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Home My WebLink About9453-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate O[ Occupancy No...Z.l.! .9.8.3 ......... Date ...O.c.t.o.b..e.r..1.3.: .................. 19...86 Addition THIS CERTIFIES that the building ................................................ Location of Property ..3..~.5..~..1.b.e.v.g..s.o.n..L..d.n.e. .......... Southold, N.Y. House No. Street Hamlet County Tax l~hp ],lo. I000 Section ............ Block ............... Lot ................. Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated S.e.P.~.e. rg.b.eF..]:. ~ ........ 19.7.7. pursuant to which Building Permit No. 9453 Z dated............................September 14, 19...77,wasissued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Addition to existing one family dwelling The certificate isissued to John & Frances Holahan ..................... loYdo;, 'F ' idd k .................... of the aforesaid building. Suffolk County Department of Health Approval ~ / 1~ N/A UNDERWRITERS CERTIFICATE NO .................................................. IFOi~ NO, 9 TOWN OF SO4fl*HOLD IUILDIN~ DEPARTMENT TO~N CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING flE~J~IT (THIS PEP-~IT MUST BE KEPT ON THE P~.EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9~53 Z Permissio~ is hereby granted to: ...... ............ ..~ ...~-/: //~'-~ to ..................... .~....../..l.....~J.. ....... .0. ........... ~.~.~..L ....... ~.....~..,...,. ................. ~ .... pursuant to application dated ~-~' ~ f · 19..?~.'./., and approved by the Building Inspector. Fee $../.../. ................ Building Inspector / FORM NO. S TOWN OF SOUTHOLD Building Delta ftment Town Clerks Office SouthoJd, 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: ]. 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 1957), 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 occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of $1.00 "~ v,~ [:h3te ............... New Building .................... Old or P~-exist r~g Bud ng .~. ~.. ........ Vacant Land .......... .,, ............. Locaton Of Property ~'.,~.~..~'..,~/,..~.,..,!"~ - L~.'(/(}~/',¢'', L~,~...~, I ~'"'~'"' ......... i ........ :~",'"~;"'"';':;~i'""~;';:;':';';':;' ....... ~7,;t;";,'~ ..... _ O nerO, ner, Of Prope,y .......... ' ................ : ....... '. ......... . ...... ...... :, .......... : ....... Subdivision ............................................... ~ ....... ~ ........ Lot No......-¢.. ..... Block No ............. House No ............. Perm,, "o..~.~..:%ate of pe~it~../..L~.(.~.7..App,cant .................................................................. Health D~pt. Approval ............................................ L~bar I~pt. Approvo! ................................................ Underwriters Appraval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and pgrmit meets oll applicable/codes and regulations. Applicant / Sworn tpbefore me"fhis~ _ ,~ , : ........~ .... ~'~',:'~7~:~.~;' ................... (stamp or seal) IRVING ~AWRENO~ Sept. 16, 1986 Arthur J. Sharp Realty Route 25 Southold, N.Y. 11971 Re: Holahan to Wectawski Att. Mrs. SharD: Dear Mrs. Shar~: Pursuant to our conversation, enclosed please find Buildin~ Permit 9~53 Z, survey, New York Board of Fire Underwriters eertifl. cate N 3~$1682 and siKned Applicstion for C~O, all in the above matter° Plemse mai]. the C/O to me as soon as it is obtained. Advise me if any additional papers are reouired. I will keep you advised of the status of the trans- action. Thank you for your cooperation. Very truly y~urs, IRVING LAWRENCE . 0 ~EY FOR " JOHN HOLAHAN ~ FRANCES HOLAHAN ARSHA~O~OQUE TOWN OF SOUTHOLD SUFF, CO., N. Y, 6ua~a,tE~u To, SCALE: "= 40' ~aE~c~N T~TLE ~nSUr~nCE CO. JAN. 21, 1966 COPY ot Fzre Underwriter8 -, Jg?R~AU ,OF [I.,.E:CTRICITy, Z, ,,,~ .... ', ', ~ ~h~ ~lo~trl~ ~orv~ equip~nt i~talled l~'e heeO d~l'y Bureau · S .a~I~e~ Sul~rintgrident ' BUILDING DEPT. INSPECTION [ ] FOUNDATION XST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION ~ FRAMING ~NAL · REMARKS: ........ /~/'~/ .... FOB~ NO, ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, No Y. Disapproved a/c .... ~ .................... ~ .............................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. This application must be completely filled in by typewriter o¢ in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plat plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and giving o detailed description of layout ofproperty must be drown 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 af 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 shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment 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 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 in buildings for necessary inspections. ........................................... (Signature of applicant, or name, if a corporation) (Address of applilsont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ ..... " - ''''''''''''''''''''''''''''''''''''''''''''''''''''7 ........................... Name of owner of premises'.~/~.~:/~L..4)~...~....~/."/.<c~.,~z'4,,'~.'£,-.~*.'.'~.~..~c~m:u~.~,'"'.".''''''''''''-'''''''''''''''''''''''''''''''''' i i.~ii.i.~t...il .a.~..~.~;~;.~:..:~.'.~..~i.~.r.~.~i..~l.~..~t.~ii~id officer. (Name and title of corporate officer) Builder's License No... : ..................... Plumber's License No. Electrician's License No. ~...,.../T..'~..~ ............................ 1. Location of land on which proposed work will be done. Map No.: ........................................Lot No .............. > .......... Street and Number ~.~,~,..G~......~..~.d..~,...~./.~b.-.f,J,~..,..--L~s.D..~,~,....J%.(?,~.~..l~ ....................... ~.~.~,%~/..~..[,t././.~, .......... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. E×,s,tin use a.d occ.pa.cy....... .(d.-. ~...~.',~ .......... J" '" '"'" '"' '" '"'"'" "" '"' '"' '"" '"'1 b. Intended use and occupancy .................................................................... .~,,~.,....~,.'. .............................................. 3.Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration .............. Repair .................. Removal .................. Demalitior .................... Other Work ...,~.../~...../../..~.. ...... /) (Description) 4. Estimated Cost ....... '~:.0 ........................................ Fee IL, (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 ............................................................................................................................................ 7. Dimensions of existing structures, if any: Front ..... //(:..4!. :z/ ............ Rear ................................Depth .................... Height ........................ Number of Stories ............................................... -~,z ............................................................. Dimensions of same structure with alterations or additions: Front ....~..:.../~... ...................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ....~..t..:.¢IL:.. .................. Rear ............................ Depth ........................ Height .................... Number of Stories .................................................................................................................... 4/ 9, Size of lot: Front ........... :k...~.' .................................. Rear ........................................ Depth ............................. 10. Date of Purchase ...... .~. ..... ../.~.'.~...~.. ............. Name of Former Owner ...... /_%.%r.>.t;:.(Z?.//......./:zf../'.,.ff. ff., .. 11. Zone or use district in which premises are situated ....... ../.[7.~.~.5./...~...~..~..z7../..~..~:...l~..f'~'/...(./?./¢...~...././.~../¢../.Q..."..'"~__ [2. Dees proposed construction violate any zoning Iow, ordinance or regulation: ..... Z'.~./...~... ......................................... 13. Will lot be regraded ........ ,/~,/...../-'{~.~ ..... Will excess fi,H, be removed from premises: (,) Yes ( ) No 14. Name of Owner of premises-' ~' // -- / .'~.¢,dd-.x/.-.--~.../-~..47-.-~-..~..~.~..ff.-~.(:~..~.,Z/Addres,~.(.~.C~¢~..~..~;..,, ,,~ Phone No. Name of Architect ............ ¢/],/:./'/.. ...................................... Address ................................Phone No ....................... Nom~ of Contractor ......... /~:..'..p/...: .................................... Address ................................Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fram property lines. Give street and block number or description acco~d, iTg to deed, and show street names and indicate whether interior or corner lot. ~ t STATE OF NEW Y~I( COUNTY OF ..... ~.~.~:~....f :'~ (Name of individuol signing contract) above n~med. %He is the ~ (Contractor, agent, corporate officer, etc.) ~s~;d o,.~~ 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; ~nc that the work will be performed in the manner set fo~h in the application filed therewith, Sworn to be(ore me this C .... :: ............. ............... , Nota~ ............... co.. ...... ......................... ~.~ /~ ~ '~ --(Signature of applicant) Commission Expires Me c 30, 9~'