The URL can be used to link to this page

Home My WebLink About8663-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13244 Date March 4 198.5. THIS CERTIFIES that the building ..... P.o..o.1..&...~.c.c.e..~.~.o.r.¥ ........................ 965 No. Field Ln. Location of Property 1700 No. Parish Dr. Southold ~- IJtDt~s~ Ho: ........................................................ Street Hamlet County Tax Map No. 1000 Section .... .0 .7.1 ..... Block 01 .Lot 0 2 0 Subdivision X ...Filed Map No. ,Lot No, conforms substantially to the Application for Building Permit heretofore filed in this office dated · .bl.a.y., 2 1 19 .7.6. pursuant to which Building Permit No. 8 6 6 3 Z dated .... .5.u.n.e. ........2.1 .......... 19.7.6., 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 ......... ....S.w.i..rom..i.n.g., .Pgp.1,..&..A. qc..e.s.s, qr. y ...... (p.o.o..1..w/...f.e.n.c.e. ! ........................ The certificate is issued to ........ cunliffe, Lois ............. ..................... of the aforesaid building· Suffolk County Department of Health Approval ...N./.~.. UNDERWRITERS CERTIFICATE NO. N2 8 712 0 Building Inspector Rev. 1/81 FOI~M NO. ~ TOWN OF SOUTHOLD BUILDING 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) N? 8663 Z Permission is hereby granted to: Matt~,tuck t,u~]d new or~vate swirl, in= pool wi.th fence & accessorvs at premises located at .....~.~.?....~:~..~.~..?..~.~..~?...~...~..o..~...tf.~_.~..~...~.e..,~...~... ...................................... ........................................................ on/:..~Q ld.....N.,.~r., ......................................................................... pursuant to application dated ...e...o..~..r...e..e...~.~..d........~.~.......~..1. ........ , 19..~...~.., and approved by the Building Inspector. NOPSI Need uade~!ters eert,~ficate fo~, electr:Le eonaeet~.ol Fee $...1..~..?..0..0.. ......... Building Inspector ~t, This application must InSpector-; with the na urvey of unusual natun 2. Final;~ aCp'~oval of 3, Appr6vol of ele~ ~omMerCJal bL ~ in~tblJatiens, a the building. Submit Planning ~d ~Far existing buildings ~p I~d ,uses: ~ccurCte; :survey of ;or toe,graphic fedt~ S~orn ~t~tement of 'Date 6f m]y housm~ T~ ~PPI jCATION FOP.' ~Hled in typewriter ling; far new with ~ccurote I ~ap~ raphic featHres' Dept. af water Mstaffahon ff~m> ,Industrial buildings' *e of EaSe ~rd~¢~pp~ov¢t of completed ~t~ )roF~erty sho~*:ng ~ll ~ro * to the Building !ines, streets, and form or equal). ~,!m dar buildings dneer responsible for ;'whele opph~.abi¢ ~gcant Land .......... H<>use ~ulations, FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in dupltothe 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 features. 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. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, 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 safeW inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. F~es: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00., Date .... .J .a,~.... ,2 .~.,.~. 9, ,8 ,5 ........ New Building .... ¥ ........ Old or Pre-existing Building ............ Vacant Land ............. 965 North Fie~d. L_ane Location of Property 1700 North Parish Dr. Southold House No. Street Ham/et LOIS CUNLIFFE Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section 071 Block 01 Lot, 020 Subdivision X p N ,Lot No. ................................. Filed Ma o ....................... Permit No...8.~.6.~... Date of Permit ,.6/.2.~./.7.6.Applicant .................................. Health Dept. Approval ..... .NJ.~ ............... Labor Dept. Approval ......................... Underwriters Approval...~ J~.7.], ~ 0 ............. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ........ ~ .............. Fee Submitted $ .~r'~ ...................... Construction on above described building and p~ermit meets~all applicabte codes and regulations. . , ,-~,,~i-J Applicant . .~...'¢~-"~...-~. · · .-; T~..-.-;. ~ ..................... Rev, 10o10-78 . "~* '!~ ~!,T'HE}NEW;~YORK BOARD ,OF FIRE UNDERWRITERS '~' '~"~r ~Unliffe~ ,No~th,P~ish Dr. ~ Northfield, Southo~d, L,I, to have frequen~t!/test Glenn R,'~; Bradley Ho~.tor~ Avenue~. Mattituck, L.i. Lic., 1227 D This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified FO~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL ~.~..~ ................................................................... ................. ~: ....... ~..-f .....................~ ........ for per2~, construct .,;1~ ~~'"~'~ ................................................................ ............................ Street the~remises Io ted~ ......................................... Map .............................. ' .......... Bilk ........................................ Lot ................................................ is r.~.r..a ~erew,~..~ a,.~..ro..a o. ~ow,n~rou.a,~ ........... ~¢~ ....................... . .... ..~...~..~ ..... Z~..t.,~ ....... : ...... ~~.:~....:~..... ~. ~-~ ~ ............................................................................................. Building Inspector INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, ~ 3 ~ of plan~,accuh3te 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 at areas, and giving a detailed description of layout ofpraparty must be drown 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 approvdi of this ckoplicatian, the Building Inspector will issue a Building Permit to the applicant. Such permit shallbe 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 a Certificate of Occupancy shall hove been granted bythe 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, 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 inspacto~ on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Address of dpplicant) State whether applicant is owner, lessee, agent, amhitect, 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 corggrote officer) Builder's License No..~~..~~.. Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ................. ~...~. ....................... 1. Location of land on which proposed work will be done. Map No.: ............... /..~... .................... .......~..... Lot~.~... Street and Number ............................ /.,~..~.....i~.........~.~i~......~..~. ....... ~...~(.~. ...................... Municipality 2. State existing use and occupancy of premises and intended use and occuponcy of proposed construction: ............. .............. ........................ .. ................................................... 13. 14. Locate clearly property lines. Give whether interior or Nature_ of wo~k (check which applicable): New Building.~ ................. Addition .................. ,~AIterati°n ................ Re~air Removal Demolition .................... Other Work ......... .~./... ............. (Description) Estimated Co~t .................. ."/~'..~-~. ................................. Fee ....../'..~.' (to be paid on filing this application) If dwelling, niJmber of dwelling units ............................ Number of dwelling units on each floor ....................... If garage, number of cars .................................................................................................................................... If business, (:ommercial or mixed occupancy, specify nature and extent of each type of use ............................ Dimensions o~existing~ structures, if any: Front ............................ Rear ................................ Depth .................... Height ......~ .............. Number of Stories ................................................................................................................. Dimensions ~f same structure with alterations or additions: Front'. ................................... Rear ............................ Depth .......... / ~ ..................... Height ............................ Number of Stories ................................ Dimensions at~ entire new construction: Front .................................... Rear ............................ Depth ..................... Height ................... Number of Stories ...................................................................................................... ; ............... Size of lot: F~ont ........... Z~.....'. ................................. Rear.... ....... /..~.'~......................... / ..... Depth ........ K~...~. ................. Date of Purchase ..................................................... ].Name of Former Owner ....................................................... Zone or use district in which premises are situated .................................................................................................... Does propose~ construction violate any zoning law, ordinance or regulation: ........................................................ Will lot be re(. 'aded .......................... .~. Will excess fill be removed from premises: ( ) Yes ( ) No Name of Owne' of premises .......... ~.....~.......~-~.~.~.~..~..~. ...... Address ....Z~.P.~...~.,~..~.'..'. Phone No...~....~...~..c..~...~....~ Name of Arc hitect .............................................................. Address ................................ Phone No ....................... Name of Car 'rector ............................................................ Address ................................ Phone No. ...................... PLOT DIAGRAM nd distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from street and block number or description according to deed, and show street names and indicate ~rner lot. STATE OF NEW Y( cOuNTY OF ..... (Name above named. He is the ............... of said owner or o~ this application; t~ thor the work will I~ Sworn to before me ........... ~..'1.~... day Notary Public, ....... NeTARY P · qo. 524 )RK,.., [ ¢ c ~..OJR~.~.:R'. ............................................ being duly sworn, deposes and says that he is the applicam individual signing contract) ~ (Controctor~ agent, corporate officer, etc.) 'nets, and is duly authorized to perform or haVe performed the said work and to make and file ~.t all statem~qts contcdned in this application are true to the best of his knowledge and belief; and . performed Yn the rfl(i~,r~r, set fo~th in the application filed therewith. 125t~50, Suffelk