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Home My WebLink About8429-zNO. · TOWN OF SOUTHOLD BUH.BINC, DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. z77~6 ....... Date ............... June .28 ...., 197~.. THIS CERTIFIES that the building located at .. t4egarm 'Lane ............ Street Map No. Eas.t ~ -~h- · · Block No ........... Lot No. ? ..... Greenport ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated ..........'l~arctz · · 1 ?', 19 '76' pursuant to which Building Permit No.. ~+29Z' dated .....i-i ..... Eaz~..l?..., 1976.., 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 .. Private' 'acce'ssory '~(to~'Z '& 'Sto~'~ge')' 'bui~'din~ ................... The certificate is issued to Eric..~-&. ,Oolores 'Tyrer ....... 0wne-~s ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .l~,id.. ............................... UNDERWRITERS CERTIFICATE No. -N ~ ~ ~ ....................................... HOUSE NUMBER ... !92~' ...... Street ....t~c~ann -Lane ....Oreenport ......... Building Inspector { L FOEM NO. ~ TOWN OF $OUTHOLD BUILDING DI~PARTMENT TOWN CLI~K's OFFICE SOUTHOLD, N. Y. BUILDING PERMit (THIS PERMIT MUST B~ KEPT O~ THE'PREMISES UNTIL FULL ~COMPLETION OF THE~'~'ORK AUTHORIZED) 8429 Z Permission is hereby granted to: t./~ . / ~ ~.....~ ....... ~.~g ....... ~.~.. ,o ..... ......... 2 .... ~,~,~ ..... ~ ...... z~ ........- ~...~~.., ............ : ........................ FORM NO. 6 TOWN OF SOUTHOLD , Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instruction~ 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 ~ines, streets, aha 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 buddings 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 "pro-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 inspechon 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 $1.00 , ' New Btlilding ....~.Z:~i ..... Addition ..... ~ ..... Old or Pre-existing Building ................ Vacant Land .............. Locotion Of Property .... .~....~...-,~......,~..~......,.~....~/~',,~J......~.../~./~,..~-~ ........ ..~,..,J'....~...~,...,~.~..~.~.~'.Z....,~../../- '~"',,, 't" ,-,,:r' ~...~...~..~ A'..~..$....~. ~ Owner Or Owners Of Property .... ~J......~.....~...:...~r. ..... .......... ,../c,'...~../ZT.. .............................. Subdivision .~.~J~.~.....~./~,a,c~ .......................... Lot No.....~.. ..... Block No ............. House No.../?......Z.~. Permit No..~...~...?Z..~...~-Bate Of Permit ....~./.../.,°.~/-,Applicant ...,~..7..(..~......~.~..[~..~.~...~...../~. ......................... Health Dept. Approval ............................................ Labor Dept. Approval ...... ~......~. ................................ Underwriters Approval .............................................. Planning Board Approval ..~.,.!..~.. .............................. Request For Temp.~ry Certificate ........................................ Final Certificate-. ........ ~ .................. Fee Submitted $ .... ./r.~ ,~.~.~ ................... Construction on above described building and permit meets aJJ_apl~licable codes and regulations. Applicant ~~...'~ ;.~..,~~ ................................................... Sworn to before me ..... day of ................. .......... Notary Public ~/~'.~. County Cstamp or seal) Dis(~roved o/c ............................................................................................ APPLIGATIOfl FOR BUILDING PERMIT , ~#~. . .. ~. ............ ...~...~..~ ................. , ~9.Z.~.. INSTRUCTIONS Inspector, with 3 seto of plam~ ~mcurate plot plan to.Kale. Fee according to schedule., b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets ox areas, and giving a detailed description of layout ofproparty 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 Bu Id ng Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the c~plicont. Such permit shall be ke~t on the premises available for inspection 'throughout the work. e. No bullding~s~oll be occupied or used in whole or in part .for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. HEREBY MADE to the Building Department for the ssuance of a Bu ding Permit pursuant to the APPLICATION IS Building Zone Ordinance of the Town of Southold, Suffolk County, NeW York, and other applicable Law~, Ordinances or TR,egulati.o. ns, .for the construct!on of. buildings, additions ar alterati ,o~s, or for removal or demolit on, as herein descr bed ne applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulotlo~j, and to admit authorized inspectors on premises and ir) buildings for rjecessary Inspections. .......................... CSignat,';~ o~'~'l'i'~i~"~r ~me, if ;' cOrpOl~ti~'~ ' ...... (AddresEof applicant) / ' ' ~1 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nam, o~ owner of prem,ses .~./.~...~'.,..~......p..a.l.~..:~.......~. ......... .~y~.~ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's LiCense No ..................................................... Plumber's License No ............................................... . . Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of load on which proposed work will be done. AAap No.: ...... ..~'...~ ....................... ,.. Lot No..Z ................... Street and Number ...~..~.....~.(~....~,,~.~...~,,~..~. ...... ~..~,Z~.Fg,/:..~..~ .~. ............... ...................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. ExisitJng use and occupancy ..~ 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ................................................ . .... (Description) , ......... ............................. .......................................................................................... (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 ..................................................................................................................................... 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 .................. ~ ...... ;.;N/grpber of Stories ........... >..)]..~: ........... ~ / 8. Dimensions of entire new construction: Front ....... /...&.. ....................... Rear ........... ~ .............. Depth ..... ~. ................. Height ..... Number of Stories ...................... 9. Size of lot: Front ....... L/..?....'.~ ................................... Rear Z ! ~ e Depth ./,~ I). O ..... 10. Date of Purchase ....... ..~..,.~l.......J.~.~. .................... Name .......... Zone or use district in which premises are situated ..................................................................................................... 11. Does proposed construction violate any zoning law, ordinance or regulation: ........ ~...tt.~....~. ......................... ]2. 13; Will lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes ( ) No Phone No. Name of Arch tect .............................................................. Address ................................ ~o-,, -~.Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate c early and distinctly a bud ngs, whether existing or proposed and indicate all set-back dimensions from property lines. Give street and block numberJ;~z j;le~cription according to deed, and show street names and indicate whether 'nterior or corner lot. ~-~ ~' - --- ~,~ STATE OF NLM/)~)RJ~'./. ~,/ t S S' COUNTY OF~.-f ' ................................................................................................. being duly sworn, deposes and says that he is the applicom (Name of individual signing controct0 above named. He is the ...................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or' have pe6ormed 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 performe~d in the' mdnner set forth in the application filed therewith. Sworn to befem me this . ....... /2. ........ d of,. ............................ . X . .. Notary Pub' nty .......... ;..;; ................................. JUDITH T. BOKEN Notary Public, State of New York No. 52-0344963 Suffdk Count~/~ ~oiamission Expires March 30, N. 74-' 04' 10" E. 7 8 160.0 04-' i60. Q MAI:) OF ~ SU2.VE Y~D NOR. TNEAST BUILDEITS G I~EEN POR. T bJ J map ~qumbev 4'021 / / / / SCALE,; 40~ |" Licen~.ed La nd " G MAP OF' ~ ,eo.o ~ NO ET FI EAST, 'BUI LDEI?S G P-.-~;E N PO t~T 'rOV~N OF' $OUTHOt~O, t4,,g. hJ - .N $CAUL: 40~ I" ,,jfai~ j LicenSed Land