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Home My WebLink About6824-zTOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at Cedar. Point Drive.,..Eas.t Street Park, Map Map No. Cedar .Bch.. Bt~ck-I~..$.90 ...... Lot No... !0.9 ........................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... August .~7 ..... , 19.7.3. pursuant to which Building Permit No..6.8.2.4..2.. dated . August .27.. ., 197.7 , was issued, and conforms to all of the req-lre- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. addition, to. privy, re. one.-. Sa~;~Xy..4w.e.l.1..i~g. ....................... The certificate is issued to . S.c..v.e.r.u..s..S...D.e.L.e.q t...O~7..er. ........................... (owner, lessee or tenant) o£ the aforesaid building. Suffolk County Department of Health Approval . .N./A. .......................... I$NDERWRITERS CERTIFICATE No.., .N./.~ ....................................... ] ~OUSE NUMBER . 3.~. 0 ........ Street ...C.e.d.~..~..~.o.i..n.t..~.~..i?...~9.~.t. ............. ........................................ $outhold¢ New York . FORUM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDIING PERMIT (THIS PERMIT MUST BE KEPT GN THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6824 Z f~ermission is hereby granted to: S .S .DeLeo 1t+-16 l~O~..h ~t dhitestone toe.~,~.. ~A..~.a...a.~.t ~5..n....?.r:...~ ~.~..~:...d,~ ~..~ ~.r~. ............................................................... Cedar Point Dr ' "' Southold ............................................................... ~.a.~.~ ...................................................................................... pursuant to application dated ........................A.~g......~.~. ............. , 1~.,~....., and approved by the E;uilding Inspector. 'ee $1..~.,....0~.. ............. Building Inspector FO]~[ NO. $ TOWN OF SOUTHOLD , Building Deportment Tow,~ Clerks Office Southc,ld, N. Y. 11971 APPUGATION FOR CERTIFICATE OF OGGUPANCY Instructions A. This opphcatlon must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: ]. Final survey of property with accurate location af 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 ]957), Non-conforming uses, or buildings and "pre-existing" land uses: ]. Accurate survey of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous o~vner as to use, occupancy and condition of buildings. 3. Date of any housing code or s~fety inspection of buildings or premises, or other pertinent formation required to prepare a certificate. C. Fees: ]. 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 D~te ....................................... New B~ildmg ......~... ....... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property w'~,:.~¥2.~.~ ..... ~?~...4../~..~......~?.~./.~:/..~.....~.~...'~..~..~.../.....~.~/.;;..~.~.../J.~.~.z~ ......... ~.:~.-~... .............. Owner Or Owners Of Property ,~'Z~4.~x~.~..~.~,C. ...... ~.,..../~.z~..~.,x~.~.. ................................................................. Subdivision ~.~x'.~.~.....,~¢/.~.~...~:./~.......~..,¢./.~. ....... Lot No./J~.,,~..... Block No ............. House No ............ Pe~rmit No.~..E~?~.~...~.. .... Date Of Permit .~...:~?..'..;!..~...Applicant ,~...~74..x~...,?...~..~.......~.,../_~,~?...~._.,-~.....~. .............. Health Dept. Approval .......... ~..../~... ........................ Labor Dept. Approval ......... ~(...~'. ............................. Underwriters Approval ......... /~..../~ ........................... Planning Board Approval . ..~....~. .............................. Request For Temporary Certificate ........................................ Fined Certificate .......... ~ ........................ Fee Submitted $ ~'~-~ d~ le codes and regulations. Construction on above described building an rmit meets~_~.pl~9~,~ Applic~.,,~,~....~ ,/,...,'~,. ......... ?. ....................................... Sworn to before me this ~ ................ day of ............................................ stomp or.a, No, ary Public .................................... County ~,'~),~/.~/'~/ I09 h,,4Ap OF' L_ SUI~VE~eE O ,,,..~EVEI~U,~ ~ JOSE.; -VOWN OF SouT; Application No ............... .~ .............. Di~pprov~ a/c ...................... INSTRUCTIONS a. This application must be ~ompletely 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. 1- b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, anal 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 o 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 shell have be~ 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, Saffotk County, New York, and other applicable Laws, Ordinances or Regulations, for the constructiOn of additions or alterations, or for removal or demolition, as. herein desCribed. The applicant agrees to comply with all applicable lawson. buildings, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premj~ and in buildings for necessary inspections.~[ // ",' 'i" ............................ (Signature of applicant, or name, if a corporation) z (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... .................................................................................................................................................................. Name of owner of.premises ...~..~..~..~...~...~...~......~.:../~..~-..../-....~....~. ......................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................................................... Plumber's License No ......................................... ~ .............. Electrician's License No ..................................................... Other Trade's License No ................................................... 1. Location of land on which propo~d work will be done. Map No .............. ~.~ .......................... Lot No..~.~. ............ Street and Num~r ~ .~/~ ~-~/~/~ ~.~.~....~.~ Municipality 2. State exi~ing u~ and occupancy of premiss and intended use and ~cupancy of propo~d construction: . . ~/~ ~ a. Ex~ng u~ and ~cupancy ...... ~ ...................... ~. ................. ~ ......................................................................... b. Intended u~ and occupancy ................................................................. Nature of work (check which apl)licable): New Building ....................... Addition ..................... Alteration..:. ......... ~.~ -- Repair ......................... Removal ......................... Demolition ........................ Other Work ..o..u..T..~.5.q..~....~..~...~..~..~.~. - (DescriJ~tion) 4. Estimated Cost ............................................... F=~ ................................................................................................. (to be paid on filing this application) 5. If d~welling, number of dwelling units ...... ~... Number of dwelling units on each floor ......................................... If garage, number of cars ................................ : .................................................... 6. If business, commercial or mixed occuoancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front .....................Rear ........................... Del~th ................................... Height .................................... t ...................... Number of Stories ............................................................................. Dimensions of same structure with alterations or additions: Front .......................... Rear ......................................... Depth ......... He ght ~ ~ ~ Num,b? of Stor es ..... ~. .......... Dimensions of entire new construction: Front .~o ~. ,/~..~..~.. Rear .~v~lJ.;.:J:../....~.q..~.~Depth ..~... ~.. ........... 8. · ........... -r---.. Height ............................................... Number of Stor es ......................................................................................... 9. Size of lot: Front ...................................... Rear ............................ , ............. Depth .................................................. 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: ......... .~C..~ ............................................. 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 ..................................................................................................................................................... ~d_,x~,~.,.,.j~ (Address) (Phone No.) Name of Contractor .......................... (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate a(I 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 lot. 7~,~/ ~'L~-~' ~- ~'~co/~ ~ fo.,~ ~- STATE OF NEW.YO~.K,/~/~ _/ ) /5. .......................................................................................................... being duly sworn, deposes and says that he is the ~l~plicant above named, (Name of individual signing contract) : --~-~-~ J ~ t ~ He ,s the ................................................................................................................................................................ .v:.?-..~..-.~.~J.. ............................... (Contractor, agent, corporate officer, etc.) /J 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 I~lt~l~f I~iaB~l~a~ledge and belief: a~C-~at the work will be performed in the manner set forth in the application filed therewith NotaW Public, Sfale o~ New Yor[( . ~ ~4z/ "~:~ No. 52-03~:49~3~ Suffolk Count'?~ / / / .............. o, ........................................... ~Si~mre o[ appl~cantJ I