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Home My WebLink About8813-zTOWN OF SOUTHOLD BV~,r)ING DEPARTMRNT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..2;79.1.~- ..... Date ..............~ep.t...:~ ..... ,19~.?... THIS CERTIFIES that the building located at ~oose..C~eek .L~u~ ........ Street Map No.. X~ ........ Block No..~ ...... Lot No .... zx ..... ~utho~l.~.. N.,.~, ...... conforms substantially to the Application for Building Permit heretofore filed in ~.hl, office dated ..: ......... Aug.. 2~., 19. ?6 pursuant to which Building Permit No..~8~1.~. dated ........Aug...2~ ......, 1976.., 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..s~ri~lng..Dc>oZ..~lth £e~ce. ~ .acc~ssory. s .................. The certificate is issued to . ~'.s..~. ~.e..T. :..T. eggR~.'~ .... . .0X~q~' ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N ,~Lo. ............................... UNDERWRITERS CERTIFICAT~ No... ~/.~/?.7... bY..~, s. ~.~be¢~c~, ............... HOUSE NUMBER ... 70.o. ....... Street..o.~qs~..c.~k .~.e. ....... Sp~bo;L.~ .... Building Inspector TO~N OF ,~O~TSOLD BUILDIHG DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Building Inspector "~:~,, !N? 8813 Z ~¢"~/_ - Permission is hereb~ ~r~nt~ to: ~;L2~ · ............................................................................... ~b~. ................. : ................ ~ ......................................................... .~ .......................................................... FORM NO. $ 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: I. Final survey of property with accurate location of all buildings, property lines, streets, eno 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 ,nstallation fram 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 as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertlnent 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 $1.00 o/_ /_~ 0,,, ...... ..................... New BqiMing ................ Addition ..~....'.r~....~;... OM or Pre-existing BuiMing ................ ¥oc~nt Land .............. Location Of Pr°perty~'""~'°"°'$"'~'"C]~'("~'"~"' '~":"~"°"~'Z:'"'~'L'I"~[I'~"'q'"I'~s'"'['"r_ -- _..~/~....~,_-~_/'_rz......]..,.L'"'~""~'"~'b":"~':"~"~'G""'I/ O~ner or O~ne~ of Pro~ ...... .O...~.~*... ........ /..q..~.?,.~.~..L:.....r.?.....O...o..~s.~....~..~'.~,~....*:..'t.~ ..... Subdivision ................................................................ Lot NO ............. Block NO ............. House No..7.~..~. ..... Permit No..~..l.~....Zr .... Date Of Permit ~(.Z...~.{7..}.....Applicant ....~./~...~..~......~...'~....(Q.~....~...~.....~.. ................... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval ......... ..~../../...2.../?...?. ................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ FinaJ Certificate .......................................... Fee Submitted $ .~...~. ....................... Construction on above described building and permit meets all applicable ~:odes and regulations. ........ ~ ~'-' ................................................. ~"~ ~" Nota~Publicv~~~Coun, .... ...... ,;[~u~,,c,~~~~'~'~'~' ~ 7 '*~,* ~'" ' ~ ':~,bRi~.~OARD O~-FIRE uNDERWRITERS~'" ' ~NEW ~* : ~ '~- ~ ~ ~'..-~- ~='-~N ~TREE~ NEW Y~R[.NEW YORK 10038 - _. ~..,~.~ '~ -~-"~';~700*:~6sse-Creek L~, Southo , L.t. m ~ i - UNIT HEATE~ MULTI-OUZEl ; DI~ERS DRYE~ MOTORS'- :~-' ~TURE APieCE F~DERS P~IAL REC'PT NO. OF ~ET ~:'SERVI~ DISCONNE~L-- - ' :_ ~-,'~ .~S ' R - t V: _ ' t ~"~ C l[anceJ:a~-~ the ' ;" only.' ' :" ......... 'a' ="" ........ made~b~-a,:~ _ $~_ person, must no~ be alter~ m any mannerr return to the 1~0~ NO. $ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, bl. Y. O.~E. TO Date ..... ~~..../....~....., 19..Z.Z [,ddress o owner or a thor' ea ge PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance .~~.~ ........... Other Applicable Laws, Ordinances'or Eegule~ns ............................................ at premises hereinafter described in that~~.~....~ , ~ ~ate character of violation) ... ~~.~~~~ .......................................................................... ............................................................. (Stero ~ection or p~ro~r.~h o{ ~pplic~ble I~w, ordin,nce or r~ul~tion) YO~ ARE THEREFORfi DIR[CTED AND ORD[R[~ to comply with the I~w ~nd to remedy the ~o~,~,o~ ~77~'5";~~ o~ o~ ~o~ ~ ................... ~.~....~ ............................... ~ o, .......... ~.~~ ..... , ~...Z7 T~ premises to which~is O~ER TO REMEDY VIO~TION refers ore situated at /~O.~~.~~~,..~~.County of Suffolk, New York. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. ........."~' '~" ~'~ ~uil~'lK~o~' ~"~/~"' ~Y~'-~ "' TOW. OF SOUT.oLo , BUILDINQ DEPARTMEHT ~ '~. TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .............................. 19 ........ (Building Inspector) APPLICATION FOR BUILDING pERMIT Application NO. '~-~ ~ 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. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or. public streets al areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part at 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 Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until o 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 Togm of Southold, Suffolk County, New York, and other applic.able Laws, Ordinances or Regulations, for the 'construction of buildings, 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 inspections. (Signature of applicant, or name, if a corporation) (Address of applicant) ~tate 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 on which pr~oposed work will be done. Map No.: ........................................Lot No ......................... Street and Number ~ ~ ~ ~lll~e ~l~dl~e lie ~'er Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: o~ Exisiting use and occupancy . ~ltl~ -~1~....~....,~ ........................................ :~' b. Intended use and occupancy ............................................................................................................................. 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration .............. : Repair .................. Removal .................. Demolition .................... Other Work ~.i~l~l~.~i;~). ............ 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 ............................ 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 .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ......................................................................................................... : ........... Size of lot: Front ........................................................ Rear .......................................... Depth. ............................... Date of Purchase ........................................................ Name of Former Owner ............................... ~ ........................ Zone or use district in which premises are situated ..................................................................................................... Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ Will lot be regraded . ........................... Will excess fill be removedl,w ,~,'~f~l~P~:~er~,(~"~) ,Y~,s ~.~ ( ) No 10. 11. 12. 13. 14. Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ...: ........................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly oil 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 .~r'~LIr, ............. f~""'- ..... ~J~..~J .................................................... being duly sworn, d~oses and says t~t he .is'the applicam (Name of individual signing c~trace above name. He is the ...~...~9~..~~ ........................................................................................................................ (Contractor, agent, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work a~ to ~ke and file this application; that all statements contained in this application are true to the best of his ~owledge and belief; and that the work will be performed in the manner set fo~h in the application filed t~rewith. Sworn to befor~ me this ' .......... ......... .......... Nota~ P~lic,,.....~..~.~..~....~ ....... Cpun~ ..................... (Sig~; ~ ............................ JUDITH T, ~ ~ Nm~, Public, State of Ne~York Ne 5~-n344963 Suffolk County