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Home My WebLink About9236-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy THIS CERTIFIES that the building located at~//(MK TO/t/ I~e[. Street Map So.~.~.~.~. ?.~:.. Block So .......... Lot So~.~.0.e.~.~ ~ .... e-.~.~;~..~.. conforms substantially to the Appl%cation for Building Permit heretofore filed in this office dated . . ..~.~ .~ .(~. , lg?.., pursuant to which Building Penait No.d~. ~. ~.~.Y~_, dated, i~. ('~[. .~. ..... , 1977.., was issued, and conforms to al! of the require- ments ofT~he ai~plic~ble provisions of th.e law.~he occupaney for which this certificate is issued is~ ........ T..~¥. ,.1~. .... ~./~~~ ............ ~ ........................ ~ (owner, levee or ten~t) of the aforesaid building. ~o~, Coun,~ ~m.n~ o, ~e~th *~p~o..~ a~ ~. ( ~.~. ~ .... ~. ~'. V~ ~. HOUSE NUMBER ~./~--. .... Street~~¥~...~.' ..... ~z Z(. ~O~.,c.-- Building Inspector FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 9236 Z Permission is hereby grant~cl to: ~v--::' '~ ~t premls~es Icx:oted o~..ljF~-.~a~.:.: ................................................................................. 7~~. %,~_ ~,~ _~. , :~- -.-.,~ . , . ....... ~ ~. .................................................. ~-~%%,'~ , ?: , ~ -'' - ',,~ ~'~ ~' ...... :..~ ...... ~ ....................... : ................ '. .................. ~}-'p;~a6nt' 'to application' dated .:i....; .................. ~..~, ............... , 1~7.., and ~prov~ by the ~_~ ~'~ Budding inspector. FORM NO. 6 TOWN OF SOUTHOLD Building Deportment Town Clerk. Office Southold, 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: 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 Arch,tect 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 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. Certihcate of occupancy $5.00 2. Certihcate of occupancy on pre-existing dwelling or hand use $5.00 3. Copy of certificate of occupancy $1.00 New Building ..... ../.,.,....... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property .//~.~.----~./f~.~/.'....~.~....~..' ...... ~~ ..................................................... Owner Or Owners Of Property ..~1~....~......~..~ ................................................................ Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No....~'~....~.....~. Date Of Permit .~.L~/..~.~......Applicant .~ ...... ~ ................... Health Dept. Approval ...'~...L..J'/~.....~...~.. ................... Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Ce, rtificate ........................................ Final Certificate .....~ ................... Fee Submitted $ ..~.... .......................... Construction on above described building and permit meets all applicable codes and regulations. (stamp o~ se~eaa~~ ~'--C5 "~ ~ THE NEW YORK BOARD, OF FIEE'-UNDEP. WRITE R,$ '} ' L,, ,,',",~, ,, [l~'~ ~ ~ JOHN &TREET. ~ YO~K. NEW YOF~ IO~'~ L ' ,& ~, · '~ ," , 'h<, . · ~ , v ~.~ ....... ., ~ " ~- "'' ~' , ~>~- -~ .... ~ -~-~... ~4.- [ ~-:-- ~ ~-~.., :~) .... ~-~' - l-O.~. I. :-- " " 1 ~oko ~tecto~ ' 227 E. B~eal~a~o~ Road ~ ~s cert,f~cate must not be altered ,n any monn~, re)urn to fhe cfi:ce of the Board TOWN OF SOUTHOLD OFFICE OF BUILD~G I~qSPECTOP- TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 August 16, 1978 Mr. J. A. Clarke Box 972 Darien, Connecticut 06820 Dear Mr. Clarke: Your dwelling at 5815 Vanston Road, Cutchogue, New York was build under permit 9236Z. Pipes are to be pitched and drains provided at the Iow points. An inspection was made and the approval given to cover the pipes. The Certificate of Occupancy, Z8039 was issued on December 5, 1977. If you have doubts about your heating pipes being drain- able, you can have your system blown out or put anti- freeze in your system. Yours truly, GHF:bcc GEORGE H. FISHER Sr. Building Inspector cc: George Ahlers Disapproved a/c ~..,.........,.....~ ............................. AFFMCATION FOR BUILDING PERMIT TOW. C~.'S omc~ "/'/-~-~ ~/~~ ~ ~ ~ ~ ~%~,~a,o, No.-?.A..~...~ ........... Permit No .... ~..~.~..~ ...... INSTRUCTIONS a This application must be completely filled in by typewriter or in ~nk and submitted in triplicate to the Buddi, 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. areas, and g~ving a detailed description of layout ofproperty must be drawn on the diagram whmh is part of this applicatio. 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 apphcant Such perm 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 Occupant shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterahons, or for removal or demolition, as herein describe. The applicant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and ir~ buildings for necessary inspections. re of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ............... ~...(. ............................... Plumber's License No ....... ..~....~.../......~...). ................... 24 Electrician's License No ............................................. Other Trade's License No ................................. ...~.....r~-._?... ~7~,,~ ~ ~ ~ ~- ~ ~ Locahon of land on which proposed work will be done. M~g N~ ...... ~ ........................ Lot No ...................... Street and Numar ~~..~.....~.~..~....~ ........... ~, Municipali~ State exmtmg use and occupancy of premises and intended use and occupancy of proposed construction: ................ ................................................................................ .. ....... ...................................................................................... ", / 3. ',~ture of work (check which applicable). New Budding ..-..~... ......... Addition .............. Alteration ....... Repair ..............,Removal ................ Demolmor ............ Other Work ................................................. ~*~.,*~ _l'"! C;~,.;~ /12 (Description) 4 Estimated Cost .~...~..,~.....~...~....~....,.....C~....~ff. ................. Fee .Z..~ .............................................................................. (to be pa~d on filing th~s apphcat~on) 5 If dwelhng, number of dwelhng umts ....... .~.. ............... Number of dwelhng umts on each floor ........................ If garage, number of cars 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use ....................... 7 Dimensions of ex~stmg structures, if any' Front ................... Rear ................................ Depth ............... Height ...................... Number of Stories ...................................................................................................... D~mensions of same structure with alterations or addmons: Front .................................. Rear ............ Depth .............................. Height .... Number ,of Stones ............................ 8 D,rnens,ons of ent,re new construction' Front ...~.?/~ ................... Rear .... ...~....~. ............... Depth..~..../. ....... Height ...~..~....'.--~ ' ... Number of Stones... ~ .......................................... 9 S,ze of lot Front /..~.~. ........................... i.'i'...'.'..i Rear ...... ~...'.~. ................. ii... 'De~th :::::::::::::::::::::: 10. Date of Purchase .......................................... Name of Former Owner ...................................................... 11 Zone or use d~stnct m which premises are s~tuated ........................................................................ 12 Does proposed construction violate any zoning law, ordinance or regulohon ...................................................... i3 Wdl lot be regraded .............. Wdl e.xcess fill be removed from premise~s: ( ) Yes ( ) No 14 Name of Owner of prem,ses. Name of Architect ....................... Address ................................ Phone No ..................... Nome of Contractor .................... Address ................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buddings, whether ex~stmg or proposed, and red,cate all set-back dimensions fro, property hnes Gwe street and block number or description according to deed. and show street names and indicat whether interior or corner lot. Sq-ATE OF NEX~x(O~ . ~ IS S COUNTY OF ~.. · .~.....~ ......... ~..~...~'~'~.,~ff~.. ............. being duly sworn, deposes and says that he is the applJca (Nam~ of indiwdual s,gn,ng contracf) above named. He ,s the .................... ~~ .~ .~~ ...................................................................... ~ (Contrac~r, agent, corporate officer, etc ) of sa~d owner or owners, and ~s duly authorized to perform or have performed the said work and to make and f~ this apphcation; that all statements con~a~ned in this apphcahon are true to the best of his knowledge and behef; a~ tha~ the work wdl be performed m the manner set fo~h ~n the apphcation filed therewith Sworn to before me this of ..... .................... , ......... ...................... ............................ ~/~ ~~ (Signature of applicant) ~ARY ~ DAWSON N~ARY PUBLIC, State of New York No 5~464372~, Suffol~ Cou~t~ Term ~p~res Uarc~ 30, 19~ ~.~ ~'~ - - ~ % , . .. j ~ TO ADDITIONAL INSTITUTIONS O4 SU~EI~UEN~ ":'", ' ' '~ ~,~ ~ ~ ,':;' "~ ~'~__ ~-~d~'_ . . Sz :-)r~ e '. ~ ~' ~. ~ ~. _-. ~ .... ,_.~,~'~,. ..;~,,, '~:.. '~ _ . . ~.so + ~ .... _~_,..-. ..... ~:.: ..~,: .... .--,,. -_ .- . ~ ~,,,~ v~,r~,//. ~c. ~ ~&.~,. ' " ' ' -~.. ~~,: ................ 7' ' - t.. z~. 9, P. S ~ F<'~'?~e ~ ~.~' ~ ,>. ~.5~ ' ,. ' + -i_ [I I APPROV]:D AS INOTED J II 1 ,4, I \ J i 3L~'' /