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Home My WebLink About9332-zF~BM N~. 4 TOWN OF SOUTHOLD BUH.BING DEPARTMENT Town Clerk's Office Southold, BI. Y. Certificate Of Occupnncy No..Z..-/.~./.~. Date ............. ~'f..P.7.... ?:..~., 19.77.. TI-nS CERTIFIES that the b~ding located at~. ?.~.. ~ .ZV. ~..~'..E... ~.~ .~..~. Street Map No. ~' Block No. ~ . Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated ...,J ~ ~ .... ~ ~., 197.~. pursuant to which Building Permit No. ??..~..~..-f dated ....... O.v.~X ..... 2.~.., 197.~., was issued, and conforms to ~! of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is The certificate is issued to ~.U.C E ..... .~..S.O..~ .~..-~ ............................ (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval ~.~'P.'f..?'7.~. ! UNDERWRITERS CERTIFICATE No ........ .~.[. ?..~J..~/. (.~. ........................ HOUSE NUMBER ~. ~.~.~... Street .... .~..[..~..~. ! !..~ .... .t...~..x/..~. .............. ............................................. .C. ?..7. (. !~. p.e..~..~. ................ a,,~ ~e ~,.,,~ c ^ ~e ~,~',~ r Building inspector FO~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT -TOWN GLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 9332 Z Permission is hereby granted to: ..................... ~.*.!~..,.~. ................................... to pursuant to application aated ...... FORM NO. ~ TOWN OF SOUTHOLD Building Deportment Town Clerk. Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be hued 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-0 form or equal). 3. Approval of electrical instal{arian from Board of Fire Underwriters.' 4. Commercial buddings, Industrial buildings, Mulhple Residences and similar buildings and installahons, 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 ]957), 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 inspechon of buildings or prem~ises, 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; New Building ....... ~ .... Old or Pre-existing Building ........................... VaCant Land ............................ ,/, Location Of Property ...~ ............................................................................ ¢ ........ ~...~...~ ...................... ~ner Or ~ners Of Prope~ ..~.~.R..C.~. ....... ~.~.~.~.~. ..................... { ............................................ 5u~ivision ................................................................ Lot No ............. Block N~ ............. House No ............. PermitNo. ~ ~Z DoteOf PermJt.~/~.~...Applicont ~,~/L~ ~Ja~ /~C Health Dept. Approval ...~/~.~.~2.~ ...................... ~bor Dept. Approval ...~ ............................................ ~e~/~ ~2 vi -' ~proval Unde~riters Approval ............................................. an,,mg Board ' . ....................................... Request For Tempora~ Ce~ificate ........................................ Final Ce~ificate / Fee Submitted $ ........ ~.~.~ ................. Construct)on on above described building and permit meets all applic~able cbdes and regulations. p,,cont ........................................... Sworn to before me this (stam~ or seal) ................ day of ............................................ Notary Public .................................... County TOWN OF SOUTHOLD Building Inspector's Office Town Clerk Building Southold, N, Y, 765-2660 Vom NO. 1 7/1 77 � TOWN OF SOUTHOLD BUILDING DEPARTMENT O'1to/y�_ g Q ,✓ TOWN CLERK, OFFICESOUTHOLD, N. Y. Examined .... .... ..... ..........fl' .., 19E. Application NO. 3 Z� �-j 9x Afiwr � �/ Approved ... .............. ..........,......, 19. ? .. Permit No. ..!...3..3 'L..... ��(�� 7, c.Lh. n -Gea 8y +•ncCo U) Disapproved a/c °^ i ........ �a a� 14 0-e —� ................................................................................ ..... )to �ztac �p�itGQ M�. .... ..... .......... . . � T4o-T td-- H --T......... .. ........................... .................... . ....... ...... ................ (Building Inspector. ) �28�/� ?leti ., ><+ f p4+ s 60."Xp� APPLICATION FOR BUILDIN PERMIT Date ........G? . �".3......................... 19 7.... "U INSTRUCTIONS a. This application must be completely filled in b typewriter r pp p y y typ oar 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 b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets of Z areas, and giving a detailed description of layout of property 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 >, 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 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. ?J The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to i admit authorized inspectors on premises and in buildings for necessary inspections. W .r ..:...R ./.. .4X...-`...So ni.s....../.NC �Q (Signature of applicant, or name, if a corporation) ....................................r.A..=.................IfySZ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................................................1�3 u,i�--a e/ ................................................................................................................ Nameof owner of premises ......(:A .........L. . � �C.S V.C.. 5............ ......................................................................................... If applicant is a corporate, signature of duly authorized officer. ........... a...... .............. . . ...................... (Name and title of co rate officer) Builder's License No. ..1)............................................. N .�. /�+� 7- SO- Plumber's License No. ........................... /000 - /01 - e9 - /9 Electrician's License No. t! Z 2 oM 1..................... Other Trade's License No. .............................................. 1. Location of land on which proposed work will be done. Map No.: .............. Lot No. X.................. Street and Number ..................EIS.........A!A v i.....�:!� !z....................................... ..................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................. F•a .h 1 y 9 a. a.4 /A/CI b. Intended use and occupancy .....1......... ............ .............................................................................................. V W J 3. Nature of work (check which applicable): New Building ... Addition .................. Alt ration .............. Repair .................. Removal .................. Demolitior.................... Other Work ......... ....................................... .. y 0-0 (D' scription) 4. Estimated Cost .................z. �.poO, op..............Fee C7`...`................................................. .. ............................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ..........................Number of dwelling units on each floor ..................... Ifgarage, number of cars ..........MA k<...................:................................................................. .............................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of us ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................ DePth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of some structure with alterations or additions: Front .................................... Rece ............................ p ions o..�..................construction, root.1 � '3 6 tuber of Stories.................................. �pth ..iy................ DepthHeight 8. Dimensions of entire new construction: Front ... .... .......... Height .................... Number o .............. ear ............................ ori 9. Size of lot: Front ........................................................ Rear .......................................... Depth .1.............................. 10. Date of Purchase ................:.......................................Name of Former Owner .........................j.............................. 11. Zone or use district in which remises are situated ........................................... P . ............................... � 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ...o...........j.............................. 13. Will lot be regraded ......l./°............... Will excess fill be removed from premises: ( ) Yes ()() No 14. Name of Owner of premises ...tr..K R f e !:s,!A�A....... Address ................................ Phon No. ...................... Nomeof Architect .............................................................. Address ................................ Phan iNo, ...................... �/ �� V So NS /,,hC ........ Name of Contractor ...../9.t..!e. . ...... No. ...................... PLOT DIAGRAM ress ........./..'� � Phan Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-b4k dimensions from property lines. Give street and block number or description according to deed, and show street ames and indicate whether interior or corner lot. ICI see s � teVey i li x S % S, o AL, I I' VA s AN �T ATE OF NEW YORK, ISS COUNTY /IO''F ................................f �(Na& o.A du.e.. �al signing cant ') .. .......being duly sworn, deposes and says that he is the appliceru above named. Fieis the .................... ................................................................................................... ................................ (Contractor, agent, corporate officer, etc.) 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 are true to the best of his know) dge and belief; and than the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .. , NotaryPublic County � Y!.!.. �.(Sig. . .t .re. ............................. . .................................................... (Signature of app ica�ifl N.55 52 30 E. W. 5tMCHtK LONG ~vGL. TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW fORK STA~ ~DUCATION LAW C'OPIES OF THIS SURVEY MAP NOT THE LAND SU?VEY..),~'S iNK b ~. /'-AF' \k...._. CUTCHOGUE ~ow~: OF ~UmOLq_~.X: X 755.97 (SEE Z7S739 -t1--1-) CO.HE5N.TH lDf-=P-f-APPROVAL P) 2t �( � P �E r 'su y F7 D� 4 7 HO, C H I K Cam!Tc H C)is u E- 7Ei L—-7 ZZ-5W,--3 5-rA"rFHMC-t-4T -0�. !,NTEN-r 748.26 NY Q N.55 52 30 E.- — 7PE V4%TER 5UP1':-,1'Af4D SSWAi-,'-5 POSTI U-) -r, F0 JZ — i CoNiz To I 0 -1-AfF-J0i'4k0 Z ;Ji; 1 AE OFF.eO, SGRVICC=S, . Lj APPL-i-r/14,4 T i z Z' 'COMM DEPARTMUil y ,:�R-.CO.QG P I. Gi��HEAI-i,14 SGQVICHIS F02 APP:�'�\A4- 0'-: C 17' Q -T Zia feel '17 I 1-itt-es fo 2 < ")f'ation, ha-Va been In-Pected by > IA4'+ thi-9 depa�,-t-%--at APPQ0V0',): to b. t\,,;T. ral Efiginearine SUFF.CO.TAX MAP 0E51GNAT14df,4 0 Ld 1'5 i 1000 1'5ec T 10 1,eux 1/-2:' 19. m p k cn 'NACANT) 01 12 A)L c LONG ISLAND I L 755. )7 R A I` 0 &55ump-D r=Lev, (REF.). F::,Ofz OATUPI I c,'rAMP -r1-rL1.: i re. B,6-4 5 46.544B TEST 14OLC— --UN—kLlItiMl'yl�;�A-WOWOR-ADDITION - TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE G-UA-� 71-:1-: 0 TO 4 C:0. SAND E C U 2 1 T V 11-L F� L) EDUCATION LAW. 710175011.- C COPIES OF THIS SUIVLY MAP NOT GEARING AS S0Q\/EYU` SE PT, 20 19- ANoy�-cvl-m THE LAND SU-VEY-'),,,'S I-NA-D�7AL OR �7 'A' c 1-f GRAVEL EMBOESED SL - ONSIDERED TO 132 A VALID r ,j- "'k GUARAN'TE2, W-,:CAi L! ONLY To-mi LL gUp4 SUAyiV HEAVY IS PP[;AfLr-, -;IAL� TO TILE I TITLE "A,,/ LEN0I,%:G 1, '4 TO THE ;F 1;,E DRY 5X40. FUT"O-'-.GUA,�ANTE:5 7YAPuUCEN��-' L I:) LANL,; L-Y A:. VERY "v" TO AD,-,710"AL OR 5Vg5jQUft# JIN GRAVC-1-