The URL can be used to link to this page

Home My WebLink About7943-z(THIS TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTItOLD, N. Y. THE % BUILDING PERMIT ON THE PREMISES UNTIL F THORIZED), N? 7943 Date Permission is hereby, anted to: to ..au.. at premises FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...z.~.4.7..5. 7 ......... THIS CERTIFIES that the building ......... .A.d.d.x..~ .~.o.n. ............................. 1645 East G~llette Dr~ve, East Marion, N.Y. Location of Property/:/~s~ h/'o[ ....................... ~r'e~t' ....................... ~/~t~/~ County Tax Map No. 1000 Section ...3.8. ....... Block ...... ~. ........ Lot...2? ............. Subdivision...M./.o...M.a.r.i..o.n..M.a.n..o.r .......... Filed Map No.2.0.2.8. .... Lot No. 80 conforms substantially to the Application for Building Permit heretofore filed in this office dated M a y 20, 19 .7 .5. pursuant to which Building Permit No. 794 3 z dated .... .~.a.y..2. .0., ................ 197. 5.. , was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which tiffs certificate is issued is ......... Add£tion on existing one family dwelling Max Plsseldorf (Charles & Adele Smith) The certificate is issued to ........................................................... (owner, le~to2/d~ Te~ of the aforesaid building. Suffolk County Department of Health Approval ............ N../.A ........................... UNDERWRITERS CERTIFICATE NO .................... N../.A ........................... Rev. 1/81 Ao Bo FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted ~. ~..mm. 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 dmposal-(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 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. For existing buildings (prior to Aprd 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty 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 condition of buildings. 3. Date of any housing code or safety inspection of buildings 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-existing dwelling $15 o 00 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 Date ...... 3....q...~? ........... New Cons truct z on ...... Old or Pre-existing Building ...'~,. ....... Vacant Land ............. Location of Property ..................... ,~..' .~, ,~,..: .......... .~.'...Y~q.~.. House No. Street Hamlet Owner or Owners of Property J~'l County Tax Map No. 1000 Section .., ,,.~. ,o~ ......... Block .... ,~, ......... Lot..,~?, ~ .......... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above descmbed building and permit meets all applicable codes and regulations. Applicant .~L..QA Rev. 10-10-78 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [] FOUNDATION 2ND U INS~::A~ION [ ] FRAMING ~ FINAL REMARKS: · o.. TOWN OF SOUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N. Y. D~sapproved a/c .................................................................. ] .... ~ APPLICATION FOR BUILDING PERMIT Date .......... ........ INSTRUCTIONS Application No...Z...~....?..?... ............ a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildinc 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, relahonsh~p to adjoining premises or public streets o areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application c The work covered by th~s apphcation may not be commenced before issuance of Building Permit d Upon approval of this application, the Building Inspector wdl ~ssue a Building Permit to the apphcant. Such permi 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 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 th, Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o 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 t, admit authorized inspectors on premises and i~ buildings for necessary inspect,~s. ...~..~.~..?.......,~....~.~.~...~.:.~., ~ .x~.... ~' 9~ (Add;";~';'g~ '~gli;;'~i ............................ State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budde~ Name of owner of premises ....~..../~...~....~...L:...~.~....~........v....~.. '.~..~.~.~.......~. -......~....z~...)...~.../.~. .............................................. If applicant is a co~orate, signature of duly authorized ofhcer. (Nome and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Elecbician's License No ............................................ Other Trade's License No ............................................... Location of land on which proposed work will be done. M~p No. ................... Lot No..:~..~. ............. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction' 3 Nature of work (check which applicable) New Buddmg ................ Addmon ............... Alteration ....... Repair ............... ~, Rem~Rval .n .... x:~ .... Demo, litlor. ...................O, th~r Work ........................................... · ~ ~.~ ' (Description) I:stimated Cost ...................................................... t-ee L. ............................................................................. (to be pa~d on filing thru apphcation) 5 If dwelling, number of dwelhng units .......... x/ ............ Number of dwelling un,ts on each floor ........ ~. ........... If garage, number of c~rs ......................... ~ ........................................................................................... 6 If busmess, commercial or m~xed occupancy, spec~fy,,~.~ nature and extentf,of aa, ch type of use ....................... ,. 7 Dimens,ons of ex,sting structures, if any: Front ..... ~t .~.. .............. Rear ...... ~....~. ................... Depth ..~T~.. ..... He,ght ...~...'~'.. ............... Number of Stories ............ f. ................................ ?~,~i ............................. ;,~,)'5;; ......... D~mens~ons of same structure with alterations or addmons Front ............. .~. ..................... Rear . ....,~r~l~.. Depth ..... ..~. .................. Height ......... .~..~. .... :. N~mber of Stones ............................... · 8 D,mensions of ent,re new construction: Front ........ ~.t..., ................ Rear .... J."'.'/..: ................ Depth ~.....~. .......... Height ..~.. ............ Number of Stories .................................................................................................... 9 S,ze of lot Front J~o ~ Rear J~,o ' Depth /c,o ................................................................................................. ~..~r~ z: .......... ]0. Date of Purchase ....~..4~...~J..:..~..%...,/.~...7..~.. ........... Narne~,of Former Owner~...~..c./~./.~..~..~..~....~.....~...J.~?.~ ..... .~.?~.~ 1 1. Zone or use district in which premises are situated ...... 12 Does proposed construction wolate any zonmg law, ordnance or regulation' . ...... ~ .......................................... 13. Wdl lot be regraded .... ..~ .............. Wdl excess fill be removed from premises: ( ) Yes ( ) No 14 Name of Owner of premises ............................................. Address ................................ Phone No ...................... Name of Architect ....................................... Address ................................ Phone No ...................... Name of Contractor ........................................... Address ................................ Phone No ...................... PLOT DIAGRAM Locate clearly and d~stmctly oil buildmgs, whether existing or proposed, and red,cate all set-bock dimensions fron property hnes Gwe street and block number or descriphon accordmg to deed, and show street names and indicat whether i~tenor or corner lot STATE OF NEW )~DR~/,,~ ~'Z'_ IS COUNTY OF ,~Z~-~r~r~.~....[ S ........................................................................................ bemg duly sworn, deposes and says thor he ~s the apphcar (Name of indw~dual signing contracD above named. He ~s the ................................................................................................................................................................. (Contractor, agent, corporate officer, etc ) of sa~d owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and f~ this opphcot~on; that all statements contained m th~s apphcotion are true to the best of his knowledge and behef; ar that the work wdl be performed in the manner set forth m the application filed therewith Sworn to before me thru ..... dav o, ..... ....... . . Notary Public, ~..~'~.f'.~~unty ....... .~..Z~...~..~..~..~.....~....7~.'..~...~. ................... ~ x, (Signotur~ of applicant) JUD:?H T BOK£N ~-~ry P, hi,- State at New York No Ld'-O~4 W03 Suffolk County ,Gernrn~.~en Exl~r~ March 30, 19~.~