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Home My WebLink About7815-zFORM NO. A TOWN OF SOUTHOLD BU~,BING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z6~l ~ ...... Date ............ J~bn_~ .. 9 ........, 19.7.~. THIS CERTIFIES that the building located at .Donna. il~.tve ............. Street Map No.t~ep. F~ole. · ~lolc~t~o ........... Lot No,. 31 .... l~ttii;uck.. Ii ,Y, ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ tprll.. 1~)19~.~. pursuant to which Building Permit No. ~81.~Z. · dated ........ Ip~.ll. 113 .... , 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 P.~tvate. a~cessa~y, s~immlng .pool .with .fenaing. & .accassor.ys... The certificate is issued to . ~llliam. &..Evelyn. Pa.rsons ..... Owner. ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N ,ii, .............................. UNDERWRITERS CERTIFICATE No.. Ii. 22lt4320 ..... May · · 9. · .1.97.~. ............. HOUSE NUMBER ...~ .160 ....... Street .... Danna. ~ri¥e ......................... Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMI:/LETION OF THE WORK AUTHORIZED) N? 7815 Z Permission is hereby granted to: ..W~-~lam..~a~ons ...................................... ........... .1..t6...o......~..o.c.~..~..~.e. ........................... Mattit~ck to $.~.~.~..~x~.~y..~.e.~..~..w.L.m.~.n.~.~L~...°..°...1...w.~.~b..~.e.~.e...e.~.~...a..?..~..~ ~.~.~ ........................... at premises located at ...... Lot....~.l ..... ,1~ea]3..~ol, e..C~ek,..~,st .................................................... .................................................... :1.1.6D... ~o~a. Dx ............ ~a.~ti.tu~k ......................................... pursuant to application dated ..................... ~.;~i...1.Q ............... , 19..?.~., and approved by the Building Inspector. Fee $...1 ~.,..~.Q ......... CL ? C.,Z_L,. ,.. FORM NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This opphcotion must be filled m 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 hnes, 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 Underwnters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a cerhficate of Code comphonce 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: I. 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.q~ '~ 3 Copy of certificate of occupancy $1.00 \ / New I~ldh~. ~d ~)o,~,~.~. ~,%LOId ~)r:- ex. isfi n_g Buildi~.~ ~.~nd .............. Locahon Of Property ........ v'z~.-z~...='=...=....z.::=....~c;:~4~= ........... ~...~...~..~..~...~'. ...................... Owner Or Owners Of Property ..... ~.~.....~.. ...... ~ ...... ~"~....~..~...~-.:~.~...'~. ............................ v Subdiv,sion ...~.~.~..~!)-:L.~...~.C.~ ............. Lot No..~-.1 .... Block N~.~ ........... House No~.[..~...o.'~- Permit No....~...../..'?.....~.. Date--' Of Permit ..~/'~.~/~..~pplicant ...... ~...~.~r~ ......................... Health Dept. Approval ....... .~....!..~... ....................... Labor Dept. Approval ...............?.....?..z-~.. ..................... Underwriters Approvol .............................................. Plonning Boord Approvol ........................................ Request For Temporory Certificote ........................................ FinoJ Cerhficote ....................................... Fee Submitted $ ...:~...~ ................. Construction on above described building ~meets~odes and regulations. Applicant~....-~.'. ....... ~ ............... J.~. ............................... / Sworn to before me thil .......... ?. day of .... ../~ ~...~...~....'~..... (stamp or seal) LOT 30 LOT 3G LOT 55 ! ~ "~- ~ ~,-~-=--.~o t'-°- LOT LOT 32 THERESA DRIVE 0 SUP, VEY FOR WILLIA;,1 S. ~ EVELYN M. PARSONS XT ;JATTITUCK TO';';; O? $OUTHOLD ~UFFOL:C OOU~TY~ N.Y. JULY 20 ~ 1~71 REFE£:£tECE ~ MAP OF DEEP HOLE CREEK EST.'.TZ~ FILED dAN. 2G, lOG3, FILE ~°{O. 4CGG LOT 50 182 00~o,, THERESA DRIVE SU;~ VZ ¥ FOR WILLI/4;.I S. & EVELYN /,T ;2ATTITUC;( TO';';,, 0~ SOUTHOLD SUFPOL;~ COUt]TY~ JULY 20~ 1371 M. PARSONS REF~R£HCE ~ MAP OF DEEP HOLE CR.~EK FIL~:D dAN. 2C~, 1903, FILE GUAP,;J:TEZD TO ~ ~;fEP,,ICA,"$ TITLE I~JSU~/'~;C~. CO~JPANY WJLLIAM ~ ~ EVELYN M. PARSON= Examined Approved TOWN OF SOUTHOLD BUILDING DEPARTMENT~- TOWN CLERK'S OFFICE-5*~ ~ ~ ~ . ~ / ~UTHOLD, N. Y. 19.~.~ Application No. ~.(..~....~. ........... ........ Disapproved a/c~~ ...... ~ APFLICATIOH FOR BUILDING PERMIT INSTRUCTIONS a This application must be completely filled ~n by typewriter o~ in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b Plot plan showing Iocahon of lot and of buildings on premises, relahonsh~p to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is par~ of this application. c. The work covered by this apphcation may not be commenced before ~ssuance of Building Permit. d Upon approval of this application, the Building Inspector wdl 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 Deportment 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 apphcant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in, buildings~ (Signature of applicant, or name, if a corporation) ....... ...... (Address of applicant) (Name and title of corporate officer) Bu,lder's License No .................................................... Plumber's L,cense No ..... ~.._~..~ ..... ,?'Tg .................. Electrician's License No. /~:~.~..~..~...c:..~... State whether apphcant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises ...~/..~.../~..~......~....~....'~.~...~.~.....~......~.~.?..~...y...,~......~..~...-~ ......................... Jf applicant ~s a corporate, signature of duly authorized officer. Other Trade's License No ............................................... Location of Iond on wh,ch proposed work will b_e done. Map Na ...... ...~"..'~...-...~....~.. .............. Lot No ...... ..'~...,.,?., Street and Number..~../..(...~......'.~...~..~.~.4~.....~....~../.~..~./ ..~...~'...~....~...~.-..(..~.. ................................................. Municipality State existing use and occupancy of premises and m*,ended use and occupancy of proposed construction' ........ ............................................................... a Exisiting use and occupancy ........................ b. Intended use and occupancy ................................................................................................................ 3 Nature of work (check which apphcable). New Building .................. Addff~on .................. Alteration ............ Repair .................. Removal .............. Demohtlor ......... Other Work /..x~. ~ .~..~./.'.~/.--.....~.~..:/.~.. ...... (Description) 4 Estimated Cost ........ ..~....~...~..~ ...."~'.....~. ....................... Fee .................................................................................. (to be pa~d on filing th~s applicatzon) 5 If dwelling, number of dwelhng units ....................... Number of dwelhng umts on each floor ......................... If garage, number of cars ......................................................................................................................... 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use .................... 7 D~mens~ons of existing structures, if any' Front ........................Rear ................................ Depth .................... Height ........................ Number of Star,es ......................................................................................................... Dzmens,ons of same structure w~th aiterahons or addmons' Front ................................... Rear ..................... Depth ................................ He,ght .................. Number of Storms ............................... 8 D~mensions of enhre new construchon. Front .................................... Rear .......................... Depth .................... Height ................ Number of Stones ..................................................................................... 9 S~ze of lot Front ........ ./...~..~.~ .................................. Rear .... ./..~..,~..,..~....7. ................. Depth ./..~..]~.....~..~.../.~/.~.-..~...~.... 10 Date of Purchase ......... ?..:...~.....'~,.:=...~...~.....~...../.... Name of Former Owner ........... . .~....~...~...~'....~,...~.,'~....~.....%~. ....... 11 Zone or use district in which premises are s~tuated .............................................................................................. 12 Does proposed construchon violate any Tatung law, ordinance or regulahon' . ...................................................... 13. WHI lot be regraded ....................... WHI excess fill be removed from premises: ( ) Yes ( ) No 14 Name of Owner of premises..J~....~/......~.,.'J~.~..~..~....~..?J...:.~.,~. Addres~...~.~.x..~.Z .~..~.. ............. Phone No..~..~..~..:,~.~~ ~" ..... Name of Architect ....................................... Address ................................ Phone No ...................... Name of Contractor .................................................. Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~sting or proposed, and mdmate all set-back dimensions fron property lines G,ve street and block number or descnphon according to deed, and show street names and indicate whether inter,or or corner lot STATE OF NEW_YORK., , l¢ ~ COUNTY OF ...~...~?~=~,~c'.c.../(~.. f ~ ~ .~A~4.~.&.~....~.L....~.~.~Z.~...~ ............................. be,rig duly sworn, deposes and says that he ,s the applicam (Name of individual signing contrac~ above named. He ~s the ......................................................................................................................................................... (Contractor, agent, corporate officer, etc ) of sa~d owner or owners, and ~s duly authorized to perform or have performed the sa~d work and to make and fHr this apphcahon, that all statements contained m this apphcahon are true to the best of his knowledge and behef; an~ that the work wilt be performed m the manner set fo~h in the apphcation filed therewith. Sworn to bef~e me th~s ~ ~ ~- ~ , ....... ................. , 7 i ~°~ ~)~ ~~~- ~ .... Nota~ Publ c,. ....... ~. ....................................... Coun~ ...... ~.;...;;:~.~......~....... ........................... (Signature of applicant) ANTHONY P ~AZZE~ ~~ No~ Pubhc, ~ste of Ne~ York Ho, 52 7782050, Su~n'1 ' '~