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Home My WebLink About7931-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy The certificate is issued to of the aforesaid building. No. zT.~.~ ..... Date .......... ~r ....... .~k.., ~9. ?Z THIS CERTIFIES that the building located at .. ~q~t~ .~y~ ~q~ .... Street Map No.. L~.~9~ .~ock No .......... Lot No. F~ ~ ]. ~ .~2 ..... ~P~h~ ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ......... ~e~...~0.. , 19.2~. p~suant to which Buil~g Pemit No. ~7~.. dated ..... ~.. ~.~ ..... , 19.?~., was issued, ~d confoms to ~1 of ~e r~ ments of ~e applicable provisions of the law. The occup~ey for wMch ~s certificate is Thomas Con~ad & ~ife ~ers (owner, lessee or ten.t) Suffolk County Department of Health Approval ... UNDERWRITERS CERTIFICATE No..Re..nd.in.g ................................. HOUSE NUMBER . .7.020 ..... Street....N.qr.t..h...~.yy.i.e.w...R.o.~d. ..... S..oB.t. hc~d... Building Inspector FOEM NO. ~ T(Y~N 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) 7931 Z Permission is hereby granted to: ~homas Conrad & Wffe .............. ~uth=l~ ......................................... ~o ..... .B..u.l~...~....~.~.~..%~.~.~...~..~..t.~..t..~..~.~ll..~.~ .................... .(.~m~.9.~m~...~X....~.... ~e~ls at premises located at .P..~...L.O.~...I.I...~.12,....L.0.e.',f.~.:c1,..k~.~ ....................................................... ........................................ &/t~. No~,h...~.~t~a~... :40 ar& ............. acmtb~l~ ................................. pursuant to application dated ..................... ~.fJ~l ....... 2.0. ........... , 19~..., and approved by the Building Inspector. Fee $.L~.,.~. ........... FORM NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This apphcat~on must be filled in typewriter OR ink, and submitted in DUPLICATE to the Budding Inspector with the following; for new buildmgs or new use: I. 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 d~sposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buddings, Mulhple Residences and simdar buildmgs and mstallations, a certificate of Code comphance from the Architect or Engmeer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildmgs (prior to April 1957), Non-conforming uses, or buildings and "pre-existmg" 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 as to use, occupancy and condihon of buildmgs 3 Date of any housing code or safety inspection of buildings or premises, or other pertinent m- 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 Hatch 10, 1977 New Building ................ Addition ..... ?. ......... Old or Pre-existing Building ................ Vacant Land .............. 7020 N. Bavview Rd, Southo!d, H.Y. 11971 Location Of Property ...... :.....£ ...................................................................................................................... Owner Or Owners Of Property ®. ............................................................... Leeboard Aores '' No. ,~.!....~,..]l~ock No ............. House No ~0~0 Subdivision ................................................................ LO~ ........... .................... Permit5/15/75 A licanTthomas E. Con,,ad Permit No. 7931Z Date Of .................... pp .................................................................. Health Dept. Approval T]../..A. ...................................... Labor Dept. Approval H/A Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fincd Certificate .......................................... Fee Submitted $ .~::..O..~. ......................... Construction on above described building~d/ermit meets ~11/~iTble co~s and regulations. . ...... Sworn ~efo e me th~ .... t..~ ...... day of ..... -i ~ ~/,/~//~,~' ~ TOWN OF SOUTHOLD TOWN GLERK S OFFIGE '-~ ~,~ ....... ~...~ .............. ,~.~..~.~ ~,,~o~ ~o...~2...~....~..~ .......... ~ ....... .~.~...L.~ ..... , ~ ~ ~;~,~.*** **...................No ~ ~ ~ / ~- ......... ~ ~*~ ~ ~: - ........... ............................. ...... ................ ........................ .... ................................. ~ ~ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Th~s application must be completely filled in by typewriter or' in 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 location of Jot and of buddings on premises, relahonsh~p to adjoining premises or pubhc streets, areas, and gwing a detailed description of layout of property must be drawn on the d;agram which is part of this applicatlor c. The work covered by th~s application may not be commenced before issuance of Building Permit. d Upon approval of this application, the Building inspector will ~ssue a Building Permit to the applicant. Such perm shall be kept on the premises available for inspection throughout the work. e No building shall be occupied or used m whole or in part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Budding Permit pursuant to th Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describer The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and in buildings for necessary inspections. ............................... (Signature of applicant, or name, if a corporation) .7..~.~.~ ~..../Z.,.w.~.:~:~.. ~.:..~.~.~.~.~.,~,.. /(Address of applicant) Stale whether applicant Is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buildm Name of owner of premises .~....~...~...~......~.,.....~..~.~ ~.~....~....~.~.... ............................................................... if applicant ~s o corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .................................................... Plumber's License No ................................................. Electr,cian's License No ............................................. Other Trade's License No ............................................... ~0 · I Local,on of land on which proposed work will be done. Mop No: . ..~-....~... ~.. .... Lot No~ Street and Number .~....~....'~....~.......~..%...~.~.....~..'.~..~../..~.~.::.....~...~.. ............................ Municipality 2 State exlst~ng use and occupancy of premises and m.*e~ded use and occupancy of proposed construction: o Exisiting use and occupancy b ,ntendeduseandoccupancy .... ..~.........~..(..~....~.....~..~..~....~..=..g.~...~...~...~.~.. ....................................... 3. Nature of work (check which opl~ble): New Building .................. Addi ............. Alteration Repair Removal'~'~ Demolition ........ Other ¥~/ork (Description) 4. Estimated Cost ..... ~....:'.~.....?....~.~...~..~..~....~.'...~.. ................... Fee (to be paid on filing th~s application) .5 If dwelling, number of dwelhng units ............................ Number of dwelling umts on each floor ......................... If garage, number of cars ....4~ ......................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each.type of use ......................... .... . , ~ O,~" ....~. ~--,5'- ~ 7D,mens,onsofex,st,ngstructures,,ony Fron ..... .................... Rear .......................... Height ........................ Number of Stones ,,,/,, .................................................................................................... Dimensions of saree structure with alterations or addit,ons: Front ..7....~..*...?.. .................... Rear ..~..~..~ ............. Depth_ s ~.~-,.,~..~t...z~..~....~..~.~...~..:. He,ght .......................... Number of Star,es ..... ../. ..................... .... L..~.. ................. Depth 8 Dimensions of entire new construction' Front ..... ~..~ ........................ Rear ................... Height ................... Number of Stones ..... /.. ................................................................................................... 9 S,ze of lot: Front ..L..~.~.~.~..~. 199, r,72 .................................... Rear ...,...:...,....:..=. .................... Depth ,.:...'r..r,.:..-,z..- ...... ' ' 10. Date of Purchase, ........................ Name of Forme. r ,~m~ner,.~.~.:~...-:.~:..r;.:..~.../.::..~.:r...~..L .... 11. Zone or use distr,ct in which prem,ses are situated .~...~..~...~...~'..?._~.~?..,...~....O~...~ ........................................................ 12 Does proposed construction violate any zoning law, ordinance or regulation' . ...................................................... 13. Will lot be regraded ..... ..~..:..~. ............. Will excess fill be removed from premises: ( ) Yes r~,) No 14 Name of Owner of premises~.~...7~.....~.......~.C...~..?....r~....~..¢....~.~..~.~. Addres~..~.:~£....~'..~..~.~.~;..~...K.:' Phone No.~...~..~.~./..~..j..J~.. 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 red,cate all set-back d~mens~ons from property lines Give street and block number or descnpt~on according to deed, and show street names and indicate whether interior or corner lot STATE OF NE'M/YORK, I c ~ COUNTY OF ............................ :.~'~ ...~...O.../..~/~..-~.~...~......~:......~...O....~'.....~.....~....'~. ............................... being duly sworn, d~oses and says that he ,s the apphcanl (Name of indiwdual signing contracO above named. He is the ........................................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sq~d work and to ~ke end file this applicalion; that all statements contained in this application are true to the best of his knowledge and belief; ~nd thru the work will be performed in the manner set fo~h ~n the apphcation filed therewith. Swam to before me this ~ . ......... .......... , Nota~ Public, ~~~~Coun~ ...~~.~....~....~~ ~ (Signature of aDplican~ ....................... Nota~ PuLhc ,n t~ ~ .~e ~,f Hew Yor~, No. 52 C~2C&~O Remd~ng mSmro:k Coun~ ~ Oomm~smon ExpJr¢s Msrch 30, ~9'/~