The URL can be used to link to this page

Home My WebLink About9379-zTOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No..Z90.57. ..... Date ...,].u~..e..,..1.2. .............. , 19...7.5 THIS CERTIFIES that the building located at ./~.505 .Depot. Lane ......... Street Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...JuLy.. 2.7. ......... , 19..7.7 pursuant to which Building Permit No.., 9.}79Z dated ... Ju~Ly.. 2B .......... , 19.7.7., 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 ...Farm .Building ..................................................... The certificate is issued to ..... Thomas. & .And~.e.C.y. bu],ski ........................ (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval ...... N./:R .......................... UNDERWRITERS CERTIFICATE No ..... N~7~'[8 ................................ HOUSE NUMBEE . .. ]4505 ...... Street ..... ~epo.t. I,e~ne ......................... ........................................... .~u'~chague ,. ~N,Y, ................... Building Inspector IOLD , ~ N.y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FUI'L COMPLETION OF THE wORK AUTHORIZED) No. 9379 Z Permission is hereby granted to: Tho~ ..&..Anara .....CY.~LI ~ .............................. at premises located at ....~/.B...~).ap~..~a .......................................................................................... ................................................ Unt~ho~ze ........................................................................................... pursuant to application dated .................................. ..~...~..~'.......~..~..., 19 ........ 7~nd approved by the Building Inspector, Fee $,..JJS~,O~J ........ FOII~I NO. 6 TOWH OF SOUTHOLD Building Delmf~ment Town Clerks Office Southold, hi. 1'. 11971 APPLICATIOhi 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: I. 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 farm ar 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 1057), Non-conforming uses, or buildings and "pre-existing" 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 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 .~..~.~.. Z~....~...' New Buildino .................... Old or Pre-existing Building ............................ Yacent Land ............................ · ocat,on Of Property ...................... Owner Or Owners Of Proper~y ~[~13~t~.....~....~..~..~- ...... ~.~.~,../~:.~.~: ..................... Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Health Dept. Approval ............................................ Lobar Dept. Approval ................................................ Underwriters Approval ~.3. Z~.-..~.../....~... ........ Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ....~....~. ..................... Notary Public ...... ..~~.... County Construction on above described building ~ permit m_eets~qll ap_.plifeble cod_es and regulations. Applicant ......... Sworn to before me this Y?c. d'~.) ~- ~0"~7 (stamp or seal) ~e~nm;*~on E~p, ires March 30, ISL~(/~., ~ ~THE NE '~"??.tejenUary'{7~,1978 THis"CERTIFIES THAT ,' , h 'iF ,' fi ~, :,. uary I ~ ~'DRYERS i~,RD, OF FIRE ~ BUREAU OF ELECTRICITY~ ' STREET~ NEW YORK, NEW YoRK 875018~ ~i ~i Lane,i utchogue . :".~ found to be in compl~an , L'FURNACE MOTORS . FUTURE APPLIANCE FEEDERS TIME CLOCKS WASHERS MULTI-OUTLET SYSTEMS NO. OF QTHE~/~,ARATUS: - ,Francis B. McCaffery ' ,,. -'= - - TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE .,~,~*** SOUTHOLD, N. Y. Examined ................................ 19;,!_!_ Approved .......................... 19,,,,7,, Permit No ................................. Disapproved ~z~ ........ .,.~.,~. ................ ~ ......... ~:~." &. , ........................... ......................... APPLICATION FOi BUILDING Application No. / ~ ~ "" INSTRUCTIONS a. This application must be completely filled in by typewriter om' in ink and submitted in triplicate to the Building Inspector, with 3 set~ of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout ofproperty mus~ be drawn on the diagram which is 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 port for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION S 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 construct on of buildings, additions or alterations, or for removal or demolition, as here n 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 in buildings for necessary inspections. Re or appl,cant, or name, if a ~mc~aress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. '; ......... ....................................................... · .................................................................................. ~Nome aT owner of premises .......... ~ ............. .~ ...... ~ ..,¢,~.~. --,~?. ~.~,~l/ ~ / ,tlo 44 .......... ............................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate office'S) ..... Builder's License No ................ Zjlr~ ........... :~Z~....~-'~'~:' Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Mop No.: .................... .~( ................ I~ot No. ~ Street gnd Number ' .............. ' ......... ................... .................................... ~ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ............. .t~.~lb, l ....... "~l~l',t:'~'/)f;t,~,.._~. ................................ b,- Intended use and occupancy .............. )~:~'~'~)~' ......... .~.~.f)l~./~.~.' ...................................................... 3. Nature of work (check which applicable): New Building' ......~-.- ....... Addition .................. Alteration ............... Repair .................. Removal .................. Demolitior ..................... Other Work ................................................... (Description) 4. Estimated Cost ..... ./.0).O..(J.L) ..................................... Fee ......... t,,~4r'O ..................................................................... (to be paid on filing 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 ,'nixed occupancy, spec,fy 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 add,dons: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ · 8. Dimensions of entire new construction: Front ..... ~,~O./. .................... Rear ......2.0 ................ Depth "~"7 .............. Height .....j.~...i. ....... b2urnh~r 9f gtnrie~ ..................... ~a~..~ ................ ./,~.t...~.....I..~./. .............................................. 9. Size of lot: Front ...... ~6Z..~.O...t ................................... ILea, ......~O,~.f ........................ Depth ..4.,/.,¢,.~..t. ................ 10. Date of Purchase ..,~Jr~...~./...../..~'.~'.,,~ ................... Name of Former Owner 11. Zone or use district in which premises are situated ..................................................................................................... i2. Does proposed coastruction violate any zoning law, ordinance or regulation: ..... ~.g,) .......................................... 13. Will lot be regroded ..... ~..0 ................ Will excess fill be removed from premises: ( ) Yes ( l~No 14. Name of Owner of premises.~.rlo,~.,,e...~.~.(t.~4,.¢,~'.l ............. Address .~'l--~"e~ ..... Phone No. Name of Architect .../5~.Mg~.~.-.-~.~'~I.U~..~I~I ............ ,'xaaress .~.~.~,~.~.¢~,... 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 indicate whether interior or corner 1~, 0 3 STATE OF NEW/YORK, ,, t S S COUNTY OF ~~ ........... ~' '-~ , ¢ , . , . . , . . . , . : .............. , ng (Name of individual sign~g contract) above named. duly sworn, deposes and says that~'is the opplicam,a- ¢ ,,t,~ kl~/~s '"'~,"r'- .......................... (E~frac;or; agent, 'c'orporate officer, etc.) of s~id owner or owners, ond is duly *uthorized to perform or h~ve performed the sdd work ~nd ~o moke ~nd file this opplication; thd ~1~ stotements contdned in this opplicetion ore true to tho best of his knowledge and belief; end that the work will be performed in the manner set forth in the opp~icotion filed therowith. Swo~n to be{ore mo this MARY ANN CYBULSKI r;OTARY PU~L~, S~cde a~ New Yor~ ~omml*s[on Exp~es March 30~