The URL can be used to link to this page

Home My WebLink About6622-zFO~ NO. & TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's O/lice Southold, N. Y. Certificate Of Occupancy No. g. ?.~2.0 ...... Date ......... .Ju~..y....~.2...., 19..~.6 THIS CERTIFIES that the building located at R; 9.o.~.,.. $/.S...M.a.l.n...R9.~4.. Street Map No. ~ ....... Block No.. ~ .... Lot No, . .x~c.....~.a..s.~..l~.a..r.i.o.n....N.o.~.: ...... conforms substantially to the Application for Building Permit heretofore filed in this office gun~Augl 17 7319 72 6066Z dated .................. pursuant to which Building Permit No..6622~. dated . ,6/!./?.3.., ...., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...P. riy.ate...o.b.e..$..a.m.i.l.y..(.s.e.~8~o~)..d~ellir~g ....................... The certificate is issued to .Ke.r.m..i.t &..L..il.l.i..a~. W.e.a.th.e.r.1..o.~. ..... .~e.~$ .......... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ............................. HOUSE NUMBER ... 1.2.8~0... Street ....M.a..in...R.o.a..d .... E..a.s.t...Ma.r.i.o..1~ ........... NOTE: Interior to be completed by owner FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6622 Z Permission is hereby granted to: ~t..~..~.~..~e~.t~r.~.~ ................ ............. Ne~e~_ne ................................................. ......................... ¥~ ....... e~ ........................... at premises located at ...~.~..~I~,t~...H~d ........................................................................................ ............................................................ ~as.t...~l~n .............. ~.~.~ ................................................. pursuant to ~application dated ........................... ~l~e, ......... .] ........ 19..~.3.., and approved by the Building Inspector. Fee $..~,. Ot~ .......... FORM NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions A. This application must be filled in typewriter OR ink, and submitted m DUPLICATE to the Budding inspector with the following; for new buddings or new use: I. Final survey of property with accurate location of all buit&ngs, property lines, streets, ano 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 comphance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed s~te plan requ,rements where applicable. B For existing buddings (prior to April 1957), Non-conforming uses, or buddings and "pre-existing" land uses: 1. Accurate survey of property showing all property hnes, 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 bu,ldings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Cerhficate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date .... .~...O.....J~ .e.....~. ~.Z.G.. ............. New Building ................ Addition ~.~..J:.~.~DId or Pre-existing Building, ~.~.~.]-Vaca~nt Land Laa5 prop. ~erry '~'~{~'~-'i'~) Location Of Property ~:~L~;~~*~3`~e~i~:D~`~;~`~°~aS~1~3~~ .......... Owner Or Owners Of Property ~D~q'lit H, & LillJ. an ~'. ~eatherlow Subdivision ................................................................ Lot No ............. Block No ............House No ........... Permit No ......6~2274... Date Of Permit .._]..c).~..~ ........ Applicant ...... Ol~,~ ................................................ Health Dept. Approval ............................................ Labor Dept. Approval ................................................ N 289414 ~lan in Underwriters Approval .............................................. ~' n g Board Approval ........................................ Request For Temporary Certificate ........................................ Find Certificate . ..g....o..~....Q ...................... Fee Submitted $ .... ~. ;. .0. . .0. ...................... Construction on above described building and p~rmit meets all applicable codes and regulations. Applicant ...~.~.~~ .............................. Sworn to before me_this _ , ~ '~' da of (/.. ~,, /..~..~. ~.. (stamp or seal) ~ 7/ ............. .................. Nota~ Public ...... ~~Coun~ ~ '~ ~' ' ~ TOWN OF SOUTHOLD ,~,,.~,~ ~.~'~' ~ ~,~ ~, ~,~,x ~ ' TOWN CLERK'S OFFICE~/~- ~ ~ ~ 'r~4 ~.~ ~- Examined ..... ...... ....... ]9 ~ ~ ~ / '' /n ~ ~ .......... Application No ....... ~ ........................ ~proved ........................................ 19..~2. ' ~ ~ ~ ~ ~ Pe ,, No ................................... Disapproved a/c .........,~~.__.,~---~ ...... ~....~ ~ ................................................................................/ ................ (Building Inspector) / ~m ~ [~ ~A ~2~ ,- INSTRUCTIONS ~ : ~ t- ~ ~ ~ a. This application must be completely fdled in by ~pewnter or in mk and submitted in duphcate to the Inspector. b. Plot plan showm~ loc~tion of lot and of buildings on p~em~ses, relationship ~o ~lomm~ premises or pubhc strems areas, and ~wing a detailed description of layout ofproper~ must be drawn on the d~gram which ~s part of th~s applicaho~ c. The work covered by this apphcotion may not be commenced before issuance of ~uilding Permit. d. Upon approval of this ~pplicat~on, the Budding Inspector will ~ssue ~ Building Permit to the opplicant Such ~erm~ shall be kept on the premises awilable for inspection throughout the progress of the work. e. No budding shall be occupied or used m whole or in part for any purpose whatever until a Certificme of Occupan~ shall hove been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Budding Permit pursuant to th Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as hereto describe, The applicant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regulations. (Signature of apphcant, or name, if a corporation) Brookline t t~ewfane t .Vermont 053~5 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Owner Name of owner of premisqs .... ..~.~.~Ig..~.~...~.,...j~..~..:;i,~.~.9.~....~.,...Yt.~..~..~g..~...e..r...Z..o..~.. .......................... - ............................... If applicant' is a corporate, signature of duly authorized officer. * (Name and title of corporate officer) Location of land on which proposed work will be done. Map No.: ....................................... Lot No ...................... Street and Number ~.'-~]~t.~g'e.~.~.~.b.~.~.~..-..~'/..~.~.~..J:.~7~'~.~.~.~..a.~c~: ..............................~...~...~.~..]'~.~.~..o..~.. .................... Municipality State exmting ~se and occupancy of premises and intended use and occupancy of proposed construction a. Exisiting use and occupancy ......... ..~...l~,...~..e.,,z'.....~..o...~..e. .................................................................................... b, ~ntended use and occupancy .............. .~,~. ..................................................................................................... NO. I TOWN OF SOUTHOLD / BUILDING DEPARTMENT TOWN CLERK'S OFFICE ..~: SOUTHOLD, N. Y. Examined ...'~....~......[ "~ > Approved ~ ...... :: ........ !. ............. , c' ~. ~ ~ '~' 19 ........ Pemit No .................................. Disapproved a/c ............ ~LT ........ ~; ~ -- ~ APPLICATION FOR BUILDING PERMIT ~ Date ........ ~.....~....S ............. ,19......~... INSTRUCTIONS a. This application must be completely filled m by typewriter or in ink and submitted in duplicate to the Buddin Inspector. b. Plol plan showing location of lot and of buildings on premises, relahonsbp to adjoining premises or public streets c areas, and giving a detailed description of layout of property must be drawn on the diagram which ~s part of thru applicatior c. The work covered by this apphcation may not be commenced before issuance of Building Permit. d. Upon approval of this apphcation, the Building Inspector will ~ssue a Building Permit to the applicant. Such perm shall be kept on the premises available for inspection throughout the progress of the work. e. No budding shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnbe~ The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature of applicant, or name, if a corporation) .. .m...o..zt..¢. ....... ..... (Address of apphcant) State whether apphcant is owner, lessee, agent, architect, engir~eer, general contractor, electrician, plumber or buHdei .................................... ............................................................................................................................................ Name of owner of premises Ke~mit H . & Lillian ¥. Weatherlow If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1 Location of land on which proposed work wdl be done. Map No ....................................... Lot No ....................... Street and Number Q.Q.J;;.~j~L~f~ Q~..~.f~Z.-..~..~ ...~...~.~..~....~Q.%.c]; ................................ .~..~...~'i.~.?...J:..o..~. ............ Mumcipality 2. State existing use and occupancy of premises and ~n~ended use and occupancy of proposed construction' a Exisiting use and occupancy ~u~r~ez' ho~e b. Intended use and occupancy ............... ~ct,~f~ .................................................................................................. 3. Nature of work (check which applicable). New Budding ................ Add,t,on ....... /.. ........ Alterahon ........... Repmr ........./. ........ Removal .................. Demolman .................. Other Work (Descnbe) ....................................... 4. Estimated Cost .............. ~....~..0...0. .................................. Fee (to be paid on fihng thru apphcat~on) 5. If dwelling, number of dwelling units ....... .OD~ ............ Number of dwelling units on each floor .......................... If garage, number of cars ...g.~..~..~.~.e....~.~..r...~.g.~....+.~...qq~.~.~.~.~.'J:;.~...~`..~.~L~...&`.~b~ ................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ........................... 7. Dimensions of existing structures, Jf any: Front ............ .5 ............. Rear .......... .~.0 ................. Depth .......... 6D.! .... Height ....... .1J-h! .......... Number of Stories ........ one ............................................................................................... Dimensions of same structure with alterations or addmons: Front ...... 26 ......................... Rear ......... .~D.' ............ Depth ............. ~../+.! ............ Height ......... .1/¢.~ ............. Number of Stories ....... (>~e .................. 8. Dimensions of entire new construchon Front ...... ..............................lO' Rear ....... ~...0.! ............... Depth ....... Height ....... .1...Zl;.'. ...... Number of Stories ...........9. TZ..9. .............................................................................................. 9. Size of lot: Front ......... ~,~,~.! .......... Rear ........ 'i~ ................... Depth ...-J-E~l.t...3~.gJ.~.~ ........ 10. Date of Purchase ....~...ge~,,e,~be,~,...[~. ............. Name of Former Owner G.cese.ie¥~is.a~.~e.~..~.~.¥W. ee~r 11. Zone or use district in which premises are situated ............................................................................. ;., ................... 12. Does proposed construction violate any zomng law, ordinance or regulatlon> ........ =oz~e ........................................ K.H. & L.¥.Weatherlow ..... ~aue ........... 80~.-365-7573 13. Name of Owner of premises ........................................ ~aaress~.e.w .~....V.'J:...LJ.D..9.~..g... mane ~'~o ................... Name of Architect ........ .o..gf...~..e...r. .................................. Address ............................................ Phone No ................... Name of Contractor ..... ..o..vf...~..e...r. .................................. Address ....................................... Phone No .................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate aH set-back dimensions fror property lines. Gwe street and block number or descriphon according to deed, and show street names and indicat whether interior or corner lot. See attached map Garage at present is 12' wide x 20' long. Floor to be raised to house level, addition of 4' to width and lO' to length to make 2 new rooms and bath. Roof at present is flat. Eew roof will be trussed and peaked same height as house roof so as to conform. Rest of addition to add 6' in width to present bedroom. STATE OF NEW YORK, COU N'r'Y OF ................................ .f "'" J~' /'lc /q/'E' ~-7'/-/£ /~ )~ 0 ~ being duly sworn, deposes and says that he ~s the applicon (Name of indiwdual signing opphcahon) above named. He is the .................................... .0...../~...~/.~...~.. ........................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and fd this application; that all statements contained m th~s apphcahon are true to the best of hm knowledge and belief; an. that the work will be performed m the manner set forth m the application filed therewith Sworn to before me this .................... !..._day of ......... ............... ..... , Notary P b'. ........................................................ TERRI LEE ELAK NOTARY PUBLIC, Sta,~ u~ I~w Yor~ ~0 52 Ouahhed m Suholl~ ¢~'nrmss~on Expires March 30, 19 "1~ (Signature of applicant)