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Home My WebLink About6740-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z- 6258 Date: 12/27/74 THIS U~4(TIFIES that the building ACCY GARAGE/STORAGE BLDG Location of Property: 250 HAMILTON AVENUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 473889 Section 140 Block 2 Lot 5 Subdivision Filed Map NO. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 19, 1973 pursuant to which Building Permit No. 6740-Z dated JULY 19, 1973 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is PRIVATE ACCESSORY GARAGE/STORAGE BUILDING. CORRECTED 3/1/10 FOR CHANGE IN ADDRESS ONLY. The certificate is issued to CLARA FOSTER of the aforesaid building. ( OWNER ) SOF~0LKCOUNTYDEPA~11~9~T OF NEALTHAPPROVAL ELEurRICAL CERTIFICATE NO. PLIERS C~TIFICATION DA'£~U3 N/A N/A N/A Rev. 1/81 Form No, 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL APPLICATION FOR'CCERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building 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 from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Ftre Underwriters. 4. Sworn statement from plumber certifying that the solder nsed in system contains less than 2/10 of 1% lead.. 5. Commercial building, inc~"'natrial building, multiple rcsideaces and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 19S7) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing M1 property lines, s~'eets, building and unusual natural or topographic features. 2. A prcperly completed application and consent to inspect signed by the applicant If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory bnilding $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building. $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temperary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction: Old or-til~i~i~'~Bullding: LocationofPrope~y: ~--~) .~[ /'Y/.~'/.~txJ House No. Street Owner or Owners of Property: ~'~ [ ~J~ ~'p_~. )Z~ ~ Suffolk County Tax Map No 1000, Section ~ ~-~ ~) Subdivision PermitNo. b~7/'] ~) DateofPermit. Date. ~ (check one) / Ha~mlet Health Dept. Approval: Block ~ Filed Map. Applicant: 'Underwriters Approval: Lot Lot: Planning Board Approval: Request for: ~Ce~ifieate Fee Submitted: $ Certificate: FOBM NO. ~ TOWN OF ~OUTHOLD 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) N? 67 0 Z Date ........................ ~tt.~:y .......... ~$ ....... , 19~3'" Permiss~n is hereby granted to: · ..Che, e ,...i~,...Fe~t,e.~ ........................................ .......... ~o~e.~ .................................................. to ..... ~L3~..~ew...~t ~;~ ~.~..~.8~&ee..&...s~ e~e.)-..b~.l<t~ ......................................... at premises located at ..~/.,S..b~u~L:l.t~l~..~fe ................................................................................... ................................................ ~af.t ;~.?~ue~ ......... J~.,¥., ....................................................................... pursuant to application dated ........................... ~t~ ....... ~l~c~' ...... , 19~..., and approved by the Building Inspector. Fee ~O~QD. ............. Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No.Z..6. 2..~.~. ..... Date .............. THIS CERTIFIES that the building located at . .5/5. }{a~!lton. Ave ....... Street Map No...x~. ......... Block No...XX ...... Lot No .... xX.. Eati;ituck..N,i, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated .......... .~.~..l~...! 9.., 19.73. pursuant to which Building Pemit No..67.~.0~. dated J'u.]-7 ¶ 9 1973 was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .p.r.fLXa..t.e..~qe. !e~.s. ql'y..($~p.r.~g~ ). b.~lt, ldlllg ............................ The certificate is issued to . .C..l.~.r.a...Fp.s.t..er ..... .0..ri.e.r ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .E. :.R.o ............................... UNDERWRITERS CERTIFICATE No..E. :.R: ....................................... HOUSE NUMBER .. ~8..0 ........ Street ...lt.a.m.i.l.tp.2. l~.v.e. ......................... Building Inspector FOEM NO. 6 TOWN OF SOUTHOLD Building Deportment Town Clerks Office Southold, N. Y. 1197! 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: 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 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. Swam 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 3. Copy of certificate of occupancy $1.00 $5.00 New Building ~ Old or Pre-existing Building Vacant Land ............................ Location Of Property ..................................................................................................................................... Owner Or Owners Of Property ~...~ ........................................................................ Subdivision ................................................................ Lot No ............. Block No ............. House No.~..~...~.. Permit No./~..~..~..D...~... Date Of Permit .~/../.~.l~..~.Applicant .... ~,~.....~...~ ..... Health Dept. Approval ........... ~ ............................. Labor Dept. Approval ................................................ Underwriters Approval .......... .~....]....~.... .................... Planning Board Approval .... ~..~...J.....~... .................... Request For Temporary C~e~rtificate ........................................ Final Certificate ......... ~ ................ Fee Submitted $ ......~.....~: ............. Construction on above described building and permit meets all applicable codes and regulations. Applicant ......................................................................................................... Sworn to before me this ........ ......... Natary Public ......... County (stamp or seal) TOV/N OF SOUTHOLD BUILDING DEPARTMF. NT TOWN CLERK'S OFFIC~ Examined ........... 2 ~ i 9..?...-~.... /'7 ...... Application No ......... '.....~. .................. j ....... Approved ...................................... 19 '~3. Permit No. j:::~.,.....~. ........ ;....~. ......... ............ APPLICATION FOR BUILDING PERMIT 192~.... Date INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Buildin Inspector, with 3 sete of plans, accurate 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 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 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 shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan 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) ( tess o applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ......................................... ....... ............................................................................................ Name of owner of premises ....~...~ .................................................................. 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 ............................................... Street and Number ,e~-z~.~.~J~/~'~ --- ]//'/~'" ................. .~/~...~......~... ................................. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use or~ occuponcy ....~..~.,.~ ................................................................... t 3. Nature of work (check which applicable): New Building ......... ..~ ..... Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ...................................................... 4. Estimated Cost .............. ~ ............................... Fee ~.,~ :~ (Description) (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 ................................ 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 Purchase ........................................................ Name of Former Owner ........................................................ I 1. Zone or use district in which premises are situated ~ 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. VV'Jll 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 d~ed, and show street names and indicate whether interior or corner lot. STATE OF NEW~R~v/,/~/' [SS. cou. ...... .... : .................. being duly sworn, deposes and says that he is the applicant klName oT malvlaual signing contract] obove named. He isthe ...................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, end is duly authorized to perform or hove i:~rformed the said work end to make and fife this application; that all statements contained in this application ore true to the best of his knowledge end belief/ and that the work will be performec[~ the manner set forth in the application filed therewith. Sworn to befqre me this ( I .................. · ./..~'~:ly of , -~' ~ , 19.?..~. ' Notary Public, .~'~~i"~unty ...... ...~:~.......~...L'j~.. i.~..~..~ ........ (S'gnature of applicant) TERRI LIE ELAK NOTARY PUBLIC, State of New York No. 52-6168295 Qualified in Suffolk County Commission Expires March 30,