u : ....................................................................................... Name of owner of premises ..~.'~'~-'~......~....[~\l~,~....~-~(hLt,~.~,~l~.~..~..~. .......................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed,~q~k will be dog~,~ap No.: ................. ~,<.: ....:-r.;.t' ......... r:" Lot No ............. Street and Number .~~..~..]...~..' ~ ........... ..~..?.. ............................. . L.[~.(~..,..~...~. i....~C~ .......................... /~' ~ 0 Municipality 2. State existing use and occupancy of preti~,,is and intended use and occupancy of proposed construction: a. Existing use and occupancy ...,,..,...xt, J.6~,.~../~J. ................................................................................................... b. Intended use and occupancy ...~........k~....'.L~....~...L..(~. ....... ~.~ ............................... L ........ , ............................ 3. Nature of work (check which applicable): New Building ....................... Addition .................... Alteration ............. ?. Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... ..~.;)...O...~ ................... Fee ( D.e.s. cription ) . 4. Estimated Cost ..._____ ........................ , ...................................................................... (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 type 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 ......................... Rea~ ............................ Depth ................................. Height ............................................. ~ ~..~...C~.~.Q.~L .~..~....(~....~..~.~...C~ .IC~...~...j~/;~ 9. Size of lot: Front ..... .~....~... .................... Rear ......... ~).......~... ..................... Depth .C~..~{Z.~....~ ............................ 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: ............................................................ 13. Will lot be regraded ............................... Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ....................................................................................................................................... (Address) (Phone No.) Name of Architect ..................................................................................................................................................... (Address) (Phone No.) Name of Contractor ................................................................................................................................................... (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinct)y 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 (or. Or ,EW cou, ¥oF ........ ............ .......................................................................................................... being duly sworn, deposes and says that he is the applicant above named. .~me of individual signing contract) He is the ................................................................................................................................................................................................................. {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 applicati~i~l&HsTtrt}~Ntbej;m.~t of his knowledge and belief; and that the ~rk will be performed in the manner set forth in the a olir~tion filed ~l~er~9~fh S~o~ of New ~or~ - ................ 6/ ~' ~ t~ignature of applicant)