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Home My WebLink About8523-zTO~N OF SOUTHOLD BUII.I~IN~ DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificete Of Occupancy No. Z9087 ....... Date ....... ~.une. 27. ............ ,197B.. THIS CERTIFIES that the building located at w/.a .Gin .Lan~ ............. Street $outllold, N.Y. Map No. Des.c ....... Block Bio ........... Lot No. C~, .Tax .#0B.8-.3.-L8 ............ conforms substantially to the Application for Building Permit heretofore filed in t~hls office dated ... Apr ~.1..22, ........ , 19.? 6. pursuant to which Bui]dl-g Permit No..~1523Z.. dated ... April .22, ......... , 19.76., 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 .On~ .car. · .garage., and. cl,t, ning · room. addition, to .olle..t~alai~Ly .dwelling The certificate is issued to .F..r.a~..c.i.t..K.i.e..r.n~..n...J.r....%..w.f, .......................... ( owner,~X~lal~ ) of the aforesaid building. Suffolk County Department of Health Approval . .N/R .............................. UNDEEWEITEES CEETIFICATE No...~.~?.7.5.6..7 .................................. ? HOUSE NUMBEE 1.6.00 ......... Street. ~ln .Lan~,. $outhoLd, .~,..Y ............ Buillrmg Inspector IPOB~ NO. 2 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) 8523 Z Date ........................ A.]~ ~'/J. ....... 2~. ........ , 19..~.6. Permission is hereby granted to: F.A J. A.. ~,i~z~e~..~...~i~.e .................................... ................. ~,~..~ ............ .~th~l~ ................ to ..~..~. ~ ),.~1,...~rL ..~ .~..d. ~..~;.~,g.~....9.~....e..~..~. JJ..'g.~..n..g.. ~.~.~ ~.~ g. ............................................................... at premises located at ..~.f../.~....~G.~n....L....a~....e~.....~(..2..n..d.....f.?...~..m....~e"n..d.). ............ ..B..~.y....h.~..v..e.~ ...................... ..................................................... ~.~.~k~3,~.....~.,.~., .......................................................................... pursuant to application dated ......................... ,/~].~.i~ ....... ~ ...... , ~9..?.~.., and approved by the Building Inspector. Fee Sk~.~.e..O..g. .......... FOF~M ~O. 6 TOWN OF $OUTHOLD , Building Department 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 all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage dispasol--(S-9 farm or equal). 3. Approval of electrical installation from 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 oil 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 pete $ ............. / New Building ................ Addition ...... '.~........ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..... (~?./.~.~,~,~?-~. ................ ~,~./.~,~.~../ ..................................... Owner Or Owners Of Property ..~'..~.Zc~.~J.C~z~....~.~.~,~7~2:C~,.~..~.....v./.., ........... /~//..~...C~.~.. ................................ Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No.~'.~.~...?.."~.~....~... Date Of Permit :~:?.Z/..~./../~Applicant · ..~'.- .~.~c~,.¢Z~.,,~,4~.¢[,./. ~,~.~¥. ............. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval ...~.... .................... i .................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fin~ Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permit meets all applicable codes and regulations. ................ day of ............................................ (stamp or seal) Notary Public .................................... County :::T ,<-E :~ aRKBOA[~L) OF~l-'lEb UNDERWRITERS ,:,~<;i?~:i:-~}~' ~ ' ' ' '' ' ' .... 85'JOHN STREET NEW YORK NEW YORK 10038 .' ~V.~, Ma~ch ,8~ 1978' ~".; : . ~vp~i~.t*o.~o.o.~,r 929137 ' .... ' *' " ' ' ..... b ~app~ic~nt~medo~t~ab~eappllcal~on~um~ri~the .... ~:,:, ~ancis Kiernan J~* :: Gin Lane,.Southold, L.I. - :~ ~a 7 o' '; ": ' a~dfo.~d to be in compli~nce~with the ~eqi~ire~e~ts of .:Southold, L.I. '11971 must not be altered in any ma~ner; return to /he office o} the Board if incorrect. Inspectors may be identified ~ ' ·- U ?'~-- '/ ---.-, TOWN OF SOU'THOU)/~-~-'-~ - ~r~ ~Wlq CLERK'S OFFICB ~ ~ , -- - ~ro~l ........................................ , .......................... _ ........................ ................. APPLICATI~ FOR BUILDING PE~IT . ~ INSTRU~IONS a. This o~lication must be completely fill~ in by ~ewriter oe in i~ and s~mi~ in tHpJicote ~ ~e Bui~i~ In~or, with 3 ~ of pl~s, accurate pl~ plon to ~ole. F~ occo~i~ to ~h~ule. b. Plot plan shying I~ation of lot and of buildings ~ premises, ~lationship to ~joining premiss or public stree~ o~ areas, and giving a detail~ de~ription of I~o~ ofpr~ must be drawn on the diagram which is ~ of this application. c. The work c~ered by this a~lication may n~ be comme~ before issuance of Building Permit. d. Upon appeal of ~is application, ~e Building Inserat will issue a Building Permit to the ~licant. Such ~rmit shall be kept on the premises available ~r ins~ti~ ~rough~t the work. e. No building shall be ~cupi~ or u~d in w~ole or in pa~ for any pu~e whoever until ~ Ce~ificote of ~cupancy shall have been granted ~ the Building In~e~r. APPLICATION IS HEREBY NLADE 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 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. (Sigpgture of opplicc~y, or name, if a corporation) . . ,,r; //E?/ .................. ................................................... (Address~of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................. .0 ............................................................................................................................................................ Name of owner of premises ....../~..,f~:-,~.:~..~...~../..~..~' ./~...~..~..:....~.....~...~....~..t.~~ ............................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..... ~~ ............... Plumber's License No. ................................................ Electricion's License No ............................................. Other Trode's License No ............................................... 1. Location of land on which proposed work will be done. Map No.:~'..~..~,~R~.~...~r~V~. ............. Lot No ......................... Street ond Number ......... (~'/..~...~...~...~'.4~ ...................................... Ja/.~..l'/~,,..v~...~ .................................. .~'~/,z~.~.~.. .......... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisifing use and occupancy ............ ~'~ .~....~/.'f..¢~ .......................................................................................... b. Intended use and occupancy ............ ~Z'.t~./~:.. ..................................................................... 3. Nature of work (check which applicable): New Building.. ................. Addition ......~ ...... Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description} 4. Est motedCost ..... ......................................... 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 cars ................ '.....~ ....................................................................................................... ,i ............... 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 ,..~,,~J ........... Height ........................ Number of Stories .. / .............................................. Dimensions of same structure with alterations or additions: Front ..~.~....*.~..~.&..~.~... Rear~'~..*/.8.;.~.~.C-~'}..~..'. Depth ~..~/. ............................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ! ~ Rear / ~- Depth ~.,~..... Height .................... Number of Stories ..................................................................................................... : ............... 0. Size of lot: Front ......... /.~p .......................................... Rear .J.~o.,.~z ............................ n,~,h/5~-5- ,~z~,ws- 10. Date of Purchase ..... d~././../..~?... .................................. Name of Former Owner ....~..~.~>- ......... _5-, .,~.~..~:.,,...~?.~. -,~ ~' ............., 1 1. Zone or use district in which premises are situated ..................................................................................... t ............... 12. Does proposed construction violate any zoning law, ordinance or regulation: ......... ~..c). ......................... i ............... 13. Will lot be regraded . .......~....o. .............. Will excess fill be removed from premises: ( ) Yes (~x() ~o 14. Name of Owner of premises ~?Z~..~.'.~..~/.'.~.....~..,..~.C ....... ~.....?~'~dress ,.~.~'~.~¢t~-.. ..........Phone No..~'"~'~?.~..-~.~. .... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor x~.~..~..~..~.~.~./~'..~ct..~,~.~,' ' /~ ...................... Address .~/~.~m,~...~:=. ........... Phone No..~.~..~=/..~..~..~. .... PLOT DIAGRAM ,' Locate clearly and distinctly oil 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 an~d indicate whether interior or corner lot. ' STATE OF NEW '(C~K,// /// ~¢c COUNTY OF ................................................................................................. being duly sworn, deposes and says thor he is tho opplicom (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 hove 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 filed therewith. ......... ~/( (Signature of ap~cant) JUDITH T. I~e~taty Pubhc, Slate or New Yolk No. 52'0344968 Suffa k Count