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Home My WebLink About9388-zFOH,M NO. 4 TO~VN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No...Z.9.07.0. .... Date ..... ~.tm..e.....~.6. ............ ,19.7.8. THIS CERTIFIES that the building located at . .2.~0..W..u~...e.w.e.~.a...Rd... ...... Street Nassau Pt. Map No. Prop, ....... Block No ........... Lot No ......... .2.9.2.-.2.9.$ ................ conforms substantially to the Application for Building Permit heretofore filed in this office dated .-~Ug~.z.* .... 5 ......... , 19.7.8. pursuant to which Building Permit No. 9.~.8..8.Z.. dated . .Augu. s.~ .... 5. .........., 19.7.8., 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 ...... PR.I.V.A.T.E Q.NE. F..~.I..L.Y.D...~LE~...~NG' .................................. The certificate is issued to .... p.a..u!. &..Rt. $.~..F..a.r~..e.y. .............................. (owner,~ of the aforesaid building. Suffolk County Department of Health Approval ...6/.'[4/?8..-.-..-?.-.80.-.~.07. .......... UNDERWRITERS CERTIFICATE No ....... .P.e.n..d.t.n.g ............................. HOUSE NUMBER 230 Street Wunneweta Road ................ Cu'bcho~..e,. N.e.~...Y.or.k' ............ Building Inspector (THIS PERM!T MUST BE KEPT ON THE PP~EMISES UNTIL FULL COMPLETI'~DN,OF THE WORK AUTHORIZED) ? Ne 9388 Z Permission is hereby granted to: ~... ~e]~.... ;~.C...~au~..&. ]Lit~..rarle~.~ ..... at premises located at ..~tS...~2#2~-...-..]]gg~-.J~,..~.~-O~ ........................................................ ................................. ~/.~.. ~.,,~n~. ~.~..~.~.. ~L .............. ~u~e. .......................................... pursuant to application datea ........................ .~....~ ................ , 19.~..., and approved by the Building Inspector. Fee $~.~0. .......... FORM NO. 6 TOWN OF SOUTHOI.D Building Department Town Clerks Office Southold, N. ¥. 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 fallowing; 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 I957), Non-conforming uses, or buildings and "pre-existing" land uses: h Accurate survey af 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 o certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 ~ Date .......................... /. .................... New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ........ ..~......?...g. ............. ./:'~.~.~... ........ ...~....O...~....~.. ............... ~...~.....~.....,~,~_.,.._~ Owner Or ~ners Of Prope~y ........................................................ ~ .............................................. Su~ivision ..... ZZZ...' ................. -". ............. ~_~....Lot No ............. Block No ............. House No........~ .... Permit No. ,~Date Of Permit ..~.,~_~Z~licant ........... ~......~.~ ............ Health Dept. Approval ~.~ ....... ~.:~.Z. Labor ~p,. Approval ................................................ ....... ................... "o..d .................... Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ on above described building and permit meet¢/911 aDpl~cab~ code~ and regulations. Construction · /,. /. ADP ~cant ......... /4'.....% .., [... L,~"-~'~.~ .................................. Sworn to before me this ................ day of ............................................ Notary Public .................................... County Examined ............ .A...~.~ ............ ~. ...... , 19.?.?... Approved .............. .......... , 19.~.~.. Permit No ....... ........ ~,~r,,~ Disapproved a/c ............................................................................................ ~ "~ '~ ~'/~- APPLICATION FOR BUILDING I~RMIT BUILDING DEPARTMENT,~.~ ~ ~_ . · ~ ~RrS OFFI~ ~'~ ~ ~ '/'~ ~U~D, N.Y. ~ ~ q~ ~ App cot on No ......... INSTRUCTIONS Dote AB 77 o. This application must be completely filled in by typewriter o¢ in ink and Submitted in triplicate to the Budd~ng~ 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, relationship to adjoining premises or public streets o: 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 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 part for any purpose whatever until a Certificate of Occupancy shoU 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 Lq 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 admit authorized inspectors on premises and ih buildings for necessary inspections. Wa Beebe ~uilder (Signature of applicant, or name, if a corporation) Cutchogue (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. builder Nome of owner of premises PalA~ & Rita Farley if applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. ]aa~ct P]-b Electrician's License No. .~'D.g~J;~. .......................... Location of land on which proposed work will be done. Map No.: ...... ~.a...s..s..,......]~... .............. Lot No....~.~.~..-...2....°~....i.~ Street and Number ~l~.~.~.t.l~ ~ CutchoK~..e Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy vaeavt b. Intended use and occuppncv one f~ily dwelling 3. Nature of work (check which applicable): New Building. ~ Addition Alteration Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) 4. Estimoted Cost .................... ..~.~-.'..0--0..9...-.,,~+ .......... : ....... Fee ~3,e.~..O, .................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... .O...~.? ............... Number of dwelling units on each floor ............................ If garage, number of cars ......... o~e ............................................................................................................................. 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 ................................ 8. Dimensions of entire new construction: Front ....... ~[6 ......................... Rear ....... .,~.~. ................ Depth ...... ..~..~. ............. Height .................... Number of Stories 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Dote of PurchaSe: ....................................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated .....l.l..~..n....~.~..~.tt .............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: .......... .~...O. ......................................... 13. Will lot be regraded . ........ .~e~ ........... Will excess fill be removed from premises: ( ) Yes (X) No 14. Name of Owner of premises .....~?&-,~l ..&..~L~&..~&~'le~.... Address ................................Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Nome of Contractor ....~.~.,~e.e.b.~ ...................................... Address ...... .q~.~..O.~.O.~r~...~. ..... Phone No ....................... PLOT DIAGRAM Locate cleorly ond distinctly all buildings, whether existing or proposed, ond indicote all set-back dimensions from property lines. Give street ond block number or description occording to deed, ond show street nomes and indicote whether interior or corner lot. J ..... i.....i~ ............ ]t~T~.~l~.~.~.~. .............. [ ..................................... being duly sworn, deposes and soys that he is the applicam (Name of individual signing contract) above named. He is the ............................ ..]~l....~..~.~.e.~. .................................................................................................................................... (Contractor, agent, corporate qfficer, etc.) of said owner or owners, and is duly authorized to perform or have 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 tl,ar the work will be performed in the manner set forth in the application filed thq~with.,~ Sworn to before me this ............... ...... day of ................... .................. . Notary Public,. ................ .~....%~...:~.O...~.. .................. County ......... /ff~~...:,..~ .............. ~lgna~ure or appHcan~,~ ltOTARY puBUC, State o~ NeW york NO. 52,4643721, Sutlolk C, .~'~ l,~m E×oireS March 30, 1: t0 APPROVED AS NOTED 76~-2~ 2'M lo 4PM FOR REQU~R.