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Home My WebLink About9319-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Sou(hold, N.Y. Certificate Of Occupancy No ..... Z.100~ ...... Date ..... ~3,~g1,1.8.~..6,..'1.9~) ........... 19... THIS CERTIFIES that the building ....................................... .575. Shipy. ard Lane East Marian, N.Y.. I rocation of Property ~[~t~se No. ' ................... 'S'r~:e~{ ....................... ~l~ml'et County Tax Map No. 1000 Section .... ~8 ...... Block ..... .1 ........ Lot ...... 5 .......... S',ubdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... J. lXBe. 2.1. ......... 19 7.7. pursuant to which Building Permit No ..... 93.'1.9.Z. ........... dated ...... J.1JIle. 2.1 ......... 1977 , was issued, and conforms to all of the requirements of the apphcable provisions of the law. The occupancy for which this certificate is issued is ......... .................... On.e..Femk]~y. Dw.e],!l.ng with. Acceqso.ry Bu.ild. i.n~. ]'he certificate is issued to ....... H~...r/4~/..D.: . .aD.d' .D..o.r.i.s...M.o.t.t. ........................ (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval ......... .N./..R ............................. I INDERWRITERS CERTIFICATE NO ................. .l~.z'..R ............................. Building Inspector 4/79 FOR~ NO. 2 TO~N OF SOgTNOL~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (T~41S PE, RM. JT MUST ~3E KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 9319 Z Do,e ..... ...~~....~...e. ................ 19__7...7 // .,~ .~.~,..~.~,~.. , ........... ~~~.,...:/.~.. .............. ~...~...~.: .......... :::.~.~..:.:~::....~~ ~~~~'"'"'"'"'"'"'"'"""'"'"""'~:~:"'"'~ ...... ~."~ ............... ~ ~,~ ,~ ~ ..... ...... .~~~~.......................................... ..:. ....................... .~.....~.~ ....... ~...::..:....~.~~ '~ ..... ~..~~~ ~ ~- '~ ............................... .-~.~.; ........v. ............................................ r ............ ~~~ ............. L..~ ......... ~ .............. ' ~' ........ '~~~ ~ ~ z-.~ ................................... ~-p~fif tO opplicotion dot~ ............ 2 ................ , 19.. ond opproved by the Fee $ ................ Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor 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 sewerag~ 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 installa- tions, 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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 informa- tion required to prepare a certificate. 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 ..... ~¢. ,%..19.~O .... New Building ............. Old or Pre-existing Budding ............ Vacant Land ............. Location of Property ..... ~5.7.~5. ~/,p~r~;F.c], .[,~p,e. ............... ~a.81;. ~9,z?.J. 011.,..~o~. ....... House No. Street Hamlet Owner or Owners of Property .......... .~.~.~ .~..~q~;~..~..:~, ................................ County Tax Map No. 1000 Section ...... -~.~ ...... Block ....... 'J ....... Lot ....... ,5 ........ Sulbdivis~on ................................. Filed Map No ........... Lot No .............. Permit No.. 9~.1. c~.Z... Date of Permit . .~/.2.'[/.77. Applicant ........ ~)p.:~,~. [V[q~, .............. Health Dept. Approval ..... ~[/.~ ............... Labor Dept. Approval ........................ Underwriters Approval ..... ~/.~ ............... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ........ ~ .............. Fee Submitted $. 5 · g.Q ....................... Construction on above described building and~ermit meets all applicable codes and regulations. Applicant....~J'..0~/~5..../~.~.~ ................................. Rev. 10-10-78 Memorandum from.... BUILDING INSPECTORS OFFICE TOWN OF SOUTHOL~) TOWN H^[L, SOUTHOLD, N. Y. 11971 765-1802 August 6, 1980 Mr. aud Mrs. Harry Mott 575 Shipyard Lone i.~ast Marian, N.Y. ,Re,:, C.O. Z1,006~. Mr. and Mrs. Mort: t;~closed is your Certificate of Occupancy snd the application forms to be signed by you snd returned to the above office. ~[lso enclosed is receipt No. 17420 for your check No. 906 in the amount of $5.00. %~e regret the oversight in not forwarding en application along with our letter dated J~uly ~1, 1980. Very truly yours, George H. Fisher S:r. Building Inspector enci. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 765-1802 July 31, 1980 Harry D. Mort, Jrot Shipyard Lane E. Marion, N.Y. Dear ~4r. Mort: This is to advise you that the job under Building Permit No. 9391Z issued to Mort, Harry on 6/21/77 for accessory bldg. appears to be completed as of our last xnspection. Before you can legally use or occupy this structure a Certificate of Occupancy must be issued. Please fill out the enclosed form and return same to the above office. There is a fee of $5.00 for a Certificate of Occupancy Thank you for your prompt attention. Very truly yours, GEORGE H. FISHER Sr. Building Inspector encl. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..... .~~...~./. ........ 19 ........ Approved./..~,/.~Z~,~,~ .~.~ , 19.~.. Z Permit No ~...~...~. ~ 2 Di~pprove~ ~c ....... ~ ............... '..:r,~ ............................................................. AFPLICATION FOR BUILDING PERMIT ~ '~ INSTRUCTIONS Date .... /~C~,..,.~/. .............. , 19.,.-~..2. a. Th~s application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Buildin Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing Iocahon of lot and of buildings on premmses, relationship to adjoming premises or public streets ~ areas, and giving a detailed description of layout ofproperty must ~be drawn on the diagram which is part of this applicatior 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 wdl issue a Buildmg Permit to the applicant. 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 Occupanc 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 th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances · Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe, The applicant agrees to comply with all applicable laws, ordinances, building code, housing cede, and regulations, and t admltouth°rizedinspect°rs°npremisesandinbuildingsf°rnec..e~r~/inspecti°ns'~i J //. / ~ ~ (Address of applicant) State whelher applicant is owner, lessee, agent, architect, engineer, general contractor, electrmian, plumber or buiide If applicant ,s a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... ~ ............................. Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which pr.o~posed~ork will be done~ Mo,~"No.: ........... ~ .................... ..~ ~r_.O.t No ....................... Street and Number ...J....~...~.....~y~..~.~ ............................. '"~'~""'~~Munlcipality .... State existing use and occupancy of premises and intended use a~l, occuponcy6~ ~''.~ of proposed co. nstructlon: a Exisiting use and occupancy ~~I? ~ ~ ~ 3 Nature of work (check which applicable) New Building ~...:.. Add,ban ............... Alteration ........ Repmr .............. Removal .............. Demohbo~ ......... Other Work .................................................. ~.~...~....~... ,~' (Description) 4 Estimated Cost ~ ~" ~'~ .................................................. ................................................................ (to be paid on fihng th~s Qpphcabon) 5 If dwelhng, number of dwelhng units ................ Number of dwelling umts on each floor ......................... If garage, number of cars ................. 6 If business, commercial or m~xed occupancy, spec*fy nature and extent of each type of use .......................... 7 D~mens~ons of ex~stmg structures, ~f any Front ..................... Rear ................................ Depth .................... Heq]ht ....................... Number of Stones ....................................................................................................... D~rnens~ons of same structure w~th alterations or addmons Front .................................. Rear .................... Depth ............................ Height .....................Number of Stones .............................. 8 Din,ens~ons of enhre new construction' Front ......... I .O. ................. Rear ..... I.~.....= .......... Depth ...I..O.....'. ........ Height ................ Number_ o.~.,5tones7.,~ ........................ '~.~'- ' ..................~'~'~::) .............. 9. Size of lot Front ........... f..'" .......................... Rear .. :..-.... ........................ Depth .............................. 10. Date of Purchase ............................................ Nome :~,f F~o~ner Owner ....................................................... 11. Zone or use d~str,ct in which premises are s~tuated ......................................... .~../,;:; ................................... 12 Does proposed construchon v~olate any zoning law, ordinance or regulahon ....................................................... 13. WHI lot be regraded ......................... WHI excess fill be removed from premises. ( ) Yes (~") No 14 Narne of Owner of premises ......................................... Address ................................ Phone No ..................... Name of Architect ............................ Address ................................ Phone No ..................... Nome of Contractor ........................... Address ................................ Phone No ..................... PLOT DIAGRAM Locate clearly and d~stmctly all bu,ldmgs, whether ex~sting or proposed, and indicate all set-back d~mens~ons fro~ propcrty 'hnes G,ve street and block number or descnpt~on according to deed, and show street names and inducer whether ir tenor or corner lot COUNTY OF .... .O.i....~. ..... S S ......................... ...l~..~.~......?.:......l~...t,...t,.~....~..~:. ............. being duly sworn, deposes and says that he ,s the apphco (Name of ind~wdual s~gnmg contract) above named He is the ......................................... ~..~..~.. .......................................................................................... (Contractor, agent, corporate officer, etc ) of sam owner or owners, and is duly authorized to oerform or have performed the sam work and to make end f. this applicabon, that alt statements contained m this apphcohon are true, to the best of his knowledge and belief; thor the work will be performed in the manner set forth ~n the apphcation ~f'iled therewith. Sworn to before me this / / F~ J // ...... 2~,~:~, ....... day of ............. ~.~r~ ..... , ~9..~ ,~-,/,,~ /~ ~--~/.,':~ A/ ~/ , / t/ ............................... ........ tOTARY PUBLIC ~ate of New York No 52~]25850, Suffolk Term Expires M~rch 30. 19~