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Home My WebLink About7246-zNO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..~639.8. ..... Date ........... April...10 ...... , 1975. THIS CERTIFIES that the building located at . .P,,l'kview..lame ........... Street Map No. Orient. By .Sj~aock No ........... Lot No. 2 .... Ox~len,t; ................... conforms substantially to the Application for Building Permit heretofore fried in this office dated ......... Nay .... ~0'- ', 19.~. pursuant to which Building Permit No.?L~i~... dated ............ Ma~-... 10..., lir~.., 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 .Private. ~ne. f&mil7 .dwelling. with. addition ...................... The certificate is issued to . .Amb.z, ose..ButZer ..... Owner ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval ... 1/~i~ o ............................ UNDERWRITERS CERTIFICATE No..!/olto ....................................... HOUSE NUMBER . ~ .......... Street . Pa~kviev .La ............................ ( ' Building Inspector FORM' NO. ~ TOWN OF SOUTNOLD 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? 7246 Z Permission is hereby granted to: ..... /~b~.ms.e..~u,t,,J.e~ ......................................... ............ P~Ae~...~ana .................................... to ..... ~....~....~.,,e.~.~.9~....o..~...e~.~..¢~.ll.~qg ........................................................... at premises located at ..1Qt;...:~+....,~e~,..I.....(~J~z~t...l~..-~e& ................................ ", ..................... Three ~tater.~ Lane Orien~ ~.¥. pursuant to application dated ..........................~'......10 ............ , 19.~-..., and opproved by the Building In~oector. Fee $....'J.~,~.~ ......... TOWN OF SOUTHOLD BUILDING DEPARTMENT/~ .'~"~ 'TOWN CLERK'S OFFICE ~'~/ /~'~/ SOUTHOLD, N.Y. ~.. Examined .,,oproved .................. ,.,......,':...O.. ....... . ,',..,...;?Perm,t Disapproved a/c ........ [.~ ....................................................... APPLICATION FOR BUILDING PERMIT '~.~ f b ~ L C. £ u -- , te ...~.........- ................................... , 19 ............ INSTRUCTIONS ' ~ ~--~ a. This application must be completely filled in by typewriter oe in ink and submitted in triplicate to the Builc1~ng/~ Inspe~t9r, w~it~ 3 sets of plans~ ac,curate plot plan to scale. Fee accordingto schedule. b.~ 1~6f~n showing ioc*at~n ~f Iht on'of I~ild~ngs on premmes relat]6ns~p't~> a~l:oining premises or public streets~z areas, and giving a detailed description of layout ofproperty must be drawn on the diag~m which is port of this appticatiq~. c. The work covered by this application may not be commenced before issuance pf3~uilding Permit. d, Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such perq~t shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in port for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. ! APPLICATION IS HEREBY MADE to the Build ng Department for the ssuance of a Building Permit Dursdant to the Bgll~lJng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other anrllicable Law~ Ordinances or R~gulations, for the construction of ~ildJngs, additions or alterations, or for removal or de~-n~l/ition as h;rein ~escri The applicant agrees to comply with alt applicable lows, ordinances, building code, housing code, a~J regUloti°n~, ad~it authorized inspectors on premis~ s and in buildings for necessary inspections .... ~ (Signature of applicant, or r~,me, if a corporation) ,! .-A,. f~.. ~.~i~A~ ~ ~r~ .V.l%ew Lane~ O~t_ent N. · ,:" I :. ?'' -: (Address of opl~licant), 1{957 Stclt{e whether applicant is owner, lessee, agent, architect, ~ngineer,- g~neral- Contractor, electra:ion, plumber or.' builder. , · O~ner Ndr~e of owner of premises .......... .A..m....b.~ :)se L. Butler If applicant is a corporate, signature o~ duly aut.horized.0fficer.. .... (Name and title of corporate officer) ' Builder's License No ..................................................... Plumber's License No... ............................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.$)~..7.'[...Q?...l..e...n.~....b.~'...~.h...eLot No....,,~. .................. Street and Number ~, ~.,~/~ .~W ~TJ~ ........................................ ........... .S..e...a. ................. .O..R..,i~..~....N. oY: .... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ....~,...$..t.g..r.~...~..e.~.~.d...e.~.c..e..~..~,~,..&~.ac~ed...ga~.a~e .............................. b. Intended use end occupancy I~d ~P ~.~d ,~.! x 161 additio.~, to gar.a,~e for mower garden tool etc. storage only. X ~'L 3.~. "l~a~re of work (check which applicable): New Building .................. Addition ....~C~ ...... ... Alteration .......... ;...~ Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) .......... 4. Estimated Cost ........................................ F~e ...~ .................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .......................... ~.Number of dwelling units on each floor ............................ If garage, n6mber of cars . - 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimension~ of existing.~ructures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of sarrm structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................. ~ .........] Rear .......... ~ ............ Depth ...L~:..~.. ............... · - Height .................... Number of Stories ................................................................................................. ,9. Size of lot: Front 1821 Rear 1841 Deptl~4...~.O.Q.e..;....~,..],~,~l 10. Date of Purchase ......... .~!~,Y...~Q,t...~,~'3 ............... Name of Farmer Owner .....Wll~,.~.~.~.....T, rs~ ........................... 11. Zone or use district Jn which premises are situated .................................................................................................... 12. Does proposed Construction violate any zoning law, ordinance or regulation: ..................................................... 13. W~II lot-be regraded .; .......................... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ...A..~..~.n..~.~.~.~,.e.c ..................... Address~...~.~.~h:.Y.~.~..~,.~ Phone No. t~.~..~,..~.~8.... Name of Architect .......... .~..~.~ff ........................................... Address ................................ Phone No ....................... Name of Contractor none Ph ............................................................ Address ............................... one No ....................... PLOT DIAGRAM Locat.e clear..ly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from ;~p.ro~..erty h ~.s. Give street and block number or description according to deed, and show street names and nd cate wnemer In* :nor or comer Io~. n ~' : - , *_£ J STATE OF NE~/~,QP~/, COUNTY O~ ~.:.J~"" · ~ ' ~ose~ and~ays t~t he is the applicom .......... , .......... , .......................... bema duly sworn, - · t ~a~wdual s~gnmg contracO ~ove name. He is the ................................................................................................................................................................................ (Contractor, agar, corporate officer, etc.) of said owner or ownem, ~d is duly au~orized'to ~erform or have performed the said work ~d to ~ke and file this application: that ag statements contained in t~s application are t~e to the best of hisr knowledge and belief; and that~the work will ~ peiTorMed in the ma~ner~et fo~h in the app~cation filed therewith. Swam to bef~ me this ', ....... .............. D ........ ............. .......................... ~ ~ (Si~notur~ o{ ~pplicant) N~a~ Public, Stale of N~ York Ne. ~2-0344963 Suffolk Coun~ Comml~i~ ~ir~ March 30, ~9~ FOI~M NO. 6 TOWN OF $OUTHOLD Building Deportment 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 Iocal'ion 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 end 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), Nomconforming 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 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 $5.00 3. Copy of certificate of occupancy $1.00 New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..~...[~.~/..l¢.....V..]_..e.~ .~..~.~..~ ..0. :.~.~.~ Owner Or Owners Of Property Arnb.'5~$e ]b~ ]Bu~].e ; Subd v s orjVI&~ ~..~.'/.~..'/ .O.~.:$.~.~..L.....b.~. ~,~..e.....S..~.~...Lot No....~. ...... Block No ............. House No....~... ...... Permit No..~..~..~..6..~. ........ Date Of Permit .~...-..]r..O.z.?.~...Applicant ....A..rr½..b..~7..°..s..e.....~..:....~...~.~..Z.~)!~, ..................... . Health Dept. Approval t,~--.-.:.~ ...................... Labor Dept. Approval ..................................... ,---- ------ Underwriters Approval ....... ~..t....[..~.: ...................... Planning Board Approval Request For Temporary Certificate ........................................ Final Certificate ............. .'~ ..................... Fee Submitted $ ~. 00 Construction on above described building and perm-~t mee~s oil opplic, c)bl'b'~codes aod regulations. Sworn to before me this ....... 1.0..... day of .......... ....... ...... ~/r/~..~ County Notary Public (stamp or seal) '1