Loading...
HomeMy WebLinkAbout7240-zTOWN OF $OUTttOLD BUH.nI~G DEPARTMEN~ To~ Clerk's ~ Sou~old, N. Y. Certificate Of Occupancy No. Z .~8~ Date ; ..~...~... 19~. THIS CEETIFIES that the b~ding loca~ at . ~. A~ ............. j S~t Map No. Fa~mwl~..~k No ........... Lot No. I~ · · · a~t~ld ....~.~., ?[. .... dated ............ ~...$..., 1~.. pmu~t to/~ ~g Pem~t ~o..~. dat~ .......... ~y .... ~.... [, 1~.., was hsu~, ~d co,ores to ~ of ~e ~ ments of ~e app~cable pro~lo~ of the law. ~ccup~/' for wMch- ~ ce~ffica~ h issued is ~.a~,. ~,. t~Y..~W~g .... .J. ................................. ~e certificate" ~ hsu~ W .~ .E.. ~.~fe? ..... ~8 .................. (o~er, levee or te~t) of ~e ~ores~d b~ding. Suffolk County Department of Health Approval . II.,R. ....... , ..................... UNDERWRITERS CERTIFICATE No. t~l~d~ HOUSE lq'IJMBER ... 3.~0 Street .~8~.~t~. &Y.~. ...../ / TOWN OF SOUTHOI,D BUILDING DEFARTMINT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~isopproved a/c ~ ................. Application No...~......'~..~..~.....~.. .......... DQte ............................ ~'. ................. , INSTRUCTIONS a. This application must be completely filled in by t~ewriter or. in ink and submitted in triplicate to the Building Inspector, with 3 set~ 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 Build!ng Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspectton 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 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 .~.~gulati,o. ns, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. · pppticant 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 ir~,~ections. Bobert L, Hyatt (Signature of applicant, or name, if a corporation) Southold (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..................... ~T~IG .............. ~g~,ll~.e~, ........................ 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 ............................................... I. Location of land on which proposed work will be done. Map No.: ...F..~..~Z'.~.e...~.....~..B...Z'..~. ....... Lot No ......................... Street and Number .........C~t, ez,...JL~.e .......... 8~u~o,~d ......................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use end occupancy dvell~r~f b. Intended use and occupancy ............. ~.~e...~t, Js...lt..tl..~fJ~.:l..~,:l. gzl ................................................................ 3. Nature of work (check which applicable): New Buil~ling .................. Addition ....;I;:1~.... Alteration .................. Repair .................. Removal .................. Demolition.., ................ Other Work ...................................................... (Description) 4. Estimated Cost ............... .~.t6~O.......~. ......................... Fee ..1~,l~)~ ............................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ .1 .................. Number of dwelling units on each floor ............................ If garage, number of cars .......................................... i] ................................................................................................. 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 ............... .1~ ................ Rear .....~ ................... Depth ....1~) ................ Height .................... Number of Stories ......... O1~ ...................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zon'e or use district in which premises are situated ...!!~,!!..~,~.,t, ............................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~..~ ............................................. 13~ W. ill lot be regraded ...... ~ ................. Will excess fill be removed from premises: ( ) Yes '( ) No 14. Name of Owner of premises .,]'e~3..~e~ ........................ Address ....... ~A~ ...... Phone No ....................... Name of Architect .............................................................. Address. ............................... Phone No ....................... Name of Contractor ....~A..~b~&t;.~ .................................... Address .....~Ol,l,t,b~l, ........ 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 deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY Of ......................... ~q~i~l~.'~...~,.....~,,~lLt~ .................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing controcf) above named. He is the B%t:[ldez' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform o¢ have 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 thar the work will be performed in the manner set forth in the application filed therewith. to before me this .s.."Lm. .......... Notary Public, .~.'!.:4~....~....;.,f-~f~..~unty ......... ~....~...~...;.....~~ ........ '. ............ (Signature of p~_.~a nt ) TOWN OF SOUTHOLD 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? 72 0 Z Date ........................... jf/~, ....... 8 ............. 19~+... Permission is hereby granted to: I~....P, ya.f~t ...t.~.-...A/4}.. Jot~..$Je'Be~n......~ .... ............. ~oGthe~& ............................................... Build an ~.dd~...%~Q~. QXI ~2gJ~J~j~ ~w~llir~g at premises located at L~t..~. ............K&i~'.~.$~w...~a~ .................................................................... ................................................ ~s~er'"~e ........... ~o~h~2~ ........................................................ pursuant to application doted ............................ *'.'a~t' ........... ~ ...... , 1~1,...., and approved by the Building Inspector. Fee ~.~..QQ ............. V ou,oing inspector \ FOKM 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 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. §. 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 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 $!.00 Date ....... ~.}Z......B.....J .cJ 2..be ........... New Building ................ Addition ..... ~.... Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ...... .0..~...~.~.e..~...~..e..~...~...o.~..~..~...o.~. ...................... Owner Or Owners Of Property ~To~). MeLeata & W'ife Subdivision F.~.$~.Y~e.w....P..~.k ........... Lot No...f...O. ..... Block No ............. House No....~..0.. Permit No...~..~.0..~. ...... Date Of Permit ..?.[.a.~.....8. ...... Applicant ...~..:..]T...'.~..~.~.~..t....Z...~..? ................................. Health Dept. Approval ....... ~.,,,'~ .............................. Labor Dept. Approval ........... ~.:..~..'. ............................ Underwriters Approval ..?.~D=...~..i...~.g ............................ Planning Board Approval N.R. Request For Temporary Certificate ........................................ Final Certificate ............ ~ ....................... Fee Submitted $ ..~...?..0..0. ......................... Construction on above described building and permit meets oil applicable codes and regulations. Applicant ......................................................................................................... Sworn to before me this ......... ,8. ..... day of ......~..~.Z......1.~..~...~. .................. (stamp or seal) Notary Public .................................... County THE NEW YORK BOARD OF FIRE UNDERWRITERS ~.k BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 .a,. M~e?, a?, ~.97" .,,,,,'ic.t~,.No.o.,,~ 1o3~ N 150481 THI$ CE~I;IE~ THAT ~ly t~ e~t~ ~uipment ~ ~cd~ ~ ~ int~ by t~ ~nt mind on t~ ~ ~pt~t~ numar in t~ p~m~s of John ~eLean, a/a~de 390 guate~ ~ve., ~outho~d, L..I.. in the following location; [] Basement ~JXlst FI. [] 2nd Fl. OUtS I c[e Section Block Lot ~as ex,mi~ed on M~ r e h 2 5 ~ 19 7 4 . ,nd found to be (n compliance with the requirements o/this Board. E.L "2 DRYERS I mRNAO ~TORS I ~'URE AKAN~ "E"' ~'" '~'cL~Ks t EELL ~ .~TI~UT=T DIMMERS Z 3c· I I SERVI~ DI~N~ ]NO.~ I S E R I C ~r. ~p. ~ ~UI~. 1~2w 1 ~ 3~3w 3~4w ~,~C~C~D. OF ~C.~hO. HO. OF HI-LEa OF'HI:~ ~.~ EU ~ ~ 'NEPAL W. B. Ruland, Elec., Mattituck, L.I. 11 ~ ~ L Per ,,, [ COPY FQR BUILDING DEPARTMEHT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MAHNER.