The URL can be used to link to this page

Home My WebLink About9463-zFORM NO. & TOWN OF $OUTHOLD BUILDING DEPAI~TMENT Town Clerk's Of Yice $outhold, N. Y. Certificate Of Occupancy November 28 78 No ..... .Z.97.7... Date ............................ , 19 .... THIS CERTIFIES that the building located at 1265 Ryder Farm Lalle ~,.~, Map No... ~l!~....S.e. cl~]~ I~o ........... Lot No, . 57 conforms substantially to the Application for Building Permit heretofore filed in this office dated ...S.e.p.t..e.m.b.e.r....2.2. .... , 19 .'.~.7. pursuant to which Building Permit No. ..... 9463Z... dated ...S.e.P.t..e.m.be.r... ~2. ..... , 19...7.7, was issued, and conforms to all oi the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private One Family Dwelling The certificate is issued to Michisel & Gayle Savage ( owner, ~ of the aforesaid building. Suffolk County Department DE Health Approval .......... .7.-..~.0.-.1.2. ? ................ UNDERWRITERS CERTIFICATE No. N4053~6 HOUSE NUMBER 1265 Street Ryder Farm Lalle Orient, New York Building Inspector County Tax Number 1000-015-4-~ BUILDING PERMIT COMPLETION OF THE WORK AUTHORIZED) N? 9463 Z Permission is hereby granted to: Michael ~ Gail Savage 1380 Jockey Ck Dr Southold lot %7 Orient by Sea at premises located at ............................................................................................................................ Hydor F~rm Lane Orient Building Impector. FORM NO. 6 TOWbi OF SOUTbiOLD Building Department Town Clerks Office Southold, bi. 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 1957), Non*conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey o'f 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 /'7- 7.7.. Date . ~ New Building ~ Old or Pre-existing Building Vacant Land Location Of Property ~...~..~..5.~...~.:..Y~...~..../~........~.Z~....~.........~../~.~...~..' .......... ..~.../~..../.?....'~.~..~......~....~.... ................... Owner Or Owners Of Property .................................... ~ ................. ........................................... / ¥ 7'1t t Subdivision .~).4~.......~-T...'~..' ......... ~ ............................... Lo No. ~'...~...... B!cc~lo ..... .,~:...... House / / 'Permit No.....~..?.,~..~..... Date Of Permit .~/..~...~./(....~.~.Applicont ~../~....~...~. ................... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ M · Underwriters Approval .............................................. v~onnmg Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ...~..'.-..~.~ ....................... Construction on above described building and permit meets oil applicable codes)~nd regulations. Applicant .....~....~ .........~ ~ .................................. Sworn to before me this ................ day of ............................................ (stamp or seal) Notary Public .................................... County ~1 , ; ' ~'' "T ~--T:-~,- ,--,vnxx~.~ ~.~r ~-I1~C UI~UC~VV~II~H~ ' ; ' I;[,Ih,, ~;i t; ,;, I" : } ' 85 JO~N ~TREET NEW YOR~fNEW'~ORK 10038~ ' ~' ';, i'",~md''' UI ' ? t 'by t~ applicant ~med on the able appllca~O~ number in th This' ~e offlc~ identified by c~edenti ........................................ , 19. Permit NO ............................... TOWN OF SOUTHOLD,/~ ,~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~UTHOLD, N. Y. · ........................... APPLICATION FOR BUILDING PERMIT ,~ ~ _~ ~ Date JF~Pt'~ .?..~.. ................................................ , 19 ..... ~ ,.ST.UC.,O.S :< a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Buildingr~( 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 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 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 shell 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 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 applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................. ~ t/.~. M.~ .~ ............................................................................................................................................................ Name of owner of premises ........ ~.X.4:./.f./).~..4.....~...(~.~...~.:.~.....~. ....... ~J~.4d'...~...(~...~.. ..................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. Electricion's license No ............................................. Other Trade's License No ............................................... 1. Location of )and on whmch prop~d wor~ wmml be Jane. p N ,.: ~ ...................................... Lot No ...... ~ .............. Street and ............. ~.._.~ ............... ~ ........................................................................................ Municipali~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...................................................................................................... bm Intended use and occupancy ............ ~ ......... .%...~..~..~ ....... ~.~... ....................................................................... 3. Nature of work (check which applicable): New Building' J Addition Alteration Repair .................. Removal .................. Demolitior. .................... Other Work ................................................... 4. Estimated Cost ~ Fee .......................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .....J. ...................... Number of dwelling units on each floor ............................ If garage, number of cars ................ ;2~, ........................................................................................................................ 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 ........... .~..~.. .................. Rear .......... ~...~ ........... Depth ..... ..~....~... .......... Height .....~....ZT .......... Number of Stories 9. Size of lot: Front /~ ~ .................... Rear ....... ~'...~...'~ ...................... Depth ...... ./...~..~..~. ............... 10. Date of Purchase ....................... Name of Former Owner ...~...... ....... :f~...~..'?~... .................... :.... 11. Zone or use district in which premises ore situated ...... ~.~..?....~.../..~../~.~Z'~'...~/..~...~. ......................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ..~.,...~. ....................................... 13. Will lot be regraded' ......./bZ'..~ ................ Will excess fill be removed from,~Dremises'~,,cv¢~,,( )~Y~¢ (cO No 14. Name of Owner of premises ~../..~.'.~..."~...~...~......~//...~....~...~.... Address Name of Architect .............................................................. Address ................................ 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 lot. ~ t~Z~r/~ H'e is · OF NEWY(:~'F,. ~,~/ ~ ~'~ .,-Lq.. ............... ~.J...~.~'~ff,~).~.. ....... .L~...z~.lg..~.4~¢'. ....... being duly sworn, depose~ and say (Name °f indivi~al signing c°ntracf)/ '/ ~omed. . he .................. ~' ,,. L..~ ~., ..,~.~.C.~ ............................. T ' co porot, offic , that he is the appliconl 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 ore true to the best of his knowledge and belief; and tha¥ the work will be performed in the manner set forth in the application filed therewith. { ~ ~ 765r2660 9AM' fo, ~PM FOR REQUI~ ED INSPECTIONS: '1. BEFORE I~ACKFILUNG FO,U, NDA. 3. E,EFORE COVERII~IG PiP,~S OF ANY 4, FINAL WNEN JOB COMPLETED OR CONST~TUCTION ERRORS' ' ' ,- I~',, ~, ALL CONSTRUCTION MUST MEET , . REQUIREMENTS OF N.Y, STATE.'COD~ AND TOWN HOUSING CODE & zoNI~ t:,! / I T I: t,/LO ~' 'i' 1 '/'/d-CE_,