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Home My WebLink About8309-zNO. · TOWN OF SOUTHOI,~) BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Occupnncy No..sS053 ..... Date .. 4)ecel~ber 8, .193.7 ...... , 19..7.7 THIS CERTIFIES that the building located at 8510. C~..Peconic ~ay. l~lv'~treet Map No.. -21 .... Block No ........ Lot No .... 3 ............................ conforms substantially to the Application for Building Permit heretofore filed in this office dated .. November 20 , 19. 7§ pursuant to which Bui]d~ng Permit No..830g~ · dated ... November .... 20-., 19 75, 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 .-. Accessory ~i~ilctin§ ........................................... The certificate is issued to ..... .Robe~,b -Beet~ ..................................... (owner, lessee or tenant) 0£ the aforesaid building. Suffolk County Department of Health Approval ..... N, R... ........................ UNDERWRITERS CERTIFICATE No ..... .I~,.R.; ................................... HOUSE NUMBER . .881o .... Street . GT..9ECO~IC. BAY ..... BLV.'.D ............. ...................................... LAUI~ FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, Iq. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8309 Z Permission is hereby granted to: ,~.t~..~l~..,.~. ....................................... .. .... ................. ............................................ to. ~,]~ta~...m..~L~,.~t. tm:ale., b~,.tzata~.. ~e~eaBoz~,,1 ............................................. at premises located at ....~./,.~..~.~.~..t~.~.~....l~l~...~.~'.~ ......................................................................... ................. , ................... i ......................... I,~.e;L....{l~,~.~..:l.t;) .................. ~ ...................................... pursuant to application dated .................... ~41t. ...... ~ ................ , 19'.~?~j~and approved by the Building Inspector. Fee $: .......... FORM NO. 6 TOWN OF SOUTHOLD Building Deportment Town Clerks Office Sou(hold, N. ¥. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildmgs or new use: 1. Final survey of property with accurate location of oil buddmgs, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply end 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 installations, o cerhficate 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 buddings (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 os 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 cert~hcate of occupancy $1.00 Date ......... ., .'~...~. ,~..~....., .~'.~...!. ?.,?.., .~. New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property .... .~.~.,~..~ ....... .~.~.-~,~ .......'~..,.~..C...~.~.J.C~.....,.¥.c.A..3; ......... .-~,?..,~.,.,~.,.'.,.~.., ...................... Owner Or Owners Of Property .......... ...~,...0...?...~...?,..-~.. ....... ,.,.'~....~Z..?....'j~.. ........................................................ Subdivision .......: ........................................................... ~ .............. Block No ............. House No.'...:.;.:..,r' g 0 gZ,, .......... .......... .... Permit No.....~.=. ~..=..:~ . ~.ate Of Permit ..'~ ..... ,..¥..';..:.'.Applicont .(~'...~.../.~. ,,:I Health Dept. Approval ............. ................. Labor Dept. Approval ................t,:::...:.% ................... Underwriters Approval ............................................ ~'lannlng Board Approval ........ .,h.! ........ ~.~ ................. Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ?~ ~ Construction above described building an on ..... codes and regulations. Applicant Sworn to before me this ~,~ ................ day ~__.._... (stamp or seal) Notary Public .................................... County Ao FORM NO. 6 TOWN OF SOUTHOLD Bu ilding Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 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 certifmate 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 hnes, streets, buildings and unusual natural or topograph ~c 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 buddings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existingdwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 ...... .~-. ,.~..,.~¢~ .......... Date New Building ............. Old or Pre-existing Budding . .~. ........ Vacant~ '\Land ............. Location of Proper~ ~PD'~.~...~ % k.~ ~X~MS~'~ ~ ~ .... ~ ~¢'. co~w,~o. ~ooos~,o~ .... ~ ...... ~o~ ..... ~2 ...... ~o~ ....... ~ ....... ............ .... .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ~.. .................... Foe Submitted $....'~..~.,. ~..~.) ........... Construction on above described bu ild~~cable codes and regulations. Applicant . .-~.~ ...... ......... Cc. Approved ............ t.~ .......... ~ ........., FOII~ NO. 1 TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE ~OUTHOLD, N. Y. ....... errant No. .................................... Applicot,on No..&..~....O....~,. .......... ~ ...... ......................... INSTRUCTIONS a. This application must be completely filled ~n by typewriter or ~n ink and submitted in triplicate to the Buildin[ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing Iocahon of lot and of buddings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this applicatiom 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 wdl issue a Building Permit to the applicant. Such permil 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 Budding Department for the issuance of a Building Permit pursuant to thc 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 tc admit authorized inspectors on premises and in buildings for necesse~ inspections: (Signatu~i~f-'"~'~ app,icant, or name;"i~";"~;';l~';';~';i;~'i ........ ~ ~o_~_~v (~ ~c/ /~ /?/~7- (Address of applicon) ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ .............................. ..................... :;, ........ ........................................................................................... Name of owner of premises ..... .~ .~z..~ ........ J.~ ........................................................................................ If apphcant 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 ........ ?.-~. ................................... '"~?)~-~ -'~/ ~L~( _~ Location of land on which ~rop, psed wo~ will be don~e Map No ...................................... Lot No...:2 ................... Street and Number ..... ~...Z~. ........ .~..~~.....~....c~/.. ...... ~,=.....~ ...... ..~..~ ......................... ( Municipality State ex~shng use and occupancy of premises and intended use and occupancy of proposed construction: a Exisiting use and occupancy .................................................................................... b. Intended use ond occupancy ........... ..~b~.',.~...~..'~d.f~A.'. ..... ~..~ ............................................................................. 3 Nature of work (check which applicable). New Budding .................. Add~hon ................. Alteration ............ Repair ............... Removal .................Demohhar ............. Other Work ..~.~.~.~...~.~_~...~....~.'....~....~.~'....~.. tC)esc ription) 4 Estimated Cost .~..~...~.~t..%..:~. ...................................... Fee ..................................................................................... (to be pa~d on fihng th~s apphcation) 5 If dwelling, number of dwelhng umts .......................... Number of dwelhng units on each floor .......................... If garage, number of cars ........................................................................................................................... 6. If bus~ness, commercial or m~xed occupancy, specify nature and extentof each type of use ......................... 7 Dimensions of ex~stmg structures, if any. Front ...... ~ .............. Rear ....~.. ......................... Depth .~.~. ............... Height ...~ ............. Number of Storms .............................................................................................................. D~mens~ons of same structure with alterations or addmons. Front ................................... Rear .......................... Depth .............................. Height x.N~umber__ of Stories ...,~ ................ \ 8 D~mensions of enhre new construction: Front ........... .% ..................... Rear ..... ~;.~ .................. Depth ..~...~. ............. Height ..~."'x .......... Numl~r of Stories ...... ~. ........................... x ............................................. ~ ................... 9 S,ze of lot' Front ...... Xo...'~ ....................................... Rear ....... ~.~.~. ........................... Depth ...~,.~.~ .................. 10 Date of Purchase .................................................... Name of Former Owner ...................................................... 1 1. Zone or use d~stnct in which premises ore s~tuated ............................ 12 Does proposed construct,on v,olate any zon,ng Iow,'~r'~',~;~ ~'~ }'~i;}i~I iii'.~.~i~.i..iiiiiii...iiiii ...... ii .................. 13. Wdl lot be regraded ....................... ~dl excess fill be removed from premises' ( ) Yes (~ No 14 Narne of Owner of prem,ses ...N~..~.~...~.....L~...~. .................. Address~.~{..~..~.~.'~. ................. Phon~ No.~.~..~..-~'.[..k..~..' Nome of Architect .............................................. Address ................................ Phon~ No ..................... Nome of Contractor ............................................... Address ................................ Phone No ..................... PLOT DIAGRAM Locate clearly and dmtinctly all buildings, whether existing or proposed, and mdmate all set-back dimensions fro~ property lines gwe street and block number or description according to deed, and show street names and Jndicat whether interior or corner lot STATE OF NEW~..OR~..,,-. ~'o' ~ S S COUNTY OF ..~~../,~7.:. ....... f ,.--..., ............ ~...~.~IP..4C. ~... ....... ..~..., ...... ~.~ ............. be,ng duly sworn, deposes and soys that he ,s the apphc, tName of ~ndiwdual s~gnmg contracf) above named. He ~s the .............................. ~..~..~ ................................................................................................................. (Contractor, agent, corporate officer, otc ) of said owner or owners, and ~s duly authorized to oerfor~have performed the sa~d work and to make and this application; that all statements contained in this ap~hcoti~re true to the best of his knowledge and belief; that the work wdl be performed ~n the manner set fo~h in ths.opplic~ed ~th~ Swam to before me this z ~ ...................... .... ........................... ELIZABETH ANN NEVILLE NOT~ PUBLIC, State of New Y~ No 52-S[25850, Suffolk County Ter~ E~re~ March ~. 1 ~.. x' ', :, LOT ~ // F'IAP' OF- PP_OpE.r--7.3'FY SU~',.'Lz.'¢ ED GE-O-PoSE kL~' '~" "-" '"' · . I,~[~\,',-,) I - .t tAT' F~2.CO NfC