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Home My WebLink About6597-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z~91~.9 .... Date ....March .1 ............ , 19...~8 THIS CERTIFIES that the building located at .. t 235' Old $~i?ya.l~cl· La., Street Map No.. · 83~ ..... Block No ..... Lot No ...... 1 t 1 ....................... conforms substantially to the Application for Building Permit heretofore filed in this office dated . l~.ay ~-3 ., , 19. 73 pursuant to which Building Permit No.. ~97~ dated "?4ay '~ ......... , 19.. ~) 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 ..... Accessory '~ul'lcliug ..................................... The certificate is issued to . . '5ohn'& -Lorraine' .I)e~be~'~i~ .................... (owner, ll~e.p~t~u~ of the aforesaid building. Suffolk County Department of Health Approval ...... t~/R .................. UNDERWRITERS CERTIFICATE No .................... I~/~ .................... HOUSE NUMBER '123~ ' .. Street.. Old' S~lpyard'L~oae' · '/ ............. ...................................... $o~o1~'~' i~ew' ~o~,~, · ' · .............. Buil~iing I~pector ~ORl~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6597 Z Permission is hereby granted to: John DeAlbertls South old Build new accessory storage buildt~.$. tO ..................................................................................... .~V. ................................................................. pursuant to application dated ...................... .M...a.~.. ...... .2..3.. .............. , 19.?..3...., and approved by the Building Inspector. 10,00 Fee $ ........ ~ ............... ~uilding ,nspector ~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Glerk~ Office Southold, N. ¥. 11971 APPUGATION FOR CERTIFIGATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildings or new use: I. Final survey of property with accurate Iocahon of all buildings, property lines, streets, and unusual natural or topographic features. 2.Final approval of Health Dept. of water supply and sewerage disposal--(5-9 form or equal). 3.Approval of electrical installation from Board of F~re Underwriters. 4. Commercial buildings, Industrial buildings, Mulbple 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 site 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 inspechon of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 2. ~,erddcate aT occupancy o~t,[ngdwe~ling or land use :$5.00 3. Copy of certificate of occupancy New Building .....~.' ............ = Old or Pre-existing Building ...... · .~..~.....; ......... Vacant Lend ............................ ........ III ". - LOCaTIOn UT rroperty v:...,~...~....;./.: ..... ..~,.,..-~..;:~...~,~. ........ ~ .............~ ................ ~ ............... .~....~., ..... .~ .... Owner Or Owners Of Property ..... .~;;..%.~...% ...... .~..~....~.~..~..~...~ .......................... Subd,vls,on ~~.~. ....................................... Lot No..~/././.. .... Block No ............. House / ermit No, ~,,s..,.~.,~ ........ C~,~,/' 2 7// ~ 77/ 5",? ,j,~ ~-/'5'~, ,,,.,~,~ ~. ~ ~ ~, ,~ ,.~ Health Dept. Approval ............................................ Lobar Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......,~ .............................. Fee Submitted $ ....... ,.'~..,.'..,..J~.,,. .............. Construction on above described building and Rermit meet~oll applicable codes and regulations. Applicant ....... ~.,......~....~..,. ..................... t.~.l.'.. Sworn ,o before me t~is . ~/ t~/~- (stamp or seed , ~( ~ ................ day of ............................................ Notary Public .................................... County Exomined Disopproved a/c ............................................... . ~ . ,/~,..j,~.~/.~ ( dng In orJ ~:..~,.. ~'~ ,Iding Insp~o APPUCA?ION FOR BUILDING PERkUT L"')//. ~ Date ....... ..~....~.......~..,..~.....~. ............. , 19.~....~........~. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inldector, with~ 3 sets of plato, accurate plot plan to scale. Fee according to schedule. b. PIOt plan showing location of Jot and of buildings on premises, relationship to adjoining premises or public streets orareas, an~l~ giving a detailed description of layout of property 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 the premisel ~vlillble for inspection throughout the work. e. No building shell be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have bee~ granted by the Building Inspector. . APPLICATION IS HEREBY MADE to the Building Department for the issuance of e Building Permit purlulmt tm the Building Z .m~~ Ordinance of the Town · of Southold, Suffolk County, New Yodc, and other apphcable Laws, Ordinances or RngUll~JOfll, for the eQnstruction ob~llidnianngrc~s,~duii~sa c~'.~ut,sTnnaS~ef.O_r_r~e__m~_.~.a_l..or demo. l.lt,on., a.s her. em de.~.r,bed. The applicant ,reel to eompl¥ withe applicable ,lw~!~ ,, , u ,,, aha regu~azlons, aha zo aam~t autnorized inspectors on premises and in bulldlngl for neoessarv inldections. / // (Address of ~'policant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nameofownerofpremiles :::~.~...~::~.'::~:::::: ::::::::::::::::::::::: ....................... :::'" If applicant is a corporate, signe~Jre 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 ................................................... 1. Location of land on which pr_opoAed~work w II be~clooe Map No.n ........ ~..~ .Lot No..Z/..../. Street and Number .~.~,.~-e~.~~ ;~" ............... - / ....... ........ ........ ......... .......... 2. Stete existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...~: ....................................................................................................... 3. Nature of work (check which applicable): New Building ....... ~ ....... Addition ..................... Alteration ............... ............. ' (Description) Repair ............ Removal ................ Demolition ........................ Other Work 4. Estimated Cost. ...................... " '" "' '" '" '"" (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, commemial or mixed occupancy, specify nature and extent of each type of usa ..................................... 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 ......................... Rear ............................ Depth ' . ...................... Height ........................................... Number of Stories ............................................................. 9. Size of lot: Front..... ..................... ... .. .... ... Rear .................... ....... ...... ..... .... Depth ...................................... .... · ....... 10. Date of Purcnese ..................................... ,~o,,,= v. ,v,,,,=, ,,, .... ~:4 ........ 7 ..................... 11. Zone or usa district in which premises are situated .......... /..~ ..................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....................................................... 13. Will lot be regraded ............................... Will excess fill beremoved from premises: [ ] Yes [ ] No 14. Name of Owner of premises ~ ........................................... .~, ....... i~,'~i ..................................................... {Phone No.) ' ........ ~ Name of Architect ..................................................................................................................................................... (Address) (Phone No.) Name of Contractor .............,~ ................... ~ ................................................................................................. {Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildinga, 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. COUNTY OF (Na~ of individ~ si~ing con~act) (Con.tot, a~nt, coyote o~r, etc.} 'rof sa~ owner or owners, and is duly au~horitsd to ~rform or hays ~r~ormed tbe said work and to maks and fils this aoplicafion; ~at all stat~en~s contained in this aoolicafion are trus ~o t~ ~st of his knowled~ and ~lief: and that the work will ~ ~dor~ in Sbe ~nnsr ~or~h in ~he application filed t~rewi~h.