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Home My WebLink About12778-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,, N,Y. Certificate Of Occupancy No... 7~ .1 ~3.0. l 9 ........ Date ...i~ o. ¥ 9,m.b.e. ¥..2.6. ................ ,19 ~.~. THIS CERTIFIES that the building .A.d..d .i.q~ q .n..t.q..d .w.e.Z. 3...5_ .n.~. a..n .d.. a. 3_..~ ?y. a..g .i.o.u. ..... Location of Property . .F.i,s.h. ?.s..~..s.5.a.n.d., p.e?. :..C.o.p. ~:, ?.a.s..~..E.n.d.: ..... .F.~.s.h. ?.s..~..s f.a. nd House No. Street Hamlet County Tax Map No. 1000 Section .. 5 .Block 2 ..... Lot 2 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Nov. 2 127.78Z ...................... 1983 pursuant to which Building Permit No. dated P ?,c.....2 ..................... 198. 3.., 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 ......... Addition to existi, ng .d.w.e..1.1.i.n.g and alteration to existing bath. The certificate is issued to EDWARD M. CRANE JR. AND JEAN D. CRANE (owner, ~eZ,~q~ Xo2q~Izq.~ X of the aforesaid building. N/A Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO ................... P.e. n..d.~.n.E ....................... Rev. 1/81 Building Inspector IrORM NO. I~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING FEIU~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1~8 Z Date ....................................................... , 19 ....... Permission is hereby granted to: ....¥...,.....:......~~....~.~. ....... ~ a,,/~a¢/~ ~ ;~ at prem,ses I~ated at .............. ~....{ ....... .~.....~Z.~..~ ....... ~ ................................... .......................................................... L....:~.....~.: ..................................... County Tex Mop No. 1000 Section .......... ~ ........ Block ....... ,~,, .......... Lot No ...... & .............. pursuant to application dated ...................................... , 19. and approved by the Building Inspector. O0 Fee $ ........................ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,~JouthoM, 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 Inspec- tor with the following; for new buitdings 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 installa- tions, a certificate of Code compliance from the Archite~t 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), No.g-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/ land use 3. Copy of certificate of occupancy $1.00 --Fre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date Nov 3,1984 New Building.,.....new Add....... Old or Pre-existing Building ... ........ . Vacant Land ............. Location of Property . ~.'.. ~gP~, ~ .~:)~. ~. ~..~U~U. ~..~, ~,..Qd390 Hou~ No. Street Hamer Owner or Owners of Property ~w~r~.. . .,~'.............Cran° Gr,...~Bd...................,...Gem'a D, Crane ............ County Tax Map No 1000 Section 5 Block . .'.~ Lot .~ · · Subdiws'on Filed Map No Lot No Permit No.1 Date of Permit .Applicant ............................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Tempora~ Certificate Final Certificate ye.s .......... Fee Submitted $ ,5.00 building an rmit ee all ap 'c le codesand regulations Applicant ................................. S.~ggq'~grZ ........ Rev. 10-I0.78 TOWN OF $OUTNOLD , Building Department Town Clerks Office So#thold, 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 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 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: l. Accurate su~rvey,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 certificate of occupancy $1.00 New B~ilding ................ Addition ......./........ Old or Pre-existing Building ................ Vacant Land .............. Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No ..................... Dote Of Permit .................... ^ppficant .................................... Health Dept. Approval ............................................ Labor D~t. Approval ................................................ Underwriters Approval .............................................. Planning Bo~rd Approval ........................................ Request For Temporo~ Certificate ........................................ Fin~ Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permit meets all applicable codes and regulations. Applicant .~.~.,.~./.~..~.~. ~. ~...~ .V~...~..~-~.~. t~__~.: ........... Sworn to before me this ..,~.,d~.~.. day of .o..~.~..../.~..~..?. ..... (stamp or seal) ~/~,~ , FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ PLEASE TAKE NOTICE that your application dated ......................... for pe~it to const~ct ~ ~j3 / ~'7 / o ~ ~ .~]'(9.. ~... {3~/~. k/. ~ {~ ~": ............... at Locatlo~ oI r~op~ty ,q, .......... ~ .......... ~ ...... ,_ .............. County Tax Map No. 1000 Section ........... '-)... Block ... ~- Lot Subdivision ........ ~". ..... Filed Map No ................. Lot No ...... ;~ ...... is retumea herewith aha aisapprovea on the follow~g grounas t a/.~ ~ ~'/.~'.~. ~( ~ ....... /'./ ~ ~.~ (F/F/co ~ 'o, Building Inspector -P,./ , ,,,- - October 20, 1981 Z & S ContractEng Inc. Box 202 Fishers Islandl, New York 06390 Re: Building Fermit Application Dear Ronald: for E~ward M. & Jean D. Crane I have had to disapprove your application since you not have 26 feet 3" for the total of the two side yards. I have enCloSed the addrese of the adJoinin~ property owners to who you or someone will need to send the "notice" tO. The instrUctimns and forms are enclosed. GHF:J~ EnclOsure Yours very truly, GEORGE H. .FisHE~ SR. BUILDING ~INS?ECTOR will FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-18013 .......... Approved ........... ./~..~..., 19 .~.. Permit No..( ~ ~~ Disapproved a/c . .~ ................. ...... ~. ~.¥: ~ ~ (Building Inspector) APPLICATION FOR BUILDING PER~IT Application No. t/'~ ~'? ~ INSTRUCTIONS a. This application must be completely filled 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 giving 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 this 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 Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as heroin 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 building for necessary inspections..o ~ .... ............ (Sig. l~tture of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises...~-d~.. ,~....~'~--.~.4'~'~'. .'/... ~.. ~' .... ~-e~z~,.-.d. ........... (as on the tax roll or latest deed If applicant is a corporation, signature of duly authorized officer. ((Nanf~'an~ title of corporate officer) Builder's License No.. ~.../: .~.~.~! .............. Plumber's License No. ~.....~.3~..'..~.. ......... Electrician's License No. ~..~.~?~. :'.~.~. ......... Other Trade's License No ...................... 1. Location of land on which proposed work will be done...~~.. '~..~~ ~ .... ...... .... ................................................ House Number Street Hamlet County Tax Map No. 1000 Section .............. Block ~ Lot... Subdivision ..................................... Filed Map No ............... Lot ...... :..-:'. ..... (Name) ~fa~ilt~sgeUS~j~c~lCpCaUnPc~SC~ c~em]' .~~ded u~ccup~/~s, yf..i~,,ii~ti~: ....... b. Intended u~e and occupancy....~.~.-'.~ .... ~ ..... . .~..~'. ..... .. i*.'..i.' ...... iiiii 3. Nature of work (check whi~ apt~fflcable): New Building .......... Addition ........ Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) (to be paid on filing this application) 5. If,dwelling, number of dwelling units ..... ]. ........ Number of dwelling units on each floor .............. arage, 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. Dimensions of entire new constrUction· Front /. M- . Rear / ~ r~,th / ~ e of lot. Front ...................... Rear ......... Depth ...................... 10. !)ate of Purchase ............................ ,~-~Nameof Fo~mer Owner ............................. 11. Zone or use district in which premises are situated .~.~:~5. ff/~'~. ~Z. ..................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .. ~.~. ......................... 13. Will lot be regraded ....... .~...t2 ........,~ ........ Will exces~,fill be rgmoved, from premises: Yes Not/ 14. Name of Owner of premises ~.~F_~,,~Z...~.. Address . ~. ~ .~,~..~. Phone No.~./g .2ff~... ~.2'~. Name of Architect ....................... Address .................. Phone No ................ Name of Contractor .~....~. ~.. ~'~i ....... Address ~..~-~-~,~.*~ Phone No.~'~,~d~.~...~,f. ?.. 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 Y,ORK, ._ S S COUNTY OF... ¢~.{.~ . ' ~, ~ ,,,~'" 'f' 'r~lam~c'o~"~"~'~) being duly sworn, deposes and says that he is the applic~t above named. He is the ...................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or ownem, ~d is duly authorized to perfom or have perfomed the said work and to m~e and file this application; that ~1 statements contained ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~ner s~t forth in the application filed therewith. Sworn to before me this ~ C~ day of. ................ , 19f~ ......................... c . Nota, Public, ~~) County H~ARY PUBLIC, STALE Of NEW YORK t) ~o, 52~795o - SUFFO~ ~UNIY ~A~MMISSION EXPlR[:~ MARCH 30, 19~q FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......................................... 19 ........ Approved ........................... ~ .......... , 19 ........ Permit No ..................................... · ~ j ' ~ . ......... Disapproved a/c ...~.~/'?~.~.?..?~./:~.~.~q:.~/~_.,~ ...... ~,C~.,~- /~.~,,~..-. Application No ................................. (Building Inspector) APPLICATION FOR BUILDING PERMIT J .......................... ........ Date / 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 o~ 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, os herein described. The applicant agrees to comply with ali 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 r~ e, ' a c po 'o ) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..~~....~.:.....d'.....~.~...--~..:-...~.',~.~ ................................................... If applicant is a corporate, signature of duly authorized officer. " (NaYne an~' title of corporate officer) Builder's License No .... !..~..~.?. ......................................... Plumber's License No..;~.~....~.,~;~.cj...~ ................... Electrician's License No..~.......t .................................. Other Trode's License No. Street and Number C~.'.....~...~~ .......... ~-~. ...... ~...j..~..~;i~ ......... ~ ............................................. Municipality 2. 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 --<:-~c~ .................................. 3. Nature of work (check.which ,applicable): New Building'. ................. Addition ............ Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... '! .................. Number of dwelling units on each floor ....J ....................... If ggrage, number of cars .... ......................................................................................................................................... 6. If business, commercial or: mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Numlber of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ...........) .................... 8. Dimensions of entire new construction: Front ....'.~..~ ......................... Rear..!..~. ...................... Depth ........................ Height .................... Numbe~- of Stories ....1 ................................................................................................................ 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Dat~ of Purchase ................ , ........................................ Name of Former Owner ........................................................ 1 1L Zone or use district in which~ premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded i'~3. a i . . Will excess fill be removed from premises: ( ) Yes ( ) No Name of Architect ..... ~ ........................................... Address ................................ Phone No ....................... Name of Contractor %..&....~..,. ~ ei~,c. Address ~ md, ~.~, Phone No. q ~ ~-'l ~..~.~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frorn 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 Ye)RI<, ,/~ 'SS ...~..!..~....'~..%~ ................................... being duly sworn, deposes and says that he is the applicam (Name o~ individual ~ning contracf) (Contractor, agent, corporate officer, ~c.) of said owner or owners, and is d61y authorized to perform or have performed the said work and to make and file this application; that ali 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. ......... ........................ ....... Co.. ........................ NOTARY ~JBLI~, STATE OF NEW 0 NO, ~826795d - SUFFOLK COUN~ COMMISSION ~P RES MARC~ ~, 19~