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Home My WebLink About9659-zFOF,,M NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No...Z9066 .... Date ..... Jlule. .....~.5 ........... , lg..7.8. THIS CERTIFIES that the building located at . .6.~.5. B.r.a.y. Ay.e. ............ Street Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .. April .... 5 ........ , 19..78 pursuant to which Building Permit No...9..6.5.9.Z. dated .. April .... 5 .........., 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 .. ACCESS.0R~.. BUILDING ................. : ............................. The certificate is issued to ....... Joseph. k~.eak..Zimri.o~k:l, .. ~[.I.l .................. (owner, ~) of the aforesaid building. Suffolk County Department of Health Approval ...... ~.~.:. N/R ............ · ........... UNDERWRITERS CERTIFICATE No ................... N./R ....................... HOUSE NUMBER .... 65.5 ...... Street ........ .B.~.ay. %v..e ........................ ............ Laurel, N.Y. ... Building Inspector BUIL~IBIG pERMIT (THIS PERMIT MUST BE KEPT ON THE P~EM[SES UNTIL FULL COMPLETION OF THE WORK AUTI~ORIZED) 9659 Z Permission is hereby granted to: ...::&.C.L.~;/:! ......... ?..L'~..!.x.!~ ......... .Z.!.';?.. ^!.!'2.C 1 ot premises located at ............................................................................................................... I. /~ L'/' ,FL pursuant to application dated ' ,A?' 1~ '~- 19.~.~. and approved by the Building Inspector. *.:./..L ............. TOWN OF $OUTHOLD , Building Depuffment Town Clerks Office Southeld, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application ~nust 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 suwey of property with accurate location of oll buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposol--(S-g 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 approval of completed site plan requirements where applicable. B. For existing buildings (prior to April ]957), 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 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~ildin~ ....... Addition ................ Old or. Pre-existing Building ................ Vacant Land .............. oco,,o o, :/... .......................... Subdivision ................................................................ Lot No ........ ~.. Bilk NO.., .......,. House No...~.~.~ ............. Health Dept. Approwl ............ ~ ......................... Lobar ~t. Approval ................................................ Unde~riters Appr~l ............... ~ ....................... Planning B~rd Approval ...... ~ ........................... Request For Temporo~ Ce~ifica~e ........................................ Fin~ Certificate .........~ ............................ Fee Submitted $ .................................... Construction on above described building/elnd permi/~ me_~ all apj/licable codes and. reclulations, Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or seal) /~/, ~/~ o~' SU:{VEY FO~? JOSEPH F, ZZZ (5 E~ARBP, RA ZtMNOSKI AT M,~TTITUCK TO, wH OF SOUTHOLD ,?,)FFOLK CuLL~7 SCALE; I"=50' JUNE ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~UTHOLD, N. Y. Examined ................. (.~.?,.,;/.., ....... ~4., 19...4-.:. Application No. ::{.Z,../.,~./.. ........ ......~ Approved ................. '.d:.:.l ....... ~',..., 19'~.,~i%Permit No ...... ,~....f~....~.Q~..'~' D sa rove -- "~' ................................................ ;. ' pp da/c ...................... :vt:...m:'.77. ,.:l ~ ............................ :'; ("~6~i'1'~6~' ' i~;~[~'f~j ................................. ,~ 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 Buildin Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to echedule. b. Plot plan showing Iocation. 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 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 Bud ng Permit pursuant to the~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other appl cab e Laws, Ordnances 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. .... l(Signoture of ap ,cont, or name, ........ ........ ..................................... ....... J (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. I ........... .................................................................................................................................................................. Name of owner of premises . ~.C. .... ~..~. ...... /.../~. PY.O. ................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate office,,r)~/,0j~:~ Builder's License No...Q./JJ...':...~..~..j ................... ~..~/ .... Plumber's License No .................. -Q .............................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location,. of land on which proposed work will be done. Map No.: ...................... Lot No ......... r , , , .~. ~ . ' ............... Street, and Numbe ...PO.,~)(~..~......~. B.fF..).......~.~D..~Z~J.V.~ ....... J~.~,...J~j, ........ .~..J. ........ g. ok ........ ,~..~...~. .................. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: e. Exisiting use and occupancy ....~..b.~..c;:.'....~A).. ...... .~.¢......~ ...... ..Q,..¢./..~.?. ................................................. b. Intended use and occupancy /:) ~,~J~L~./~' ~b c~ZCZ~ (~o9.e property lines. Give street and block whether interior or corner IoL 3. Nature of work (check which applicable):,, New Building .................. Addition .................. J -- ,- ~'~Alterati° ....... i ([:/escription) (to be paid on filing this application) 5. If dwelling, number o¢ dwelling units ........................... Number of dwelling units on each floor ............................ If garage, number of curs ...... ! .......................................................................................................................... 6. If business, cornmercia~ ar t¢~ixed occupancy, spc. c.~'y noi'LJre and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Fro~,t ........................ Rear Dimensions of same structure ,witb alterations or ,Mditions: Front ..... ~.)...~: ..................... Rear ..... ).l...~'..'J:. .............. 8.Dimensions of entire new con~trucbon: Fronl . .............. , ............. Rear ............................ epth ........................ Height ................... Number !of Stories .......................................................................................................... 1 1. Zone or use district in which FCremises ore situuted .................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulolion: .... ..~-)...~....'~...Z~, ...................................... 13. Will lot be regraded . ........ '~3.O .............. Will excess fill be removed from premises: ( ) Yes (,) No Name of Architect . .............. ! ........................................ Address ................................ Phone No ....................... Nome of Contractor .............. L ................................... Address ................................ Phone No ....................... ~ PLO'f DIAI4RAM Locate clearly and distinctly oilI buildings, whether existing or proposed, and indicate all set-back dimensions from number or description occordin9 to deed, and show street names and indicate STATE OF NEW YOI~.K, / ¢ c COUNTY OF ......................... fl'''~ (Name of individual sig~ing cataract) above named. belnq d dy sworn, deposes and soys that he is the opplicam Fie is the ' I (Contractor, agent, corporc~te officer, etc.) of said owner or owners, and is dully authorized to perform or hove performed the said work and to make and file this application; that all stotementY contained in this applicetion are true to the best of his knowledge and belie~; and thor the work will be performed in tJ~e manner set forth in the application filed therewith. Sworn to before me this ........................ day of .................... ................................ , ................... Co.n , ....... .............................. Notary Public, [ (1 [ (Sigeo(~Qre bet bpp ica~t)