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Home My WebLink About9687-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. g..1 .~ .4.5. ~. .......... Date ...... .3.. a..n .u.a.r.k'' .2.6. .............. 19.8.3. THIS CERTIFIES that the building .a..d.d.&.t..ig.n ...................................... Location of Property 705 Marlene Lane Mattituck h/o ........................................................ Street Ham/et County Tax Map No. 1000 Section . .1.4.3. ....... Block . . .0.3. .......... Lot ...0.2~ ........... Subdivision .... .X. ......................... Filed Map No.. ~(. ..... Lot No....X .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..A.p.r.i.~. 1. 9 .......... 19 7 ~1. pursuant to which'Building Permit No...9.6 $ ?..5 ............ dated .... A. p.r.i.1.. 1..9 ............... 19..7.8, 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 ......... an addition to breezeway.. The certificate is issued to ......... . .M%..R.T.I.N. F, & ROSE CARTY " ' ................ . ...... of the aforesaid building. Suffolk County Department of Health Approval ... n,/.a ................................... UNDERWRITERS CERTIFICATE NO. N 419029 Building Inspector Rev. 1/81 TOWN O~ SO~THOLD BU~ I)~PARTMBirr 'ro~H CL.KItK'S ~ SOUTHOLD, H~. Y. ~UILDIN~ PERMIT (THIS PERMIT MUST BE KEPT ON THE P~E~ISES UNTIl FULl COMPLETION OF THE WORK AUTHORIZED) N°. 9687 Z Date ....... ~~. ....... ../....~.. ............ , ~9.~,,..~.. Permissio~ is hereby granted to: 7~.' ~/ ~ ~ * .~..~..~?....~.~ ...................... :...; ....... ....... ...................... Building Inspector. 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 subr~itted in duplicate to the Building Inspec- tor 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 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. B. 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, Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date.. New Building ............. Old or Pre-existing Building(Z). _..J~_,. - = fVacant Land ............ .... ..... Location of Property .......... Hou~ No, Street Hamlet Owner or Owners of Property .... ~ ~ .~. ~ ~ . ¢~Z' ~'~' ' ~/~ ........ County Tax Map No. 1000Section ../.~.~ ...... Block ..~ .......... Lot..~ ......... Subdivision . . . ~ .............. Filed Map No...; ....... Lot No .............. Health De~t. A~proval ........................ kabor ~ept. Approval ......................... Unde~riters Ap~rova~ ........................ ~lannin~ 8oard Aporov~l .............. ~equest for Tem~oraw Certificate ..................... Final Certificate ................. Fee Submitted $...~., ....... Construction on above described building and ~i[meets all ap~cabl~odes and regulations. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~r0 BUREAU OF ELECTRICITY -- 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~te January 2~, IqT~ Appl~catlonNo. onfile 9~99~! N~.,~ ~-~ THIS CE~IFIES THAT t~sexamlnedon January J~' |gTg ~' J and found to be in compliance ~ith the requirements of this Board. RXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS OUTLLrrS SWITCHES FLUO~SCENT 4 DRYERS FURNACE MOTORS FUTURE AFIKIANCE ~E~eRS TIME CLOCKS SERVICE DISCONNECT S E R V I C OTHER AFPARATUS: ~.S Contrs. ,~out'hoJd~, t/oY, ~ ~g?! LIc.578 Fp#r This certificate mu~ ~t be a~r~ in any mannerr return to the offi~ of t~ ~ard if in~rr~. Ins~ors ~ ~ identlf~ by t~ir COPY OF CERTIFICATE MUST NOT BE ALTERED I. N ANY~E~R~. _ _= ~ lrORM NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ..... proved ...... ,,.Z2 erm,t No ...... ...... Disopproved o,~ .......................... ~..~ ......................... / ..... APPLICATION FOR BUILDING PERMIT Date ...... ~'~..'..~.......<.~' ...... , ~9..~. INSTRUCTIONS 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 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 permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used Jn 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 o 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. (Signature of/d'pplicant, or name, if a .corporation) , ......... (Address of applicant) /" State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises ..... /..c'.~..6~ ........ ..~....O...~....~.... ./.~. ... ..................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Electrician's License No. ~ --~Z~ ~/~ Other Trade's License No ............................................... Location of land on wh ch proposed w~rk w be done ~/,op No Lot No Street and Number~..7.~...~......~..'~./.,~i?..~.~.._~.~...'~......~...~.....,~...~.. ................................................ .~..~.~...,/~...~.(Z./...O...~.~T~..~ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: I ntended use and occupancy ......-~..~ ...... .~/.....~.,.-:.cc.,.~..<~... ~?~.~ .................. b. 3. Nature ~)f work (check which applicable): New Building'. ................. Addition .................. Alteration .............. Repair .................. Removal .................. Demolitior ..................... Other Work .................................................... ~ ~ ~ (Description) If go~og~, numbe~ of corn ............................................................................................................................................. Dimensions structure Depth ................................ Height ............................ Number of Stories ...~.....~~ ........ 8. Dimensions of entire new construction: Front ~ ............ Rear ............................ Depth ........................ Height .................... Numbe~of ~s .................................................................................................................... 9. Size of lot: Front ...... ~.....~~ ....... Rear .......................................... Depth ................................ 10. Date of Purchase .............. ~/~.~ .......................... Name of Former Owner ...;~; ........................................... I ]. Zone or use district in which premises ere situated ..................................................................... ]2. Does proposed construction violate any zoning I~w, ordinance or regulQtion: ...~.'. ......................................... 13. Will lot be regreded . ........................... Will excess fill be removed from premises: ( ) Yes ( ) No iA. Name o~ Owner of premises .................................................... Address ................................ Phone No ....................... ~ome o~ ~rchitec~ .............................................................. Address ................................ Phone No ....................... h~om9 of ~ontrQctor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate cte~rly end distinctly ~ll buildings, whether existing or proposed, ~nd indicate ell set-~ck dimensions ~rom properly lines. Give street Qnd block number or ~escripf~on ~ccording to deed, end show street names end indicate whether interior o~ corner lot. STATE OF NEW rY~ORI~,, ~ }. I S S \ COUNTY OF ..~ ...... f ' be ng duly sworn, deposes and says that he is the applicant an,ng contract) 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 this application; that all statements contained in this applicction are true to the best of his knowledge and belief; and tk, a~ the work will be performed in the manner set forth in the application filed therewith. .S,.w.~.;~,.o~.b..;.f..o,r.; dmaeytho;S ..... ~..).£.i~,~/~f_ ............... ~....., 19.?.~.. ....... ~~.~?/~....~ ................................... of lerrn Expires March 30, 19~ FOlt~M NO. 1 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c .......................... ~..~ ...... ~ii~ ..... APPLICATION FOR BUILDING PERMIT Date ...... .......................... , ............ INSTRUCTIONS 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 or areas, and giving o detailed description of layout ofproperty must be drawn on the diagram which is port 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 port for any purpose whatever until (3 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 code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ¥" (Signature of~pplicant, or name, if a';~)';l~;~l;i;~i'""~" ......... (Address of applicant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..................................................... 7' ....................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Bu,,der's..c se No Plumbers License ~1oi .... Z ........... Electrician's License Other Trade's License No ............................................... Location of land on which._~_, ~ x,// ~- /_ ~-Pr°-p°sed vmrk will be done. /J~ap No.: ........................................ Lot Np...~.~ .......... Street and Number~../..~...~......./~....~../.z~...~ .~..,.~.~..-.~.../.4..../'x/-.~.. ................................................ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ..............-.~...~...........~/......~--~P~ ~- ~ ~¥ ........................... b. ntended use and occupancy .... ...... : .................. 3. Nature of work (check which applicable): New Building. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolitio~ .................... Other Work .................................................... ;:~/ -- ~ ~ (Description) ' 4. Estimated Cost ...................... /(/~..~,~.~..~..........::. Fee '""/'"'"i;~ ~;' l~;~"~'~"~'iii'~";~i;"~ii;~';;~i .................. 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars 6. If business, commercial or mixed occupancy, sp___e,~cify ~,re and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ..~...~.~,4~;jf ................................. Depth Height ........................ Number of Stories ...... O/~..',~ ........... / ~ .. D~mens.ons of same structure with alterations or additions: Front .~-,~;T..~~'~;~;"iiiiiiiiiiiiiiiiiiill ....... Depth ................................ Height ............................ Number of Stories ...(:~ .~....~........:/ ........ 8. Dimensions of entire new construction: Front ........ ~ .................. Rear ............................ Depth ........................ Height .................... Number of S~.~es ...................................................................................................................... 9. S ze of lot' Front --~...~-,~. .',~.~....~-"' Rear ' ....................... 7" ................................................. Depth ................................ 10. Date of Purchase .............. · '~'/~"--'7-' .......................... Name of Former Owner ..... ~ ..... :': ...................................... 1 1. Zone or use district in which premises are situated ............... .<.,~,~..r.?. .......................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ......~...~...'. ..................... 13. Will lot be regraded . ........................... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises .................................................... Address ................................ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... 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. STATE OF NEW ~DRI~, ~ ~ ~ S S \ COUNTY OF ..~ ...... f ' ................... ~ ....../~f~.vf~-~w~ .................. being duly sworn, deposes and says that he is the opplicam (Name of individual sj/gning contract) 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 this application; that all statements contained in this application (:re true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this · ..J..~...~/~ .......... day of .....~/.).£.~/~. .............. ¥...., 19..?..~.. Nota Pub,c,. .............................. County ........ ~A~~ ~-- '-'""- /ignature of applicant) NOTARY PUBLIC, State of New York Nq 52-8125850, Suffolk County ]'erm Expires ~a/ch 30, ]gQ'/_.2