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Home My WebLink About9603-zFOSS! NO. d TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at . .2.97.5...N.a.~.S..~.u..P.~. ?..~.d.: .... Street Map No....7.~.5. ...... Block No ........... Lot No, conforms substantially to the Application for Building Permit heretofore filed in this office dated . .D.e.c.e:~.b??... 2~ ...... , 19 ?.7.. pursuant to which Building Permit No....9.6.0..~.Z dated ...D.e~.e.m..b.e?....2.~ ....... , 19.7.?., 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 .... .D.e.~..a.c.h.~.~..G.a?.a.g.e .................................................. The certificate is issued to ~iss JoAnn Talbott (owner~ of the aforesaid building. Suffolk County Department of Health Approval ............ N./.I~ .................... UNDERWRITERS CERTIFICATE No ........... P..e.n.d.i.n.g .......................... 2915 Street Nassau Point Road HOUSE NUMBER ..................................................... Building ~mspeetor BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9603 Z Permission is hereby grante~d~to: -~, ,.~ __ .... p~ursuant to application dated ............................ ~.-,.-~,..,~.~..,.., 19-~'~ and approved by the Building Inspector. Fee $..1. .................... 1/ ....... ~..-.~ ........ ~ ........... ...;~ .,~,.,...,.~ .................... FOK.~I NO. 6 TOWN OF SOUTNOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate 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, 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 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 ]957), Non-conforming uses, or buildings and "pre-existing" land uses: ]. 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 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 $5.00 3. Copy of certificate of occupancy $1.00 / ~",...~0~ Date .....~ ........................... New Building .................... or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ................................................................................................................. / ................. Owner Or Owners Of Property ...~...'~'~"'~..,...d.O,~... ,.~,...'"./...~.~ .~...~..:~ ........................................... Subdivision ................................................................ Lot No ............. Block No: ............ House No ............. Permit No.,~.~,..~....~..'..~.... Date Of Permit ~).f~.-~.....~-.,~.,./..~',,~,~plicont .... ,,~,,.,;,,~,1~,.;..~,.~..~.~..:. ..................... Health Dept. Approval ....................... {..,~'.....l.......Labor Dept. Approval ................................................ Underwriters Approval'~/.; .............................. Planning Board Approval ...//~.~ ................ 7': ............ //t~//~ Request For Temporary Certificate ........................................ Final Certificate ../.. ..................................... Fee Submitted $ ....~. ....................... Construction on above described building a,~,,~m,//~eets all ~;L~lica~codes and regulati~s. Apphcant ...~..~ .................. y.~...~~ .............................. .,. ~ Sworntobeforemethis ~.~¢ ~/;__ ................ day of ............................................ (stamp or seal [ ~/iNFORMATION FOR BUILDING DEPARTMENT WE ARE IN THE PROCESS OF ISSUING A CERTIFICATE OF coMPLIANCE FOR THE ELECTRICAL INSTALLATION AS COVERED IN AN APPLICATION FILED WITH oUR DISTRICT OFFICE. THE NEW YORK BOARD ~IRE UNDI~RWR~rERS ~. . . , . . ~ . ,,. . , ' .,.'-:: .... '~-: .... ~' .:.'· · ' :. - .. '~..,,-:.,-'.'.' . - .......'"',,"' · -"',:'-..' -,L,,,:.; · ~ , ,. . _ -.. ~ · ::, I-...:. ': - }."~:-' --. , -..':...-: . . '" " - ' ' ' "' ....... .' ~ .. , : '.. . . . - . , ....... ,. , . ~ . .-. , . .L ~.:',~:,',~; ~::'.' ' ' ':' ' ' ' ' ' .- f ~.. .... >...~ .... . ......~......... : u~ '- ..... '""~ :7: :-:~'-:: ~Y. · .. . , . ,_,., : ' ~ ~ .-: ..,,'. '/''. '..,.'-~: . . . .~,:::: .' . . ,-..' ~' ~ '_ ', ,..',...'....:.-~; '.",':" ':...:',' . C..,~ "',. ( -,~.- :. ,' ,.~.:":' ' ' ' """' '' ~ ".? ' ':.: :' '"', .:. ":':' '-:'"': I~., .... ,.:./ ~ : ....... ' '' ..' ,'-'' '~ .' : ~ ROD~CK VAN.TUY~ ' ' ' '"" '" '"' "' :u::Ho~: -' :...-- .-- /:. . ~ : ..... :.:, .. SUFF. CO. DE~. OF H~LTH SERVICES . STATEMENT OF I~ENT ' DATE~ ~, [0 , OlSPO~L ~Y~T~M~ FOR TH~ ~Sl. ~Ofi~ DENC~ WILL CONFOR~ ~ THE H. ~ REF.' NO.: ' , . TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Yo E×omined ~) *' ~ ....... ............ .~'?../.,:...':~.:z..., 19'?.'-? ............................ L.Z...., z,~ o ,,: X~.., ,,prom'~ '~? :,Z.i Permit No ..... /. .......................... · Application No. .............. ~:~ INSTRUCTIONS Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according t0 schedule.~ b. Plot plan showing location of lot and of buildings on premises, relatior~ship to aSjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced befgre issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Buil~ling 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 hove been granted by the Building Inspector. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building APPLICATION IS HEREBY MADE to the Building Department for the issuance eta 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and ir~ buildings for necessary inspections. ...... ................................ (Signature ofza)/l~li~t, or name, if a corporation) .... ~ .z:........~ ~ ¢%. f...¢. ~.,~.7. ~-.-., .-.f/.-.~. (Address of applicant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~ ¢''~ .~_ ~....t~..~./~...~. :~&~'~.,O.. ~ 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 ............................................. /ooo .- lay- , Other Trade s License No ............................................... ~ 7¢~ ¢ /J . r · · 1. ~.-.. ......... State existing use and occupancy of premises and intended use and occdpancy of proposed construction: a, Exisiting use and occupancy ....... ./............................................ ~I :'l I II: b. Intended use and occupancy ..... ~.......1~,..~ ........ ~ .~.....; .......... ........~......?..c.../.-~ .................................. ? t 3. Nature of work (check which ap~J~lable): New Building'. ................. Ad~ .................. Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work 9 .~fr~.~.' 4. Estimated Cast ................................................ Fee ......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling pnits 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 ................................Height ............................ Number of Stories ................................ B. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ............................................................................................................. = ...... 9. Size of lot: Front ........ j',..~..~.. .................................... Rear ..... ~. .................................. Depth ~....~...Z..~..~...~....~... 10. Date of Purchase ........................................................Na~e~ormer Owner ........................................................ 1 I. Zone or use district in which premises~are situated ...... ~..~.-,~....~..~..~/.'~...~.. .................................................... ]2. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded. ........................... ~l~¢~-/,,~ / ^ ,-r'?' ,., ~,Will .e, xcess fill be removed froml/~.~,~,,/')premiss: ( ) Yes ( ) No 14. Name of Owner of premise's'::.C~....~J.~../T~.,....I.J~.~..P..I.. Address .~../~l~J~..~.~.,../.¢.~.~ Phone No ....................... Name of Architect ............................................................. Address ................................Phone No ....................... Name of Contractor .~..~...J..,..4~..~./~.~ .................... Address .~.~..9.~..~..t~.......~...... Phone No. PLOT DIAGRAM ~ ~/Z~ Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frorn properfy lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ................................ i,.~ _ .......................................................... rang duly sworn, deposes and says that he is the epplicom (Name of individual signing contracf) above named. /~' (Contractor, agent, corporat? officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that ['he work will be performed in the manner set forth in the application filed therewith. Sworn to before me this / M AR~,~E. DAWSON NOTARY pUBic, State al New Yor~