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Home My WebLink About10149-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No..g95 .......... Date ...... O'l,a'le .....1 ................ 19.7.9 THIS CERTIFIES that the building ............................................ ,~ .... Location of Property ..... ~0~...Ifil. olf. hSla. ~l'e .................... l~la~..~.ltck.,~5,/~el,: House No. Street ~ flare/er County Tax Map No. 1000 Section ... ~0~ ..... Block ... 0~ ......... Lot ......... 0~',l ·. · Subdivision ...... ~ ............... Filed Map No..~ .Lot N0 ...... ~ conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... ~,~ · · · &~Z · · · ~ ....... , 19.79pursuant to w~ch Building Pemit No, ...... ~0~gZ ' ' ' } dated .... .~[... ~ .............. 19 ~, was issued, and conforms to a~ of the requirements of the applicable provisions of the law. ~e occupancy for which tbs certificate is issued is ......... .................. A~%gon .~o. A~eee.o~. a~e~re ......................... The certificate is issued to ........... Rebe~ .}I~. itO~,O~.°. .. ...................... towner, t~i~-~ /. ' ~ of the aforesaid building. / ' Suffolk County Department of Health Approval ....................................... I UNDERWRITERS CERTIFICATE NO ......................... 1.5/~i; ..................... Building Inspector Rev 4/79 TOWN OF SOUTHOI.D BUILDING DEPARTMENT TOWN CLERK'S OFlqCE SOUTIfOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF: THE WORK AUTHORIZED) N'.° 1014.9' Z Permission is herd3¥ granted to: ........ ~ ....... ~ ...... ~. ................... ~..~.~ ~ ~o ......... ~.~.~. ........... ~..~.~ ............ ~. ............ ~..~C~,~.~.:~....~&~.~..~t~.~ ~ ~ ~ ~ p~ ~ m ....................... ~.0.5 ......... ~.L.C~.~.~ ......... A.~Z~ ........................... ................................................. , .............................. ~.~.....~?'...~.~..~.~ ......................................... pu~nt ~ a~t~mi~ dm~ ............................... ~.~.~ ....... ~.., ~..., a~ ~p~ ~ the Buil~ !~. Building Inspector FORM NO. 6 TOWN OF BOUTHOLD 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 featu res. 2. Final approval of Health Dept, of water supply and sewerage disposal--(S-9 form or equal). 3. Approva~ of electrical installation from Board of F~re 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pr'e-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 occupancv on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date..~4Z. ,'~..~/~/.~. ~..~' ...... New Building ............. Old or Pre-existing Building .~.~ ,~./~.z.o..~., Vacant Land ............. ...... '[/.'~., ..... ./.~... .... X ....... Location of Property .~,~.._~..O..~'..,...~. z, .~./.~.'~..~..~f.,, .~../.~.'~.., House No. Street Hamlet Owner or Owners of Property . .~.~..~.~?':. 'V?. ,~,'~,../.~ .'~. · .~.~'~'..~.~.g". ~' .~..~..~..'~.'.~. ............. County Tax No. 000 Section ....... .7... B ock ..... ......... Lot .... ? ........... Subdiwsion ................................. Map No.. Lot No ............... Permit No./.~, .J.~/'.~..~.Z. Date of Permit .~.T .~.~,~.~...Applicant .~.~..~t'. ,~./~'../..~/. . ./~..~.~C..~.~4. C!'.~.~. :~.' ..... .... .a....~4 ~"~'~ ..... Health Dept. Approval ~ /~' .............. Labor Dept. Approval .~. fff/, ':~.~.'~,..~.d..~.°.'.~., Underwriters Approval .~,4, , ,~,4: .g~, ~.~/.~. ........ Planning Board Approval . ./~'.~.~...~'.~?~..~.: ........ Request for Temporary Certificate ..................... Final Certificate Fee Submitted $ Construction on above described building and permit meets all applicable codes and regulations, ................ R.V, 10-10-78 Applicant ~'~ ~ ( 5~'~(,O ~- co~ ~../~. ¥."'.~. P ....... ~.~.~s, ~s,~.~.s. co.s~uc~o~s s~.~. ....... o~ ....... NEW YORK -%¸ ~0 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Disapprov?d a/c ............ , ...... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .4Pr.i.1...3_., ......... 197.9.. 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 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 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 preinises and in buildings for necessary inspections. ............... (Signature of applicant, or name, if a corporation) .P., 0....Bom .58,..Ma.t.t. ituek ~. N...Y.. 1.1952. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner Name of owner of premises .Rober. t. H....and. .Mar. y .C ....Bo ec.k. man. n ................................. (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 ...... .~...h'~...~,.... , ..... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ................................................. 3'505 Wlckham Ave. Hattltuek, N.Y. .1.1.9p.2 .................. House Number Street Hamlet County Tax Map No. 1000 Section ....... ]..0. ~. ...... Block ........ 7 ........ Lot....~. ............. Subdivision ................................. Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...C7..a?.a.g.e..(.e.x. ~_.~.~.~..rig.) .............................................. Garden Equipment storage b. Intended use and occupancy .................................................................... 3,~ Nature of work (check which applicable): New Building .......... Addition . X..x.. ..... Alteration .......... Repair .............. Removal .............. Demolition ............ ~. Other Work ............... [ ~ (Description) 4. Estimated Cost .... ~.lS0O... -' ' ............. Fee ,~l~,5,,O~- (to be paid on filing this application) 5. If dwelling, number of dwelling'units, .. NA. i ........ Number of dwelling units on each floor..I~. '. ". ......... If garage, number of cars .. ~.., '. ~..' ............................................................... 6. If business, commercial or mixe~d occupancy, specify nature and extent of each type of use .. I'IA ................. 7. Dimensions of e_xis[i.ng structur?, if any: Front...~.0~ f.~.: ..... Rear ...2.0.. ?.~.. ..... Depth ...2.0..f..~ ........ Height ~i l"c. Number of Stories .... ~ .......................... ............. 28',ft. 28 ft. Dimensions of same structure With alterations or additions: Front ................. Rear .................. Depth ........ 20. £.t ..... : Height ... 8..£t .............. Number of Stories..1 ................... 8. Dimensions of entire new construction: Front . N2i...' ........ Rear ............... Depth ............... Height ............... Number, of Stories ................. , ............................ , ........... · .128,:7.2 .~.~ .......... Depth 252.8.5. f~.;..a.v.e~... Size of lot: Front ..... ~-~.6...43..f.~, ..... Rear . ' " Date of Purchase . . .7./.~../.~14:~i.,. · ':: .............. Name of Former Owner . . Jq~lTl, l}c. ..................... Zone or use district in which premises are situated...P~..~.i..d.e.~.~. ~..a,.1 ...................................... Does proposed constructzon wolate any zonmg law, ordinance or regulation: ............................... Will lot be regraded ...Eo... i .................... Will excess fill be removed from premises: Yes 'X No Name'of Owner of premises ,R~. It.o..]3oe.ekmarm. · Address3505..~fl± ek.ham..A, v0 Phone No.'~98-8t9~ ...... Name of Architect ...ixlA .... 1 .................. Address ................... Phone No ................ Name of Contractor O.W.12~T~ ............. Address .................. Phone No ........... PLOT DIAGRAM buildings, whether existing or proposed, an& indicate all set-back dimensions from number or description according to deed, and show street names and indicate whether 10. 11. 13. 14. Locatei c/early and distinctly a property lines. Give street and blocl inter/or or 'corner lot. ~O STATE OFNEV~O~ ;Y , oo ~ff/~~~~ (~ ~ ~ividual signing contract) above na~ed. '" He is the ~¢r. (Contractor, agent, corporate officer, etc.) of ss.id owner or owners, ~d is d¢ly authorized to perform or have perfomed the said work and to m~e and file application; that all'statements con'tained work will be perfomed in the m~ger set forth ~ the application filed therewith. ........... rif ........... Nota~ Public, ~ ........ County