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Home My WebLink About10079-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk'S Office Southold, N.Y. Certificate Of Occup ,ncy Z10202 No .................. October 15 80 Date ................................. 19 ... THIS CERTIFIES that the building ................................................ 68950 Main Road Greenport, N.Y. Location of Property $~rsst 53 2 County Tax Map No. 1000 Section ............ Bloelc ............... Lot ................. Subdivision ............................... Filed Map No .... Lot No .............. conforms substantially to the Application for Building Permit heretofore Fried in this office dated 9~ 1 0079Z December 18 1 8 pursuant to which Building Permit No. December 19 78 dated ............................ 19..., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... Private One Family Dwelling with Addition I. and G. Oostas The certificate is issued to (owner, leG~or~nt) of the aforesaid building. I /R Suffolk County Department of Health Approval .......................................... N469899 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector 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) ~o. ~oov~ z Dote.~~.....~..~.. ...... , ,~.Z~ ~ermlss e Y g : ~' /' G/ ~t . ...... ........ ................... ........ , ..X ................ ~: ........ ............ , ,o....~~....~.......~.~~..~..:~.., ...... ~.~'~].'"'~ ~~~ .... ~~}~~ ............ . .................. pursuant to ~pplic~tion d~ted . ~ .,~ ..... , Building Inspector. Fee ............ 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 natura~ or topographic features. 2. Final approval o1~ 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. Cert[ficate of occupancy 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 .... ............. New Building ...; ~, ....... Old or Pre-existing Building . .~..~..~: .... Vacant Land ..... ~.. Location of Property..~.L~ .?.,..~....~/./?..'~"'~...".~,~./~.f?../'.. ........ ~--------~%~'f:/'. '.~.~.~.~..~-~. ..... Owner or Owners of Property/-~., , , ,~-~.. ~ ~,~'~ . .,~. ' County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit N0./~,~.~).'2.?. Date of Permit .(~v.//~/~.~.Applicant ,~.~.~,,...~.~.~?..~-.~..-;~. ............. Health Dept. Approval ...' ..................... Labor Dept. Approval ........................ Underwriters Approval.//~..~ ~..~.~[~ ,~. ........ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted Rev. 10-10-78 2/0 , ~!: Mr George/~. Bauer Main Roa~Y, Pecon~ New York TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 August 1, 1980 Dear Mr. Bauer : This is to advise you that the job under Building Permit No. 10079 Z issued to T ~ ~ ~ on December 19~'78 for Additions appears to be completed as of our last inspection. Before yOU can legally use or occupy this structure a Certificate of Occupancy must be issued. Please fill out the enclosed form and return same to the above office. There is a fee of $5.00 £or a Certificate of Occupancy Thank you for your prompt attention. Very truly yours, GEORGE H. FISHER Sr. Building Inspector encl. Disapproved a/c .......................... /~.... ................... ~,~'. ................ ~.....,~'.] ........ ............................................... ............................. ........... i~ (Bu~din i~. Inspector) ^pp,,cat,o. ........... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date ............................ : ................... , 10 ............ a. :This application must be completely filled in by typewriter or 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 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 for inspection throughout the work. e. No building shall be occupied ar used in whole or Jn port' for any purpose whatever until a 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 oDerofions, ar for removal or demolition, as herei.n described. The applicant agrees, to comply with all applicable laws, ordinances, buildi. Dg code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary.~0~sjpecJiions./i f/f/ /, /.'/y ~ r-r/. ./->~x-~-- . .... i'X~ss ii ~'o~l~;;;ii ............................ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....... ~ .............. .,.~ .......................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) .o. ................ o Plumber's License No .... Electrician's License hal i~4~"~iiiiiiiiiiiiiiiiiiiiiii --' ~ . Other T ode s Lice No ................ : ................ ' ............ ~S~, a~- /~O 0 _ 1. Location o~ land on which proposed work will ~e done. Mcp No.:.,..~.~......~..~....~.r. ~Ot No....~ ............... Stre~ and Number ~..~.~....~ ........ ~.~.~.~-~.~-.~..~.~.~. ............. ~:.~ ..................] ............... / ~unicipali~ 2. ~tate existing use and ~cupancy of premises and in~en~ed use and occupancy of propped const~ction: a. Exisiting use a~ ~cupancy ...... -- ~~1.~.~.~...: ...... ~.~.~ ...................................................... b. Intended u~o ond ~cup~ncy ................ 3. NabJre oi'work (check which applicable): New Building .................. Addition ...~)~.'~ ......Alteration ..,,~'~-K, ..... Repair .................. Removal ..................Demolition .................... Other ~/ork ...................................................... (Description) 4. I~.stimated Cost ........................ · Fee/~,.../-,'~' (po be paid on Filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ..... , ...................... If garage, numberof 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 .,~ ......./.,~. ............ Depth ,c~/../.~...~.'... Height ........................ Number of Stories ..... c~- ..................................... ' ................................................................ Dimensions of same structure with alterations or addJtions: Front ..... 4~.;~,! ...................... Rear .~'~).....I. 2. ........... Depth ...~.~./...~-.-~ .......... Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ......... 4-/~.~-..~..,..'~.. .......... Rear ............................ Depth ...,/~../. ............. Height ...: ................ Number of Stories ........ .~. .......................................................................................................... 9, Size of lot: Front .......... ~/.~. ...................................... Rear ........ ~.~r. ........................... Depth .../,..3~)~..,..,~..4~) ....... 10. Date of Purchase ........................................................ Name of Former Owner ................... t .................................... 11. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction ¥iolate any zoning law, ordinance or regulation: ...... .4~..~. .......................................... Wilt lot be regraded ............I~.E.?,..~ ..... Will excess~fill be removed fr,om.p,icecgisfis:,( ) Y~%., (~ No 14.13' Name of Owner of premises "'~'~'~ (~O~J~.,H~r'~' . Acldress.~,..~..!..~..!.~....~.....~..(...~./.~l~honeNo- .~.~../.~..~..¢ Name of Architect ........................ ~-%T .................................... Address ................................ Phone No ....................... Name af Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-b~ck dimensions from properly/ lines. Give street and block number or descriptio,,~ according to deed, and show street names and indicate whether interior or corner lot. ~;~/~j~ ~ ///" ,, - °" -et " cou ' tOF /'e t, ....... ~.-.~.-..~_-~-~ .................. '. ............. u" beinfi duly sworn~ deposes and says that he is the apphcon[ (No/fie of individual signing cant?oct) above named./ He is the ......... r: ....... i~2 ............................................................................... i; .................................. (Contras'tar, agerft, corporate officer, etc.) of saR'! owner or owners, and is duly authorized~,to oerform,,Or have performed the said work and ~'oe make and f'il~ this application; that all statements contained in t~is application are true to the best of: h,is knowledg and belief; ant that the work will be perforrr~d in the manner set forth in the/applicatl/an filed therewith. Sworn ta b~f,o~e .me this ~ ]/ / ~ --',/ /,, SOtA~'~(~TPU~ ~ t ~*c, S,~* o{ No[ VO~]~ '"'k~'~'"~" ~ -- -- ~' '~ /' (~'(S~gn°tu re Of appllcant)' 't / APPI OViD AS NO.TED~_ _ DATE: ......... T AT OH ..... FO~ DESIGN NOT RE o ~'~ OR COl SL~