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Home My WebLink About7030-zTOWN OF SOUTHOLD B~m.nlNG DEPARTS~NT Town Cl~k', O~iee Sou~ lq. Y. Certificate Of Occupancy THIS CERTIFIES that the builaing located at .F~ ,R,0,I~,. Pst .~1~ ~.~.. Street Map No~tehardson. Block No... ~,x ..... Lot No, .¥. tilt. ~riol~.. II.,l[, ........ conforms substantially to the Application for Building Permit heretofore ~ed in this office dated ...............Dec...1~ 19. ~ pursuant to which Building Permit No.. dated ............D. ee ! ~ ..... , 19..~J, was issued, and conforms to an of the require- ments of the applicable provisions of the law. The occupancy for which thi~ certificate is h~med i. Prlvata .one..~y .dw. lltr~, vith. &ddit$oa ....................... The certificate is issued to .~,4aa. BeanerY. · · · Ovner ............................... · (owner, lessee or tenant) of the aforesaid building. Suffolk County Depm-huent of Health Approval .11,I~. .............................. UNDERWRITERS CERTIFICATE No... IE1.~)~30~ · · · Nov- I?~.,..19.~ ............... HOUSE HUMBER ....~O ....... Street .... Pet..R~ad. ~'3 ........................ ..... ....... Building [ 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) No. 7030 Z Permission is hereby granted to: ...... ~. ¼1~,.,~, ....... .~/~.. ...... /....~.~:..~ .......... ~ ?.:.~ U..~C ~... at premises located at ~'/-)' ~'' /YF A 7F~c"/~' ~ ~ ~ ~ 7 /F ~ A ~ .................................................................................................... ~.~.~.z ....... ~A~.~:.~./:'..~ ............. ........... ~(~.~ ...... ~ ~ ~ ~ ~ -~ .......... pu~u~nt to application dat~ ................................/.~....~.~....., 1~..., and approv~ by the Building In~tor. Fee $ / ~- ~ Building Inspector -' i TOWN 'OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~UTH~D, N. Y. ............. :' ................... " ........ ¢ (Building Insurer) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application ~ust be completelY/ 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. 1,1 b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, an 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 on the premises available for inspection throughout the work. e. No Uoilding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been grant~d 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 CounW, 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 buildin~ for necessary inspections. ' ~/ (Address of applicant) / / ~3~7 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder; Name of owner of premises Edema Bennett If applicant's a corPorate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ....8~..~. ........... Lot No.~ N.J4. .......................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~...f..a~.....l~....(..2.)...h.~ ......................................................................................... ~tud~.o & Cl2-eenhouse b. Intended use and occupancy .................................................................................................................................. Nature of work (check which applicable): New Building ....................... Addition ....JE ............. AIteratior~ .............. Repair ............. ............ Removal ......................... Demolition ........................ Other Work ........i'l~[~;[~¥i'~i": ....... 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 ..... ~,~. .......... Rear ..~l~~. ................... DePth ...~1. ........................... Height ........................................................... Number of Stories ..... ~, ..................................................................... Dimensions of_ same structure with alterations or additions: Front .....?~.! ................ Rear .....7~! ............................... 36' Depth ............................................. Height ......................................... Number of Stories ....~, .................................. 6e 8. Dimensions of entire new construction: Front ..... ~.2.~ .............. Rear .....~..2..~ .................. Depth ...~ ............................ Height .............................................. ~.. Number of Stories .....~, .................................................................................. , 9. Size of lot: Front .......~.~. ......................... Rear ....... J~ ............................... Depth .lS9 ........................................... Height .................................. ; ................. Number of Stories ...................................................................................... 10. Date of Purchase ...OR..tL.~..~.~ .............. Name of Former Owner ..~nrLa. te~.JlAl~m:tct,..~l'~.&.adz~ .................. 11. Zone or use district in which premises are situated ...... ~r~.li.~;Le~, ........................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ...[I~- .................................................... 13. Will lot be regraded ................................... Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises ~...~...~.~R~.~..~.R~.~...:~...~.~..R~`.~.~ct~.~.~..~.~.~J~.~..~.~.~ ...... ~77.......T~6.. ...... (Address} (Phone No.) Name of Architect ............................................................................................................. ' ....................................... (Address} (Phone No.) Name of Contractor ....... ~.~ .......................................................................................................... '. ................ ~.--.~. ........ (Address) // (Phone No.) PLOT D AG A= Locate clearly and distinctly all buildingS~ whether existing or proposed, and indicate all set-beck 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 ,ot.~o ~(~c¢~'P ,~'~' ~ ~,,~4h~ I .......................................................................................................... being duly sworn, deposes and says that he is the aPl~licant above named.. (Name of individual signing contract} He is the .................................................... .~. ............................................................................... :. .......................................................................... ' (Contractor, agent, corporate o/~cer, etc. ] of said owner or ov;ners, and is duly authorized to parforj~ar, have oerformed the said work and to make a~d file this application; that ell statements contained in this applicatio~ are true to t~llsl~l~?l~A~le~e.?e~d bPI?f; and that the work will be parforrne~l in tile manner set forth in the application filed therew;th. J2-03449~3 Su~i~olk Countw ~~ . ~.ommi#/o~Expirel March 80,, ...................................... day of .................................................. 19 ............. Notary Public,, .................... [ .......................................... ~.. County / [S~atare of applicant} FORM NO. $ TOWN OF SOUTHOLD , Building Depmtmeet Town Clerks Office So#thold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink., and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: ]. Fine[ 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, ~Aultiple Residences and similar buildings end 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 1957), Non-conforming uses, or buildings and "pre-ex'st'ng 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 owner os 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 certifioate. C. Fees: 1. Certificate of occupancy $5.00 ~ 2. Certificate of occupancy on pre-existing dwelli~ng or land use $5.00 3. Copy of certificate of occupancy $1.00 Date .......... ..fi~....~... ~!~...../..?..~.....].. ~.~..~ ~ New Building ................ Addition ................ Old or Pre-existing Bulldog ................Vacant land .............. Location Of Property ..............~....~.....~.. ....... _~...,...~..A..?....E. ...... ..-~...~.~.....~.......~...¢ ......... ~_-_-~..~.~......r~.....~....'~...,..0...~.!... Owner Or Owners Of Property ......... ?....~....~....~......i..~...~...~!...~....~..~ ................................. Subdivision ..................... .~.....::~ ................................. Lot No.......~. ..... Block No ......'~..:... House No.?...~...?.. Permit No. 7 ~)-~O 7_._ Date Of Perm t ................ .~.Appl cant Health Dept. Approval ................... ../~.....,~.,. ............... Labor Dept. Approval ................... ...~....~..~.. ............. Underwriters Approval ~..J..~..~...~..~.~,~.~/~..2J/.rT..~.....Planning Board Approval ........... .../~....;..../....~. Request For Temporary Certificatee' -~,~o~c~,,~ ........................................ Finczl Certificate ~ Fee Submitted $ ......... ~.. ...................... Construction on above described building and permit meets all opj>licable codes end regulations. ......................................... Sworn to before me this ................ day of'~,q~..~....... ....................................... Notary Public .....~............ County THE NEW YORK BOARD OF FIRE 'UNDERWRITERS BUREAU OF EI. ECTRICITY~ · [-- ~.,,Novembel' 21 ~ 19~s JOHN STREET. NEW YORK, NEw yORK' I00~S .,,.,~,,.o.~o.o.~/,,. ?3]m~.q.. :' N 195306 THIS CERTIFIES THAT only the e~ctr~c~ equipment a* ~ri~e~ ~ ~m~ intro~u~e~ by t~e ~p~t ~M o~ t~ ~e ~ppl~t~on ~umber in tb~ prer4~e~ o~ ~s. Edna Bennett~ Pv~. Road~ w/s/de Roc~ Pt. in the.following location; ~-~ E-.~,,-.,.t [] ~. rt. [] ~ tn. out;slde s~ta,~ Sto~n ~ot V I C 2 MUUI-OUTW~' SYSTEMS NO. Of NET EXHAUST FANS H.P. DIMMERS AMT.' WATTS O ~ 5 Cont~., PoOoBOX 215, $OUthold~ L.I. 11971 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICA~,MUST NOTT BE ALi'I~Ifl~D, IN, ANY MAHNER. _ f