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Home My WebLink About9731-zFOB,M NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of OccuPency No..ZgJ.9.Q ...... Date ...August .... 2~ ............ , 19..78 THIS CERTIFIES that the building located at .... .7.8.q..S.u.~.$.o.n..P.1..ag.e' .... Street Map No...~0..~.~ ...... Block ~o ........... ~ot No .... .~.~ ............................ confoms substantially to the Application for Building Permit heretofore filed in this office dated ..... ~Ia.y.... ~2 ....... , 19.7~. pursuant to which Building Permit No..973J.Z,. dated ..... ~Ia¥ ....~.6 ........ , 19..7.8, 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 ....... P.~.ive.te. 0n~e .Family. D~elling ................................. The certificate is issued to ........ Eugen.e..F,. Lindsay ............................ (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval ..... 8. ? .S .0.-. ~ .7 ....................... UNDERWRITERS CERTIFICATE No. N398075 HOUSE NUMBER 780 Street Sutton. Place Greenport, N.Y. Building Inspector l~oP~I NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 9731 Z Permission is hereby granted to: at premises located at -~ (~' ~ C,? 'TI- D I~t -q'~l j~r ~ pursuant to application dated ........................................................ , 19. , and approved by the Building Inspector. I-I~ ~ Fee $,.,../.,: ............... Building Inspector FORM NO. S TOWN OF SOUTHOLD , Building Depn~tment Town Clerks Office Southold, N. Y, 11971 APPLiCATiON FOR CERTIFICATE OF OCCUPANCY Instructions A. This applicatio, must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: l. 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. S. 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 oil 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 New B~ilding ..... ~.~. Addition ..... , ........... Ofl~'~r~Pr¢-existing Buildin~;l,~ ............. Vacant Land .............. L ot,on Of Pr erty ..... ........................................ .............. Owner Or Owners Of Property ....;~....~......~.........~....,. ...... :.L)..~%~.S../~'~..~=... ..................... Subd,v,s,on ......... .'.~.,.?_~..! ...................................... ~ot ~o. -S- ¥ B,~k ~o ...... ,o~e ,o Permit No ................. ate Of Permit .................... Appllcont .................................................................. ,ea,th Dept. ^pprovo, .....~......~....~i.'Z.. ...... ~r ~,~. ^pprovo, ................................................ Underwriters Approval ............................................ Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described bulldir~d~it, meets ~appl~_~odes ~ulations. Apphcant "~ "~au,~ "¥.~: ..... Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or seal) TEL. TOWN OF SOUTHOLD I-IFFII3E I'lF BUILDING INSPECTnR TOWN ~LERK'5 rlFFII3E 50UTHDLD, N. Y. 11971 TOWN OF SOUTHOLD BUILDING DJ:PARTMENT TOWN CLERK'S OFFICE ~UTHOLD, N. Y. ..... ........... Disapproved a/c ............................... .................... ~r:r.e...~.~...~~ .................... (Buildin~ Inspoctor) APPLICATION FOR BUILDING PERMIT / Date ................ ..~./.~..~.~... ............... , 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 o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is port of this application. c. The work covered by this. qpplJcation may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue o 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 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 alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable lows, ordinances, building code, housing code, ar;~regulations and to admit authorized inspectors on premises and ir~ buildings for necessary inspections. / i ............................. ... ~(Sig~..o~ure~ of applicant, or niame'~Fif a corporation) ........... ....... " (Address of applicant) State whether op~t is owner, lessee, agent,~itect( engineer~ general contractor, electrician, plumber or builder. ........................... ~..e...~.c...r~...~.~ ............... .%- .~.-~., .*~:.~-~:.~ .~.~ ........................................................................ Nome of owner of premises ........... .....~..... r, ................. : .................. e.~..%..~:~.~. ................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... C~ ~ ' Location of land on which prol:~sed wCrk will be'~l~e., Map No.: ....... ~ ............ ( ......... Lot No. ff... Street and Number ............. ~.~..~..~ .......... ~.~.~=KX~ ...................... ~,.~.~.~.~.,~~'"' ...................... ~ Municip~li~ State existing use and occupancy of premiss and in~ended use q~d occupa~of proposed construction: ,e ............. ........ ...................................................... / .. ,......~ ~...~.~ .................... ~.~- ~...~r~ ........ .~ ................................................................ ~d 3. 'Nature' of work (check which applicable): New Building', ................. dition .................. Alteration ................. Repair .................. Removal .................. Demolitior, .................... Other Work .................................................... ,,m,f (Description)'"- 4. I:stJmoted Cost ......% .................................................... tee ......................................................................................... .¢... (to be paid on filing this application) ! 5. If dwelling, number of dwellin~ units .......... [ ................. Number of dwelling units on each floor 1 If garage, number of 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 .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ........................... Depth ................................ Height ............................ N~u ~mb~ of Stories ...... ~,......, ................ 8, Dimensions of entire new construction: Front ........... .~....?..,....~.. .......... Rear ..~...~.,~ ........... Depth ..~..~......(-~'. ............. Height .....~,...~.. ........ Number of Stories ......... [ ........................................................................................................... 9. Size of lot: Front ...... '/'/'"O'"'""'x'~¥//~/7(J' ................................ , Rear "~"*"' '/'"x~"'C"'~'b/~t~ ~,~Deptb ......~.~.~.~....cT~.~ ............ 10, Date of Purchase .........../.:.../4 .................................... ixlame of Former Owner .~..~.-..~.?~.:'..~.=...~:.....:o~ .~:.....~m~. .... 1 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... '..v~...,..,,~.,., ....................................... Will lot be rearaded v~ .~. Will excess fill be removed from premises; ( ) Yes ('~) No 13 ..... . ...... ~ ............. 14. Name ofOwnerofpremise~4~=....~..~ J~-~"~-~'~'r~... Address..~.v.~,,¢0~,~.-C~..m~..~.. Phone No ....................... Name of Contractor .....~...e...'~...~.ff:.~,,-~? ......................... Address..~.k.~.~..~,...~..~L~.... Phone 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 according to deed, and show street names and indicate whether interior or corner lot. , L/ STATE OF NEW YQRK ,, /'¢S ................... ?~..~!.~.~. .......... ..~.......~J~.~.Y. .................................. being duly sworn, deposes and soys that he is the applicon, (Name of individual signing contrac6 above named. ~ fi~ ( He ~s 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 fiK this application; that all statements contained in this application are true to the best of his knowledge and belief; al~c! thor the work will be performed in the manner set fo~h in the application filed therewith. ~ ..... ....... o{ ............. ........... , ~o~, ¢~,. ..................... ~.~/~. ...... co~ ......... ~.~:.....~..-.~--.>.~ .......... ~ ~gnarure or appl~canr~ ~H ~NN N~ILt~/ NO, 52-8125850, Suffolk County Term ~x~i~es ~arch ~0. 19~ o'j COPIES OF THIS SUR~Y ~AP NOT BEARING H. ~* REP, Ndl.: , ..... DENO~ Wlt~[. C~F~M TO ~E OF H~LTH,~RVi~ [ 1- 4 K~TCMEN APPROVEE~ AS, N_O/TED DATE, FEE= NOTIFY BUILDING DEPARTMENT AT 765-2660 9A~ fo 4P~ FOR REQUIR- ED INSPECTIOi4S: 1. BEFORE BACKFILLING FOU~DA-