The URL can be used to link to this page

Home My WebLink About8445-zTOWN OF SOUTHOLD BUIT,DING DEPARTMENT Town Clerk's Office Southold, l~. Y. Certificate Of Occupancy THIS CERTIFIES that the b-~lding located at . .A??.o.~.h..e.a.d..L..a.n.e ........... Street Map No.A~.~'.qhrhe~.cl .Q C]~l~ck No ........... Lot No, ] l .&~.2 .... .P.e.e. Q~;[.e. .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... ~.',a~'...2~..., 19.7.~. pursuant to which Building Pemit No,~.~.~ ~... dated .............. 1.4.a.r....2~., 1~.6..., 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 ... P.~Iva.~e. one. ~'am±~..d~re3.~- Lug ..................................... The certificate is issued to . P. au3.. & .Lorraine..Lynela...0waer~ ................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .v-.u.~.~....2.6...]. ~?.6...b.y. ~:..V~[~i.I.s~ .... UNDERWRITERS CERTIFICATE No..N.2.9.2.~.0. 9 ..... .0-.u.~y... ?...!976. ............... HOUSE ND-MBER ..... ~.l!. 3.0 ..... Street .... ~,~'~.~4he ~cl .~aae ...................... Building Inspector F~M N~. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N? 8445 Permission is hereby granted to: ............... , ...~~.~ ......................................... 'L FO~ NO. $ TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Th~s apphcation must be filled in typewriter OR ink, and submitted m DUPLICATE to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate Iocohon of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage d~sposal--(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 for the building. 5. Submit Planning Board approval of completed s~te 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 hnes, 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 New Building ...............Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Locat,on Of Property ./~.~.../..~...T.....,~.J..~...~...~.....~../~.~.~.g~.`~..~'~..`~.~'~.~.~...~.--.~-.-7~.~./`~.~.~e~~ Owner Or Owners Of Property .."~..~.~..L..~...~,....~..~....ar.~.~.~-~ ..... L..~../~/ff~..~L~..: ..................................... Subdivision . .~.....~..~..~c...~.~.~...~......¢~...~...~.JE- ............ Lot No.~.~..-k,~[ Block No ............House No ............ Permit No. ~D..~n..'~r~..,~...o/J/J/' ~' Date Of PermitP/ "';~xg.../~'..~,~..Applicant ............. ...... ................. ..... Health Dept. Approval ................ .l~l.:~.~.z~.i.~.~....Labor_ Dept Approval .............................................. Underwriters Approval .~.~...L,..~.....[.7.1~.7.~..7. ........... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fincd Certificate ....~ ............................. Fee Submitted $ .....~.,..~ ................... Construction on above described building~and g~nit meets all oppl,caJ?le codes and regulations. Applicant ...~...~~~..,.~/~ ....................... Sworn to before ,~ '~/c~ ~'~'(~/~ ~' ..... .... ........... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 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 featu res. 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 peoperty showing all property {ines, streets, buildings and unusua~ natura~ 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- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-exist~ng dwelhng or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date.. ,'/...~'../..~...~..~,. ' .......... New Budding .~,u.,X.~..~ ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ./...~.~.~. ......... .//".'~, '.,/~...~:..~'~c~.' .~. ~.-',~'~.~...~..~.., ............. .~..-,~..~..~.. House No. ~ ~ Street / Hamlet Owner or Owners of Property . ~.~. C.¢~.. ~.. County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivisio . .~.' . .~ . .Filed Map No ........... Lot No..~.-~'../'..-'~..~...'~'.. Permit No: .~. ?, ~ .'-.?. Date of Permit ~ ./.2~., ./.~.'..Applicant ..... -~. ............................ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ / '~--'~-- Construction on above described budding dod permi,,t meets all applicable cod,es, and regulations. Ap p lica nt ~.. '~.~.'~k;..~. -~,~~ .......... ~.~..~'~ THE NEW YOrk BOARD OF FIRE UNDERWRITERS , -- d I BUREAU OF ELECTRICITY I 85 JOHN STREET, NEW YORk, NEW YORK 10038 lt,,~,. July 7, 1976 II,I, hcatronNo, oliftle 856106 n 292:109 THIS CERTIFIES THAT onl), the electr.'al equipment as described 6elotv and introdtzced by the applicator named or~ the above application nttmber tn the premises of Mr. Lynch, Arrowhead Lane off of Indian Neck, Peconic, L.I. miheJollo,oingloca,,o,,, [~ Base,herr, [~ ~,,1:1. [] ~.,,~ *l. outside S~ction ~"o& Lot ,,,,I ..... ,,.,,edo,, J u I y I , 1976 a"df°u"dt°l'em¢°'al*hancew'ththerequ'rement~°fth'~B°ard' FIXTURE J FIXTURES J RANGES JCOOKING DECKS ~ OVENS I DISH ~/ASHERSI EXHAUST FANS ~S FURNACE MOTORS CUTURE A"~LJANC~ F~B~* I~P~CIIAL REC'PTj TIME CLOCKS I B~tL ~UNIT HEATERS IMULTI'OUTtET ~-' DIMMER'~ ~;,~o,~c~o..~.' ~o~' -' ~ ~-- .' 'v ' , ' ~ '~--~ ' OIHER APPARATUS Motor/s: I-I/2hp I GFI I-5.Ton Air-Cond. Unit, I Smoke Detector, 1-10amp Compactor Charles M. Hall 760 Long Creek Dr. ~., S o u t h o I d, k. I. I I 97 I L i c 657 GENERAL MANA:GER~ /'~-'/ D C'~:'~ ' -'/ -. TOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N. Y. (Building I~p~r) / APPLICATION FOR BUILDING PERMIT NS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, withy 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing Iocetion of lot and of buildings on premises, relationship to adjoining premiss or public streets or areas, ancL~ giving a detailed description of layout of property must be drawn on 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 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 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 ot~- 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. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................... ~..~.~....~. ................. x~.~ ~ ,~.£ ~...E~.. ...... ~ ........................................................................... Name of owner of premises .~..j~..~`.~.~.~..~..~p..~.~.~./~../...~(.~4~.~.~.~...~.../.~....~:~../~..~ ........................................... I f app~t i.~s a~c, orp~orate~, si~._e_o_~f duly auth~?~ze~d o/ricer.J~ ....... (Name and t['~~=~t~ of corpor~";~rT~ .......... Builder's Licen~ No...~ff.~.~.~..Z..~..~ ........ Plumber's License No ..... ~:.~...~..(~.~ ..................... E ectr can's L cen~ No.....~..~ .......... Other Trade's License No ................................................... 1. Location of land on which proposed work will be done. Map No..~.,...~..~Lot No.3.!...~..~..~.. ..... Street and Number ../.~.....~.~. .......... ~ .................. /~......~.. ............ /......~. ................. ~. ....................... {:2~_,c.~e.4s C_ . N-"~', Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................................................................................... b. Intended use and occupancy .....O..~...~. ...... .F..~..t~....*.~..~.. ...... ~.y~..G.L~,L.[~..~.: ..................................................... Repair ......................... Removal ......................... Demolition ........................ Other Work (Description) 4. Estimated Cost ...~....~...0-,...O....O. · -O. ..................... Fee ........ ./. ....................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... ~... ...... Number of dwelling units on each floor ..2'.....s.~...o/~...~..~'.(..f-J..T..Ef~ If garage, number of cars ....l~.°....~t= .......................................................................................................................... If business, commercial or mixed occuoancy, specify natu~re and extent of eacJn type of use .............. ~ ..................... 6. Dimensions of~xisting structures, if any: Front ...~ ........ R~th~ .~ ........................ 7. Height . ~ ............................ Number of Storie~...~:.-...~..: ......................................... Dimensions of same structure with alterations or additions: Front .......................... Rear ......................................... Deoth ............................................. Height ......................................... Number of Stories ..................... , .................. 8. Di'mensions of entir/~ new construction: Front ...... ~Z~..../. ....... Rear '...~.~.= ............Depth .~.....~...../. .................. Heiaht .~.~. ..... Number of Stor es -qf.J~.~ I, .~,....t~..],..~,..~...~.~ ., ....... 9. Size of lot: Front ...... ~....~..~. ..................... Rear ...... ~...~.~.. ........................ Depth ...~.~. .......................................... 10. Date of Purchase ....~.~..G..,..,.~..~..~....... Name of Former Owner ............................................................................ 11. Zone or use district in which premises are situated ............................................... 1Z Does proposed construction violate any zoning law, ordinance or regulation: ....4~..O.. .............................................. 13. Will lot be regraded ~,6/..0..~ ................. Will excess.fill be removed from. premises: [ ] Yes [k/] No 14. Name of Owner of premises ...~',~12 t, .T. ~.~.~. .~.......~.~.l~-.......~..~L(g.~...~. ........................... (Address) (Phone No.) Name of Architect (Address) (Phone No.) Name of Contractor .E°....~....~...t..~..~....~...~......~,~.~.~..-..~'..~'....../~.~ ................................. .'~.~.~...-.~..t~....O-. .................. (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. oo, o ... ......................... ' - ..... ~...~..... ........ ~[.~. .......... being duly sworn, deposes and says that he is the applicant above named. - {Nameoft3dividual sigMn~,,fontraf4h (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 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. .......................... ......... ......... .... ~.ta 0 Vv( Cac!litiea for this loc~t~on hard bee~ Inspected by this department and found SECTION 7299 OF ThE N~W YORK STATE EDUCATION ~W APPROVr"g A.~ NOTED OAI',~: ~ ,~ ~' ~ -~ NOTIFy BUILDING D[PA~TMENT 765-2660 ~AM TO 4PM FOR ~Eqt4~ ED ]NSPECTION~: BEFORE BACKFILLING FOUNDA. TION OR START FRAMING BEFORE ~OYERING HPELINE FINAL WHEN JOB COMPLETED / ,f --I ,.I 0