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Home My WebLink About6508-zFOR~ NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. ~869 .... Date ...... Apr!Z 2~ .., 19.7~. THIS CERTIFIES that the building located at 8otlr~] A~,~ .... Street Map No.. ~ Block No. ~ .... Lot No. ~. ~.¢It~mk ~,Y, ....... conforms subs. tantially to the Application for Building Permit heretofore filed in this office dated .. .Ap.,'~_ 2h. , 197.3 pursuant to which Building Permit No. 6~.0~Z . dated ~ r ipl'il 21~ , 19 73', was issued, and conforms to all of the require- ments of th~ applicable provisions of the law. The occupancy for which this certificate is issued is ~flcesaol~ (stol'age) bu,~,ding .......................... The certificate is issued to ~omas & ,71~a. Harmful ...Owl~,~z ....... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE No...lq,R, ................................ HOUSE '~ ~UMBER ~,~80 ..... Street .. goriest..A~ ........................... t /?.,:.,..,/.. Building Inspector/ FORI~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 6508 Z Date ......................... Zb~.~.:~ ....... 2~.:. .... ~9.Z~.. \ Permission is hereby granted to: ................ Yia.t, tStuclr ......................................... ~o ~.~.e.~.a.~.q~..s..s.~rz~.(`.~.s..t.~.q~.a..~.e.~.)~..t~..u.~.a.~.n.~. ............................................................. at premises located at ...... ~/.~......~.'~..,~'~ ................................................................................... ..................................................................... Mat.tituak.....~.~Y.~ ............. : ......................................... pursuant to application dated ..........................~-;[-1. ..... 2~ ....... , 19~.~ ....and approved by the Building Inspector. Fee $.I.0~.QO ............ FOF~M NO. 6 TOWN OF ~SOUTHOLD Building Department Town Clerk* Office Southold, iq. ¥. 11971 APPLICATION FOR CERTIFIGATE OF OGCUPANGY 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: 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 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 Englneer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), No~-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: l. 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 pete .... ..... New Building ............. Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ....~.~.L,~..~..~....~.: ...... ..~.....~'....~.~Z'~.¢~. ............................................................. Owner Or Owners Of Property ......~.~:~/~..~.,S......~.....~/.~. ........ .~......~...~...~. ................................... Subdivision .............................................. t ............... Lot No ............. Block No ............. House No ............. · ,/ / Permit No, .~. ....... ?.. ....... Dote Of Permit ..~ ...... APplicant .... ,/.~.~Z?... ,/-.'.'~.~;~CfZ.. C4~. ..................... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building,~ Tit meets all aT/[/_c, able cod_es a~egulations' Cstamp or seal) Sworn t.~_before me this · .J-~.. ....... day of,....~...~..) .......... ,..i..~..~..~... Notary Public ././~. ............................... Count~FPGTER M. cOLGMA~'I . / J m i /i NOTAP, Y PUBLIC, State of New York .//.L / . ~. No. 52-5658570 ~t"~*~-~¢~--~_ Qualified in Suffolk CountF ~ -- CeerJdeim E~ims Mgrch 30, 1976- FOir,~[ NO. 1 BUILDING DIPARTMINT TOWN CLBRK'S OFFICE SOUTHOLD, N. Y. Application No. ................................ Approved ........................................ APPM~,,ATION FOR BUILDING PERMIT Date ........... ......... ......... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with~ 3 sets of plans, amurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streetS or areas, and giving a detailed description of layout of ~must be drawn on diagram which is pert 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 building shel! be occupied or used in whole or in part for any purpuse whatever until a Ce.rtificate of Occupancy shall have beer~ 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 La~s, Ordinances or Ragulationa, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with al~applicable laws. ordinances, building code, housing code, end regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Address of applicant) State whether applicant is owner, lessee, agent, archi;tect, engineer, general Contractor, electrician, plumber or builder. ........ ...................................................................................................................................................................... Name of owner of premises ....~..~...O....r~l...~.~......aD.~......~...u....r).~.....~)~.f~...r'..~.~.~. ................................................................. If applicant is a corporate, signature of duly authorized 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 .................... .~i~.... ................... Lot No. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ?:'a. Existing use and occupancy ..... ~:~.L~..~.!../I:.Q. ~.:;....~.D.~'......-'~,,~73/.'~.....~.~,, ........................... .,~.~" Intended use and occupancy ...... J~IJ92gg.....LJ.f.A/,/~.. ................... (~LC~ t'~.,~.~'~[....~...u-..i/.~.~. '/9~ .... ~.i'i~.i~..iiil. 3. Nature of work (check which applicable): New Building ...................... Addition ..................... Alteration ............... Repair..,...... . . Removal .......... Demolition Other Work ................................. (Description) · 4. Estimated Cost ...... ~..~...0...~.~ ......... ,~ ......... :~ Fee ................................................................................................. (to be paid on filing this application) 5. If dwelling, number Of dwelling units ................ Number of dwelling units on each floor ......................................... garage, number of cars .~ ~.Z)~.../J~J~..CE......~).0:/~q.~..:.' ...... ~...~ ............................................................. If 6. If business, commercml or mixed occuDancy,~Spac'fy nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front .....................Rear ........................... Depth ................................... Height ................................................. ~ ......... Number of Stories ....~. .................................................................... Dimensions of same structure with alterations or additions: Front ....~... Rear ......................................... Depth . Height Number of Stories ..... 8. Dimensions of entire new construction: Front ...... LO.../. ........... Rear ........ I.~.../. ............ / Depth .....t...~. ....................... Height .../a.....~.(d~.~.....~..~..~za.~,... Number of Stones ....( .................................................................................... 9. Size of lot: Front ..../...O...O...x. ....................... Rear ........ ~.P..~.../. ....................... Depth ....J..~.~:...~..~...~ ............................. 10. Date of Purchase ...0.~.~.:....../..~.?.~. ........ Name of Former Owner?.~..~.~...r~.. ......................................................... 11. Zone or use district in which premises are situated ..... ,~t ........................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~..g~ ............................................. 13. Will lot be receded ._._~....., ................ Will excqs Sill be remo~_,ecl from premises: [ ] Yes [~]~1o . "~- /// (Address) (Phone No.) " Name of Architect ..................................................................................................................................................... (Address) (Phone No.) Name of Contractor ..... (Address) (Phone No.) PLOT DIAG RAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all sat-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. STATE OF NEW_Y_OR_K,._ ) COUNTY OF ......*~...'~..;~..~.~ .~..X,,.X..~ ........................ ) "~ ........................... ~...'.'~ .......................................................... being duly sworn, depoms and seys that he is the epplicant ebove nan'~d. (Name of individuq_l signing contract) He is the ...................... (Contractor, agent, corporate officer, etc.) of said owner or owners, art~t~ly authorized to perform or have performed the said work and to make and file this application; that ell statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. .......... "~'-~ day of ~.~ Hew Yo~'k, 19"-" .............................. · ur' i t~o Coun,y ~ .~ · ~f, .. ~ (S/gnature of applicant)