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Home My WebLink About9102-zFOR31 I~0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Ot~ice Southold, N. Y. Cerfi icnte Occupnncy No.. Z8.91,0 ..... Date .. Fehruar~.. 22 ........... , 19.. 7.8 Bayview Rd. THIS CERTIFIES that the building located at 678d .Nor.th. i{d.~, tO ........ Street Map No..~-599 ....... Block No ........... Lot No ....... 1~ ......................... conforms substantially to the Application for Building Permit heretofore filed in this office dated . F, arch ... 21 ......... , 19 7.7.. pursuant to which Building Permit No...9.1.02Z. dated . March ... 2.1 .......... , 19 .~.7., was issued, and conforms to all o£ the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .~RIYA~E. ~I~E. FID4ILY..DWELLING ...................................... The certificate is issued to ...Greenbria~..Homez. Yane, ............................ (owner, of the aforesaid building. Suffolk County Department o£ Health Approval ........ 7.-~.0-. 27. ................... UNDERWRITERS CERTIFICATE No ................. .l~6. ]..~.6.~. ................... HOUSE NUMBER..~80 ........ Street ...~.o.~.$.h..~.q$.d..~o...~.a..~..l.e.w...Rd.,. ......... ........................................ ~.o.u..t.h9.1.~. ,..N.e.v..~.o.r.k. .................. /../, ./,4~/Le.~.,~..' ......... Building Inspector FOI~M 1~0. 2 ?OWN OF $OOTHOLO BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~REMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 9102 Z Permission is hereby granted ~ A t~,~ff ~'t pursuant to application dated ..................................... .~?.~.f.\.....f(~../., 19.~..~..., and approved by the Building Inspector. Fee ,....Z~ .............. Building Inspector FORM NO, 6 TOWH OF SOUTHOLD , Building Department Town Clerks Office 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 Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of oil buildings, property lines, streets, unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposol--(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, o 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.of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner os to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or p~emlses, or other pertinent formation required to prepare o 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 / ...... ............... New BHilding ................ Addition ................ Old or Pre*existing Building ................ Vacant Land .............. Location Of Property ..~....~....,~..~..,~..~,./~.....~.~.%~. *'~*~.*~*..*~**~**!~.~.~/~.~*.`~..~..~/.*~'~.~/~..~*~-~.~2***~*~~~ Owner Or Owners Of Property .................................................................. : Subdivision ~.. ~...~.:../~.../~,.,,'~:?......¢.?..~::..~.;..~..~: .................. Lot No....~....~.... Block No ............. House No.~:..~.?..~ Permit No ..................... Date Of Permit .. Z...Applicant ............................................................ Y = - Health Dept. Approval ........................................... tt.aoor Dept. Approval ................................................ Underwriters Appra¥ol .............................................. Planning Bo~rd Approval ........................................ Request For Temporary Certificate ........................................ FinoJ Certificate .......................................... Fee Submitted $ .......... ,~, / Construction on above described building and/p, er~it meets all al;~cable codes and regulations. Sworn to before me this /:'/z~'~'~-5* ................ day of ............................................ Notary Public .................................... County (stamp or seal) Examined . ~ ~, -7- ..... Approved .................. .?....~....~.....~../', 19.~.~... Permit No ....... ~ ......................... Disapproved a/c .............. ~ ............................................... (Budding Inspector) APPLICATION FOR BUILDING PERMIT Date ............. ~',.~?../.. ......................... , 19.~..~......C~ INSTRUCTIONS a. This application must be completely filled in by typewriter or, 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. Plot plan showing location of lot and of buildings on premises, relationsh p to adjoining premises or public streets 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 shall have been granted by the Building Inspector. B .A.P, PLIC~ATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to the ui~aing zone Ordinance of the Town of Southold, Suffolk County, New York, and other app cable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for remova or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, build ng code, houslnocode, and regulations, and to admit authorized inspectors on premises' and i~ buildings for necessary/~,,//~/~ -~'/'~/oinspecti°ns' ~ ~lJJ~JJJ~[t,~ ~,u~J~lJ~ ~,' ....... ........... (Signature of applicant, or name~:,ff'a corpora'~i;~'i ........ ...Z>..Z.:..:/ ....... ........... ,,_: ... ...... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... If applicq/nt is a corporaJr;e, sigp~ature of duly authorized officer. Builder's License No ..................................................... Plumber's License No ....... ~', ....... ' ................................ Electrician's License No ........ ?.¥.,.~,./..~, ........................ Other Trade's License No ............................................... Location of land on wh ch, proposed work w be done Map No · Street and Number :~ ,-dU~.-')¥.-7 ~2'.~.~../..~",.~:.~' ~-~ ~ 7~ 0 Municipali~ State exisHng use and occupancy of premises and in~ended use and occupancy of proposed construction: a. Exisiting use and occupancy ~[)/~7~?~ ~ //~'~' b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building, ..... ,~.... ....... Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior, .................... Other Work ................................................ . .... (Description) Estimated Cost ................. ~ .......... Fee .......................................................................................... (to be paid on filing this application) 0~ u 5. If dwelling, number of dwelling units ............................ N tuber of dwelling units on each floor ..... , ...................... If garage, number of cars ...,4~..,.~.. ............................................................................ 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 ar additions: Front ....................................Rear ............................ Deptb ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... ~..~... .................. Rear ..... ..~....~...~ ............. Depth .,.?...~... Height .................... Number of Stories ........... I~...~'..,4~- .............................................................................................. 9. Size of lot: Front ......../...~.~.?, ....................................... Rear ......... ./..~? ........................ Depth ......~...~...O. ................... 10. Date of Purchase .............--~ -- ..~_/~' .,~1~..h~. ...................... Name of Former Owner ...~./.~'.,~..'...~/..,~...4~.;~......,~..~..~....~...~.: ......... 11. Zone or use district in which premises are situated .............. ~.{-!~rM/.C..,~;.~.. ....................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded Will excess fill be removed frorr~p~n~ses: G ) Yes ( "')/'No ........................ · r" ;~L6 ~' '~. x~ Name of Architect .~.4~r~.~r~4,.~...~/£./.~,/. .......................... Address .~..;../../.~.'"./.~¢/.~;:~.~,~ ..... Phone No. '2,~..~..~,~.~.~..~.. Name of Contractor ..~J;i',A.-~4~/~..~.~!~..?.~....ff~f~.K{~?..~.../..~...~. Address N o. ~ ~ .~..."?.-~T~. ~. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property linee, Give street and block number or description according to deed, and show street names and indicete whether interior or corner lot. f STATE OF NEW YOj~K, ~ ~ c c COUNTY OF ...../:~.,/..~..S.~"~.,..~.. ....... f~'~ ............. ~.~K.~.......~.~....K~..~.~.~ ...... ~ .................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contracf) above named. He is the ....~.~.Z:~ ......................................................................................................................................... (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 trge 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. Sworn to beJore me this , / ~ ........... ..... .................... , ,,..? //Z / 0 ....... ................ Co..U ....... ..................... ~ ~ ~ of ~ew Yor~ ~ ~ ~610286 ii £f APPrOVeD AS NOTED 'I