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Home My WebLink About9644-zFO~ NO. 4 TOWN OF SOUTHOLD BU~ING DEPARTm~T Town Clerk's Of[ice Southold, N. Y. Certificate Of Occupancy No. Z9106. Date July 13 ................................. , 19.?.8. THIS CERTIFIES that the building located at ...~070. Sounc~ .lite. Ave.. Street Map No...5675 ..... Block No ........... Lot No, 5 conforms substantially to the Application for Building Permit heretofore filed in thi.~ office dated ....M.~..c.h... ~. ........ , 19..7.8. pursuant to which Building Permit No ...... 9..6.~Z dated ....M..a~.c.h....2.7. ......... , 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 PRIVATE ONE FAMILY Dt~LLING The certificate is issued to David & Mar~orie Phillips (owner, of the aforesaid building. Suffolk County Department of Health Approval ...... .8~..~.0..-.0.7. .... .J..u~.. y..~.2.,..~.9.7..8. UNDERWEITEES CERTIFICATE No. Pending HOUSE NUMBER 14070 Street So,nd Vim Ave ................ **************************************** Southold, Ne~ York .... Building Inspector BUiLDi ~ ; (THIS PERMIT MUST BE KEPT ON TH~,P~EMIS~ES UNTIL EULL COMPLETION OF THE WORK ^UTNORiZED) : Ne 9644 Z Dote ........................................................ , Permlssian is hereby granted to: ...... d:.....; ...... .C ................... ~ .............................. ~/..c ........ .0...~..!'..!. ~ ~. ...~. ....... ~..(..~.~- ~ ~-~ at premises located at........../~ {)........7/) ~O....U I'u.D.. . ..V[i~ .L4/ ,f.:\ (...r~ ................................... .......... ~: u. ~. ~..P. ~.-. ~r ~, .~£ , k o-~ 5' ~t ~'-rt~ Lu£D~ .~'..~Z ~ ::~ ~.(~ ~ ~h...]~z~.~..~.....~.~..Z~ ...... ~ ~; ~ ) 1~..., and approved by the pursuant to application dated ........................ '...~ ...... ~ ............ 2-....., Building Inspector. Fee $..(.~..Z ............... Building inspector FO~ NO. 6 TOWN OF SOUTHOLD Building Deportment Town Clerks Office Southold, Al. ¥. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector 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 installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board appravot 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 .~.~...~..~ 3. Copy of certificateL./~/of occupancy $1.00 Dote-.~. ..... /~.'~/.../. ~ New Building .................... Old or Pre-existir~ Building ..x...~.....~. ........ Vacant Lond ............................ Location Of Property ~ ~..~..'~.....~- ........ ~ ....... ~~ ........................ ii'i Subdivision~..~.....~...,..'....~....--.~.....~..~......Lot No...~..~..'~. Block No .......... :.. House ~ ......... pe rmit No. ~...~...~../~...~. Dote Of Permit .....'~...i.~...~../....Applicant ~...~..:.~~' ~ Health Dept. ^pprova 7 .......... Lo,or Dopt. ^pprovo' ................................................ Underwriters Approval ..~~ .................... Planning Board Approval ................ ;. ...................... Request For Temporary Certificate ........................................ Final Certificate ....~ ....................... Fee Submitted St~..,-~,..,~,,,~, ................... Construction on above described bu,lding a~%m~all applicable codes and regulations. Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or seal) FOB.-~ NO. I TOWN OF $OUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. ............. . Approved ............. Z~.~...~.......~;'.~.'.'. , .~.~.'~Permit No.........~.....~................................ Y ~ Z Application No .............................. ............... ~_..'~..~......~./..::../..~ ..................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Oate .......... ...................... 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 oJ 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 or used in whole or in part 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, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing cede, and regulations, and to admit authorized inspectors on premises and in, buildings for necessary inspections. 2~/' (Signature'~"~'i~i'i~i"~r '~'~]"i~:"~'[~';l~[;~ g~ .... .... ......................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contract6r, electrician, plumber or builder. ..................................... .................................................................................................... Name of owner of premises ..~..4.¢/.R..~..../.~.~...(.~..J...°..f~/.~i ...... /..~'..~..(~Z:./..../~...~. ......................................................................... If applicant is a corporate, sig_nature,~,,f, duly authorized officer. ...... . (.~,/ ~l~o~e and title of corpor~';;'"~ff[[~;f ......... Builder's License No ..................................................... ,:~'~ u~.,se ~..~.~,~..~.~.~.~..:, ....................... Other Trade's License No ............................................... Location of land on which proposed work will be done. Mop No.:JP...J.'.f...('..~.../~.4¢~ No.. Street and Number .................................................................................................................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .~,, .............................................................................................. b. Intended use and occupancy /.2.~.)~,~f~?...~?. .................................................................... 3. Nature of work (check which applicable): New Building, .....~............ Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other W~k ................................................ ..., (Description) 4. Estimated Cost ..~..,2, ..O.~!,?. .................................. Fee ................ ..~...~...~ .................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... Z ............... Number of dwelling units on each floor ............................ If garage, number of cars 6. If business, commercial or m~xed' occupancy, specify nature# and extent of each type of use ............. ? .............. 7. Dimensions of existing structures, if any: Front .....~ ........ Rear ...~ .............. Depth .~ .......... Height ...../'.Z../. .......... Number of Stories ......... / .................................................................................................... Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...~.~..~....~.Z ................. Rear ..~....~../....~.../!. ........ Depth ...~/..'.?..:. ........... Height .../..~... ........... Number of Stories ....... / ..................................... ::.:~ ................................................................. 9. Size of lot: Front ........... /.~..~...~../ ................................. P, ear ...Z.~...~.:...~...~... ................... Depth .~,..'~'..?...~. ................. 10. Date of Purchase ........................................................ 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 regroded ....~....~...'ff.¢ ............... Will excess fill be removed from premises: ( ) Yes X) No 14. Name of Owner of premises .~....¥:~.......~./ ............................. Address/~.6...~..~.?,~(2~.~..' . . Phone No ~.?.~" ~..~....~. Name of Architect ............................................................. Address ................................ Phone No ....................... Nome of Contractor ..... :...t.:.....:: ......................................... Address ...~...~..Z.~.~,/.(.~Z~..~.. ....... Phone PLOT DIAGRAM _ocote 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, end show street names and indicate whether interior or corner Io~. Sworn to before me this ...~!./..(S. ~.. ..... day of ....... Z.J.J/~./rC~/.. ................. , 19..?..'~.. Notary Public, . ................. .>,, ........ .~. ~'~z':7~./,~.., County -- ~/ ELIZABETH ANR NL~/ILLI~ NOTARY ?UBLIC, S~te of New ¥or No. 52-8125850, Suffolk Term Expires March 30, ~ ~' (Signature of Opl~licant)' ~'IAIE OF NEW/Y'IDRJ¢..~ ~L ~ CpUNT_Y OF ......... ., ~: .......... .~.....~..~.¢.,,~.~J~ ...... ~,~ ....... ..~-.4~..C/).~f~-//. ................... being duly sworn, deposes and says that he is the applicam (Nam~ of individual signing contract) above n~med. 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 this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work wilt be performed in the manner set foffh in the application filed therewith. .1~ NOTIFY BUILDING DEPARTMENT AT 1. BEFORE DACKFILLING FOUNDA- TION OR START FRAMING 5. ALE :CONSTRU~TION M~ST ~:EET !J