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Home My WebLink About6854-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMi~,NT Town Clerk's Of[ice Southold, N. Y. Certificate Of Occupancy No. Z..~.~?.2. ...... Date l~ov 29 1973 THIS CERTIFIES that the building located at .Brie~'woo~l .La ............. Street Map No. ~ ......... Block No...x~.. ...... Lot No.....x~.....CB.t. qh..o .g~.q.' .N.:Y.; ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ' .Sept, ..10 .... , 19.7.J~ pursuant to which Building Permit No. 68~Z.. dated ...........~.ep.t.....1.0..., 197,~., 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 . Pm~va.te .ac.cessor. y. s.tora&e hu~ld.~,ng .............................. -.:..' .~ h.e'"s"- Certificate is issued to. A~,e. XeTl.d. er. ~.o. g811 ........ .cxeTl,r ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . ~.,.R., .............................. UNDERWRITERS CERTIFICATE No. 1~ oR° HOUSE NUMBER ... ~.l.~. ....... Street .B.r..l.a..m~.q.c~l....l~. ........................... Building Inspector ~ FORM NOo 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N; Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6854 Z Permission is hereby grante~ to: ' ...~..v..~., .~,a..~ z-...~, .o.g.a..~ ......................................... , build ney accessory (storage) building at premises Iocoted at ....~.../,.~.......~..~..~.a,~,.O..O..~.......~.. ........ ..~..]'..S.....~.,~p..o..r.....L.,.a. ....................................... ~ Cutchogue pursuant to application dated ..........................~...e.~..~ ..... .1..0.. ........... , 19.~.., and approved by the Buil~i,ng Inspector. Fee $..1.0~Q0. .......... FOR3A ~qO. 6 TOWN OF SOUTHOLD Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be f,lled in typewriter OR ,nk, and submitted in DUPLICATE to the Building Inspector w~th 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 disposol--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Mulhple Residences and similar buildings and installations, a certificate of Code comphance 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 buddings and "pre-existing" land uses: I 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 2t Certificate of occupancy on pre-existing dwelling or land use $5.00 - 3. Copy of certificate of occupancy $1 00 New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property .................... :,.~,.,~,~. ,~,,../..,,.~...,,~.,/,,~..,~,..,,~., ........... ,~,.,.~,...,A.,~.,~,.~, ............................................. Owner Or Owners Of Property ........ 2~....~....~.-~..X....~...~!...L~.....Lz.-../.~ ........... ...~....O....~....~....../~.... ................................ Subdivision ................................................................ Lot No ............. Block No ............. House No..~. ....... Health Dept. Approval ......................~........~. ............. Labor Dept. Approval ................)~.......7-.~.. ...................... Underwriters Approval .................... .../~........~.... ............ Planning Board Approval ......... ...~..,....T-~... .................. Request For Temporary Certificate ........................................ Final Certificate Fee Submitted $ ....... ~., ..................... .~ '~'~- ~ Construction on above described building and permit meets all appli..~cable codes and regulations. ..... .............. Sworn to before me this ......................... ~ ......... ~1'~:";~ t~/~ (stamp or seal) ~-~' Notary P No 52-0344963 SuiJolk Co~nt,~ Commission Expires Ma~ch 30, TOWN O~ SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. App,cot,on No .... d Z.¥ ........... Disapproved a/c ............................................................................................ APPLICATION FOR BUILDING PERMIT Dote .......................... !!..e.~.~......?.,O...., 19.~..~. .... INSTRUCTIONS a This applicatton must be completely fdled in by typewriter or' m ink and submitted in tr~phcote to the Bulldin Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buddings on premises, relationship to adjoining premises or public streets, areas, and giving a detmled description of layout ofproperty must be drawn on the diagram which Js part of this applicatior c. The work covered by th~s application may not be commenced before ~ssuance of Building Permm d. Upon approval of th~s opphcoflon, the Budding Inspector w~ll ~ssue a Building Permit to the applicant Such perm shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used ~n whole or m pa rt for any purpose whatever until a Certificate of Occuponc 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 th Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances · Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe, The opphcont agrees to comply with all opphcoble lows, ordinances, building code, houmng code, and regulations, and t admit authorized ~nspectors on premises and in buildings for necessary inspections. Alexandr Bogan (Signature of apphcant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, e~ectric an, plumber or buiJdei ................................................ .~.J~.~ ............................................................................................................................. Name of owner of premises Alexander hogan If apphcant ~s o corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's L~cense No ................................................ Electrician's License No ............................................ Other Trade's License No ............................................... 1. Locahon of land on which proposed work will be done. Map No. .......... :~cX...... ...... .. ............. . Lot No ...................... Street and Number ...... Z',~Zf~fg.9.~....~.~.....~/..~.......]~.a?...b..o..~..~;f.~.q ....... ..0..-g.?...o.~..o..~.~..e.. ....................................... Municipality 2 State existing use and occupancy of premises and in'ended use and occupancy of proposed construction: a. Exisit,ng use and occupancy .......... .~.r.e...q;.~...~..~..~ ............................................................................................. b. Intended use and occupancy ............. ~.1?.t.l?....~..~..ith accessory building 3 Nature of work (check which applicable): New Building ...~ ........ Addttton .................. Alteration ....... Repmr .................. Removal .................Demolihan .................... Other Work ............................ (Description) 4. Estimated Cost ..................................................... Fee .......... ~...0. ........................................................... (to be prod on fihng th~s apphcahon) 5 If dwelling, number of dwelling umts ...... .O...~.?. ............... Number of dwelhng un~t~ 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 ................. Hmght ........................ Number of Stones ...................................................................................................... D~mens~ons of same structure with alterahons or additions Front ............................... Rear ............ Depth ................................ Height ....................... Number of Stories ............................ 8. Dimensions of enhre new construction: Front ............... J..0. ............. Rear ....1...0. .................. Depth .. 'lC).. .... Height .................. Number of Stories .......... ~ .............................................. 9 Size of lot: Front ....................................................... Rear ......................................... Depth ............ 10 Date of Purchase ................................................. Name of Former Owner ................................... II ti * ] ]. Zone or use district in which premises ore s~tuated . ..~.....{]~q.~ ............................................................. 12 Does proposed construction violate any zoning Iow, ordinance or regulation ......... lg.Q ....................................... 13. W~II lot be regraded .........D.O ............... Wdl excess fill be removed from premises. ( ) Yes ( ) No 14. Name of Owner of premises .... ~,"J.G~..~o~:~1% ...................... Address ................................ Phone No ...................... Name of Architect ...................................................... Address ................................ Phone No ...................... Name of Contractor ..... ~.~J~ ....................... Address ................................ Phone No ...................... PLOT DIAGRAM Locate clearly and distinctly oll bu~ldtngs, whether ex~sting or proposed, and indicate all set-back dimensions fran property lines. Give street and block number or description according to deed, and show street names and Jnd~cat~ whether intenor or corner Jot STATE OF NEW YORK. ~,c COUNTY OF ......... .8..~.~.o. ~ ...... ........................ ..~..]r...e.~.~.C.".~.~....~.9.(~.~.~ .................................. being duly sworn, deposes and says that he ~s the apphccn (Name of in&vidual s~gnmg contracfl above named. He IS the ....................... .o.~.~.~.~ ................................................................................................................................ (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 fll this application, that all statements contained in th~s application are true to the best of his knowledge and belief, an tha~ the work will be performed in the manner set forth in the apphcation filed therewith Sworn to before me this .................. day of ................... Notary Pubhc, . ................................................... County ~... (Signature of appticar~