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Home My WebLink About9321-zNO. & TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ! T .Z .c..~ ........... Street Map No/l~t - .... Block No..~ ..... Lot No, conforms substantially to the Application for B~lding Permit heretofore filed in this office dated ~ ~ t ., 197.7. pursuant to which Building Pemit No. 7.~. ~.~ dat~ . ~.. ~.1. .. , I~Z., was issued, ~d confoms to ~ of ~e requir~ ments of the applicable provisions of ~e law. The occupancy for which ~is certificate ,~uea ~. ~~~..~. ¢~ ...~~ .................. (owner, lessee or ~n~t) ot~ ~e aforesaid building. ~o,~ co~. ~e~r~men~ o, ~,~ ~rov~ ~ uNn~aWmTmaS c~arzmc¢~ No. ~.3~. ~~Z ~ ~~¢' 2 ~ ........ ~~.~--~~Zf.Z 7. ~o~.~ .~, ~ ~.. ~,re~..~~..~.~.:~...~',% .... Building Inspector FO~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 9321 Z Permission is hereby granted to: ................ ...~.~...~....~ .......................................... ~0 ............................................................................................................................................................ at premises I~ated at ,~ = pumuant to application dated ..i ....................... ~'.~ ............. , 1~...., and approved FOII~ NO. $ TOWN OF $OUTHOLD Building Department Town Clerlc~ Office Southold, N. ¥. 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 Iocahon 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 cert,ficate 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 of property showing all property hnes, 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 inspechon 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 $5,00 3. Copy of certificate of occupancy $1.00 Date ...././.~..~ ~../......~....~... ............ New Buildm~ .................... Old or Pre-existing Building ........................... Vacont Land ............................ Location Of Property ...~...~.....~.../~.., ........... ~.'~ .............................................. Owner Or Owners Of Property ~~/,~:..~...~.4:~...~.....~ ...................................... Subdivision ................................................................ Lot No. ~ ...... Block No ............. House No ............. Permit No. ~.~.~Z ,/...,.-~.,.. Date,,z/_ --Of Permit .~.~.~./2~..Applicant ..~¢~1~¢:..~ ................... Health Dept. Approval ..'.~.~../.~..~,.2~-. .................. Labor Dept. Approval ................................................ Underwriters Approval ..... ~,~.././,~,./.~.,.2 ............ Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ......~,,.,. ..................... Fee Subm:tted $ ~ c:YO ,~ Construction on above described building and permit meets all applicgble codes and regulations. Applicant ...... ~ ...... ~..., ......... .;.. ......................... Sworn to before me this ................ aay or ...... ' ....... Not,~ Public ..... ~~ ......... Coun~ THE NEW YORK BOARD OF FlEE Cu~chosue, L.[. ', FIXTUR~ OUTLETS 22 39 DRYERS Approved TOWN OF $OUTHOLD BUILDING DEPARTMENT ~...~--~ ,---*'-*~" ~ Tow CLE 'S .......... ' ............................. Disapproved a/c ......... ~ ........................................................................ APPLICATION FOR BUILDING PERMIT o. owe ........... ~.~ ............................ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi~ 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 premises, relationship to adjoining premises or public streets, areas, and giving a detailed description of layout ofpraperty must be drawn on the diagram which is part of this applicatlo, c. Thu 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 o Building Permzt 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 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 th Budding 2'one 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 opplk'ont agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t admit authorized mspectors on premises and in buildings for necessary inspections. ...... ........ (Address of applicant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buildei '~' ii~ame and titl'~':[~"[~'6~'f6~"~fi~'~';~ ......... Budder's License No ................. ~../ ............................ Plumber's License No .......... .~...,~'./.......~.. .................... Electrician's License No ...... I.~...¢~..~.. ...................... other Trade's License No ............................................... Location of land on which proposed work will be done. Map .... .~...,~ ....... ........... Lot No...~... ............ Stre:.,. and Number ...~,,~...../~....~..C~. .......... Municipality Stata existing use and occupancy of premises and mte~ded use and occupancy bf proposed construction: a Exisiting use and occupancy ~'~~~~~~~~ b. Intended use and occupancy .............. 3. Nat~Jre of work (check which applicable). New BuilrJmg .... ~.. .........Addition .................. Alteration Repair ............. Removal ............. Demoht~or ............ Other Work ....................................... 'Z O (Description) 4 Estimated Cost ...... ~..,.~.~.~.. ......................... Fee ..~...C~/ .~ .................................................................. (to be pa~d on fihng thru applicahon) 5 If dwelling, number of dwelling units ....... ~ .......... Number of dwelhng 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 Dimensions of ex,stag structures, if any Front .................... Rear ................................Depth .............. Height ........................ Number of Stones .................................................................................................. D~mens~ons of same structure with alterations or addmons. Front .................................... Rear ....................... Depth ........................... Height ................. Number of Stories ............................ 8 D,mens~ons of entire new construction Front ....... ~ .................. Rear ......~.....~'.. ........... Depth ...~..~.....~.... ! Height ....~.~. ........ Number of Stones ...... ~ ................................................................. 9 Size of lot Front ....... /.~.~...~ ............................. Rear ........ ~..~.~...Z ..................... Depth ..... ¢~..~.,~,....z. ........ 10 Date of Purchase ........ ..~'.~...~....?--~'..~....~.. ........................ Name of Former Owner ...................................................... 11 Zone or use district m whmh premises are s~tuated ............................................................................... 12 Does proposed construction wolate any zoning law, ordmance or regulahon' .....~... ..................................... 13 W~II lot be regroded ...... ~Z~...~.. ....... Wdl excess fill be removed from premises: (.) Yes (-~"'~o 14. Name of Owner of prem,ses .~.~_~......~rrr,~ ......... Address ........... .........:...........Phone No. ~..l.~;...~...- Name of Architect ................... Address ................................ Phone No ..................... Nome of Contractor .................................... Address ................................ Phone No ..................... PLOT DIAGRAM Locate clearly and dishnctly oil buildings, whether ex~sting or proposed, and ad,cate all set-back dimensions fro~ property Hnes Gwe street and block number or descr:pt~on accordmg to deed, and show street names and ind~cai whether ir terror or corner lot STATE C'F NEW YORK., tS S COUNTY OF .... $~.~O,1~ ........... f ' ....................... ~.~,:D~,..~,I;::~]~,~ .................... bemg duly sworn, deposes and soys thot he ~s the apphco (Name of md~vidual s~gning contract) above named He ,s the. ......................... ..~.~...~.~....~.~....~.o..~.~..~, .a:~..~..O...~. ..................................................................................... (Contractor, agent, corporate offmer, etc ) of so~d owner or owners, and is duly authorized to perform or hove performed the said work and to make and f this apphcahon; that all statements contained ~n th~s apphcohon are true to the best of his knowledge and behef, a tha~ the work w~ll be performed m the manner set forth m the apphcat~on filed therewith. Sworn to before me this ....... ~..].1~, ...... day of ............ ~.t~t~ ....... , 19. Notary Public, . ............................~.~.~.~..~-..~. ..... County ' · Term Exl~res h'larch 30, 19 (S~gnoture of apphcant) DEP~RTHEN[ OF HEAL'f['t q PlERHF ~'D, N.-Y. M A~ICANT ADDRESS TEL NO TE · = MONUMENt' SUEO/V/S/ON MAP FTLEO IN 7'HE OFFICE 0~' TH~' CLKHK OF SUFFOLK COUNTY ON NOV SO~IgZ~ ~S FILE NO 6048 NEAREST WATEH MAIN - 5 M/LES ~ WAFER SU~ L Y- PR I VA TE WELLS YOUNG & YOUNG 400 OS1RANDER AVENUE, RIVERHEAD NFW Y{JI~K ALDEN W YOUNG HOWARD W YOUNG SURVEY FOR: R/CHARD d. SCOTT/ E~ LOT NO. 8, "LITTLE MARIAN C. SCOTTI NECK Pt?OPERTIES AT iGUARANTEED TO EAST CUTCHOGUE isourNoLo SAVINGS EAN~ TOWN OF SOUTHOLD j 'J ~ SUFFOLK CO, N Y .~(_, SCALE ,~ ~ DATE NO - I = 40 APt~.2Z, 1977 ' 77'242 THE LOCATION OF WELES AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR FROM DATA OBTAINED FROM OTHERS vACANT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESICENCE WILL CONFORM TO THJ~/~TANDARDS OF TH~ ~UFFOLK J~O~NSY DEPARTMENT OF HEALTH ooSE TRAIl- SUI~OI.,K ¢OUN~ REVISIONS JUNE II, 1977 JUL Y I~, 1977 AUG 9, 1977 and water suppl~ loca%ien have beem The sewage dispo~ facilities for th: tnspeeted by this department aadfotlmd to be NO TE · -- MONUMENY SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON NOV $0, 1975 AS FILE NO 6048, NEAREST W,~TER MAIN - 3 MIL ES ~ WATER SU~L Y- PR I VA TE WELLS YOUNG & YOUNG 4-00 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W YOUNG HOWARD ~.' YOUNG SURVEY FOR: LOT NO. B , "LITTLE MARIAN C. SCOTTI NECK PROPERTIES " AT I GUARANTEED EAST CUTCHOGUE SOUTHOLD SAVINGS BANK TOW. o~ -- SOUTHO£'D C~/CA~O TITLE INSURANCE '1 =ii40 I" ~PR. ZZ, 1977 j ' 77'~42 L[ Gozdon K. Ah]ers, P. E. of this Document except by (~ Licensed Profe. s- SiOn~'r Engineer, is file§mi'. Sedion 7209, Subdivision N. Y. Stc~le Educatlo~ Law ,% Jl ; J O{JJce exceFt by d Licensed Prafes- ,I iI Sadron 7209, T(' GOr(~on L. Ahl~r;~ ]E: