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Home My WebLink About6904-zFO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. No. 6329 ...... Certificate Of Occupancy Date ........... !~eb . .1.3 ..... THIS CERTIFIES that the building located at ]~/.8. ¥/e. stphalaa..Road .... ,. Street Map No..XX ......... Block No..XX~ ..... Lot NoXxx.. ~4atti.t.uek...~.,y... :~. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. 0.Ct.. ~, 19.. 73 pursuant to which Building Permit No..690~Z. dated ......... :.Oct.. ~' ......, 19. ?3, was issued, and conforms to all Of the require- merits of the applicable provisions of the law. The occupancy for which this certificate is issued is Business btttlding with office addition The certificate is issued to . .North. Fork. a~.l. Heat. lnc ........................... of the aforesaid building. Suffolk County Department of Health Approval (owner, lessee or tenant) .............................. UNDERWRITERS CERTIFICATE No. ]TeRd;Lr~g .................................... HOUSE NUMBER .... ~. ...... Street .... l~e a.tph$~.;La .~o.Rcl .................... Building Inspector/ FOEH NO. 2 TOWN OF $OUTHOLD BUILDING DEFARTMENT TOWN GLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CI-H~S PERMIT MUST BE KEPT ON THE PREMISES,UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) lq? 6904 Z Permission is hereby granted to: North Fork Oil }[eat Inc ¥~ttituck N,Y, build an addition on existin~ busine$.s .~.~..ld~g at premises located atS /~ ~'ies,..~.halia Rcad : ......................... ~'iatt ltu~k ~ ,Y, . pursuant to ~pplication dated ............................O.g.~...:3 ............. , 19~.~...., and approved by the Building Inspector. Building Inspector j FORM NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Thts apphcation must be filled in typewriter OR ink, and submitte ~'n I~UPLICATE ~g the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buddings, pr~T6'l~'Ft~ lines, streets, aha unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposalm(S-0 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 s~te 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 in- formation required to prepare a certificate C. Fees' 1. Certificate of occupancy $5.00 ~ 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 Rte ....... ...~....~...~: ............. ./. ........... New Bqdding ................ AdsJition ...' .~.... ...... Old ,or Pre-existina Building ................ ~Vacant Land ............. '-~..~- D^ ,~. /~,~.~,~- _/,4 .~-~ ~ ~.~ Location Of Property .~:.~..~. ...... .~...?..:......'; .............. (./ ...... ~ ....... ~. ....... ..-Z.F.~~....'~-~...~ .......... Subdivsion ~..~..~.,.1' ....... ~ii.~'l..iii....~..~..( .............. Lot No. ~..?...~... Block No ............. HouseNo.~ Permit No ..~.~...~.~...~..7~ Date Of Permit ../*?/...~Z .7.~....Applicant .~......~...~...u....(~....?.:,....?.:.'?..~.~..~..~:?..(.~....~... Health Dept. Approval ......... .~....t..~,?.~:...~ ......... labor Dept. Approval ..... ..,.~..,....~.~._ ................ - · ............... Underwriters Approval ....... ~. ..................................... rmnnmg Board Approval Request For Tem~a~ry Certificate .......................~;?~... Final Certificate .......... ..~..... ........................ / Fee Submitted $ Applicant ......~...//f~,~,~...?,,~~ //// /x~ ~~)~ ...... ~ ........................................ Sworn to before me this dayof /.. ...... ..... Public X"t ............................. Coun (stamp or seal) P~TER M, COLEMAN NOTARY PUBLIC, State oF New Yor~ No 52-5658570 Quahfled ~n Suffolk 'C~unty ~O~mls$ion EXpires March ~0, 197~ FOR~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. App"ca.on No. 0 Disapproved a/c INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ in ir~k and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of Jot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn on the 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.approva! oflthis 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 pa rt 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. ........... ......... (Signature of applicant, or name, if a corporation) (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No .....................7~.~ ...................... Electrician's License No ............................................. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................... O~e~er~ Co, eraS. Contractor Name of owner of premises ...................................... , ............... N~):L,~i.~.OFk..D~'I .l~,~e.. T~g ..................................... : ....... If applicant is a corporate, signature of duly authorized officer. Other Trade's License No ............................................... 1. Location of land on wh ch pr osed work w be done. Map No.: .............. ~ Lot ~..~_ ... Street and Number ...... ..~.~....,...~..~~ ....... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ~[2..~...'~ b. Intended use and occupancy ..... :.....i ............ ' Off:J.~O Fao~l:J,.~. ~.....~....~..~ . 3. Nature of work (check which applicable): New Building .................. Addition ........~ ........ Alteration ....~.. ......... Repair ......; ........... Removal .................. Demolition .................... Other Work (Description) 4. Estimated Cost ................................................... Fee .......................................................................................... (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 ...... ;30 . Rear 30 Depth J~O' Height ............. 1~ ....... Number of Stories .,], ................................................ Dimensions of same structure with alterations or additions: Front ~40 Rear Depth .................. ~ .......... Height .1..2. ........ ; ............... Number of Stories ..3'.. ............................ 8. Dimensions of entire new construction: Front ...].Q ............................ Rear ..;LQ ..................... Depth .............. ~. ...... Height ............ .1.[... Number of Stories ....~ ............................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ...................... .. ......... 10. Date of Purchase ....................................................... Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ........................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ ]3. 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 distinctly 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 whether interior or corner lot. STATE OF NEW t.~,~)l~,. ~/ [ S S couN'r, ...................... ~.,.,.~.~-~-~ ............................. being duly sworn, deposes and soys that he is the applicam (Name of individual signing~bntracf) above named. He is the ....................... ......~....~i.~~ ............................................................................... · ~ Z :0 (~r~tractor, agent, corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the Aid work and to make and file this application;~that all stateme~its~contajned Jn this applicati~are true to tJ~ best~pf his know~le end belief; and that the work will be performed in the manner set forth in the al6pli~:ation filed therewith. I Sworn to before me this __ I I I I I/ ~1 I .................... ....... ................... ,,, ........ Notary Public, . ................................................... County ...... ~:j4i/.~x.v.;..,,~....v. ........ ..~..-~-/...-wc...~.w,~........-,~x......-~ ................... -I' (Sign,~fu~ of applicant)