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Home My WebLink About6953-zFOR~I NO. ~ TOW1N OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.. Z5'885.. Date ..... ~ 2 ....... , 197.~.. THIS CERTIFIES that the building located at W/8. Harbor. Lane ....... Street Map No. ~ ... Block No.. ~ Lot No. ~ ~tcho~e. ~, ...... conforms substantially to the Application for Building Permit heretofore filed ~ t~s office dated 0Cg ,2% , 19.73. pursuant to which Building Permit No. 69.~3Z dated . 0og 2~ ., 19. F3., was issued, and conforms to all of the req~e- ments of the applicable provisions of the law. The occupancy for which this certificate ~ issued is Ag~ic~tur~ .st~age .build~g ....................... The certificate is issued to Jo~ph & .Stap~ S~ski. ~ers. (owner, lessee or ten,t) of the ~ores~d buil~ng. Suffolk Co~ty Department o~ HeMth Approval ~.R, ........ UNDERWRITERS CERTIFICATE No .... H~R. .................................. HOUSE NUMBER ... 2~00... Street ..... Harbor. ~no ........................ B~lding Inspector { ]FOF~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON TH]~ PREMISES UNTIL FULL COMPL~-TION OF THE WORK AUTHORIZED) N.o 6953 Z Date .......................... 0~t ....... ~-~ ............ 19..7.~.. Permission is hereby granted ~to: ..-3~-.-.~-&n~..s.t .............................................. .... ~..~.~..~.o..~ ................................ to .,~..~.¢.]~;!...~e.~r...~ g~.~.~.t~m~.~ .. ~.t ~.~ ~..l~.u~2,~ ~ ........................................................ at premises located at .... ~...-~[a~...~,l~li~ ................................................................................. ....................... : ..................... C,.u~~ ....... ~t,~. ..................................................... ~. ....................... pursuant to application dated ................... .~......~. ................... , 19...~3., and approved by the Building Inspector. Fee $.t.~OQ ........... FOI~M NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANGY Instructions A. This apphcation must be filled m typewriter OR ink, 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 topograph,c 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, Industrml buildings, Multiple Residences and simdor 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 opphcoble B For existing buildings (prior to Apr,I 1957), Non-conforming uses, or buildings 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 Dote of any housing code or safety inspechon of buildings or premises, or other pertinent in- formation required to prepare a certificate C. Fees: I. 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 Dote ......~....~.-? .~.....". Z../. · .................. New Building ......~. Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Prope, ..... ......................................................... Owner Or Owners Of Prope.rty ...~-~.,.~...~..,.,.~.....~...~.~.~...~..~./~,~...~..,...~....~....j~..~...~.~r~...~...~ ..................... Subdivision ................... '~.....~. .............................. )...Lot No .~ Block No .Z...~. House No Permit No....~...~.....~.......Z:". Date Of Permit ....~....~.7..~Applic~nt' .ii'~..~.~.~.'i:i~[z4.4~/.~..~..~.'.':~ii:i:i Health Dept. Approval .......... .~.......K~... ...................... Labor Dept. Approval ........ ./h).....!..~... ............................ Underwriters Approval ............ .~. ............................... Planmng Bo~rd Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......... .~ ....................... Fee Submitted $ ....~.. .............................. Const~ction on above described building an~yermitmeets ~al~blecodes and r~e~ulations. Sworn to before me~is ..... ~ ....... day of ~.~..~.~.I. ................ / ~ ~'L ~/~ TITL~ ,N~. 0]-74090 ~',I~UTflORff. ED ALTGA'IION OR lo ~IS SURV~ IS A VIOLATION ~ SECTION 1209 O~ THE N~W YO~ ~ ~DUCATION (OHLS OF THIS SURVEY ~AP ~T TO THE ACS GNEES OF THE L[NDINO INSfl- T~ION GUAP, ANT[ES ARE NOT TO AbDJ~IONAL INSTITUTIONS O~ bt~L t..U t.-T 6~,RP. f S~',4~'ra"/:: . - ..~!.~.~ TITLL- NO-. 01-740g0 Approved ........................................, ........ TOWN OP SO~TNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Permit No~..~....~...~,.:~ ............ Application No..~...?....~..,~.. .................. Disapproved a/c ...................... z:rzz ...... ~ .... ~ ..... ............-~,.,~-'-'~ _ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. Th~s apphcahon must be completely filled ~n by typewriter or ~n ~nk and submitted in triphcate to the Building! Inspector, w~th 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing Iocahon of lot and of buddings on premises, relahonsh~p to adlmmng premises or pubhc streets o~ areas, and g~ving a detaded description of layout of property must be drawn on the diagram which is part of th~s application. c. The work covered by th~s apphcohon may not be commenced before issuance of Building Permit [ d Upon approval of th~s applicohon, the Budding Inspector wdl ~ssue a Building Permit to the opphcont. Such permitI shall be kept on the premises available for inspection throughout the work. ~ e No building shall be occupied or used m whole or in part for any purpose whatever until a Cerhficate of Occupancy[ shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the msuance of a Building Permit pursuant to the Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other opphcable Laws, Ordinances or Regulahons, for the construction of buildings, additions or alterahons, or for removal or demolition, as herein described The apphcant agrees to comply w~th all apphcable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and Jn buildings for necessary inspechons. . , (S~grfoture of applicant, or name, if a corporation) (Address of applicant) .j -j ~.~br State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................ Q¥~.ZLO. Z' ......................................................................................................................................... Name of owner of premises ..O~P.~,b,..~%..~.~.~.~.~,TL~.~. ..... ~.q.~,:.'.~,D ~.~f.:~ .............................................................................. 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 ............................................... I. Location of land on which proposed work will be done Map No.' ...... ]? ............................ Lot No .... .~.~ .............. Street and Number ..... ,?../..~.......[:~.~?...b.g.~..~?...e. .......... .C..'g..~..c..b....o.~..~..e. ....... .[......~;.: ..................................................... Municipality 2. State existing use and occupancy of premises and m'ended use and occul~ancy of proposed construction: a. ExisJting use and occupancy ...... ~.9,.q.~,~.~....~..c..e...z'..~&e. ................................................................................ b. Intended use and occupancy ...... ~.~.Z...~.c.~.3:.~...~.?.~.~...~.~..o..7.~.~.e:...]D.~.J:.]...,~.~[~ ...............................................