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Home My WebLink About9358-z ~'OEM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PJ~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 9358 Z Date .......................... ~1~. ......... .~J ..... , 19..~.. by g -~ Permission is here ranted to: / ~ '~'~ ~ursuant to application dated .............. : ........... .~..~.g~...;.j~ ....... ,~ J~.~.;., and approved by the. ;~,-~C~-~<~ Fao *...!.~. ........ J FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted I ~ 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 sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buddings, 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. B. For existing buddings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty 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. C. Fees: Additions $25.00 1. Certificate ofoccupancv New Dwelling $25.00, Accessory ,$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $t0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date ... NewConstruct, zon ...... Old or Pre-existing Building_=. ........... I Vacant Land ............. Location of Property .......................................... I ......................... House No. Street Hamlet Owner or Owners of Property ...... %... r.: .... ............ County Tax Map No. 1000 Section '-~ O Block 1 -~ · ...,..~..Filed Map No ...... i ..... Lot No .............. Permit No...~vf/,?¢... Date of Permit ..../~//.~...Applicant ......... , ......................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval .Planning Board Appr val ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ~ Construction on above described building and P~,~zt~ns. Rev 10-10-78 hq (.5 7 Applicant .... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southotd, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ~nk, 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 sewerage disposal-(S-9 form or equal). 3. Approval of electrical installat~on from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code comphance 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 unusua~ natural or topograph ~c 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 buddings or prer0ises, or other pertinent informa- tion 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 certihcate of occupancy $1.00 , New Bu,[d,ng Old or Pre ex,st,ng Budd,ng(:X)Date House No. ._._.,Street , Ham/et Owner or Owners of Property . {~?~JJ~.IYl J~..f3/...~. ~d.j,~:. ! ~ ................................. County Tax Map No. 1000 Section ............... Block ............... Lot ................ Health Dept. Approval ........................ Labor Dept. Approv~al ...................... ,.. Underwriters Approval ........................ Planning Board Approval .................. Request for Temporary Certificate ..................... Final Certificlate ........ Fee Submitted $ .............................. Construction on above described building and permlt'meets all app.Li,c_abte_.~ odes and regulations. Rev. 10-10-78 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall , Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m~ 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 topographm 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 Remdences and, similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the build,rig. 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 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. C. Fees: Additions $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ,$]0.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certiflcate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5. Updated C.O. $ 50.00 Date , NewConstruction ...... Old or Pre-existing Building ............ i Vacant Land ............. Location of Property · · · , House No. Street , ! ~ Ham/et Owner or Owners of Property ~ o¼ ~,n .~ County Tax Map No. 1000 Section ...... .~..0, ..... Block .. J.'.~ .......... Lot .... . .z~D.., [..~.. , , · Subdivision ....... Filed Map No ...... ~ .... Lot No .............. Health Dept. Approval ........................ Labor Dept. Approval I ........................ Underwmters Approval ' .Planning Board ApproVal Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $. Applicant AFFIDAVIT Re: Lot #3, Paradise by the Bay, Southold, NY Tax Map No. 1000-070-013-0200.003 I, John Nickles, being duly sworn depose and say that I am familiar with the in-ground swimming pool with fencing located on the above property. Such in-ground swimming pool has been on such property since prior to the institution of zoning in the Town of Southold on April 23, 1957. STATE OF NEW YORK: COUNTY OF SUFFOLK ~ On the~ay of May, 1988, before me personally came John Nickles to me known to be the individu~al described in andthat who he executed executed the the foregoing same. instrument, and acknowledged Notary Fubl£c KIMBER/Y NORTH souTHO£D ~YV/EW RO~D NECK ROAD PINE N 69°52' 50''E 0 0 0 0 PEC~EYORS , P C (516) 765 - 5020 P.O BOX 9O9 MAIN ROAD SOUTHOED , N Y ~97~ f.,__L:1020.~ $ 85o~0' 30"W -----AREA = 49618 LOT 2_75 81' LO'T 4 49,588 SQ,FT 0 N'85°4 8'25"E I 71' SURVEY OF LOT $ " MAP OF PARADISE BY THE FILED NOV 4, 1976 FILE NO AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY,N.Y. 1000 70 - I 3 - SCALE I"= 40' MAY 9, 1988 B AY" 6463 20.3 CERTIFIED TO: COMMONWEALTH LAND TITLE INSURANCE CO VIVIAN CORNACCHIA TITLE NO. 860 668 - $ - S Prepared in accordance ~ tim m~m ~tandards for rifle sunn~/~ a~ eetabt~ne¢l by file L.I.A.L.S. and approval and adopted for such me by The New York State Land Title Association 88- 332 ROAD NECK ~ 4 7 oo oo 14o M~P OF PARADISE BY THE BAY SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, iVY sc,~ oo' ~b&-~D CofG' Sco~' I%600'