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Home My WebLink About9708-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Sonthold, N. Y. Certificate Of Occupancy No...Z. 99~Q .... Date .... .~a.Y.....2.5. .............. , is..78.. ~80 Pv~. Rd. # ~ THIS CERTIFIES that the building located at ...RO$on~lz~.g .............. Street Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated . M..a~.0h ....28 ......... , 19. ?8. pursuant to which Building Permit No. ,970~Z. dated . Ma.Y. ...... ~ ........... , 1978.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ....PR!¥A.T.E. 0..NE...F.AI~..LY..D..1~..~.I,!N.G .WZT~..~. D.!T..ION. ................... The certificate is issued to Dorothy Abbott (owner, of the aforesaid building. Suffolk County Department of Health Approval ........... N./.R ...................... UNDERWRITERS CERTIFICATE No. HOUSE NUMBER . .~.e0 ......... Street ....P~.. :, .ad:...~..~.--.R.o.$.e.~.D. ,%~..g. ........... East Marion, N.Y. 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 CQMPLETION OF THE WORK AUTHORIZED) 9708 Z Permission is hereby granted to: ...... ..s...o. ~.e..?.~...~,.....~....t.~.z..z.. ................................ ...... .~/..~ ....... ~:~r.o~h,y...,,T,,,.,a~bo.t,,'l; .................. ~o ........... ,.a,¢,,.a.,,,o.~ .....~.....~.~ ....r.~....,.]~.. ~.~ .%;!...a. g ........................................................................... at premises located ot ........~...8g...~....~...j:..~..8`..~..~....R..~...a..d..~.....-.....~..~.~..e..~..~.1.~...g ......................................... ........................................... ~a~t,.Yi~£~w,...~Ie~..York .................................................................. pursuant to application dated .~'~J~lXtO]2.....~.~) ................................. , ]9..'~.8., ond approved by the Building inspector. Fee $ ....... .1..q .. QO ..... Building Inspector TOWN OF $OUTHOLD , Building Depn~tment 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: i. 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 dlsposol--(S-9 farm or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, o 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 inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: I. 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 · ' g ................ ' ' . .............. Old or Pre-existing, Building ................ Vacant Land .............. Owner Or Owners Of Property ........ p~...[C~.Z~.7. ....... ~.~.~/./~Z~../ ~ ................................................. Subdivision ...................... ..~.....-.~.'. ............................ Lot No...~.. ...... Block No ............. House No ............. Permit No.~..Z.~. Z. ,.......~..__. Date Of Permit Applicant ..~¢.:.~...,.....,...........~,_....~...... Health Dept. Approval ....... .~:..._.~.~ ......................... Labor Dept. Approval ........ ....[~ .................................. Underwriters Approval ...........'.._.]; ........................... Planning Bo~rd Approval .... ~ .......................... Request For Temporary Certificate ......... ~ .............................. Finc~l Certificate .......................................... Fee Submitted $ ....~..f.......~.. ................ Construction on above described building and ~;~qrnit ~neets oil opplicgble-~codes,~nd regulations. Applicant .............. ! ........................ Sworn to before me tiffs ................ day of ............................................ Notary Public .................................... County II ,. % TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved .]~[~1.3~. ....... 5 ..................... , 19...Z~ Permit No, ...C~.~.OE~Z ..................... Application No..,~.];0/~ .................... ~ Disapproved a/c ............... ~ ....... .i]2.L~ ........................................................... -,. , (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTP, UCTIONS 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 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 commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such ~r~'~it 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 a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment 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, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ................... ..................... ................. (Ad,Jess of appl'icant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises Dorothy I · Abbott If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ............Z...~... ............................... Plumber's License No ................................................. ~ .~r~ Electrician's License No ............................................. ~,_ . Other Trade's License No ............................................... 859 t ~-. Location of lag~or, t,w~hic~j~r,.~,o, se~w~or~l%wi~[.I,,b~e,i:lone. Mop No~.~...,~.,~.~.~u<w ........... .~ ..... L~o~la ........ ~t.v ............ '-3 Street and Number ..... ~.~'~......."/.'~.,~u.t~:~....,~.~.~....~....~ .~....ff.a.-,~.~.i%.b u~.~.~._ ............. ............ ............ ... '~ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: summe~ cottage o. ExJsitJng use and occupancy ................................................................................................................................ b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building'. ................. Addition ..XX .......... Alteration ................ R^~-:- Rem~va Demo t o' . ............... Other Work ...~,c~./e~'ed..~eck..; ........ .... '~ At. / (Description) · 0..: ~ t-e( ....... 4. Estimated Cost ................................................................................................. (to be pod on f ng ths app cat on) 5. If dwelling, number of dwelling units ..OP, e ........... 1'4 :rnber of dwelling units on each floor .....O,.D....e. ................. If garage, number of ca~s ............................................................................................................................ 6. If business, commercial or mixecl occupa~.cy, speciiy nnmre and extent of each type of use ............................ 7. Dimensions of existing structures, if any: F~ont ............................ Rear ................................ Depth .................... Height Number of Stories _..~D,~...~.t,O.~'~..f.l~i~l~...CJl2.t~g~t ..................................................... ........................ ,,.. 30 ft. ~ear 20 Dimensions of some structure with ollelations or jq , o,q mont ................................... r~ ............................ Depth 25 ftJ Height 10 ft. hluqq e' of Slories one 8. Dimensioos of entire new construction: Front' , ..,~-~..~.* ................ Rear ..,~...f~ ............ Depth ..~...:~* ........... Height ..... ~....&D,~,.,. Number of Stories ..~ ...................................................................................................... 75 ft. 52 ft. .. .. 335 ft. 9. Size of lot': Front ....................................................... ~ l ................................. uepm ................................ . ~970 ~dom¢' of Former Owner 14, McOal%rt ...... 10. Dare of Purchase ....................................................... ~' Marion ................................ 1 ]. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning Jaw, ordinance or regulation: ~O ................. 13. Will lot be regroded ~ Will excess fill be removed from premises: ( ) Yes (X) No No7.3.4-5498 14. Narne of Owner of premisesDO.~O.~...~.,...Ab]~.o.ttJ3,OX, ~l~ressC~t~lO~lti/ill"[~ ..... Phone ...................... Name of Architect .................................................Address ....... ~"'~i ................. Phone No ....................... Name of Contractor ...~/...~.~...'.~-.:.~~-.. Address ...d~-.',~ Phone No.'.7...~..C..~.....~..~....Z- PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description accordingi to deed, and show street names end indicate whether interior or corner lot STAT OF ':(drFKIA X Ls.s COUNTY OF ./~- '--/~-- p/, 5 f ~~-~ ...... ~.%rr~ ....... bom,j duly sworn, deposes and s~ys that he is the app[icanl (NQ~ ~n~vidua[ signing con~mcf) above named. ~ . ~ He is the ~~,~ ............................................................................................................................... ........................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file [his application; that all statements contained in this application are true to the best of his kaowledge and belief; and that' the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this m. , / ........... ....... co,,,,, .... ................. Natatory, ....~)~j"~'~-~'; .... ' ........ (Signature of applicant) .J b ll C, ,&