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Home My WebLink About10451-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No ...... Z9905 ..... Date ...[,le-~.¢b. 2.6. .................... 19.80 THIS CERTIFIES that the building ............................................... Location of Property .... P3r.~.,.. 1~l.,..~.I...6.~ .8, .7..~...ll/~.a.]~..:[.e.~.. R.cI.,...I~..:[.~.....~.o.~..~ .hg.~.~, No ¥, House No. Street Ham/et County Tax Map No. ]000 Section .... 07'7 ..... Block ...... 03. ...... Lot ...... .0.2./~. ....... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · . .$ep.~;elllb.el?.. 6 ..... , 19 79. pursuant to which Building Permit No ...... .~.O~-5 .1Z. ........ dated ...Oo~o. bel'. 22 ............. 1979., 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 ......... ...................... One. Famil),. I~welling ................................... The certificate is issued to ............ Del'liel. ttlld. S~ISOll. I~llll. }/.elt~C ................. (owner,~ of the aforesaid building. Suffolk County Department of Health Approval .. 9.-~0.-,8~[ . . . lilaX?Oll. J~5,..~.~10 ........... UNDERWRITERS CERTIFICATE NO .......... p.e. tl~l~.Ttg ............................... Rev 4/79 Building Inspector FO~ NO. ~ TOW~ OF SO~TSOL~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 10~51 Z Permission is hereby gronted to: ,o ..... ~~.~.~.....~.~...~.~....~.z~? ....................................... ~, ~,~,~,o~,~ o,.~r.~..~z .......... ~..g~...../..~..~Z...~w.~..~ ........................................................................................................................ to opplication d~ted ..~~.~...~...., 19 ., ~nd ~pproved by the pursuont ~uildin~ Inspector. Fee $ .................. 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 Inspec- tor 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 electrica( 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 requ[rements 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. 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 occupancv :$1.00 ~ Date ..... ~.~/~ .~.~...~. ......... New Building ....I, ......... Old or Pre-existing Building ............ Vacant Land ........ ~-~ ... Location of Property/~o.u.~.^.~..'.....~.~2.'..~..~/ ....'~'?~"'~' '~'S' 't~ ~//~ ; / ~. .~/.~. .z~/. . . .~. . ; .~. .~.. ~. .~. .H, ~:.~t ~ Owner or Owners of Property .../~...~..'./, .~....~....~..~...~.....~...~f~....~...//.~..~'...~. ............... County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ......... ..~ ...................... Filed Map No ........... Lot No .............. Permit No ........... Date of Permit ..... ~..~; '; ~.. r~J Health Dept. Approval .. ¢c. ~. %. ~ ~ ....... Labor Dept. App royal ........................ ... ~~ ......... Planning Board Approval ...................... Unde~riters Approval Request for Temporary Certificate ..................... Final Certificate ... ~ ............... Fee Submitted $.. ~.~.~. ................... Construction on above described building and p~ts all appli~blffco~and regulations. Applicant~. ~~ ~/~~. ~:...~..~. / 765-1802 BUILD,lNG DEPT. INSPECTION FOUNDATION 1ST []ROUGH PLBG. FOUNDATION 2N'D []INSULATION FRAMING []FINAL REMARKS: DATE //~/~ INSPECTOR ~~.-~-- FO~ NO. 3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL ~ ,, ~at~ '"~~ ...7. .... , ~.~ ,,e ,~o. ; ..................... ....; ............. ~'/-: ........ r ~ ............... i _ Y,~, :~,~ :~'Z,.~:.~.....~ ........... , PLEASE TAKE Y',IOTICE that your application dated .... ~ ............................ , 19..Z~. for permit to construct ........................................ at the pr~emises located at_~..,~...~..., ........ /2~/,, z.~-?.7~' ~ ~.~~~ ~~~,~, ~"~?~'""'?'~'"':'z'Z .......... ~"'""~ '~ ~' .. ,~ / Map ..Z~.~..W...~..~.,Z. .... Bloc~ ....... ~ ................................. Lot ..................... ~ ....................... ~ returned herewith and disapproved ~n the following grounds~~.,~.~,,... ~ ~.~..~:;a.:....~...~/~,...~.... ~~a....~...~~, ' ~2~:~Z~..: ............ ~ ...........................................~ z ............ Building Inspector TITLE No, 7908-082730 DF_.SCRIPTION ALL that certain plot, piece or parcel of land, situate, lying and being in the Town of Southold, Co~ty of Suffolk, State of New York, being more particularly bounded and described as follows: BEGI~INGat a point 658.79 feet northerly, frc~the northerly line of North Bayview Mad said boundary line being also the westerly line of a 30 foot right of way over said land of Schu~acher, from said point of beginning run~ing along the northerly line of a 30 foot right of way, north 72 degrees 25 minutes 30 seconds west 139.05 feet to the easterly line of said 30 foot right of way; thence along said easterly line, north 17 degrees 34 minutes 30 seconds east, 105.18 feet to land of Kennedy; thence along said land of Kennedy, south 72 degrees 25 minutes 30 seconds east, 139.24 feet to said land of Sch~nacher and said westerly line of said 30 foot right of way; thence along said land of Schumacher, south 17 degrees 40 minutes 30 seconds west, 105.18 feet to the point of B~GINNING. TOt~'i'HER with all the right, title and interest to a might of way 30 feet in width over the land of Schumacher and adjoining the westerly boundary thereof from North Bayview R~ad northerly a~?ut 1620 feet to a dredged canal leading to Goose Creek. Also together with all the right, title and interest to a right of way 30 feet in Width from the southeasterly corner of the pr~mises westerly about 169 feet and then northerly about 790 feet and then easterly about 170 feet to said 30 foot right of way herei~oefore described. Also together with all the right, title and interest to a right of way beginning about 35 feet southerly from said dredged canal along the easterly line of said 30 foot right of way hereinbefore described and rum~ing northeasterly about 1400 feet to the North Road to Bayview. DESCRIPTION ~ - continued - FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL: 765-1803 Date ........ .~/. ~. .... INSTRUCTIONS a. This application must be completely filled m 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 of property must be arawn 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 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 Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction 6f buildings, additions or alterations, or for removal or demolition, as herein described. The apphcant 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/n~,pections. ~ /9 (Signature of app~cant, or name/if a co~lSoration) ../.0. ..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ .......................... Name of owner of premises...~.?Vt?~../. ?..X( .~.. ~..~~...ff~~ ........... (as on the tax r~ or latest deed) If applicant is~poration, signally authorized~fficer. ..... / (Name and title of corporat off ) Builder's License No .......................... Plumber's License No. ~. ~ ~ .~/~.~.~ .~ Other Trade's License No ...................... 1. Location of land on whichj~roposed work wil~be done..~/J...'.~.. ~.'O~. ~/,~..~.~.~'.~. :'~.~.*...~. · .~. ....... .... ....... ............................ -- "' Street Hamlet ' House Number County Tax Map No. 1000 Section..~. 7' ~ ....... Block. · .O.'-~. .......... Lot...~.~ .~. ......... 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 ...... .~..~..~'.~. ....................................................... b. Inten~led use and occupancy .... . .t~... ~.i~..//~7 . . .~...~]. t...~, q · '. ................................... 3. Nature of work (check which apPhcable) New Building .... Addition .......... Alte~ration x ........ Repair .............. Removal .............. Demolition ..., ........... Other Work ............... · , ..~ ~ ~ (Description) (to be paid on filing this application) 5. If dwell'ing, number of dwelling ~nits~,.;..O~.~.. ..... Number of dwelling units on each floor ................ If garage, number of cars ........ ~J~t/2~. ..................................................... 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 wilh alterations or additions: Front ................ .~ Rear .................. Depth .................... :.. Height ...................... Number o{ Stories ......... . ...,. ¢.,~ ....... 8. Dimensions of ~e,ntt~re new construction: Front ..... .~J~...._~. Rear ... ~. ~ ......... Depth ...~.~. ......... Height ..... / ......... Ntunb~r of Stones ......... .~. ............................................ 11. Zone or use district in Ohich premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ... ,gY.o ..................... 13. Will lot be regraded ...... ~$ ........ , .......... Will excess fill be removed from premises: -- Yes Name Of Architect .... , ..... i ................. Address .................. /Phone No .... ,;, ........... PLOT DIAGRAM Locate clearly and d~stmctl¥ all bmldmg, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block humber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YOJ).K, .//,/.., ~z' ,- ,, COUNTY OF~.~' a ........... ~. I~jm~-~.~.. [~).,.l~J .t~.~4 ~0. ~-.~ ........... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ......................... : ................................................................. (Contractor, agent, corporate officerl etc.) of said owner or owners, and is dul~ authorized to perform or have performed the said/york and to make and file this application;that all statements contained in this application are tree 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 thi~ ' ............ u ~taw Pub c, ~tate of N~ York ~ ~ NO, 52-03449~3~ ~lSUf[°lk ~un~/ ~'~ .................. ~"-'(~zgnatu=c of apphcant)~ ...... '~ .... , ~mmi.ion ~p~r. ~roh ~, ~ / ,' /