The URL can be used to link to this page

Home My WebLink About5304-ZFO~r~ NO. 4 TOWN OF SOUTHOLD BUH.r~ING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupancy No. Z~306 Date Jul~ 26 19 73 THIS CERTIFIES that the building located at 2360 0ak~&~ra Avenue Street Map No ............. Block No ...........Lot No .................................. conforms substantially to the Application for Building Permit heretofore fried in thi.~ office dated l~y ~.? 19. 72 pursuant to which Building Permit No. dated ~tay 17 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 l~'~v~te b'wiaming The certificate is issued tol~lr, & lirS. Robert & V~,l'~.~t& (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Pending UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER . .2.3.6..0 ........Street ...0..a~...a.~...A..v..~.u.?~..S.o..u.~..o.1..d~..N.: .Y: .... Building Inspector ~ FO]{,I~ NO. ~ 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? 5304 Z Permission is hereby granted to: to t~t~8..a~..l~e~..m~,, g...1Pee®:~..... {~eee~ s®~-~') ............................................. at premises located at ................... ~J~/~...OIl~r-~'dl~. Al ..................................................................... ............................................................ 8mJ,t,.il, e.l.~l .............. ~.Zo ......................................................... pursua:n¢ to application dated ....................... ~Jt ....... .~.~ ..... , 19...~.1., and approved by the Building Inspector. Fee $. ~.~. ............. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ea~ to the Building Inspec- tor 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 installa- tions, 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~:onforming 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 informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2 ~i~;~ f . . ~ _a,Le,_o o(~cupancv on nre-e×mtma dwellina ~$. CoDy of certificate ~f oc~Hn~qn~;y ~;1~ ~.Vacant Land C.O. $5.0~ ' $15.00 Date ....... .~./.~. ?/..~,. ..... New Building ............. Old or Pre-existing Building ............ Vacant Land Location of Property ..... .1~....~...~ ~ ~~ ............. Ho,,, No. ,/. Owner or Owners of Property ...... ~( ...... ~ .................. County Tax Map No. 1000 Sect on ..... ~.' ..... "lock ...... Subdivision '~ '~'TA ........................ Filed Map No ........... Lot No .............. Permit No...~.~.. Date of Permit ....... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval gnde~riters Approval ........................ Planning Board Approv Construction on above de~ribed building an~it ~eets all apphcable de nd re u atJons e, 0,~ ~H~ /~ .... F~ ~ ' ~i~p~.~ g · . ,,.v 2q: zz" ........ ............ ~ILJO 60UTLiOLD lviAp oF LAL/D '~ u ~.,., r--. y r-, D 'P'O 12 SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No. ~'''~ TOWN CLERK'S OFFICE /,~c~/~..,~ ~ m A~li~tion No, ..~.~...~ .......... Disapproved a/c .................................................... ' FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted In d~pllcate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premise~ or public streets or areas, and giving a deeailed description of layout of Property must be drawn on the diagram which Il part of thle 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 progress of the wark. 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 Bulldlng Permit pumuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable I. awl, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal ar demolition, al herein de.crlbed. The applicant agrees to comply with all applicable laws, ordinances, building code, hauslng code, and regulations. ........ Si'ate..~.~.ether~ ~l~,~applica'nt is owner, lessee, agent, l~hitect, engln~y: .g~.71Y. i' ,ontractor, II~Tii~i~:. plumber ar builder. ......... .__.._......_._..._..._...,. ...................... ~r .......................................................................... , ............ ,om. o, o, ....................................................... If applicant Is a corporate, signature of duly authorized officer. I~ Location o{ land on which proposed work will be done. Map No.: ........................................ lot No.: ...' ................... Sire. and Number ...~.~..~ ................... ~ ................................................ MUnlclpall~ 2. State existing use and occupancy of premises and Intended use and occupancy of praposed constr~¢tlon: a. Existing use an~ occupancy,. ............... t~^ ~ // -~' ff ~/?~,~ ~~~~"*"~ ...................................................................... b. ,ntendeduseandoccu,,an:' ......... ~..........--~ ....................................................... l¢~ ~ /~ ,~. 3. Nature of wo~k (check which applicable): New Building .................. Addition .................. Alteration ............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) 4. ~timated Co~t ...... ~..~...~..~ ................................. Fee ......................................................................................... (to be paid on fi:ing 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 0f Stories ............................................................................................... Dimensions of same structure with olteretions or additions: Front ....................................Rear ........................... Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ............ ~L .......... Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ...... ~.~.~. ............ Rear ..... /..~'..Z:~ ................... Depth ..... ~ .~....~. ................ 10. Date of Purchase ........................................................ Nome of Former~'~'r" ........................................................ ] 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does Proposed construction violate any zoning law, ordinance or regulation? ....... .~..,: ......................................... 13. Name of Owner of premise~..,~f~,~.....Address ...... ~~.... Phone No Name of Architect ...................................................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly oll 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 indicat'e whether interJ0r or comer lot. STATE OF NEW ~ORIC _ . !,, COUNTY aP ....~..~,..~...~.,~.t~i....~a'a' .................. worn, (Name aT indi~ual signing a~lication) a~ve named. He is the ............................... ~..~.~.~ .................... , ....................................................... ' ~ (Contractor, ~t, co~orote officer, ~c.) of said owner or owners, and is duly authorized to perform or hove perfo~ed the said work and to ~ke and file this application; that all statements contained in this application am tree to the ~st of his knowledge and belief; a~d thor the work wiU ~ perfo~ed in the manner ~t fo~h in the ~plication filed t~r~ith. Swam to ~e ~ ~is ......... ......... ........ ................... Nato r/ Public, ~~...~. ~~~~;~~~ ............................ ~OT~Y p~L~ SI~ ?~ ~w Y~ ~OT~ ~LZC, State of New Ymk