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Home My WebLink About7630-zTO~FN OF SOUTHOLD BIm'.I'~I~G DEP.&It'r~ Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z6.~ ...... Date ... ............. ~,p.~ll...30.., 19.?~. THIS CERTIFIES that the bufldlng located at . .R,.(I,i~,..(ifS. 9.th. St; ..... Street Map No. X~X~ ........Block No. xxx ......Lot No..xxx....Gr~enpo~.t.. I/~¥, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..........No.v...12 .... , 19. ?.be pursuant to which Building Permit No. dated ............~.o~r...~2..., 19?.It., was issued, and conforms to an of the require. ments of the applicable provisions of the law. The occupancy for which thl, certificate is issued is . ?~lw.~e. ope..£ar~.ly, d,~e~ ~InE .w~;h .au. ~dd;t.t. lon .................. The certificate is issued to J.o~.~..~ .h. ~ .P. by~.],~s...c, el,.o.f.f.....o.,,~.m, qT~.: ............... of the aforesaid building. St~olk County Department of Health Approval (owner, lessee or tenant) · ~., .~t. ............................. UNDERWRITERS CERTIFICATE No. N~-t~986 ..... Eaz. 3.~.. · 19Y.~ ................ HOUSE NUMBER.. 16.~.0 ....... Street .... n~r~th. ~.t. (?3st ..................... FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTM~:NT TOWN CLERK'S OFFICE SOUTHOLD, Nm. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 7630 Z Permission is hereby granted to: l~i~...~e...~:~,o~-~e~,,.~..~,/~.J~,s C~of£ & W, .......... .~.~.e~o~.~. ............................................... to ..~..~,,~ ..t~.. ~d.4 J,.tJ. On..~...~x:t s.t, ir~g.. ~ao ~,:~ ~. ............................................................... et premises located at ..... .~...~..O...*:.~..?....O.~.:~....~.~...~..9.th...~.~. ............................. . ..................................... ....................................................... .~lenpo~....~*~,* ........... · ......................................................... pursuant to epplication dated .........................~.~.~. ....... .!.~ ...... :,..., ]9.~.~..., and approved by the Building Inspector. Fee ~.~-'.00. ............. Building lnspec~)r FOBM NO. 6 TOWN OF $OUTHOLD 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 in DUPLICATE to the Building inspector with the following; for new buildings or new use: l. 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. 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 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 $5.00 3. Copy of certificate of occupancy $1.00 Dote ...... .......................... New Building ................ Addition ......X. ......... Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..... .R...*..D.?.~.:...fl?..f'.....e..n..d.....9.~..h...~.'.~.~.e.~ ........... .~.e.?:.n...p.~ .......................................... Owner Or Owners Of Property ..~.htJ,LJ,.~t~..~...~fl.~.~.D.h..D.~.~.~.f'. ............................................................. Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No...7..G.~.L)....Z. ..... Dote Of Permit ...]:..[../..~..2:../.?.~.Applicont Richter Home Imp, Co,, Inc. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .....~...~..5...~.~.G. ......................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate X Fee Submitted $ 5,U0 Construction on above described building/~ermit ~_~opp~le 7~" regulations. Applicant .. kZ..~'J~. ~ .~........~....x~..../(.....lr{~. <'.'.~-~¢. ................................ (stamp or seal) COV£- Exomined .... ~...../.....~......, Approved (I ~'~"- APPLICATION FOR BUILDING I~RMIT INSTRUCTIONS oe. in ink and submitted in triplicate to the Buildin~ a. This application must be completely filled in by typewriter Inspector, with 3 ~ of plato, occurate ploe plan to ~cale. Fee accaeding .to ~chedule. b. Plot plan showing Iocation'of lot and of buildings on premises, relationship to odjo n na oremises or ~lic streets *~ areas, and giving a detailed description of layout ofpraparty must be drawn on the diagram wl~i~h is part of ~h~s a licatii:x~ ~ PP . c. The work covered by this application may not be commenced before issuance of Building Permit. 'q d. Upon approval of this application, the Building Inspector will issue ~, Buil~ling Permit to the applicant. Such permit shall be leept on the premises available for impectien throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ssuance of a Building Pewnit purstmnt to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other pppltcable Law~, Oedinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolitlen, al tmmin described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on remises and in buildings for necessary Inspections. (Signature of applicant, or name, if a corporation) N.Y. Z;~ ~ (Address of applicant) State whether applicant is owner lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................... F.~NI:'H,gJ.... CDIII. T.R fl~T.Q~ ...................................................................................................... Name of owner of premises ....... .~.0..S.~.P...H....&....P...H..Y..L..L.~..S....C..R..R..0.?...F. ....................................................... '. .................................. If app,~nt is af/~,~, s~aT~..~_~f duly authorized officer. ...... ............. Name and title of corporate officer) ' Plu.ber's ',cerise ,o. ................ Other Trade'~ License No ............................................... 1. location of land on which pro~o~l work will be done. Map No.: ........................................ lot No ......................... Street and Number ....... .~.II~.~-q..Cl~/[..Cfl~,,. ...... .,.~I.-...~...~.t, I1..SI.,....~X'IiSIIi~ZlL,..J~.~ ............................. 2. State existing use and occupancy of premises and intended use and occupancy of pro~d construction: o. ~:xisiting use and occupan~ ....... -qlUDJ.~I..~ .............................................. . 3. N~tum~b~ work (check which applicable): New Building.. ................. Addition ....t~J .......... Ite tion ................. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) ? 4. Estimated Cost ........~...~J~,O.,.Q~ .............................. 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 ........6D.". ............. Rear ........... 6D.! ............... Depth ....... 6D! ....... Height ...... ,~. ............. Number of Stories ............... 3' ............................................................................................... Dimensions of same structure with alterations or additions: Front ...... ~[~ .......................... Rear ....... ~J~. ................ Depth .....~P'! ..................... Height ......... 1.F~..~ ........... Number of Stories ............1' .................. 8. Dimensions of entire new construction: Front ...... .~.l;].." ........................ Rear ......... ~!. ............ Depth ...~ ................. Height ....316.! .......... Number of Stories ..............T ..................................................................................................... 9. Size of lot: Front ...... ~.~.~.". ......................................... Rear .......... ~1'~,, ......................... Depth ......... ]J~6.! ............... 10. Date of ,Purchase .; ...................................................... Name of Former Owner ...... ~QI/i~I~..'[.(iDI~. .................. ~ ...... 1 1. Zone or use district in which premises are situated ..... ~..F~Q~,,I~.~.~/~. ....................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ......... ~ ........................................... 13. Will lot be regraded ...... Y'~iJilt~I~"8;__ Will excess fill be removed from premises: ( ) Yes (X) No 14. Name of Owner of premises .P. bVJ.].$~.Ca=a~'.~ ....................Address ....~t~b..St,.. ............ Phone No...it. 9...9...@.6..g..9.... Name of Architect .............................................................. Address r4~allrlpoz't; iN~,~,,, id,, Name of Contractor ..E~ne~t,.~.o..P4,=h~. .................... Address ....~i,T~...~.~..~.... Phone No.../f?.?...{l~l~'~... 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 deed, and show street names and indicate whether interior or corner lot. PLAN ATTACHED· STATE OF NEW..,,Y-,O~:~'.~ I ¢ ~ ...........~~;-~'~mc~)"'""": .......... : ............... ~ ......................... _ being duly sworn, deposes and says that he is the applicon! He is the ......................................................... .............?~ ................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this application; that all 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. .... ........... Notary Public, . ...................... ~~...c~_~ County ............................! ........ ,~. ........ ~/,~,,~:~.....%,,~.....A~...L, ........ · ~'"'// , (Signature of applicant) No. 52-0344963 Suffolk County~t/