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Home My WebLink About7885-zFOEM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z?.~2.~ ..... Date ............ Feb... a5 ....... ,19.7.7 THIS CERTIFIES that the building located at . Oak. A.ve .................. Street Map No.~OOS.e .BAY. .~ock No ........... Lot No. t conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... May...~ .., 19.~.~. pursuant to which Building Permit No. 7889'Z.. . .dated ....... .M.a~... ~. ...... , 19 ?~., 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 . .Private..one. family. .dwelling. with addition .................... The certificate is issued to .V. er~..~oeb, el .... 0what ............................. (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .I~.R.o ........................ UNDERWRITERS CERTIFICATE No .... ~130.8.218 .... 0c.t... ] 8...1976. ............. HOUSE NUMBER .. 32~ .... Street ...... Oak. AYe ...... S.o.uthold ............ ......... Building Inspeetc~r I~ORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7885 Z Date Mey ~ ~ ~ ........................................................ , ' Permission is hereby granted to: V~...J...G~ebel. ..................................... ................. ~o~th~ld ...................................... to ...~ld...~...a~ldLti.~...~..e~i~.t~g...6~¥:c...i.~,~ ........................................................ at premises located at ....... ~O.t.:a..,~J.~...-.....~.~,l. ....... ~CD. Se...'~.~...,.:2.~ ........................................... .......................................................... 32. ~......gak. J~.~.~ .......... ~\~t~l ~ ............................................. pursuant to application dated ...................... .:'2;~. ....... ~. ................ , 19....~.~'., and approved by the Building Inspector. Fee $..1.5.,.0~). .......... ........ ,.~. ............. :F,~. ......... ~ .......... .p ................. Btam,rig Inspector / FOR~ NO. 6 TO~N OF $OGTHOLD , Building Department Town Clerks Office $outhold, 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 Inspector with the following; for new buildings or new use. 1. Final survey of property with accurate location of all buildings, property lines, streets, aha 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 installahon 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 site 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 as to use, occupancy and condihon 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 B~tilding ................ Addition ~'/ Old or Pre-existing Building Vacant Land Location Of Property .......... .~...'~..~-:.. ..... .~.../~.,...~......./~...~'....L~.. ........ ..~....O...O...E~...~.....~....~..~.~....~....~....-~...~...-~....~.....c~. ....... Owner Or Owners Of Property ...... ..¥..~..~...~........~..:...~.?...c.._...~...~....~.. ................................................................ Subdivision ................................................................ Lot No. !..~..~.:./.~! Block No ............. House No..,~....~..~.':. Permit Dote Of Permit ........ ................. Health Dept. Approval ...... .~....!.I..~... ........................ Labor Dept. Approval .................If_..../?... ................. Underwriters Approval ,Z[/~)~;.5~..~......./.~.F2.~. ' /.~/I~'- .................. ..,Planning Board Approval ..................... Request For Temporary Certificate ........................................ Final Certificate ........... ~ .................. Fee Submitted $ .... ~.......~.. ..................... Construction on above described building a~t~./o~~:s ~ ~. lotions. Applicant ..... ~~,', ...................... Sworn to before me this 17~-- d "~'"~" '"~' ~2:~ (stomp °r seal)/'~9-~r'~/~/~ Notary Public ........... BUREAU OF ELECTRICITY B5 .JOHN STREET, NEW YORK, NEW YORK 1003B v.,,, 0ctobe~ 18. 1976 ,.,,~,,.,,.,,,.'..,,,,.n,-~757"" N 308218 HIS CERTIFIES THAT ~1) the electru al equ~pmen~ as described below a~tl ~roduced by ~t~ applicant na~ned on ~he above appllcatlo~ nutt~ber in the premises of Vera J. Goebel, 325 Oak Ave., Goosebay Estates, L.I. ~/,,.f,,//,,,,,,,~z.,,,n..,; ~ ~ .... ,,,,,,~ [~ z~r~t. [] ~.,,~ ~ Outside s.cno,,11 ~/o,~ ro~156- .......... ,,,,',~,,,, October 14, 1976 .,.Uo,,,-~ ...... o,,,pn~,~,~/,~,~-',m~",~,'~/"~'""~ 161 ~IXTURE I / FIXTURES [- RANGES ~'~OKING DECKS OVENS ~lS~ WASHERS EXHAUSt_ FAN~ --~-Jr 7 j3 j~--lj v I -! L I I I I I_l/ I . ~ APPARATUS must not be a tered n any manner return may be /dent,fled by th e~51s to the office of the Board if incorrect Inspectors TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c ...................... APPLI~ATION FOR BUILDING PERMIT ~ Date .......... H..~..~.......~. .................. , 19.7..~.. ..... ~ INSTRUCTIONS o. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building Inspector, with 3 set~ of plans, accurate plot plan to scale. Feeaccording to schedule. b. Plot plan showing location of lot and of buildings 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 p~rt of this application. c. The work covered by this application may nat 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 occbpied 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 of buildings, additions or alterations, or for removal or demolition, as herein described.~ The applicant agrees to comply with all applicable laws, ordinances, bu~c..nde, housing code/~nd regulations, and to admit authorized inspectors on premises and in buildings for n~~o~~ (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. ..................................... ...................................................................................................................................... Name of owner of premises ......... ..~...~...~....~..,....'""~....0..,~....~...~..,..~.. ........................................................................................ If applicant 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 ............................................... GOO5~- 1. Location of land on which proposed work will be done. Map No.: ...... )..~...-/...~. ...................... Lot No..I.~..~.~..J..~..~ ...... Street and Number .............. ..~.....~..~. ....... .~./~,~.....~.~....~ ......... ..~..~..~...'~'.~.~).~.~.. .......................... -;-~ .................... · Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .....................I ....... ..~'...~....t~...~....~...~. ....... ~.....~?...~....~..~...~..~.h~...~... .............. i ........................ b. Intended use and occupancy ..................... ..~.....'~...~......~.. ........................................................................................ 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... 4. Estimated Cost ........... k~'...O...O.. .................................. Fee --?'~---- ; (Description) (to be paid on f!!ing this application) 5. If dwelling, number of dwelling units ........... .~ ............... 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 .......... ~1.....'~..~. ..... Height ........... L~. ............ Number of Stories ......... ! ...................... 8. Dimensions of entire new construction: Front .................................... Rear ........ ..~.[ .............. Depth .....I...~t.. .............. Height .......I,..~.. ........ Number of Stories .............~ ........................................................................................................ 9. Size of lot: Front ...................J..~....O. ............................. Rear .......................................... Depth ....... I...~..O.. ................ 10~ Date of Purchase .......... )..~..(~..~.. ................................. Name of Former Owner ..... .~....~...~....T....~....t~.. .............................. 11. Zone or use district in which premises are situated ............... ...~....~'....~...~...~.. ................................................................. i2. Does proposed construction violate any zoning law, ordinance or regulation: ......... .~....0.. ........................................ 13. Will lot be regraded ........... ..~....O. .......... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ......~..~...~...~..~...~.O...~..~...~..~.. Address .,...~....~....~...~ ............ Phone No.'~.~..~.:.~.~.. Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ 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 i_n. dic~te.~ whether interior or corner lot. .' STATE OF NEW Y01;~/.~,/~'~ I S S ' COUNTY OF ....... ..'~- .Z'2~..-....~/.,,,[ ' .................. ~,....~.~.~ ............................... be ng duly sworn, deposes and says that he is the applicam (Name of individual signing contrac~ above name. He is the ............... D.~.~ ........................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and file this application; t~t all statements contained in this application are t~e to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the appl~at~led therewith. ~ Sworn to before me this ~ / ~ ~ / ] ...................... . ,o o, .................. ........... .... ............................ o, ~z-4~3~b - Suffolk Coun~ C~mm*ss~or,'Exp~res Marc~ 3~,