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Home My WebLink About7836-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No ....~.9..5.5.~ ......... Date .......... .3.qn. O..8.,. .............. 197.~. THIS CERTIFIES that the building ................................................ Location of Property ... 2. Q.8.0..D~.eP.. I~ol.fi. Driv. e .................... Matt i.~uck ..... House No. Street Hamlet County Tax Map No. ] 000 Section ...12 3 ...... Block .... Q 4 ......... Lot .... O 3 ........... Subdivision .... X:~_~X .................... Filed Map No ..... XXX. Lot No ..... 2[ZZ ..... REQUIREMENTS FOR ONE FAMILY DWELLING BUILT PRIOR TO conforms substantially to the ~Xi~itg~DI~ .... t~lliX~Ii/iXiltX'll~t/~]lOlglX CE TIF C CY Z 5 ..... Apl:ii..2 3, ..... , 19 5.7. pursuan~ to ~vYl~/}aTl~_ ~~/~ ........ 9...5 .8 .......... dated ............... Jla.ne.. $, ..... 19 7 9., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ... ~ ..... .P.~.VA~. O~E .FAMILY. D. WELLXlgG. W. ITH. A~DITI.QN..(Inclu~3~e. o~ .B.P....783.6Z and 3838Z) The certificate is issued to .. J. OHN..& .ELAINE..V~LLANQ ............................... (owner, l~,~lyx:l~ia~t] of the aforesaid building. Suffolk County Department of Health Approval ...P.~.e.-..E.x.i.~. ~..i.n.9. ......................... UNDERWRITERS CERTIFICATE NO .......... .~p.e.-..~.x.i.~..t .i.n.9. ......................... Building Inspector Rev 4/79 FORM NO. 2 TOWlq OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, lq. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N? 7836 Z Permission is hereby gronted to: ...... ~.~:.cT./..~..~..~.Z ....... .~ ........ ~L.c..L.~.~ 0 to ...~.~..P. ...... ..m..c ....... A ..... ~..v.~.~.~.~ ...... at ............. l..~ ......... ~.y. ....... ~...W..~ ..... L. ........ .~. at premises located at .........~..~....~....0.....,,~.~;...~.. ....... t:J..O../,~.J.~-. ........ ~]~...-~...~..?.,.~. ............................. .................................................................. {~.~.~..!.~.~..c...?..~.,. .................................................... pursuant to application dated ....................... ..~.~...~..~./~...~'...../~.. ..... ~...~, 197...~...., and opproved by the Building Inspector. / t~ Fee $ ..... ~t, .~. ............. Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions dst be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- rig; for new buildings or new use: roperty with accurate location of all buildings, property lines, streets, and unusual aphic features. ,Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 'ical installation from Board of Fire Underwriters. ings, Industrial buildings, Multiple Residences and similar buildings and installao '. of Code compliance from the Architect or Engineer responsible for the building, foard approval of completed site plan requirements where applicable, 'gs (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" ~'~[~ f peoperty showing all property lines, streets, buildings and unusual natural or '%wner or previous owner as to use, occupancy and con,?tion of buddings ....... --Jg code or safety inspection of buildings or premises, o,. other pertinent i'nforma- required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelhng or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date .... ~.. ,?.?./.? ] ............ New Building ....... .~.~ ~o ..Old or Pre-exist~ng Budding ............ Vacant Land ............. Location of Property ~; ~. .... ~.5~. ?~ t ~.5 . . . ~;~ ¢ : ...... ~'*:~ ¢ '~;;~e; Owner or Owners of Proper.'¢¢¢ ~/~ }/.. ~. ~ ~.~. ................................ County Tax Map No. 1000 Section . . f.~.~ ........ Block ..... ~ ........ Lot. ~ Subdivision ................................. Map No ............... Lot No. .... , .......... Permit No..?'.'~.~ .~. Date of Permit ,~. ?.~.?...Applicant . .~./..~..~.'¢.~..'/.....~. '~...~./..C../7.~?.~.... Health Dept. Approval /7//~'J .Labor Dept. Approval ........................ Underwriters Approval ............ ~ ........... Planning Board Approval Request for Temporary Certificate ..................... F mai Certificate .... 'X ............... Fee Submitted $ Construction on above described building and pCrm~t.r~eets all app. Jica~e codes and regulations. Applicant .. ~ ................................................ Rev. 10-10-78 FO~.M NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ................ 72 .............. 7 ......................... D~sapproved o/c ..................... ...~..~..~ .............. ~. .......................... ........................................................................ ..... ...... / (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This apphcat~on must be completely filled in by typewriter or 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 location of lot and of buildings on premises, relat~onsMp to adlo~ning premises or public streets or areas, and g~wng a detailed description of layout of property must be drawn on the d~agram which ~s 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 unhl a Cemf~cate 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 Bud&ng 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 alterahons, or for removal or demolition, as herein described The applicant agrees to comply w~th all applicable laws, ordinances, building code, housing code, and regulations, and tc admit authorized inspectors on premises and ir~ buildings for necessary inspections. (Signature of applicant, or name, if a corporation) ................. .o..z....8..6.~..~.a..t..t..Ct..u..c...k.....~.~..2 ..... ~ ............ : ............. (Address of applicant) State whether apphcont is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ...~'r.t~ho~y..~,...V.i.!.!.~.o. ....................................................................................................... If applicant ~s a corporate, ssgnoture of duly authorized officer. (Name and title of corporate officer) Builder's bcense No ..................................................... Plumber's License No ................................................ Electrician's License No ............................................ Other Trade's License No ............................................... Location of land an which proposed work will be done. Map No .................................... Lot No ........................ Street and Number ...... .~.~?.'~..u.~.u..e..'~..~'~...~...e.~.D.~.'J:..~'..~.~..~...t.'~.J:.~.~..~: ........................................................... Municipality State existing use and occupancy of premmes and intended use and occupancy of proposed construction' a Ex,siting use and occupancy ............... ~,4~:i. fJfl~,~,~ ...................................................................................... b Intended use and occupancy ............... ~,~s~-~ae ............................................................................................ 3 Nature of work (check which applicable) New Building ........... Addition . ..Z~ .......... Alteration ............. Repair .................. Removal .................. Demoht~or ................... Other Work .................................................. /~...~. (Description) 4 Estimated Cost $2 ~ 000 Fee ........................................... (to be po~d on filing th~s opphcobon) 5 If dwelling, number of dwelhng units .. .1 .............. Number of dwelling umts on each floor ..1..f_l..o.o.r. ......... If garage, number of cars ..................................................................................................................................... 6 If bus,ness, commercial or m~xed occupancy, specify nature and extent of each,type of use ......................... 7. Dimensions of existing structures, if any. Front ...... 2~8.'. ............... Rear ............ .2..8..'. .............. Depth . ?. ?. .~. ,6. ~.. .L ....................... Height 12'~ Number of Stones ................................................. ~>. ............................................ D~mensions of some structure w~th alterations or oddmons. Front ......... 3~..'.~ .................. Rear .... :~..6..:~ ........... 12-2 1 Depth ....... ...~...¢~..~ ?.'3 ........... Height ........ :...--... Number of Stones ........... .~ ................ · 8 Dimensions of enhre new constructmon' Front ................................... Rear ...........................Depth .............. Height ..... ]~....'.i ...... Number of Stones ................................................................................................ 9 51ze of lot. Front ............. .4.0.' ................................. Rear .... 60' ~ Depth ~T0+ 10 Date of Purchase // ~' ~' 9/66 .................. Name of Former uwner .............................. ............................... M~tt J. tuck ....................... 11. Zone or use district mn which premises are s~tuated ............................................................................ regulation .................... ;..~ ........................... 12 Does proposed construction wolate any zomng law, ordinance or ' 13. Will lot be regraded ..~.o.....?..:. .......... Will excess fill be removed from premises. ( ) Yes ( ) No t 4. Name of Owner of premises .~..~.:.A;-~.,%.f¢.£i~.~,6 ................. Address ~°d~..~,,..M,:q~.t~l;~d~one No. ~,~.~r.~.4..~..~.~. Name of Architect ................................ Address ................................Phone No ...................... Name of Contractor .................................................... Address ................................Phone No ...................... PLOT DIAGRAM Locate clearly and distinctly all buddings, whether ex~sting or proposed, and red,cate all set-~ck d~mens~ons fron prope~y lines Give street and block number or descnpt~on according to deed, and show street names and indicat, whether interim- ~ STATE OF' N COUNTY OF (~ above named He ~s the .... of so,d owne this apphcat, tl",o~ the work Sworn to befc Notary Publi, I .' is the opphcan make and ill- and behef; on,