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Home My WebLink About8556-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . .Deep..H.o. ~.e..D.z'At.v.~. ........ Street conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... /29/.76. ·., 19 .... pursuant to which Building Pemit No..8~}~-z 2?28 ~/1~ dated ..... ~/3/76' ~ .......... 9 .... , was issued, and eonfoms to ali of the requke- ments of the applicable provisions of the law. The oeeup~ey for which this certificate is The certificate is issued to .~ohn .g,. ~albo. t ..... ~ ............................ (owner, lessee or ten,t) of the aforesaid building. Suffolk County Department of Health Approval . .~ ~ ............................. UNDERWRITERS CERTIFICATE No..N~83~36 ..... ~a~..18:..1976 ............... HOUSE NUMBER ..... 2.~0~ .... Street ...... Dee~ .~o~ .D~t~e .................. Inspector FOB*~ 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') N? 8556 Z Permission is hereby granted to: ............... ~.~tr~.~. ~;.~e k. ........................................... at premises located at ..~/.~..~..~.,...~J.o~..,~,.e ............................................................................ .................................................. ~t ~.£t ~Y~....~.~ ..~...~.. ~., ........................................................... pursuont to opplicotion doted ........................... g~,~.~.~,~,..:~.~ ......... , 19.~.., ond opproved by the Building Inspector. Fee $..1..~'.,.01~ .......... Building I~spector J FOl~I NO, 6 TOWN OF SOUTHOLD , 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; far 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 disp0sal--(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, a certificate of Code compliance from the Architect or Engineer responsible far 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 pertinent 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 Date ......... . .~--~ ..~../,.../..~ ./.~...~/' / New Building ................ Addition ........... g~.. Qld or Pre~xistLng Building, ;~'"';~ux"s: Vacant Land .............. Location Of Property ...O~ff.~..~:J.~.'3 ..~.~..~....J~..~,..~../..~~.~.r~.....'..~.~,.: ....... Owner Or Owners Of Property//' -'~ .~.~.~.~......~ V Subdivision .......... .;~..~. ............................................... Lot No .............. ~ck No .......... ~,~ouse No ............. Permit No,~....~..~.. Da~/~rmit .~~pplicant Health Dept. Approval ..~u....~......~ ....... Labor ~t. Approval ...... ~.~.~ ............................. Underwriters Approval .,~ ........ Planning ~B~rd Approval ...~.~ ............................ Request For Tempor~ Certificate ~...........~....~'.....~...~ .......... Fin¢l Certificate ..........._..~ .......................... ............. /, Construction on above described building a~ ~ee~~¢~es and regulations. WILLIAM F. (~ seal) Swo)'n, to before me th, i~ I']' // .... ...... day o, ..... Notary Public .................................... County No, 030~67600 QUALIFIED IN BRONX COUNTY Camm, ~xpires March 30, 19.7~..~ :' ',THE ' NEW,, YORK BOARD OF FIRE UNDERWRITERS F-- ~a~ ;~q?:l!i ',i ;' :~5 JOHN STREET NEW YORK NEW YORK 10038 i ,~,,~,ay-zs;?,~976:.~,.:..., . .~,,,,,,c,,,o,,~,,o.o,,;,,e 855~80 N 283836 ; ~oh~ ~Zbe~ Deep ~ole D~lve~ ~i~cA, (Swimmlng P'o ~),~Th!s ;certificate covers Compliance at the date of inspoction only, Because of unusual environments it is advisable to have,freque~t~test,and/or repairs made by a qualified person. LOT 2. t 50.0 i ,",,,'lAD OF LAND' 4 L,,..~ ,.J. TALFOT AT Ivl AT T l T U C' TOWL; QF 5OUTI..4Ot-D. IdBW yoIzI4. GU~,I2.AMTEED T° TUB ,SECU[;?,tTY TI'I'LE & ~UAI2AIJT~' COMPALJY ,&igC) TI4E ,~OUT{4OLD ~uc, v~¥ED - JL:t,~ .4. ~'r~. VA" TUyL & 0~' TOWN CLERK'S OFFICE ~. SOUTHOLD,, N.Y. ~ Application No. ~..~..:.~.. .............. Disapproved a/c ....... ...~,~:~ ................... ./..... q ...................... --~,. ........... ~,~BuJlding Inspector) / , APPLICATION FOR BUILDING PERMIT/'~ ............ INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, acc~irate 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 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 a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection thr6ughout the Work. e. No building shall be occupied or used in whole or in part for an'y purpose whatever 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 Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations,,,~ for remora or demolition, as herein described. The applicant agrees to comply with oil applicable laws ordinances,/~uilJJ ng code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necej~ry/nspec~i~ns. / ......... .................. .,~(Signoture of ap~'licant,//or.name, if a ~'~l~'or~'ii~'i ........ ( ddress of applicant) ....................... State whether applicant is owner, lessee, agent, archi~tect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..... .~.~l::.~ ...... 'J'-.'..-.'"'~...l~.(-bO~ .......................................... ............................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer), Builder's License No ......~'~,//~ r~' ~ ~..~.~..~;~..~;c.....~....~......~..).k~..~.~ Plumber's License No ................................................. Electrician's License No Other Trades' L,cense' No ............. ~LZ 1. Location of land on which proposed work..~ _~ .~will be done, Mop No.: Lot No ......................... Street ond Number ......................... ~....¢r~......~.~......~ v Municipality State existing use and occupancy of prer~ses and intended use and occupancy of proposed construction: ...... ............... ............................... i~i~.o. Exisiting use and occupancy ~..~..J.....~...~ ~ ..................... b. Intended use and occupancy ..~.! '. ~ .~.~...~.~ ~ ~'"~ ................ 3. Nature of work (check which applicable): New [~uild~ng~. ................. Addition ........... ~1~/ Al~e,~o&,~ ...... .~....,.~ P, epair .................. Removal .................. Demalitior ..................... Other Work ......... ~'~'esc r Jption) 4. Estimated Cost ....................... Fee ..~: .................................................................................... ............. (to be paid on filing this application) I e~¢h floor ..;..,: ........ '.' ............. 5. If dwelling, number of dwelling units ....................... Number of dwelling units on If garage, number of cars ...................... ~ ............................................................................................. Z'"'"~,~,'T; ......... 6. If business, commercial or mixed occupancy, specify nacre and extent of ~ type of use ............................ 7. Dimensions of existing structures, if any: Front '"T ...... ~'~ .... Rear ...... ~ ............. Depth .....~ ..... Height ...................... Number of Stories ......... : ........ ~ ....................................................................................... Dimensions of same structure with alterations or additions: Front ~ .... Rear ...:;.~;::.,; ............... ~' ~ . Number of Stories ................................ Depth ................................ Height ........... Dimensions of entire new construction: Front ... ; ...... Rear ... ......................... Depth ....... ~', ................ Height ......... Number of Stories ......... "~ ........................................... %"~ .......... ~ ' ..... ~r~nt I ~ Rear ~ ~.~ Depth .~ L~....~ ......... 9. bize of ~o~: ............................................................... ................ 10. Date of Purchase .......................I..~.~..I· ................. Name of Former Owne? ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... Does proposed construction violate any zoning law, ordinance or regulation: ..... ~.¢ ............................... 12. 13. Will lot be regraded · ....... ~..~.....; Will excess fill, be removed from premise~: ( ) Yes (' N0 14. Name of Owner of premises ...... ~.,~*..~,,~....,~ ........ *~ ........... ~"~ ~ ... Phone No.~ ........ , ' ' :' Address ................................ Phone No ................. Name of Architect .............................................................. Nome of Contractor ............................................................. Address ................................ Phone No ....................... Locate dear y and d st ncr y all buildings, whether exis'~g%~ pr9Posed~ :nd indica? atl set-~ck dimeh~o~s,~rq~ property lines. Give street and block number or description according to deed, and snow street names aha ma~c~T~:r ~hether interior or corner tot. STATE OF NEW YORK, ~ S S COUNTY OF ..... ~tZ.~.;~.l.]6 .......... ~ ' ...................................... ]?~.c.~£[..~,et~.T],~1~....:, .................. being duly sworn, deposes and says that he is the applJcam (Name of individual signing contract} obow~ named. He is the ......................................................... 0.4}~,'b~'~¢.CO ............... (Contractor, agent, corporate officer, etc.) a her or owners, and s duly authorized to ,perform or have performed the said work and to make and file of said w ' · · e best of is knowled e and belief; and this application; that aB statements contained tn thts appltcahon..are, tru?..to th.~ . ,~f/~ g tha~ the work will be performed in the manner set forth in the oppuCat~on rile~ therew~tT/ Swam to before me this ......... .~.~, ........ dayof ......... ~.~[,q?/: ........................... , 19..:~.U. ~_,% ~,~~ Notary Pubhc, , ¥~(~1~ County · . ................................ ..... '7 .... ]'e~m ~x~,res ~arch 30, IU~.~