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Home My WebLink About8622-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..g .1.4.6.6.3 ......... Date ......... J.~.17..~.7, ............... 19 ~.6. THIS CERTIFIES that the building ... gr.e. er~bO.u, se. ~t.cl4ig;k.o. tl ...................... Location of Property 235 Ships Drive Sou~zhold, New York - h3ds'o hid ...................... 's't;~3i ....................... County Tax Map No. 1000 Section 079 .Block 03 .Lot 009 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Bnilding Permit heretofore filed in this office dated June 3, .8.6 8622Z ..................... , 19. pursuant to which Building Permit No ...................... dated .......June .... 3, ..... ............ 198. 6. . , was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... one family dwelling wi%h greenhouse addi%ion. The certificate is issued to ........ ke.n.o..r.e..A.d..a.m.s.o.n. .................................. of the aforesaid building. Suffolk County Department of Health Approval ........ .N/.A. .............................. N/A UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 Building Inspector FO~M NO. ~ 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) 8622 Z Permission is hereby granted to: to ..~...n~..~o~: ~t premises Ioc~t*d ~t ....~.~l,~a..~g~:$~,~,~it~: ............................... ...................................................... ~n~o~ ............. : ........ :.....: .......... , .............. ,..... .......................... pursuant to oppfic*tion d~tod .........................:~ ......... $ ........ , 1¢~[.~, ~n~ OpprovoB b~ the Building Inspector. Foe $~.~ ............ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y, 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF Instructions This application must be filled in typewriter OR ink, and submitted aa~ to the Building Inspec- tor 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 featu res. 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. Commercia{ buildings, Industrial buildings, Multiple Residences and similar buildings and installa- lions, 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. 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 informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.V~cant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 Date .. ,3.u.Jy..1,~ .I?.~.~ ............. New Building . .X..X.X, .X.X. .... Old or Pre-existing Building ............ Vacant Land ............. Greenhouse ShiRs Drive Southold Location of Property ~.~.% ............................................................. House No. Street Ham/et Owner or Owners of Property ....W.aj.t~;r..a.n.d..L.e.n.o.r.e..A.dArrjs. o. n' ................................ County Tax Map No. 1000 Section ..... 0.7.9. ....... Block ... 03 Lot 009 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No..t~.... Date of Permit..~./:~. 1.~..~.Applicant...W.a.lt.e.r..&..L.e. qo.r,e..A.d.a.m..s.o,? ......... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..... ~ .............. Fee Subm,tted*.. Q .......... Construction on above described building and~permit meets all appljcable cqdes a%,~gu!ations.,~ R.v.,0-,0-?a Paul A. Caminit,, Esq. ~o_~' A~amson Examined 'I Approved .. a/c TOWN OF SOUTHOLD BUILDING DEPARTMENT TOI~'N CLERK'S OFFICE SOUTHOLD, N. Y. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ...................... ~., ,,, ~'..~..~., .e,.,, .~j 19..~..6...... INSTRUCTIONS a. This ,a. pplication must be completely filled in by typewriter or' in ink and submitted in triplicate to the Building nspector, w~th 3 sate of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of iai and of buildings on premises, re!ati6nship to adjoining premises or public streefs o~ areas, and giving a detai ed description of ayout ofproperty must be drawn on the diag['am which is port of this opplicat on c. The work covered by this application may not be commenced 6efore 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 whate;ver 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 Lows, 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. Walter Adamson & Wife (Signature of applicant, or name, if a corporation) Sou¢hold (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. owner - builder M~s Walter Adamson 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. owner Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... xx ~x Location of land on which proposed work wi!l be dgne. ~apo,Np.: .D..~ .......... ~S'itl.~l'~]id'"" Lot No ......................... Street and Number North Road to oayvmew ~: ~nm'g Municipali~ State existing use and occupancy of premises and in~ended use and occupancy of proposed construction: a. Exisiting use and occupancy ....~f~.~.~.~.~ .......................................................................................................... same with greenhouse addn b. ~n~e~ded use ~md eccu~ncF ................................................................................................................................ 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior. .................... Other Work ....... ,~.flT~D.~,S~ ...................... (Description) 4, Estimated Cost ...................................................... Fee 'J O, 00 (to be paid on filing this application) 5. If dwelling, number of dwelling units ....0.~.~ .................. 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 ............ 'J..'J ............ Depth ..,:,.J.2 ............. Height .................... Number of Stories ...... ..o..~..e. ........................................................................................................ 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..... .~, .....~.~.$..~ ............................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...Zt...O. .................................................. 13. Will lot be regraded .......,q.o.. ................. Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of v ...... ~ ...................... : ............................. Name of Architect .............................................................. Address ................................ Phone No ....................... Nome of Contractor ..................... ~..8:.~..e. .............................. Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frorn property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. COUNTY OF .......... ~..~... ~.~ ~.~..... ~ ~'~ (Name of individual signing contract) above 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 are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application fiJed therewith. ~ Sworn to before me this X~ /~ .................. ............. ............... , Not( ~ Public,. ........................ ~gZt¢ .......... Coun~ ...~=c-.z~f;~--~.~,.~ ................. (SJg~fure of applicant) ~ ' 0 A~L~te ~ 'New Yar, N~ ~t25~50, SlJffolk COtlflt~