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Home My WebLink About8469-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z11334 Date December 13 19 .8.2. THIS CERTIFIES that the building .add.Ll~i on ...................................... Location of Property ...4..3.5 ............... W..a.t.e.e.s.e..d.g.e. Way Southold House No. Str~i ....................... County Tax Map No. 1000 Section ...q~ ...... Block ...0.5. .......... Lot .... q5. 9 .......... Subdivision .... T.~..cry..W..ake. e.s. ............. Filed Map No..2.9.0. l...Lot No....4 .......... conforms substantially to the Application for Building Permit heretofore filed in this offic~ dated ....... /{ g .r.i.1..2. .......19 7.6. pursuant to which Building Permit No...8.4..6.9..Z. ............ dated .... .~ p.e.i. %. R ................ 19 ? .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 ......... a greenhouse addition to one-famil~ dwelling. The certificate is issued to ..... RICHARD & MARY LINDSAY ................ .................. ..... of the aforesaid building. Suffolk County Department of Health Approval ...... tl/a. ........................ UNDERWRITERS CERTIFICATE NO .............. ~/~.; .............................. Building Inspector Re~. 1/81 FOR~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENY 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? 8~69 Z Date ....... ~l~rtl...2 ................................ , 19..16. Permission is hereby granted to: ............... I~Chz~cl.. Lln~&.y. ............................ ....4~5.....Ha~,~r~e~lge...W&¥...,... ~o~th~l~, .. N, y. to .C~ S.~lll~.t, ...(.Gr~enh~s~)...a~li.~ion..t~..ex ~a~in~...one.. f ~m~l~.. ~w~ llin~... at premises located at ..~/.~..~la~erae~lg~..W&y..,.....~&outhol~,..1~,...y .................................... ..... ..s..u.k......o. Lv.......T.,...r..r..nZ.~.~..r..s..,....t..~ ~..0.:i.....-....~...o. ~....l..4. .................................................................. pursuant to application dated ................. AIDX:~.]....]., ................... , 19....7.6, and approved by the Building Inspector. Fee $.,1.5..Q0 ........... g qnspector FORM NO. 8 TOWN OF SOUTHOLD BuiidJng Depar~menz Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and subr~itted in duplicate to the Building Inspec- tar 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 topograohic features. 2.Final approval of Health ~ept. of water suBply and sewerage d sposa --(S-9 form or equal). 3.App[oval of electrical installation from Bo~rd of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar building~ and installa- tions, a certificate of Code compliance from the Architect or Enqineer responsible for the building. 5.Submit Planning Board approval of completed site plan requiremer~ts where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing afl 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- lion 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 Date .. New Bud ng ...fA JCl) ...... Old or Pre-existing Building(Z) ........ ~ /Vacant Land - Location of Property ................ House No, ' .......... -'' /-/am/et County Tax Map No..1000 Section ..... ~ ...... Block ,..~7 ......... Lot .... ~ ...... Health Dept. Approval ........................ Labor Dept. Approval ...................... ,.. Unde~riters Approval ........................ Planning Board Approval .................. Request for Temporary Certificate ..................... Final Certificate ,.. ~ .- ......... Fee Submitted S .... /~.¢. ~ .............. Construction on above described building and per'it meets all app~able .... April 2 E×omined ........................................ , Approved April 2, Disapproved o/c .............,~,. ,~,,..3~. · ~ .X. ~X, ......................................................... XX~XXXXXXX BUILDING DEPARTMENT TO~N CLERK'S OFFICE 76 ~o~ N 8469 ,. ........ ..... .................. 76 8469 Z .~ ]9 ........ Permit No ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter oN in ink and submitted in triplicate to the Building Inspector, with 3 sets 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 o~ 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 Building Inspector will issue o 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 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. ..... .... ............ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises ..... '~'ha~d'"an'd'"~a~y'"~i~ds'~y ..................................................................................... If applicant is o corporate, signature of duly authorized officer. (Nome and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Location of land on which proposed work will be done. Mop No.: ..... ~DJ]~: ......................... Lot No .......... Street and Number ..... ~.~'~...~.~.'..~.~...~. ................................................................ ~.Q~Q~.~ ............ Municipali~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: Private one Family Dwelling ~. [x~s}fin~ use and occupancy .................................................. ............................. ~ ................................................ 3. Nature of work (check which applicable): New Building. '""~x' ........ Addition .....~ ..... Alteration ............... ~..~ ~..~.~).~....:z.~d. ~',~ '~//v¢,~£~ Repair .................. Removal .................. Demolitior .................... Other Work ....... (Description) $45o~ ...... . ......................................................................................... 4. Estimated Cost .................. .~ ........................................ Fee /'~'''~ (to be paid on filing this application) Or~e ...... 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ................................................................................................................................... 6. [f business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ..........~..C.)M.f..~.* ...... Rear ................................ Deptb .... Height 0.~,~...6~0.~..0,7: 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.'.Q..~f,., ................ Rear ............................ Depth ...... ~..£.t,,. ..... Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ............ 1.O0...£.t, ............................. Rear ........ l-0~3...f, ti.i .................. Depth ....... p_q~0~..ixt,.i ......... 10. Dote of Purchase ........................................................ Nome of Former Owner ..... r .................................................. 11. Zone or use district in which premises are situated ............. I~e.s::i. ch~z~.t,:L~,l. ............................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ................... ~r~ ................................ 13. Will lot be regroded . ........................... Will excess fill be removed from premises: (x) Yes ( ) No 14. Narne of Owner of premises ...........~:J,r~cls~y. ........................ Address ................................ Phone No. Name of Architect .............................................................. Address ................................ Phone No. Name of Contractor ..L:i. ob.~.t,..~/J..q.k,~sO.~ ................... Address 0~.14~w~...~,~e.,.... Phone No ....................... PLOT DIAGRAM L6cate 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. STATE OF NEW '~RJ~,z ..,/ I ¢ S COUNTY OF .~~.....~ ................................................................................................. being duly sworn, deposes and says that he is the applicant (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 ore true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn to befQre me this ....... ........... Notary Publi~.__.~.__~... C~:iunty ..... ' (Signotu'~'6f[applicant) ,// .............. JUDITH-r APPROVED,AS NOTED ~^T~~/~b-' ~76S'2~01NSPE~iONS:¢AM TO ~PM FOR RE~uIR. 1jBE~RE BACKFILLING FOUNDA. T~N OR ~ART FRA~N~ 2. BEFORE COVERIN~ ]. FINAL.WHEN JOB C~ ~O~ RES~NSIBLE FOR DESI~ OR ~TRUCTION ERRORS