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Home My WebLink About12084-z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. :~.1.1.4.0~ .......... Date ..... D.~q~9.b?.~...?-9 ............... 19 ~.2. THIS CERTIFIES that the building. ~le ~R .......................................... Location of Property . .3.6. .0 .............. .8.o.u..~.h. ?.a..r.~.qv.. ;~97.d... $ou tho !d.. House No. Street ................ County Tax Map No. 1000 Section . 9.7.5. ....... Block ...0.3. .......... Lot.. p.0.?. ........... Subdivision...Z ............................ Filed Map No...~ ...... Lot No..~ ........... conforms substantially to the Application for Building Permit heretofore Fried in this ot~ce dated r 28 · , / Decmmbe 19 .8.2. pursuant to which Building Permit No. 1"20~4 g dated .... Pg.c.m.e.b..e?..~.9 ........... 198..~. , wa~ issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate h issued is ......... a deck addition to dwell/nh. The certificate is issued to Pauline C. & Walter N. Pharr, Jr. (owner, ~ ~,~.~)- of the aforesaid building. Suffolk County Department of Health Approval n / a UNDERWRITERS CERTIFICATE NO., n/a Building Inspector Rev. 1/81 BUILDING DEPARTMENT TOWN HALL ~ $OUTHOLD~ N. Y.: BUILDING pERMIT (THIS PERMIT MUST BE KEPT ON THE PRE/~ISES UNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) ! $°. :12084 Z DO,e ..~..~:~-_...~......~.. .............. , Pe~ission is hereby granted to: .... ~~..,.~..~~~ .... ~.~~~~--~ ..... ~...~......... ................. ..; ........ ~~ ......... ~:..?...:~ ................ ~ ......................................... at ~r~ml~* I~t~ ~t .................. ~..~. ~ ........ Building Iinspector. Fe, $.Z~..~.~ .... pursuant to application dated .... .~... .................., 19.~.~-.and approved by the :,- - ----- -Bulldlr i~lnspectcir 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 submitted in duplicate to the Building Inspem tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of aH bui~dings, 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. Commemial 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 pertigent 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 3. Copy of certificate of occupancy $1.00 $5.00 Date December 28, 1982 New Building × Old or Pre-existing Building Vacant Land (deck) Location of Property 360 South Harbor Road Southold House No. Street Ham/et Owner or Owners of Property Walter Iq. ?harr, Jr; and Pauline C. ?ha. rr County Tax Map No. 1000 Section . 075.00 Block 03o00 Lot 007.000 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.[.~'.. ~,/?/.~, Date of Permit[V~. ~.~.~;-J~pplicant .~,. ~.. ,~,r...~.~ Health Dept. Approval . ~'-- '" .Labor Dept. Approval ........................ Underwriters Approval . .'---'-~ .Planning Board Approval Request for Temporary Certificate ..................... Final Certificate .... X Fee Submitted $ 5.00 N, ~"Z~I~'50" EL. ,,~, ~0°~.5'00" W, 210.88 BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved o/c ............................................................................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .................. .d.'.~...,~.... ,2, ...~... .......... 19..........,. INSTRUCTIONS o. This application must be completely filled in by typewriter ox in ink and submitted in tripllcate to the Buiiding 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 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 laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, 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 .................................................................................................................................................... If applicant ,/;/a corporate, signature of duly authorized officer. ~CC~J~?~Y ~R (Name and title of co~orate officer) [,~ ; Builder's Lic~se No ........... ~ .......... ~ ................... -~ Plumber's License No .......... ~.~, .......... ~ ......... ' ~ ~ Electrician's License No ......... ~ ............................. ~I~~ ~]~~"~ ~ Other Trade's License No .............~. ........................... ~ r~ ~~~(~ ~ 1. Location of land on which proposed work will be done. Map N .: ............... ~ ........................ Lot No ......................... Street and Numar ..~.~...~...~.~..~.'......~.~.~..,~..~'....~..~.',~,~ ................................................ Municipali~ 2. State existing use ~nd occupancy of premises and intended use and occupancy of proposed construction: ........ ........................................... b. ........ ................... 3. Nature of work (check which applicable): New Building.. ................. Addition'~..~....(....~x... Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ..................................................... '~'~'0 .~.. ~;~ (Description) 4. Estimated Cost . Fee (to be paid on filing this application) 5. Jf ~we~Jing, number of dwelling units ...... ~ ............. Number of dwelling units on each floor ...~ ................. If garage~ number of ~rs ......... ~ ........................................................................................................................... / i~ / .... ~ / ~2 /o ".~.~.(.~."~' 7. D~mens~ons of ex sting structures, if any Front ................... .~ ...... Rear ................................ t Height ........................ Number of Stories .......... ~ ..................................................................................................... ~io~s~;r~y~~ o'torot,o,~ or odd~n~ ~r~;t$[~.[~.~.~.~.~.J~. ......... "8or ..~.~~ ........... .............. .......... ........ .......... .......... Hoi~ht ...~ ....... ~umbor o{~ Storio~ ........ ~.& .................................................................................................. ~. s~, o, ~o~: ~o~ .............. ~..~:~5~..~. ...................... ~ ............. ~.~ ................... ~op~, ....~C .................. ]0. Oote o{ Purch~so ......... .~2.~..2.~ ........................ ~mo o* Formor ~ner ]1. Zono or uso distri*t in which promisos ore situotod 12. Does proposed construction viol~to ony zonin~ I~w~ ordinonco or regulation: ......... ~ ....................................... 13. Will lot be roflraded ........... ~ .......... ~1 excess fill bo~om~d from pr~mi~es: { ) Yes ~ome of Architoct ...................... ~ ............................. Addrom ................................ ~hon, ~o ....................... Nome of Contractor W/~ ............................................................ A~ress ................................ Phone No ....................... PLOT DIAG~M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from prope~y lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. APPROVED AS DATE: _ B,P. ':~ FEE: __ BY: NO'lZlFY BUILDING D~PARTMENT 765-1802 9 AM TO 4 PM FOR FOLLOWING INSPECTIONS: '~. FOUNDATION - TWO R!TQU FOR POURED CONCRETE 2. ROUGH - FRAMING & Pt 3. INSULATION 4. FINAL - CON$"FRUC:, !ON BE COMPLETE FOR C ALL CONSTRUCTION S',IALL THE REQUIREMENTS OF THF STATE CONSTRUCTION & CODES. NOT RES?ONS!P! DESIGN OR CONSTRUCTION STATE OF NEW YORK_ COUNT,~ OF ........ ~,~...-C. EJ~.,q ~..... r''''~ ............................................ ~ ........................................ being duly sworn, deposes an~ says that he is the opplicam (Name of individual signing contract) above named. ~He is the ~...~)...~...~...~. . (Contractor, agent, corporate officer, etc.) 05 cc!~ cvm=r o, ,~w~n,% and is duty 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 will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........ ..~..~ .....day of .......~..~....~.~.~.~,,~m.. ..........., 19...~....~'. ~ /; - /,'~/'~/ Notary Pub c, ..~...~..~.r~/..-~..'C¢~.. County ... (Signature of applicant) Suffolk C~.[~ N."/7 6 ,,~0 L MAP OF PAIJt_INE C. ,~UTNOLD TOWN OF