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Home My WebLink About10006-z1~0~ NO, ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's OEice Southold, N. Y. Certificate Of Occupancy No.. Z9/+76 ..... Date ... March...26 .............. , 19.79. THIS CERTIFIES that the building located at ./+060.0t.e .Jul. e .Lane ..... ~ Map No...xx~xx .... Block No...xxx~o~ · .Lot No ...... xxx~xxx .................... conforms substantially to the Application for Building Permit heretofore filed in this office dated . 'November ' · I ....... , 19 78' pursuant to which Building Permit No.. -1.0006.Z dated . .Iqo.v. embe~....5 ........ , 1~8.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ~rd:va~;e..One..F. amit.¥ .DwelLing. w.i.~h. Addition ............... The certificate is issued to .......... Nor,ma. l%o. -Po.rden ............................ (owner,~ of the aforesaid building. Suffolk County Department of Health Approval .......... N./R ...................... UNDERWRITERS CERTIFICATE No ........... N~.1.9026. ......................... HOUSE NUMBER .../~060 ....... Street ...... 01e. Jule. Lane. .................... ........................................... .Mat.tituck,. Ne.w..York ............. ........... Building Inspector County Tax Number 1000-122-~-27 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10O06 Z Permission is hereby granted to: at premises located at ............................................................................................................................ pursuant to application dated .................................. ..~../...C/......,.~.. ...... ,flg..Z.~ and approved by the Building Inspecto~r. /: Fee $ ........................ Building Inspector FOI~M NO. 6 TOWN 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 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 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 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: ]. 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 3~ March 19'79 New Building ................ Addition ....Y~ ..... O~d or Pre-existing Building ................ Vacant Land .............. Location Of Property ~tO~.Q .Q~[~. No=ma R, Po~:don , Owner Or Owners Of Property ....................................................... Subdivision ................................................................ Lot No ............. Block No ............. House No..4G60.. Permit No. ~00.013 ........Date Of Permit l~/.~/..7.~t...Applicant .~-l~,i~ll~l. I~I.G~ ;[Xltl.e ........ ~ ........... Health Dept. Approval ......... a:t/.& ........................... Labor Dept. Approval ........... t~,,Z.a, ............................. Underwriters Approval .................:; ........................... Planning Boclrd Approval ....l?../..e.. .............................. Request For 'remporary Certificate ..Jl~ ................................ Fincg Certificate .......~.,e...s. ........................... Fee Submitted $ ,~,..Q0 ........................... Construction on above described building and permit meets all applicable codes and regulations. Rober~ Sworn to before me this ~6 day of ...... ~4~L3:D. t3 ......................... Notary Public .~,..~1~.~3,~, ..............County Applicant ......................................................................................................... Inland Homes, Inc, (stamp or seal~~5 'ih h,h , ~r! 'hr , ', {3~ gOHN STREET, NEW ,YORK, NEW YORK I:~XTURE$ FUTURE APPLIANCE FEEDERS TIME CLOC{($ J m ~ny monner; return to the off[ce of the Boar* TOWN OF -c:IOUTFIOLD" OFFICE OF BUILDING INSPEDTOR TrlWN [~LERK'S r'IFFIDE SOUTHOLD, N. Y. 11971 TEL. '7 6 S-2 E~613 o TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19Z....~. Permit No. /O (Building Inspector) APPLICATION FOR BUILDING PERMIT I.~ovember ] Date ................................................ , 19...f.~ ..... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sate of plans, accurate plot plan to scale. Fee according tq schedule. b. Plot plan showing location of Iot and of buildings on premises, relationship to adjoining premises or public streets or 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 commenc~ed 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 o 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. The applicant agrees to comply with oil applicable lows, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises If cpplicont is c corporate, signature of duly authorized officer. (Marne (]nd title of corporate officer) Builder's License No....Q~ ............................................. Plumber's License No. ~J..Z;:.:?. ..................................... Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ~,e ~ s~t~.'vey Lot No. Street and Number .... ;....,;...;.: ................................................................................................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy1 ...~,-.r?J.~'..~,...i.~Y.~!:~'.~.~.? .......................................................................................... b. Intended use and occupancy ................................................................................................................................ " I:EE: /~ ~ BY: -- NOTIFY BUILDING DEI~ 765-2660 c)AM to 4PM FOR REQUIR. ED INSPECTIONS: 'L BEFORE BACKFILLING FOUNDA- TION O~ START FRAMING BEFORE COVERING PIP, ES OF ANY KIN~ 4. FINAL WHEN JOB COMPLETED NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS $. ALL CONSTRUCTION MUST MEET REQUIREMENTS OF N.Y. STATE CODE', AND TOWN HOUSING CODE & ZONING