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Home My WebLink About9436-zTOWN OF SOUTHOLD BUN.DING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificnte Of Occupnncy No. Z..7.9..~. ...... Date ............. O¢.t ......3~ ...., lg.77. THIS CERTIFIES that the building located at .Delmar. D.vIve ............. Street Est Map No.L~t~'e%..C.~y. Block No ........... Lot No...2 .... Laura. el.. ~,Yo ............ conforms substantially to the Application for Building Permit heretofore fried in this office dated ........... ~ug.. g9 .., 197.7. · pursuant to which Building Permit No... 9~6Z dated ........... S.ept.. 2 ..., 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 ~s issued is..P.r:~y.~.t.e...one,..f~.~]..~,..d, we..~.l.n~ .¥~.th. g~rage...a~d..l.t.i.o.n. ............. The certificate is issued to . P.aul. P.aasch .... .o.~mer ............................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N..~ ................................ UNDERWRITERS CERTIFICATE No..~...R.: ....................................... HOUSE NUMBER ...... ~ ..... Street..D.c..1.m~..r...D.r.i. ye. ....... .L.a.u..r.e.~. ........... Building Inspector( :, BUILDING ~E~ !A~TMENT TOWN GLERI :S'OFFICE SOUTH'OLI~ N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9436 Z Permission is hereby granted to: ~. t itu( ~.~¢7!d add:~t:i, or. on existing d.we].3, in~ pursuant to application dated .................................... '. ................... , 19...M~., and approved by the Building Inspector, Fee :' ' *" $.2./ ................... Building Inspector / FORM NO. $ ?OWN OF $OUTHOLD Buildlng D~BIMffmenf Town Clerks Office Southold, H. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY I~structlons 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. Fina~ survey of property with accurate ~ocation of all buildings, property ~ines, 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 19.57), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey or 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 3. Copy of certificate of occupancy $1.00 $5.00 ....... Date ,,..O..c...t, .o.~..e. ~... ~..2, ~., ..Z. ~,.Z 7. ....... New B~lrn~ ....~..d...d. .......... ~P~e-existing Building ............................ Vacant Land ............................ Location Of Pr~pertyL...~..~...~..3...~.~...e:.~...~e.~..~.C.~.~..~...~..~.~.....~..s.~.1~..~.~.~'.~.[~.~9~g.[9~.~. ........ Owner Or Owners Of Property ?..a...u.?:...?..a...e:.~...c..~. ............................................................................................. Subdivision ................................................................ Lot No ...... ..3..... Block No ............. House No ............. Permit No...9..~..3....6..~.. ....... Date Of Permit .................... Applicant ~..3:..a..~..~.....~...o.~.e...s.~.....[..~...c,... ....................... Health Dept. Approval ....... ~../'.,~. .............................. Labor Dept. Approval ....,~,./.,,~. ..................................... n/a yes Underwriters Approva~ .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ~o Final Certificate .. ~..e..s .... Fee Submitted $ ?.....0...0. ........................... Construction on above described building~~cat~-' and regulations. Applicant .~ r. ~.. ~.~r...~......~....~..,~.~r.~..: ................................................. KENN~ Sworn to before me this ................ day of Oc~cobe~, 1977 Notary Public Suffolk County ~KJRB~R ~ I~AND HOMES ~ INC. (stamp or seal) ~>~ Examined .......... ~· ................. ~ , 195. oproved .......................... ......... . ............. = ....... Disapproved a/c ~.....~ (Building Insl:~:tor) ~ BUILDING DEPARTMENT /o~/ I~. TO~ CLERK'S ~FI~ .~ Y~7; ~ ~ ' ~ - ~U~D, N.Y. ~ ~ · ~ ~ V Application No ....... Z......~ ................ APPLICATION FOR BUILDING PERMIT A~g~st 29 Date ................................................ ,19...?..7. ...... INSTRUCTIONS a. This application must be completely filled in by typewriter of in ink and submitted in triplicate to the Building~ Inspector, with 3 sets of plans, accu~te, plot plan to scale. Fee according to schedule. b. Plat plan showing Io~o*tion 6f l~'~nd 0f buildings on premises, relationship to adjoining premises or public streets areas, and giving a detailed descriptl0n'i0f layout ofproperty must bP drawn, on the diagran~ which is part of this application. c. The work covereo~ by 'c~is application may not be commenced before issuance or,Building Permit. d. Upon approval of this application, the Building Inspector v~ill 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 shall have been granted by the Building Inspector. APPLICAT ON S HEREBY /V~DE to the Building Department for the issuance of a Building Permit pursuant to theT Bud ng 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, os here n descr bed. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) t .... .................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Gene~alL P&ul Pa~sch Nome of owner of premises .................................................................................................................................................... {{ opp[icont is o corporate, signoture of duly outhorized officer. Robe2:t R. Hiltz, PTes. (Nome ond title of corporate officer) Builder's Liceflse No ................ -. .................................... Plumber's License ~o ................................................. Electricion's License No ...... ..2..1...4..8...-..I}. ........................ Other Trade's License No ............................................... 1. Location of land on which propo~ed work will be done. Map No.: ................'?...(. ~............:........... ~ Lot No.....~ ................... Street and blumber .W.../..~...~...~........~/...~..J'...l~...~...?.~..~.?.?.t......l~....l~...?..~.R....~.~-.~.~ .................. .'. ........................................ Municipality :2. State existing use and occupancy of premises and intended use and occupancy of propo~ed construction: a. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy ..~...~...~..Ag~.. ................................................................................................... 3. l~l~t~re of ~ork (check which applicable): New Building.. ................. Addition .................. Alteration :L.:..,....-. .... Repair .................. Removal .................. Demolition .................... Other Work ................................................ . (Description) 4. Estimated Cost ,~.~...~.(~.e.(~. ...................................... Fee (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 oars .... 1~. ..................................................................................................................................... 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 .......... .]:..5.. ...................... Rear ...... .~.~. .................. Depth ...~.7.. ................. Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ...; ...... .1.~ ....................................... Rear ...~..0~.. ................................. Depth ...~.(~10 ...................... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded'. ........................... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ....~..&...~..3:....~.a~..~....~.. ....................... Address l)e~l~l~ .~..~.~...~..e... Phone No ....................... Name of Architect ............................................................ l'nl&nl:l ~es~ Xnce Address ~[~.~{~.[~.~/~,~,~o¥...,..,~ Phone3~ No ....................... Name of Contractor T~Z~a¢! l~al~es~ Xnce Address ................................ Phone No. ~lJ..-.9.~.~.6... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. lOC.) STATE OF NEW-YQBK.. ~ ¢ S COUNTY OF ..~.z..?...z~.. .............f,-,. .................. ~1~..~...~1,~.~ .................. ;...;. ..... ~ ....... ;:being duJy sworn, deposes oqd says that he is the opplicam (Name of individual signing contracf) above named. Cont~&cte: He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, 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 applicafiim~:~re tra~ tO the best of his knowledge and belief; and t~ar the work will be performed in the manner set forth in the application filed therewith. .... ~,..'~.d ........ day of ~jill~l[~lL-, ~ .~.~., .~..., ........................................ _ Notary Publi~ .........:~ ............ /~ .......................... County · I~y E. OAWSON NOTARY PUnt, lC, State ~ New York Ne, 52-4643721, Suffolk Counl~ Term Expires March 30, m = MONUM£Nr ON JUN~ ~, 19~0 AS M~P~ ~40~ .EV,$,ONS YOUNG & YOUNG MAY 17, 1971 400 0STRANDER AVENUE, RIVERHEAD, NEW YORK JUNE 4~ 1971 ALDEN W. YOUNG HOWARD W, YOUNG SURVEY FOR: PAUL P&~SCH LOT 5' "L~URE/ COUNTRY ESTATES" GUARANTEED TO: AT LAUREL SECURITY TITLE ~ GUARANTY CO. RIVERHEAD SAVINGS BANK TOWN o~ SOUTHOLD N Y ~Y ',, ' '" SUFFOLK CO., ' ' ~/o-co-e~..~. ~taz-~--