The URL can be used to link to this page

Home My WebLink About7658-zFOILM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z?.~.9.~ ..... Date ............... ~..~. .... ,2.9..,, 19. ,7.7.. THIS CERTIFIES that the building located at ~lla~.d. RO~ ............. Street Map No. X.X. ......... Block No...X~ ..... Lot No, . ~...~l~al~Qg~le...N,Y., ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ].2~.0./?~ .&..~/.1..8/~?.~, 19 .... pursuant to which Building Permit No.7.6~SZ..& 7832Z dated ]~/10/?~ .&. ~J18/7,~., 19 .... , was issued, and conforms to all of the require- ments o£ the applicable provisions of the law. The occupancy for which this certificate is issued is . a~.e.e~ .s.o.~.y...(.~..~.b.lp.).. b.~t~..!d..l.~..&..P..l~. ~.i.~. $,..a. pp?.o.v.e..d..b.y...~...A, pp.e.a, lz The certificate is issued to .. Leltoy &..N~.~.h.~...P.~.~I.$... ^~.e.~.$ ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .N.?.R., ............................... UNDERWRITERS CERTIFICATE No. N,R, .................. HOUSE NUMBER ..... 2.1~.0,.. ~...B.i.~.},~...~.o.a.~,..C.~.~h0g~ ...... Building Inspector FORI~ NO. 2 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? 7658 Z Permission is hereby granted to: k~ ..I,e~ ~...& ..l~r, t3~..l~Z ................................ at premises located at .~.~...~].]~r~..]~O~L~. .................................................................................... .~.~.o. ~.e. ........... ........ : ............................................................. pursuant to application dated ............... t .......... Dee......~) ............. ,, ]gr~+~.., and approved by the Building Inspector. Fee $...'I.(~.QO .......... B uildin'g"lnspector { TOWN OF SOUTHOLD , Building Delmttment 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: 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: ]. 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 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 New Building................~ Addition ................v~ Old or Pre-existing Building ................ ¥ocant Land .............. Location Of Property ...~./~.:.' .~.?..'.~../../~..../~.,.~....~.......~.,...~,,..~..~.., ............................................. Owner Or Owners Of Property ........ ~ .~... ............................................................................................ Subdivisi°n'7~':~'~'/~'Zoo ............................. 2,z.~..~../,~..w Lot¢/' / ~/ No...~... ...... Block No ............. House No Permit No. c~./.~-.~..~,... Date Of Permit ~./.~./..7~.--..Applicant ~.~.~'/~,.-~', ..~.....~"~/~'/~ ...................... Health Dept. Approval .............. ' .............................. Labor Dept. Approval ........ ; ....... ; ............................... Underwriters Approval ........... ' ................................... Planning Board Approval Request For Temporary Certificate ........................................ FinQI Certificate Fee Submitted $ ...~.. ............................. Construction on above described building and permit meets all qRplicable~cles and regulations. (stomp or seoD d~//~ ;.~;.. ~:: of :..~.~......~. ~ ........... ~7~ ........................................ , ....... Permit No .......... IUILMNG ~L~A~M~NT $OUTHOI~, N. Y. (Buildi~ ........ APPUCATION FOR BUILDING PERMIT Date December 10 19...~.. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building inspector, with 3 set~ of plans, accurate plat Plan to scale. Fee according to schedule. b. Pict plan showing location of lot and of bu dings on premises, relationship to adjoining remises or I oreas, and g V ng a detailed deSCrinti°n of In~-,~ of~r----.~ .... ~. ~ .............. p,I. .pub ic streets o, ,- -;v-. I.' ~.~, ,~' ,,,ua, u~ uruwn ~n rne alagram wnicn is part ot th s cat n c. The work ~overed by this application may not be commenced before issuance of Building Perm~ ' app o . 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 ~,ailable '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 Occupancy shall have been granted by the Building Inspector. .A,P..PLICATION !S HEREBY MADE to the Building Department for the ssuance of a Building Permit pursuant to the Budding.. Zon,e Ordinance of the Town of Southold Suffolk Coun . - - Regular ons, rot the constructi . . , [ty, New York, and ~ther applicable Laws, Ordinances or on of buddings, 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 impectiom. ' (Signature of applicant, or name, if a corporation) Btl~ard Road Cuteho~ue (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...1".cz'air & ~artha P&IL1. 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'$ License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ZZ Lot No.....~.. ................. Street and Number ~,~.S Billard Road Cuteho Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy. b. Intended use.and oceUppncy sa~le with accessory building (barn for horse) 3. Nature of work (check which applicable): New Building....~ ........ Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ..................................................... · (Description) 4. Estimated Cost ................ .~. ............................ Fee ..1~e0O ............................................................................ (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, commerc~n or m~xed 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 ...... .1~ ....................... Rear .....1.0~' ................. Depth ...~(~t:. ............. Height .................... Number of Stories ................................................... 9. Size of lot: Front ...... .1.~8~. ..................................... Rear ........ 1.~.~.e~. ...................... Depth 10. Date of Purchase ................................. ! ...................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ...!.~J'[!.~...~,~4.~ .............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ..~e) ................................................. 13. Will lot be regraded .........~.~ .............. Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ....~-.~...X.....P&I~. · ..................... Address .....(~e.Yte~l~ ..... Phone No ....................... Name of Architect .............................................................. Address ................................ phone No ................... ,.. Name of Contractor ..Z...,.s~a~e ......................................... Address ................................ Phone No; ...................... PLOT DIAGRAM Locate clearly and d stinctly 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. STATE Of NEW YO~,~,. [ S S COUNTY OF ..... ~.lJ~'.~.o.j,~ ........... ~ - ................... ~ ~ ...................... being duly sworn, d~oses end soys tMt he is the epplicam (Nome of individuol signing contrec~ above nom~. He is the ................................. ~-== (Controctor, og~t; co~orete officer, etc.) of s~id owner or owners, ond is duly eut~rized to perform or h~ve performed 'the sold work ond to ~ke end file this application; t~t all statements contain~ in this application are t~e to the best of his ~owledge and belief; and thor the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this 10 d- of Dee , 19~ , ~ Nota~ Publi~~:~,~ ~n~ "~ '~'~C(SignatureX"~of applicant, ............................... JUDITH T. ~OKEN ~ Public, State of New Y~ ~ :u 52-0344963 Suffolk Coun~ ~ ~ommissien ~pimi ~ 30, lgm