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Home My WebLink About10461-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No...Z99.6./~ ......... Date ......... May. Z9 ................ 19.80 THIS CERTIFIES that the building ............................................... Location of Property ~l~t~s'e No. Street Ham/et Connty Tax Map No. lO00 Section .... 3...~ ..... Block ..... ~.. ........ Lot ..... .~. .......... Subdivision l~a~b~.13. Sb, clI~es...E>r;¢.o.2 ..... Filed Map No../+./4~.~...Lot No...T.Q ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... 0ogo.be~c. 2.9 ..... 19.7. gpursuant to winch Building Permit No .... .'1.0/~6.'17~ .......... dated ....... 0¢.~ObOlc'..29 ......... 19 .~..~, 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 ......... ...... Glazed. I~nclos.ure. ~n. ex&~ting The certificate is issued to ................ ~p.8. ~. p.h..~.a..s~.~.o. ........................... of the aforesaid building. Suffolk County Department of Health Approval ......... I~Ix/R. ............................. UNDERWRITERS CERTIFICATE NO ................. N, .~.7.8 ./450. ....................... Building Inspector Rev 4/79 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10461 Z Permission is hereby granted to: .... · .G.,,~o.,.'¢,.~,.~...~.~f......~..p .... ~.:.:. ~...~....//~..,,...M,~o.~:.~.~_ _ ~. , ,7<: ~....J~.r,~p~......,~P,,.~,.~..,,, ............... ~.~.~...~c~.~.....~:~.o...-~..-. ~,~/~..,~ ~/. ~ ............................................... ,, premises located at ~..-..~¢~¢~-"X~'"'~~~"* -~, Buildino Inspector. ~~~ JOSEPH F. BASILE, E.A. 403 MAIN STREET GREENPORT, NEW YORK 11944 (516) 477-0927 November 1,1979 Building Dept. of Southold Town Main Road Southold, N.Y. 11971 Gentlemen: Please accept this letter as complete absolvement from fault regarding relaxation of restrictions covering patio foundations of 30" below ground level. It is understood and agreed that only the builder of the enclo- sure and myself can be held culpable for damages resulting from frost's effect upon a shallow patio foundation. I respectively request that you issue a building permit in view of our acceptance of culpability. Very truly yours, JB:jb NOTARY PUBLIC,, Qualified I1~ Commission Expires FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 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 responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. 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 unusuat nature~ or topographic featu res. 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 or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date .............. New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property .':Z ................................................. Hou~ No, Street Hamlet Owner or Owners of Property ~ o,5' ~ ~. ~.~ ~J ] L ~ County Tax Map No. 1000 Section ~7 ~ Block ~ Lot ~ Su di ,, o, !.. ?f.tf. .... M,, No. No. ........... Permit No. /.~. ~ ~. ~.. ~Date of Permit/.~ ~.7.~.Applicant . ~ ~. ~ ~... J~ ~ .~' f.~ ~ ......... Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters Approval .~ .~ ~ .... Planning Board Approval Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described budding and perm't meets a app 'cable codes and regulations. Applicant .~.~ .~..~. ~...~ ~,._~. ~,y.... Rev. 10-10-78 FOUNDATION (lsd) FOOWOATION (2n~) ROUGH FRAME& PLUMBING INSULATZON PER N.Y. STATE ENERGY CO~E FINAL ADDITIONAL COMMENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1B02 ExamineZZ,7. .¢ ...... Application No. ,"¢. /. ........ Date ....... INSTRUCTIONS a. This application must be completely filled in 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 ~ving 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 th~s application may not be commenced before issuance of Building Permit. d. Upon approval of th~s 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 Or&nance 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. .....~_.~q.a.~.t c.~...d;. ~ ~. 7:...~.~. ............ (Signature of apphcant, or name, if a corporation) .~. ~.~. (~ .77..e.~..//..z,_..../~. e~/.~A2??~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, ~~ electrician, plumber or builder. Name of owner of premises ~· · ¢ ............................................. (as on the tax roll or latest deed) If a~ant is a corp,oration, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No./..O."(~ t~. '.q . .~.: .~:."-. ........ Plumber's License No ....................... Electrician's License No .... ~ .................. Other Trade's License No ...................... I Location of land on which proposed work will be done .................................................. ...~ .';:~ ................ ~¢..~.... ~o.~o ......... - House.Number Street Hamle~ County Tax Map No. 1000 Section . .(~..~. ............ Block . ..~,. ............. Lot...--~. .............. Subdivision C..t~..~..ay~.... ~. ~.~..~r~..4~.~.~'. .~.% . .. Filed Map No..~.~. ~.~d ..... Lot. 2.O. .......... (Name) 2. State existing use and occupancy of premises and intended,use and occupancy of proposed construction: a. Existing use and occupancy .... ¢7. ~f.z~.*. . ; ........................... b. Intended use and occupancy ~(;,~,~,~.~;~ .¢¢,~.~...~.';:.... ~:~. ~,- ......................................... 3. Nature of work (check which apblicable): New Building .......... Addition .......... Alteration .......... Repair,. ............. Remoyal .............. Demolition .............. Other Work ............... 4. Estimated Cost .... ~5~ .O....Q ? ........................ Fe ........................... (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 ..... i ................................................................... 6. If business, commercial 6r mixe4 occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structureg, if any: Front..' ............. Rear .............. Depth ............... Height ............... Num:ber of Sro. ned ...................................................... Dimensions of same structure wi!th alterations or additions: Front ...,~..~'. ........... 'Rear...~...qr... i ........ Depth . Height Number of Stories 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height Number of Stories ....................................................... 9. Size of lot: Front ..... .//~. ............. 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 violate any zoning law, ordinance or regulahon: ....~. .......................... 13. Will lo{ be regraded .... ~.~._~.~. .................. Will excess?Il be removed from premises:, Yes, No 14. Name of Owner of premises_ .~.~.~/~...f~..~.Sa/.~ddress........... Phone Name of Architect ........... ! .....: ........... Address ................... Phone No./~Z~.2.. ~-/.~ ~-, 9... Name of Contractor~'~L~.~.)l~.{'~.-l~..~...~*~ddressz~..~.6. i ....... t-' ~f[~.[.~.~.~>~.~..~//~-- Phone No ~.R Z.":,Y~. ,~..~..~. ..... PLOT DIAGRAM Locate clearly and distinctly all! buildings, whether existing or proposed, and. indicate ali set-back dimensions from property lines. Give street and block Bumber or description according to deed, and show street names and indicate whether interktr or corner lot. STATE OF NEWrS~ORK., .. !~ ......... .~. ~.*~..~. ~..'../~.../'..~,. ~.~2.~:~..~..~ ....... being duly sworn, deposes and says that he is the applicant (Name of individual signing con~ract) above named. He is th (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du~y authorized to perform or have performed the said work and to make and file this application; that all statements contlained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mann4r set forth in the application filed therewith. Sworn to before me this ........ · .~.~ ....... day o~.~-.., 19~.? Notary Public, . ....... ._ ......_..~~. ~. ~'_. , ,t,- ELIZABETH ANN' NW~LE. . '~ ........................... : NOTARY PtffiLl~, State of New Yorlt (Signature of applicant) No. 52-8125850, Suffolk Term Expires March 30,