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Home My WebLink About12039-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Zl1481 Date February 16 ,1953 THIS CERTIFIES that the building .. a..d .d.J_.~ ~. 9.n ..................................... Location of Property 700 Summer Lane Southold House .......................................................... No. Street 121~/~[el County Tax Map No. I000 Section .... 0.7.~} ..... Block ...09 ........... Lot ...0.1.9. ........... Subdivision....B.~.y.s, $.d.e..T..e,p?.a.c.? .......... Filed Map No. 2,,0.3.4 .... Lot No..2.0. .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ~. 9.v.e.m.b.e.r..9. ...... 198.2.. pursuant to which Building Permit No .... 1.2..0.3.9..Z. .......... dated .... N.o.y.e.m.b.e. ?..2.9. ........... 19.8..2, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for wttich this certificate is issued is ......... ,..a.. p 9.r.c.h...e.~.q 3:. 9.s.u.r.e...a.d.d..~ ~;.~.o.n...g9..e.x..J_.s.~ ~..n.g..d?.? .~.1.~ n..g.. .................... GERALD TUTHILL The certificate is issued to . .. ................... [o'~n'e'r,'~e:~"t~,~r/'O ...................... of the aforesaid building. Suffolk County Department of Health Approval ...... n/.a ................................. UNDERWRITERS CERTIFICATE NO .............. n/. a ................................. Building Inspector Rev. 1/81 TOWN :HALL SOUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON ~HE PRE~ISI COMPLETION OF THE WORK AUTHORIZED) N.° 12039 ~..~ ..... ./..~..~.:....~~...,,?~:.: ............. .. :...~.~...~~...~;~s:.:.~5¢~. ~¢~ z ,.....z.... ... ..... . .......................... : ...... ~..~/~o/~r~ /~/- co~ ,o~ u~p uo. ~00o s,~o¢ ..... ~:...~.~. ....... ~ .,~.... ....... ~ ~o. ~:.5~d~ ........ ant ~ i ~ '/ ' ~ ~ pu~u to a~l cation dat~ .................... ~ ...................... ..,. ~...., I~...,.~., and appmv~ by the Building Inspector. .............. ~..~:.....~, . . ~ .................. R~. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall S IdNY 1 .... APPLICATION FOR CERTiFiCATE OF OCCUPANCY A. This application must be filled in typewriter OR ink, and subr~itted n duplicate to the Building Inspec- tor with the following; for new buiMings or new use: 1. Final survey of property with accurate location of ali buildings, property lines, streets, and unusua~ natural or topograohic 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 building~ 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 bulidings 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. '/ C. Fees: 1. 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 Date .. / ' _ New B'uiMi~g-..(-,)...¢~ ..... Old or Pre-existing Building(:~) ,. ..... =/Vacant Land ............. Location of Property . 7...O.q ............ ~ .c/...,~..A?..~'. ~y~ ..... (.4tZ.."~..~-....' . .~.?.'%' .~_.~.O L..~.. Hous~ No. Street Ham/et Owaer or Owners of Property ............. ~ .~., t~O~Subdvs°n~ ~~'/~ '~, ....... ~ ..... FiledMap'No.~'~. ..... ~ LotNo .............. Health Dept Approval ~ Dep~ Approval ......................... Labor ...................... ..~.. Unde~riters Approval ........ ~ ............... Planning Board Approval Request for Temporary Certificate ..................... Final Certificate .... ~ ........ Fee Submitted ......................... Rev, 10-10-78 Construction on above described building and perr~irmeets all apP~cable~codes and regulations. ................... . ..... FIEkD' IN~?ECTION COMMENTS .~- ;. . FOUNDATION (]st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined/~,~ .~f...~.~. .... , 1 .9~. Approved .~O....~...7. ., 19~enuit No.../.~. O..-~..~2~ Disapproved a/c ................................... ..j APPLICATION FOR BUILDING PERMIT Application No./. · .~. · · .~. · ....... INSTRUCTIONS a. This application must be completely rifled in by typewriter or in ink and submitted 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 ~iving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of th!~ application, the Building Inspector will issued 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 Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Re~ulatiom, for the construction of bulidinEs, 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 edmit authorized inspectors on premises and in building for necessary inspec 'OHS. (Signature of applicant, or name, if a corporation) .:.4.T. . (M~iling address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. I /~ ~/ p Plumber's License No. ~ Electrician's License No ....................... Other Trade's License No ~ 1. Location of land on which proposed work will be done. ~'oc~ F'~o C ~) House Number Street Hamlet County Tax Map No. 1000 Section ...C?..~...~. ........ Block ..... .~. ........... Lot .... {..~. ........... Subdivision. ~.~.¥ .g/.~.~...../.'Q.C'?..,~..~-.C..~ ........... Filed Map No..~..O..~..c./. ..... Lot 2, ~ (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... I .... ..... ................................... b. intended use and occupancy .... po.& .C..~. .... ?...,75.{o.~..o?..~.., .... ) .............................. 3. Nature of work (check which a~plicable): New Building .......... Addition ~ Alteration Repair .............. Removal .............. Demolition ............ Other Work ............... ' (Description) 4. Estimated Cost... J~. ! ~-DO...'--' [~" ~ f i (to be paid on ~ing this application) 5. II' dwe!ling, number of dwelling hnits ............... Number of dwelling units on each floor ................ 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 ...................... Number of Stories ...................... 8.HelDimensi°nsht I°fo ~ntire new construction:Nu ' Front ...(7. ~ .~. ? ...... Rear .15~'./. .&f'. ....... Depth ............... 'g ............... mber of Stories ........................................................ 9. Size of lot: Front ........... i ........... Rear ...................... Depth ...................... 10. Date of Purchase ........... i .................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction viol'ate any zoning law, ordinance or regulation: .... ~ ....................... 13. Will lot be regraded .... ................... Will excess fill be removed from premises: Yes N(~ 14. Name of Owner of premises .~..~/~A'.t p.. F.c~. OJ .~ .~... Address . .¢?:'g. ~¢.&..d&..,y.~... Phone No ................ Name of Architect .......... : ................. Address ................... Phone No ................ Name of Contractor .t~ I .'~.../~?.~.' .~.4~kff.~./4 ~' ...... Address ( .o p.o.(e~4;.~ P~l ...... Phone No..~/. 7. .7..% .~. ~.&..$~ .-' PLOT DIAGRAM Locate clearly and distinctly alll 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 NF~Y ~R,I~, ,( $ S (Name of ~nd~wdual mgnmg contract) above named. : i ~,,~Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authon~ 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 will be performed in the manner set forth in the application filed therewith. Sworn to before me this ~/ t~O1~RRy pUbLIC, State of New York ' ' ~ ...... N~, 52,8125850, Suffolk County, / (Signature of applicant) r~rm ~plres March 30, 19~ ALL_ WoR~ S T'AT 'Fo M E ~ '/ dOD 5~ 20o ~ iOI _[ A~'~,~rL d;ol. rS' I:OLLOW,/iNC- iNSPEC'1qON$ 1, FOUN?'~ION ' TWO REQU RED FO~ pouRED coNCR~'i'F* 2. ROUGH - FRAMING fl` pLUMBING 3. iNSULATION MuST .4. FINAL - CoN~T?UCTION BE CoMpLETE FOR C O, ALL cONqTRUCTION sHALL MEBT THE REQUIREMENTS OF THE N,Y, STATE cONSTRUCTION fl' ENERGY NOT RESPONSIBLE FOR (]ODES, __.,o.-ouCTION ERRORS, DEStGt't OR Uul'~ ~ "- POR C g, P-,,~ ~L O£ P-, s, ~ou r~ocD