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Home My WebLink About8042-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No... ?.1.4.6..9.7 ........ Date ......... 4U./Y..23 ................ 19 8.~ THIS CERTIFIES that the building .. Pat±o and fence Location of Property . .1.5..5.5..F.~.e. 9.~.w. qq.d..R.q .a.d., ...... .C.u.t..c.h.o. qu..e:..N.e..W. York House No. Street Hamlet County Tax Map No. 1000 Section . .1.3.7. ....... Block . .4 ............. Lot 3 4 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · .July..~, ............ 19 7.5· pursuant to which Building Permit No...8.0..4.2.z. ............. dated ........ J. Ul~'..~, ............ 19 7 .5., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which ttfis certificate is issued is ......... Patio and fence The certificate isissued to ........... J.a3. S. Tuthill ......... ...................... of the aforesaid building. Suffolk County Department of Health Approval .......... I'{./..~ ............................. UNDERWRITERS CERTIFICATE NO ..... Iq [A Building Inspector Rev. 1/81 FOI~M NO. 2: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~. Y. BUILDIIqG PERMIT (THIS PERMIT MUST BE KEPT ON THE PP. EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 8042 Z Dote ..................... Permission is hereby granted to: o~3.~t..~.r~d~Le.k....~.~...,:[. 0... L~u t. bJ.::L]. ..... ................ ~..o.~.¢.~o. ~.~ ....................................... at premises located at ....?...]:.e...e...~..¢.?..0..~.....~..o...~..~. ...................................................................................... .................................................... ?..L~.~..C.~....tLe..~.~ ......... .~.t,.~.~e.....~.,.g.~ .................................... pursuant to application dated ................. ~...12~. .......... 'l .................. , 19...~., and approved by the Building Inspector. Fee $.~ .Q..~..0..I). ........... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted m~ 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- lions, 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 featu res. 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. .e~'~rtificate of occupancy $5.00 Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. updated C.O. $15.00 $15.00 Date ~..~..~..,. ( .~..~.~ ...... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. House No. Ham/et Owner or Owners of Property ...... [z~ .& .............................. County Tax Map No. 1000 Section .... ~..~.7 ....... Block .. 'W .......... Lot.~.~. ........... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No .... Z Date of Permit ?/7.~.~ .Applicant f0%t .......................................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ..... ~-~,..0.~ ................. Construction on above described building and permit meets all applicable codes and regulations. Applicant ... ~ .. ~.~ ............ EOIU~ NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Examined ? ~ 9 7 ~ Disapproved a/c .~.;,..~...._.;~.~J.-'~..~.~.m~ ...................................... (Building Inspector) APPLICATION FOR BUILI)ING PERMIT Date .................... .~..~. · .~.~. ....... ! .......... , 19.?..~.....~ INSTRUCTIONS a. This application must be completely filled in by typewriter ot~ in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plat plan to scale. Fee according to schedule. b. Plot plan showing location of at and of buildings on premises, relationship to adjoining premises or public streets az areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this app ication. 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/~~j Bud ng Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regu at OhS for the construction of bud ngs, additions or alterations, or for removal or demolition, as herein described.~ The applicant agrees to comp y with all appl cable laws, ordnances, buJ ding code, hous ng code, and regu orions, and tot,/ admit authorized inspectors on premises and in buildings for necessary inspections. Donald Frederick (Signature of applicant, or name, if a corporation) Sottthold (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. buil.~ .................................................... Name of owner of premises ..... .~..'....~.g.:~!~..¢..]:.$. ...................................................................................................................... If applicant is a corporate, signature of duly authorized officer. .................. i~i~e an~ ;title of corporate ~ficer) Builder's License No .... 1.D..:...~.~.e...d;.?...~.~g~1~- .................... 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 No ..................... Street and Number ..... ~.~..e...e..tg.~Z.°.g.~-...[.~.g..8:.d. ....... ..O..~..~..o..~...o.g.~......;L~.:.~.... ................................................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ..... .~..~,.T..e.;q._..~.j;~ ........................................................................................................ b. Intended use and occupancy ............ ~.~.t~...~.~.~,b,-..~.~..~l'..-f-lf~]o.~)'&..~''~D'~'c]'''~D'~'~p' .............. 3. Nature of work (check which applicable): New Building'. ................. Addition .................. Alteration ................ Repair ...~,~, ............ Removal .................. Demolitior ..................... Other Work ...~..o..~'...~...~.~.J....o. ......................... (Description) 4. Estimated Cost ............................................................ Fee 110,00 (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ,o. ge. ............... 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 ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ................... . ................ Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .~A!!...cl.±~'~ ................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ......... .~...O. .......................................... 13. Will lot be regraded .........~.o. ............... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ,...J.,...T.u.i;hill ........................ Address............,.........,~........Cutch°~'ue Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor .,.D.,o.~E.1..~..~?.~.e..~.e..~..i..o,.~. ................... Address .......... ~.o...~.~,o.~.ct:.... Phone No ....................... PLOT DIAGRAM L.ocote 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 whether interior or corner lot, SYATE OF NEW ~,0~,[~,~_ ! S S COUNTY OF ..... .o...~.f..J:.?..z.~ .......... )' . ......................... D.Q~)~l~..~'~e~e~.'~ ~.!~ ................................ being duly sworn, deposes and says that he is the applicart~ (Name of individual signing contracf) above named. He is the ........................................ ~D.~....i..]:.~..e.~ ........................................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, end 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 thor the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this // .................. J.... of ................... ............... . .._ · Suffolk f/~K~ ~!/ /-/~¢~z~/~/~ Notary Publ,c .................................................... Count/ ........... ................................................................... ' I/ (S gnature of applicant) 76~-:18~2 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [] FOUNDATION ZND [ ] IN~JLATION []FRAMING [//J FINAL REMARKS: DATE INSPECTOR