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Home My WebLink About12207-zFORM NO. 4 TOWN OF SOUTHiOL~D BUILDING D EPARTMI~NT Office of the Building Inspector Town Hall Southold, N.Y. Certificnte Of Occupnncy No. ~q'] 6.6.0. ......... Date ............. May..'1 .~ ............. 1983. Accessary THIS CERTIFIES that the building ................................................ Location of Property fl6505 Hain Road & 50 Hill Lane Hattituck House No. Street Hamlet 2 County Tax Map No. 1000 Section .. J'.'[ .P ...... Block ...Lot Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ~arch 1983 pursuant to which Building Permit No..'1.220.7.Z dated ...5a. .r.c.h...27 ................ 19 .8.3. ,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 ......... Agricultural Storage building The certificate is issued to William 1°. Ruland [owner, levee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N/A UNDERWRITERS CERTIFICATE NO. .................... .~./.: .~..-:~,..-~..~.%... .Building Inspector Rev. 1/81 NP 12207 ~rmi$$i°n i* h~r~by BiLilI~DIN~ TOWN~!HALI SOUTHOL~D, N. ¥. (THIS PERMIT MuST BE KEPT ON ~HE PI~! COMPLETION OF TIlE WORK AUTH6Ri!zED) ; 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 subn~itted in duplicate I~o the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of ali buildings, property lines, streets, and unusual natural or topographic features. 2. FinaI approval of Health Dept. of water supply and sewerage disposaI-{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 resportsible 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 ail property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and conditioh of buildings. 3. D~te of any housing code or safety inspection of buildings or premises, or ot~er pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 lan8 New Building . .,~. ........ Old or Pre*existing Building(X) .. ........ ~ fVacant Land ............ Location of Property Owner or Owners of Property . . ~.g~ . ~ .............. ~ ............. County Tax Map No. 1000 Section ..J/.~. ....... Block ...~ ......... Lot...~ ....... Subdivision ................................. Filed Map No ........... Lot No Health Dept. Approval .4).0..,, ,~J~' ......... Labor Dept. Approval ......................... App ~ I~ ' ' App Underwriters roval .... ,.~ .......... Planning Bo rd roval ...... ' ............ Bequest for Temporary Certificate ..................... Final Certificate ............. Fee Submitted S .......................... : Construction on above described building and permirmeets all ap~cab..~odes and~ regolations. Rev, 10-10-78 FORM NO. 3 TOWN OFSOUTHOLD BUILDING DEPARTMENT TOWN CLERK'SOFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ............. i ................. To ~../.~.~.~..~....-~.~../.'~. .... .~./.~./.~.: .~.x-./.,...¢. .......... PLEASE TAKE NOTICE that your application dated .... . ./~..~.~?...~--~. · .... /. ..... , 29 .~.~.. for permit to construct..:..~_~.~./7.~.....~.... ,.~..c~.,(..~.~..~..~,,q../~. ........................ at County Tax Map No. 1000 Section ...x/~..'~..'~. ...... Block ...~..~. ...... Lot · ~.~'.~.. Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved on the following grounds ~C ~ ,~Z~. ~. ~~ ~ ..... ~ ..... RV 1/80 FIELD INSPECJ£ION~ COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY q,ODE FINAL ADDITIONAL COMMENTS: 0 0 FORM NO. 1 TOWN OF SOUTHOLD BUILDrNG DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 1 z APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No./..~, ,~, ,~,,7 ....... 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 pl0t plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of bulldin~ 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 covere~ by this application may not be commenced before issuance of Building Permit. d. Upon approval 0~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 buildinss, 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 premisas end in building for nece..s..s .ary~?.~..p,. ~ (Signature of applicant, or name, if a corporation) · I. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engiheer, general contractor, electrician, plumber or builder. Name of owner ofpremises .~.~:J.~.'~.~J'lq .... ~.~.. ~/.lg}.10~ ........................................... (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 .......................... Plumber's License No. /~.0...~...~. ~. ........... Electrician's License No...~.o....~.! .o_~. ,.'.~ ...... Other Trade's License No ...................... 1. Location ofland on which proposed work will be done. . .~.~.F. ,. /-.{.~...o~6-..~..n3;ll LO ................... · ./~.~.o..~..m~a,n g,l~ .,,qTo..m.;l 1..~-sne ......................... .m..~.r. ~..~..~..~ ............... House Number Street Hamlet County Tax Map No. 1000 Section . .ll,~.. ........... Block .. ~ ............. Cot...~..~ ............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .. ~../t~...r~. ............................................................ b. Intended use and occupancy .~"..~.C..rD.. }?iRq~,'Y~.~..¢.-?('~.~.~WT~I ................. 3. Nature of work (check which applicable): New Building . . Addition .......... Alteration Repmr .............. Removal ............ .. Demolition .............. Other Work ............... (Description) Estimated Cost~..C~00.O. 0 ~' Fee .~/.~,.,.Q.Q : (to be paid on filing this application) 5. If dwelling, number of dwelling ]units ............... Number of dwelling units on each floor ................ If garage number of cars , 6. If business, commercial or mixe{I occupancy, specify nature and extent of each type of use ~--~FrO ............... 7. D~menslons ofe lstmg structures, finny: Front Rear ....... Depth Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ...... Rear Depth .................... I' · Height ...................... Numbe~ of Stories ...................... 8. Dimensinns of entire new construction: Front . ~.~.O.t ......... Rear . .~.Q .......... Depth .~.~-.t .......... Height ............... Number of Stories ........................... 9. Size of lot: Front . .o030 ..... i ........... Rear .&3.o ................ Depth . 3 ~t~. ................. t0. Date of Purchase ~q?.c.~l.. ].~.7~ ................. Name of Former Owner .~:~/mgF..D., .~M}~rld..Q~.~ ..... 11. Zone or use district in which prgmises are situated ..................................................... 12. r)oes propose~d const[uction violate any zoning law, ordinance or regulation: .DIQ ............................ 13. Will lot be regraded . 1~ ~ .... . ................... Will exce, ss fill be removed from premises: Yes No 14. Name of Owner of premises .~,'.t},'.~..~... RUIr~. Address ~.,U..~O, ~,-O:.L'r.,-rJ¢~0J~, Phone No. ~-.~l.~.~. ..... Name of Architect .......... i ................. Address ................... Phone No ................ NameofContractormor%~..~vtl~Jm$.~..217~¢, Address 13~ /a(o PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-baak dimensions from property lines. Give street and block gumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, h COUNTY OF. ~ ?J-~ ,FtM. I,&, ...... · .W,q} ~.¢.~/~9,~... ~.... J~)U.).I9 .~. ................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named· He is the . .O..t~..r)..~..~ .............................................................................. (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 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 ..... ,:~B~...~. ......... day of].. ~f)'~..~C~ ........... 19~.-3. I~O*ARyRpUus£1~, ~t~t~. of I~w ¥or~ .... (Signature o applicant) No. 52,2841400, Sqffolk Corn}n ss 0. Expires J~arch 30,