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Home My WebLink About10060-zFO~w NO. 4 TOWN OF $OUTHOLD BU~.r~ING DEPARTMRNT Town Clerk's Office Southold, N. Y. Certificate Of Occupency No. Z9~58 Date March 7 ........................................ , 19....79 THIS CERTIFIES that the building located at. ??.~.?...F.?.c?.O..x~...A?.e. ...... Map No ............. Block No ...........Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in thi.~ office dated .Dec.amb~r...~ ........, 19..7.8 pursuant to which Buildin~ Permit No...~.0..0.6.0.Z dated .De~,ember...6 ......... , 19.7~., was issued, and conforms to all of the require- merits of the applicable provisions of the law. The occupancy for which ~ssued is ......... t~rivate. One. Family. D~llin~ ............................... The certificate is issued to Louis Stokes . (owner,~maa~aa~m) of the aforesaid building. Su~olk County Department of Health Approval l~-e-Fncistin~_ mwm~wm~as C~?Z~ZCA~ No .......................~..e.-..~. ls.t..i.n! ........ HOUSe. NUZ~mEa ... ! .~}.5. ...... Street .......... ~.a..c.t.o..ry. ?.v.e. ................... .........................................................l~.atti .t~..ck~. .................... Ne~ York .c. ...... Building Inspector Cmmty Tax Number 1000-122-2-1S FOI~M NO, ~ TOWN OF SOUTHOLD BUILDING DEPARTJv~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~REMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N? 10060 Z Building/)"~,~ Inspector. /'/'~ / / Fee $.~..~ .............. .................. b',;~';,'~;~;~;;: ....................... 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 featu res. 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1,00 $5.00 Date .. ~. ,o¥.e.m. ,b .e.~.. 2. 7 ,..~. 9, 7.8 .... New Building ............. Old or Pre-existing Building ,..X.~. ....... Vacant Land ............. Location of Property ... (,qo...~.) ......... .~.a.c;~ ,oT.y..A. ¥.e.~.qe. ................H..a~.~.~.~ ,u.e.~. ..... House No. Street Ham/et Owner or Owners of Property . . .~ .o~.~.~.. S..'c.o.~.e..s..a.~.d...~.~.~.h...S~.o.~..e.s ........................ County Tax Map No. 1000 Section ...~.~.2.; .0.0. ..... Block . .0..2:.0.0. ....... Lot....0.~.8.: .0.0.0. .... Subdivision ......... .~..~. .................... Map No ............... Lot No ............... Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approvat ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $.,. 5 o .0.Q ..................... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N,Y, 11971 APPL CATION 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 topographPc featu res. 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: 1. Certificate of occupancy $5.00 2, Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date New Building ............. Old or Pre-existing Build.~g . . .~. ....... Vacant Lan)~ ............ Location of Property IZ..~.~. . ..... ./ff:.~..~?.~. ~.."'t~_,,. .~.,;~;, .................. ?. .r'r:-r:.~.~:4 ,o,,,e ,Vo. /~. . . .~.?. .'~. .~. .~. ...................................... Owner or Owners of Property .C~. ~..~, County Tax Map No. 1000 Section ... ~/~.~,~:, ....... Block ...~. .......... Lot... ~/.~' .......... Subdivision ................................. Map No ...... , ......... J,~t No ............... Permit No./D~. ~.~.O... Date of Permit~J~'~'~...?.~..Applica~t~ ~~~..~~ Health Dept, Approval, .~j~ ................. Labor Dept. Approval . fi/ff.' ................. Unde~riters Approval ~. ~~ ......... Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ...~ .................. Fee Submitted $..~ .................... ~ Construction on above described building~:::t mee~~nd ~~, Rev 101078 Applican~./~.~--~ ~..~~ ~ .... ~ 'TOWN OF $OUTHOLD -~ TOWN CLERK $ OFFtCil o- ~/ Examined-e~.~t2J ~ ............... 19.~ App cat on No. Z~.~ ......... A~aved ~.....~ ............... , '~-7~ P~m,, ~o..~.~.~...-~ .... Disapproved a/c ....................................................................................... .,.~ ............................................................................................... ;....:..~ ........ .................... {Buildin~ ~s~or) APPLICATION FOR 8UiLDtNG PERMIT ..................... INSTRUCTIONS a. This application must be completely filled in by typewriter or' in ink end 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'bt 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 far inspection throughout the work. e. No building shall be occupied or used in Whole or in part for any purpose whatever until a CePtificate of Occupancy shell 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 all applicable laws, oral;nonces, building code, ha~usin~-~ode, and regulations, and to admit authorized inspectors on premises and in buildings far nece inspections. (Address of applicant) State whether applicant i~,s~owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....... .~.~.~.~...~.~.z~.~g ............................................................................................................................. X.o,,;~ .~,~s ..................................................... Name of owner of premises ..................................................................................... applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ....... ,.~,-~...7.....~.. ......................... Electrician's License No..L,~..~..l~..../~. ......................... -/zz_-)_-/d~ Other Trade's License No ............................................... 1. Location of land on which propose~i, work will be~on~. ,Map No.: ...;~. ................................. Lot No ......................... Street and Number ..L.~....~.....~.....~./~.'/~..~,,4/....~.67~..~t'~ ......... ~.L.'~.C~ ................................................ / · Municipalih/ 2. State existing use and occupancy of premises and m.-nded use and occupcecy of proposed construction: r-- Intended use and occupancy . ..4j..~..~..~. ...................... 3. Nature of work (check which applicable): New bSuli~mg .................. ~cyJmon .................. ttl[~rrJ¢lon ..sC/r..,~,~f ,,, Repair' .................. ReFno~/al .................. Demolition .................. :. Othe'r Y/ark ................................................ . .... ,' . , (Description) 4. Estimated Cost ..... ....................... : .............. Fee ............................... i ....... , ................................ (to be paid on filing this application) 5. If dwelling, number of: dwelling units ............ L ............. Number o'f dwelling units on each floor ........................... If garage, number o~ c~rs ....~... ,~..,.~.,~.~.~,..~6¢...~,~.: ................................................................................................ 6. If business, commercial or mixed occupancy, specify nature end extent of each type of use ...~//~1. .............. 7. Dimensions of existing structures, if any: Front ..... t..~.,.~. .............. Rear ....... /.~,.~-. ............... Depth ,~../, .......... Height .......~....~.. .......... Number of Stories ...... ~ ................................................................................................ Dimensions of same structure with alterations or additions: Front ...... ~.i~. ....................... Rear .../.~. ................... IDepth .. ~..,~. ................... Height ........~..0. ............. Number of Stories ....... ~ ................... 8. r)imensi~ns of entire new construction: Front ..... ./.~ ......................... Rear ...i.~./,~.... Depth ..~. Height ...,.~.....~. .......... Number o¢ Stories . ./~, ............................................................................................................. 9. Size of !at" Front ..... .~-..,~. .......................................... Rear .....~.... ............................... Depth ~,~..4.~.~.~..~.~ ............ C ote rcho,e ............................. ;me For er C ,er ............................................. 11. Zone or use district irt which premises are situated .,/~.,..~..~ ....................................... ].] ........ ]....]].:.]]].i ............ 12. r)oes proposed construc~vio,ote any zoning law, ordinance or regulahon: ../~ .............................................. 13. Will lot be regraded ............................Will excess fill be rernoved from premises: ( ) Yes 04,) No . 14. Nome of Owner of premises .~...0.~(~...o.~.7'~2~..~'~..,~. .................. Address/~8i~.~)~.l~C--C//'¢~,~Phone No.~,~.~'.~...'. NameN~me olaf ContractorArChitect ...... ..~...'..~..',~./?,.~..~..~..~..~..~..~: ......... ~ ......................................... ............ ~kao--" ress/..'~..&¢'~$'°~'¢j~'Address .. ................................ .~ ~¢.~,~.../.¢'4. ¢ ...... ', PhonePh°ne N°. '7'~"'/"4~,~c~''N° ........ PLOT DIAGRAM Locate cleariyJand distinctly all buildings, whether existing or proposed, and indicate oil set-b:ck dimensions fton property lines. Give street and block number or description according to deed, and show street homes and indicob whether interior or corner lot. STAT: O~,,,N ESV ......................... ~~.-. ,~.y~.//¢~....~.. ................. being duly sworn, deposes and soys that he is the oppliccr (Name of individual ~gning co~trac0 ~bove. .,'~med' ~~~, (Contractor, a~ent, cerpor~te officer, etc.) of said owner or owners, and is duly authorized to oerform or have performed the said work and to ~ke and fi this' application; that all statements contained in this applic'zt cn are true to the best of his knowledge and belie~; or that the work will be per'or.d in the m~nner se~ fo~h in ~he/appl[cadon filed therewith. ~ ~ N/O/F MARY ROACHE N/O/F FRANK HAUPT Umouthor;z~:l ohemfion or addition fo this sun~ey is a violation of section 7209 of the New York State Education Low. Copies of this survey map not bearing ~he land surveyor's inked seal or embessed seal shall not be considered to be a valid copy. Guarantees or cerliflcations iedicafed kercc, n shall run only to the person for whom the survsy is przpqred, end on his behalf to the lille company, governr, or[al oger:cy and lending institution listed hereon, and to the assi-r,ue:! oF the lendMg i'~titufion. Guarantees or certifications are not transferable to additional institutions or subsequent owners. SURVEY FOR LOUIS ~t RUTH STOKES AT MATT/TUCK TOWN OF $OUTHOLD SUFFOLK COUNTY, N. Y. SCALE: I"~ 40' OC TOSER I I, 1978 REFERENCE~ ~,IARANTEED TO ~ SECURITY TITLE ~ GUARANTY CO. LOUIS ~ NUT'H STOKES LA~ I~RVE¥OR N.Y& LIC, NO. ftlT~ I Ir¸ ri _i J APPROVED AS NOTED TIFY I~UJLDJNG DEPARTMEN¥ AT 765-2660 9AM to 4PM FOP, REQUIR. ED INSPECTIONS~ %,, ' I {I APPROVED AS NOTED TIFY BUILDING DEP~MENT AT 765-2660 9AM to 4PM FOR REQUIR. ED INSPECTIONS: 1. BEFORE BACKFILLING FOUNDA. TION OR START FRAMING 2. FRAMING INSPECTION 3. BEFORE COVERING PlPZ5 OF ANy KIND 4. FINAL WHEN JOB COMPLETED NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS 5. ALL CONSTRUCTION MUST MEET RBQU!REMENT5 OF N.Y, STATE CODE