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Home My WebLink About10034-z FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFICE SOUTHOLD, Nm. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10034 Z Permission is hereby granted to: ~..~.~.;.:~ ...... L....d~. E.-.'.!~..r.!..~/.~:. ........ at premises located at '~ / 0 L, lA, Lb ~ 77~ ,~ ~'~ ................................ ? .................................................................................... pursuant to application dated ........................................................ , 19 ........ , and approved by the Building Inspector. Fee $.../..~ ................ /roD.- tP(o- I- I~ Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 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 buildings, 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. 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 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. Fees: 2. Certificate of occupancy on pre--'~'~x~sting dwelling ~r land use $ / $5.00 3. Copy of certificate of occupancy $1.00 Date ..... New Building ............. Old or Pre-existing Building(X) ......... ~ fVacant Land ... Location of Property .... .~,_~,~ ................... , ,~,~,T~,~ ~,,, ~.~ .... ~ ~ Hou~ No. Street Ham/et Owner or Ownors of ProperW ..~.~ ~.~.~.-.~'.~ ~... ~ County Tax Map No. 1000 Section ...~.O¢ ........ Block ..... [ ......... Lot ..... {..q Subdivision .... ~ .'.. ~%~(~ .......... Filed Map No...i,~, .7,~.Lot No... J J~; ~ .... Permit No..[.~.~ZDate-- of ,erm,t ~.~ ~ ./.~,~lic~nt. ,~ ~~, ~~. ~ Health ~e~t. A~roval ........................ Eabor ~aCt. Approva} ...................... ,.. Unde~riters A~proval ..................... ~..~tannin~ Board ~p~roval .................. ~ .. ~ Bequost for Temporarg Certificate ..................... Final Certificate ........ ~ ......... ~ Fee Submitted $ ....... : ~ Construction on above described building and permit~meets all appl~,cable~co.des and regulations. THE NEW YORK BOARD OF FIRE :,UNDERWRITERS BUREAU OF ELE~CTRIC;JT~ V Detet~t~T,~L' ~, ~. ~} > ~ ~'} Y ~ 8S JOHN STREET, NE~&:. YORK,~ ~ ~NE~ ~RK 1003~ THIS CERTIFIES THAT . in thefollowing Ioe~tio,H -, ~Basem.nt¢~ ~ 1st FI. ~ 2nd Fl. 01~ ~, "Section Block Lot DRYERS OTHER APPARATUS: I C E NO OF NEUTRALS A. WG '' '~' This certificate must not be aJJered in any ~anner return fo the 9ffce o~ the Boar8 f THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY THIS CERTIFIES THAT in the following location ~ Basement ~ 1st Fl, ~ 2nd FI. Section Block Lot was examined on ,~.~,~ ~.~ 2~ ~ .~ 9~0 and fottnd to be D, compliance t~i~h tke requiremettts of this Board. FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS 6 13 6 6 DIMMERS SERVICE DISCONNECT S E R V I C E OTHER APPARATUS: OF NEUTRAL P.O~ Cox 99t 11952 This certificate must not be altered in any maqner; return to the office of the Board if incorrect. Inspectors r~ay be identified by thel cot~¥ I~oll BUlLOING BEPAIITIV~t=N?~ TI'IlS CqP¥ OF II redentials~. TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN OLERK'S nFFI~.E SOUTHOLD, N. Y. 119'%~ TEL, "TALK TIME" DOUGHNUTS Add 1 cup of sugar slowly to 2 beaten eggs. Stir in 1 cup of milk and 5 tbs. melted shortening. In a sel~arate bowl put 4 cups all purpose flour (sift betore measuring). Resift with ~ tsp. of cinnamon, 4 tsp. nutmeg and V2 tsp. of salt. Mix dry and moist ingredients. Chill the dough slightly and roll to ~ inch thickness on a lightly floured board. Cut with floured double cutter and fry in deep fat heated to 375° turning each one as it browns, Cool and dust with powdered sugar. 0-35X421-2 NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. proved ............ ......- Disapproved a/c ........... ~.:~...[ .............................. i' ............... Application No ................................ APPLICATION FOR BUILDING PERMIT Date ....~.~)..~..~.~%,g,~,~...'~ x~ .............. , 19...~.~ INSTRUCTIONS a. This application must be completely filled in by typewriter o~ 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, relationship to adjoining premises or public streets m areas, and giving o detailed description of layout ofproperty must be drown 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 port 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, os herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. {SiOh~ of opplicont, ore, me, i~ ~ corporation) ~ J ' (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... g.×.o...x:.~..c..~ ........................................................................................................................................................... Name of owner of premises .... ~.~......~ .... ~..~.~ ..x~. ....... ~).~ ......................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ~ ~4~(~(~ . G' ~ ~xe~'&,(~. ~'~:~ C~',~ Bui der s bic~se mo ......................................... ~;~.~..~. g~ O bu ('~. ~ Plumber's License No ............ '...I...J..L~...]... ................. Electrician's License No. C --: '3 %, . ~,~ , ............................................... ':: 1. Lo~ation of land on which proposed work will be done. Map No.: ........................................ Lot No .....~..~..~., s,~, ~,d N,~b~ ....... ' '~ :~:.~=~.~::~:,.....~.= ................. ~:..~.~.: ................................................................... M~nicipali~ 2. State existing use and occupancy of premises and in~ended use and occupancy of proposed construction: Intended use and occupancy 3. Nature of work (check which applicable): New Building,, ................. Addition ......... Alteration ......~....,. Repair .................. Removal .................. Demolition .................... Other Work ....... ~..C...~,~ .~Zx .xx---------------~ ,LL~ ~., ...... L~) (Description) 4. Estimated Cost ,,.~..(~.,)..~.,(~..,,~,....~..,.0...(~. ................ Fee (to be paid on filing this applicotion) 5. If dwelling, number of dwelling units ....... Number of dwelling units on each floor ............................ if garage, number af cars ..........:...~...~ ........................................................................................................................ 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 ........... ----~.....t~. ............ Depth ...~..~.. .......... Height ........................ Number of Stories ...... ~ ...................................................................................................... Dimensions of same structure with alterations or additions: Front ............. ~.~1 ............. Rear .^~...c.(. ................ Depth ............. ;.~...~ ......... Height ............................ Number of Stories ............... ~ ~ .......... 8. Dimensions of entire new construction: Front .................... · ............... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ........................... ,.~....~, ..................... Rear .................... ..~..O, ............. Depth ...... /..,~.~-~ ............. 10. Date of Purchase .... .~..q,.~/ ......................... Name of Former Owner ........ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~..~. .................. ..~ ................ 13. Will lot be regraded . .......... ~....l~... ...... Will excess fill be removed frg__m premises: ( ) Yes 14. Name of Owner of premises ..~.q.L~-...%. ........ ..~D..'~...~... ^ddres$ ..~.~g.,~...~.[.~..,,., ..... ~hon, No. o~..~.~.......~.~..~ Nome of Architect .............................................................. Addre~q ................................ Phon~ No ....................... Name of Contractor ............................................................ Address ................................ Phone ~qo ....................... PLOT DIAGRAM Lacate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions from properly lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW/YORJ~,,, ~ / [ ¢ c COUNTY OFz~.....~ °'~ ................................................................................................. being duly sworn, deposes ~nd soys th*t ho is tho (Name of individual signing contract) above named. He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and s 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 knowledge and ~elief; and that the work will be performed in the manner set fo~h in the application filed therewith. Sworn to ~re me this ~ ~ .... .... ....................... ,..,~,..~,, / / t~gnatur~ or/applicant) oENTR,aL DRIVE Lot 121 Lot 125 NOTE: · -- MONUMENT SUBDIVISION MA P FILED IN THE OFF/CE OF THE O£ERK OFSUFFO£ K COUNT Y ON dAN. 19, 1949 ,~S r'7££NO. 1672. THIS SURVEY ~ A V~OLATION OF 3ECTJON REVISIONS APR 25,1974 YOUNG & yOUNG 400 OSTRANDER AVENUE, RIVERHEAD, JAMES YORK ~ CHRIST/NE YORK ~[ MA T TI TU C F 'row. o~ SOUTHOLD SUFFOLK CO., N.Y. SCA-S: i,, = 4d J OAW: APR. $OUTNOLD SA; -A -B -C -D .E -F -G -H ~J