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Home My WebLink About7331-zTOWN OF SOUTHOLD BUI~.I~ING DEPARTtmo~ Town Clerk's Offiee $outhold, N. Y, Certificate Of Occul ncy No. 'Z791~ ..... Date ................~el~t;..26.., 197~.. THIS CERTIFIES that the building located at . 3h~pyard. La~e ........... Street Map No.. xx ........ Block No...xx ......Lot No. xx..Eaat. P,a~io~ .............. conforms substantially to the Application for Building Permit heretofore filed in ~ht, office dated ............. June. ~., 19.~t~. pursuant to which Building Peemit No..~.~lZ. dated ............Juna .17..., 19~.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which thi~ certificate is issued is P. ri.vate, mae. fa~l¥..d~eLli~ .vi.th. stumer. ~o~eh .&dd.ttiolx ....... The certificate is ~sued to .Joh~ .Rohde ..... 0vn~v ............................... (owner, ~ssee or tenant) of the aforesaid b~lding. Suffolk County De~ment of Health Approval · .N,.Y., ............................. UNDERWRITERS [CERTIFICATE No. N3~6i).~3 ..... Sept. 21 .... 1977. .............. HOUSE NUMBER . .,.. 17.5 ...... Street ... Shiplr~d. L~ne .....E ../4a~lon ....... / · FORM NO. 2 TOWN OF SO~'80LD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7331 Z Permission is hereby granted to: ........... ~t,..~M~zLm~ ......................................... m ..~..~.~tl~,_~n_..e z~t ~g.. ~ell~z~ .............................................................. at pmmJ~ i~m~ m ....$~.....~...~ .................................................................. ~ .......... ~u~Q~t to Q~Jlc~ d~ .......................... J~.....~ .......... , ]~..., c~d ~ ~ t~e Building I~tor. F~ $25,,J~ ............ ~- ~' r~ ~ ' IU . ....... ........... ...... . ,.,...,._ ...--....... ....... ..................................... ...... . ............. ............................. I~tor, ~i~ ~ ~ of ~, ~u~ ~ ~1~ ~ ~le. ~ ~cm~l~ ~ ~h~ule. b. ~l~ plon ,bowing I~tion of lot ~nd o{ buildin~ on pr*miser, relationship to ~d~oining pmmise~ ~ public areas, and givi~ a d~ail~ d~ripti~ of I~ut ofp~ must be drown on the diagram which is ~ ~ this applicati~. c. The wo~ c~er~ by th~ a~licati~ ~y ~ be c~me~ before i~e of Buildi~ Permit. d. U~ a~al of this applic~i~, ~e Buildi~ Im~tor will i~ue a Building Pe~it to ~ ~licant. Such shall be kept ~ ~e premiss available ~r in~ti~ ~ ~ ~rk. e. No buildi~ shall ~ ~cupi~ or u~ in whole or in ~ ~r any pu~e whoever until a Ce~ifica~ of ~c~ancy shall have ~en gmnt~ ~ the Building In--tar. APPLICATION IS HEREBY/v~ADE to the Building Deportment 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 Regulations, for the construction of buildings, additions or alterations, or for removal or demolition,, a~ herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulatlofls, arid to admit authorized inspectors on premises and in buildings for necessary inspections. ...... i~i~'~'~-f"~plica~t~' or name, i~ '~ ~,~i;n, ........ ...... ,>.. .................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................................. .......................................................................................................... Name of owner of premises ..... ~[..~..!.-)....~......~.~.!.~..~.~. ........................................................................................................ 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 ............................................... Location of land or~ which proposed work will be done. Mop No.: ........................................ Lot No ..................... ~... Street and Number ~L~...~.~...~`~[~...~...~.~.~.t~;~.~.~..~.~.~..~; .................................................... State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .................. b. Intended use and occu~ancy ................ {.~...O...~...~....~.1 ............................................................................................. ~-1~ ~T Nature of work (check which applicable): New Building .................. Addition..................J Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work .................................................. .... ~,_7._~_0 o~o ~,6~-- 0'~ (Description) 4. Estimated Cost ...........'. ................ ~ ............................... 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 c~rs ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent'of each type of use ............................ 7. D mens ons'of existing structures, fany Front ......... ~.~.~...t. ......... Rear ...... .~...~...~.. Depth .?~....~....~. Height~...../.~ ............. Number of Stories ........... ~. .................................................................................................... Dimensions of s~me structure with alterations or additions: Front ......... .~...~'. .................... Rear ............................ Depth .....~.,.~...~ ................ Ht~ight ......... ./....~. ............ Number of Stories ......... /. ..................... 8. Dimensions of entire new construction: Front ........... ~.~. ................... Rear / ~'~ / Depth I ~ ! Height ....... .~.. ......... Number of Stories .................. ]. .................................................................................................. ]2. Does proposed construction violate any zoning law, ordinance or regulation: ........... ..~.....O. ..................................... ]3. Will lot be regraded ..... ..~...O.. ............... Will excess fill be removed frgm premises: ( ) Yes ( ) No Name of Architect .............................................................. Addr~-~ ................................ Phon~ No ....................... Name o{ Contractor ............................................................ Address ................................ Phon~ No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all setJ~3ck dimensions fram property lines. Give street and block number or description according deed, and show street names and indicate whether interior or corner lot. ................................................................................................. being duly sworn, d~po~es and soys that he is the applicant (Name of individmal signing contracf) ~bove named. He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or.owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application ore true to the best of his know~edge and belief; and tho~ the work wiU b~ performed i~he manner .~t forth in the application filed therewith. Swom to befo~ me this ( ) -- ~ -- · ~ ~ - (Signature of applicant) JUDITH T. BOKEN Notary Public, State of New York No. 52-0344963 Suffolk Cou~.'~ Commission Expires March 30, FORM NO. 6 TOWN OF SOUTHOLD 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 location of oil buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposol--(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, o 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 oil 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. Dote of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare o 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 .~f~..~)...~...: ..........................~. ~ ~..~. "7""] New Building ................ Addition ......~......... Old or Pre-existing Building ................ Vacant Land .............. Location Of Prope,y ......... ..~./..~../..~....~...~..~I~J.'~...L/t~.,..~.../~.L~..~...~..!...I~'..~..'..Q.~...,..~.;...¥., ..... Owner Or Owners Of Property ......... J...O..~L~.. ........... ~.)~.ff~ ....... L.~.~. ..................................... Subdivision ................................................................ Lot No ............. Block No ............. House No..[....7....~,~ Permit Dote Of Permit .~.:,l.7.,'..~...~.Applicant ..... ..-~....,..~..I..4,...~........~...~....0...~...,~,. ........... Health Dept. Approval ......... ..~....!....~.. ...................... Labor Dept. Approval .............. ..~.......~. ....................... Underwriters Approval ..~...~.....~..~....~...~..~ ................ Planning Board Approval ........ ~..J....~... ................... Request For Temporary Certificate ........................................ Final Certificate .... ~ ....................... Fee Submitted $ .....~.. ......................... Construction on above described building and p~/~me~,.~s a~~codes and regulations. Applicant ....~.. .................................................................... ~.:~ .................. Sworn to before me this ~,~_~,/~ ~ ~ da of /'~ ' r ................./"'-~_~7~,Y .... ~~'~ ............ (stamp o~. I~ ~ N 356993 o~1~ ~h~ el~ctri~l ~quipr:z~txZ as descrlb~d ~low and i~uc~ ~ ~ appllca~ ~me~ o~ ~e ~ve appllcazlo~ ~u ~r i~ ~he premls~s John Rohde, 1~5 Shipyard L~ E~t'M~lon, N.Y. tO ~ in comp)ta~e with the requiremen~ of zhiz Board. · ' John Rohde , 1/)'~ Sh'lpyard La. , East M~ton, N.Y, ~ T~,s c~?((~ touCh, nOt b~alte¢Sdm'l.,a~y ~m~n~er,