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Home My WebLink About9347-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk'~ Office Southold, ~. Y. Certificete Of Occupancy No... Z915.~ .... Date .... Angu~ .~ ............ , 19. THIS CERTIFIES that the b,,flding located at .6/~250 .. lVla.t.u. Ro~d ........ Street Map No ............. Block No .......... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .... Jtme. ~EI ...... , 19...T'_'Jpursuant to which Building Permit No.. dated ... June.. 30 ....... , 19..7.7, was issued, and confo~-ms to all of the req-!re- ments of the applicable provisions of the law. The occupancy fo~ which this certificate is issued i~ .......... Buaine~s .Add~2~or~ · · (Deck) ......... , ...................... The certificate is issued to . A.~/con. Rea~: .Co,..Inc~.-/Kt~].. C~.eek. Z. rm ............ (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval ............. .N./.I~. .................. UNDERWRITERS CERTIFICATE No HOUSE NUMBER...6~.2.5.0. ...... Street ............. ?!a.t..n..R,o..a.d ..... /.~ ........... Buildi~ g Iflspeetor FORM NO. 6 TOWN OF $OUTHOLD , Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPA~ICY 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 all buildings, property lines, streets, and unusual natural or topographic features. 2 Final approval of Health Dept. of water supply and sewerage dis[ sal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences iand similar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requireme~nts 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, bu~ildings 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 pre~nises, or other pertinent in- formation required to prepare a certificate. I C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or Iond use $5.00 3. Copy of certificate of occupancy $1.00 pete .' ...... ..................... New Bqilding ................ Addition .......,~... ..... Old or Pre-existing Building .......... Vacant Land .............. Locahon Of Property ......... .~...~/...~/ ........ ..~..C...~..~. ............. ../~...,~.~.,~..~...~...~...,~../~.!~.~.~ ......... .~.~..E~..:..~.'.~.4.~..~.? .... Owner Or Owners Of Property ..~..,~..4.~...~...~. ..... ..~...~...~..~..?..~ ..... ~...~...~..: ........... ..~..!.~..~....~..,.~..1~..~..~. ..... ./..,~,..~ .................. Subdivision ................................................................ Lot No ............. Block t lo ............. House No ............ Permit No...~..~....~..~...~, Date Of Permit ~./..~.C~..'~..~.Applicant .~.~.':..37..*..-~...R~.!....T...~..~..~..~..~.~. ......... ~...~....C=. ......... Health Dept. Approval ...... ..~...(....~.. ........................ Labor Dept. Approval ........ ~(..l~..-. ........................ Underwriters Approval .............................................. Planning Board Apprc val ...~....~..~..: ................... Request For Temporary Certificate ........................................ FinaJ Certlfic;te .......................................... Fee Submitted $ .................................... ·ild g a~3,/ ~ mee/~/~e Construction on above described bu~in~/./_ per Sworn to before me this ~ r / ~ ................ day of ............................................ (sta~ Notary Public .................................... County L~ ~( fro Approved ........................................ , TOWN OF SOUT.OLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19 ........ Permit No. Application No... ,~...,~...--.~....Z ....... APPLICATION FOR BUILDING PERMIT ~ D · ' · - a ]9...'7.2.. INSTRUCTIONS ate .......... ~,~. ,..~....-:~.. ..................... , a. This application must be completely filled in by typewriter or' 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 location of lot and of buildings on premises, relationship to adjo[ning premises or public streets · areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which ~s 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 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. I 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 apphcant agrees to comply with all applicable laws· ordinances, building code, housing code,,/and regulations, and t admit authorized inspectors on premises and in buildings for necessary inspections. ~:~e of oppl~'c;~:;r name: if~a corpor;;io~i ..... .......... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buHdeJ Name of owner of preraJses .................. ~{~ .............................................................. apph,c~nt is a c~.orpora~m'/sigj~gture of duly authorized Plumber's License No ................................................. Other Trade s License No ............................................... 1. Local on of land on wh ch proposed wqrk wil~ be done. M p No.' .~ ........... .~.., .............. ;. Lot No....~.. .............. Municipality 2. State existing use and occupancy of premises and intended use and occupancy/of proposed construction' a Exisiting use and occupancy .... ~~~~.o;.....~... .................................. ..~ ...................................................... b. l nte dad use d o cupa cy ................................ 7' ......................................................................................... 3 Nature of work (check which apphcable) New Budding ........... Addmon v'/ Alteration Repmr .......... Removal ............. Demolmor ........... Other Work ........................................... ~ ¢*~O , o o ~ ,¢'~' ~ !' (Descr,pt,on) 4 Estimated Cost .......~ ......................................... Fee ............................................................................... (to be paid on filing this apphcat~on) 5 If dwelling, number of dwelling umts ..................... Number of dwelhng umts on each floor ......................... If garage, number of cars ............................................................... .~ ................................................. 6 If business, commercial or re,xed occupancy, spsc,fy nature and extent ofieach type of use ......................... 7 D~mens~ons of ex~st~ng structures, ff any Front ................ Rear ................................Depth .................. Height ....................... Number of Stories ............................................... : ..................................................... D~mens~ons of some structure w~th alterations or oddmons Front ............................. Rear ..................... ep,h ................................ ...... .......... Number of Star,es ................................ 8 D,mens,ons of entire new construct,on' pro,, . ..~.o. ) ...................... Rear ....~..O.. ! ............... Depth ....~..°° Hmght ............ Number of Stories .... : ................................ i ................................... 9 S~ze of lot Front ................................................... Rear ....... I Depth 10 Date of Purchase ..................................... Nome of Former Owner. .................................................... 11. Zone or use &strict m which premises are s~tuated ..................................... ~ ................................................. 12 Does proposed construction wolote any zoning law, ordinance or regulabon ~ ............................................. 13 Will lot be regroded ....... ,~ ......... Wdl :excess fill be removed from premises: ( ) Yes ( ) No 14 Nome of Owner of pre~,,sesJ.¢~..~.~ ~.~~..~7..-'?_~ ............ Address d~...~.~.~.~J~..-~ Phone No. ..................... Name of Architect ./~%.~~ ........... Address Z~'~..czm'....:~ ....... ..~....~....;. Phone No. Nome of Contractor'" '"/--z~¢"~ ~ ~Jr~¢ . . ...... Address ..~...a:~.....~" "...~..k..~..; Phone No. ........................... PLOT DIAGRAM Loca~e clearly and distinctly oil buddings, whether ex,sting or proposed, and~pdlcate~ oil set-back &menslons' 'fror proporty hnes Gtve street and block number or description according to deed, and show street names and ~nd~cat whether 'interior or corner lot STATE OF NEW YORK, ~ ~ c COUN I'D? O~ ......... ~¢~':-"Y"7'f'~ 7 ~ ....... ~v~.~kr....~../...~.....~i~....~...~~ ................. being '¢ (Norjde of md~wdual s~gnfng contract) above named. He ,s the ................ (~f~'~Jr~;-~' ~'~, 'c'c~r~c~ro~-~'of'f;~'~'r',";~'~'¥ .............................................. of s~d owner or owners, and ~s duly authonzed to perform or have performed th~s appbcahon, that ali stetements contmned m th~s apphcahon are true to the that the work wdl be performed m the manner set foRh m the apphcahon filed ~er Sworn to before me th~s No, 52-464372], Sulfolk C~ Term ~pfres March ~, 19~ ~e smd work and to make and fi ~est of h~s knowledge end belief, a~ duly sworn, deposes and says th~at he ~s the apphca,