HomeMy WebLinkAbout10161-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No...Z. 979~ ......... Date . .Q¢ .~.o.~.~.17.../~ ............... 19.79
THIS CERTIFIES that the building ................................................
Location of Property 706 krt~glns Lane Oree.nl~ort
House No. ' ................. 'S'tre;( ............ H~t~l'ot
County Tax Map No. 1000 Section . .0.3.5 ....... Block .... ¢ .......... Lot ..... .1.8. .........
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
. . . P~lt&~..1.'1 ........ , 19 :/.9 pursuant to which Building Permit No .... .113.'[6'JZ ...........
dated . . . .A.p.r.i..l..1fi. ............... 19 .7.9. , 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 .........
................... 9.n?..~..~..~.~.y...~..e.~..~.~.n.~ ......................................
The certificate is issued to Janet H. and Baldwin L. Humm
..................... ?o¥.'o;,'~ ............
of the aforesaid building.
Suffolk County Department of Health Approval .... 8. ..: .S.0.-. ~. /4. ~...9../¢.7./.7..9... ,R.,...~.o..V.~..1.1.~...
UNDERWRITERS CERTIFICATE NO. N647077
Building Inspector
Rev 4/79
FOK~ NO. 2
TOWN OF SOUTHOLD
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)
N? 10161 Z
Permission is hereby granted to:
..........................................................
pursuant to application dated ..........
19~.~, and approved by the
Building Inspector.
Fee $.~..Z....~..~.~. .....
/
~u~lalng inspector
FORM NO, 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
Bo
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 unusual natural 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.
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
?..Z....
New Building ~ Old or Pre-existing Building Vacant Land
Location of Property .., .~..~. ~i .x~,.: ~.~.~. $ .... ~,~..~,..~ ................. ~'~. ,~.~.~..~.~, .,~... ~ .......
House No. Street Hamlet
Owner or Owners of Property . .~.~'-~.~C.~'~,,..~z'..~.. ,,~ .~..~,~.,~,....~../?~.~.~. ~ ....................
County Tax Map No. 1000 Section .... ,O°~.~, ..... Block ... ~ .......... Lot..../..6~. .........
Subdivision ................................. Filed Map No ........... Lot No ..............
Permit No... ~ ¢<~O'. · Date of Permit ?~.. ~?.~...Applicant . .~?..,~?...~.-.'-f. ~-:~.'.~.-¥; ...........
Health Dept. Approval . ~;. ......... ~.~. ....... Labor Dept. Approval ........................
Unde~riters Approval .~. ~.~. ~ .... Planning Board Approval ......................
y C tiff Fi tiff
Request for Temporar er cate ..................... hal Cer cate .......................
..
Feo Submitt*d $ ..........................
Construction on above described building and perm~ll~ble codes
a~
regulations.
Applicant ...... ~.~~-:..~~/' .~~ 7...~ ............
THE NEW YORK~BOARD OFi FIRE UNDERWRITERS
~a~awzn Hub,Wiggins Rd. FOOt of R~:.25:EaO~.-Ma~io~ r.I~'~ -
'- Goqdale Elect', CO~t'.'
RRi Bx. 1Sa Main Rd.
Mattituck,N.Y. 11952 '
certificate must not be altered in any mJhnerj ~e~urn to th~ office, of the B~
783
I.~p(-,'/ors may be identified by their credent;o'lsj~
Memorandum from....
BUILDING INSPECTOR'S OFFICE
TOWN OF $OUTI-IOLD
TOWN HALL, SOUTNOLD, N. Y. 11971
765-1802
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
NOTICE OF DISAPPRO?L
~..~...~~_. ...... ~_ ~/~
· o~..... ..... ~ ~ ..........................................
...... ~ ~..~.~....~. ..... //e ~ ~ ~
PLEASE TAKE NOTICE that y~ur ~pplic~tion d~ted ..~...La .....
for perm~ to construct .~~.~..'...~t the premises located at ~.~.~;
7/~..~ ...... ~,_~ U ~, , ~ ~ ~o~ z~
~p ..~$~. ~...~.~ ......... D~ocm ..................................................................................
returned herewith and dJs~proved on the followmg grounds~~~.~
~~....~..~ ~..~z~. ~ ,...=.....~.~.~~ .....
....... ........ .......
After investigation and inspection the Board finds<that the
applicant requests recogntition of access for a private-right-
of-way 750 feet south of Wiggins Lane, Greenport, New York. The
right-of-way has many soft spots in it, and it must be improved.
The Board finds that strict application of the Ordinance would
produce practical difficulties or unnecessary hardship; the hard-
ship created is unique and would not be shared by all properties
alike in the immediate vicinity of the property and in the same
use district; and the variance will not change the character of the
neighborhood and will observe the spirit of the Ordinance.
On motion by Mr. Douglass, seconded by Mro Gillispie, it was
RESOLVED that Baldwin L. Humm, Dumbarton Drive, Huntington,
New York, be GRANTED recognition of access. Location of property:
Wiggins Lane, Greenport, New York, bounded on the north by Green;
east by Armstrong; south by Gull Pond; west by Fordham Canal, subject
to the following conditions:
(1) The access will be improved by one of the following ways:
(a)
(b)
(o)
Stripping the top'soil and replacing it with 6 or 8
inches of ban~ run, sand and gravel.
Stone blend, 3/4 inch stone for a width 6f 10 feet in
the center of the right-of-way.
Black top the right-of-way.
(2) Approval of the Southold Town Building
Vote of the Board: Ayes:
Douglass.
Inspector.
Messrs: Gillispie, Doyen, TuthiI1 and
,¢
,/
AB&No.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 76541802
Examined....~.~.-7../.( ..... , 197 .~
Approved..(.~..T.. (f.~ .... , 19?.?Permit No.../..~..~..~../. '~ ~,
Disapproved a/c.....~.~~../..7.l .......... ..~ /
/V - APPLICATION FOR BUILDING PERMIT
Application No.../~../.~../. .......
/
Date
IN ST RUCTIONS
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 ~he
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinancea or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ%d.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and'to
ad,nit authorized inspectors on premises and in buildings for necessary inspections.
..... ..........
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant) ,,O ~7',
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Nmne of owner of premises ...... ' -' -/ "'.'. i ;...'....'..'.'~.;-'.??.-.~z-t ...........
(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...
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done.----~k'e.~.~..~.or~ ~w;~ af~v/r~
/ ........................................
House Number Street Hamlet
County Tax Map No. 1000 Section ....... .~.~.~. ....... Block ........ ~ ....... Lot..../?. .............
Subdivision ........ .r~.~ ................. Filed Map No ............... [~* .'. ~ ~. .............
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed Construction:
a. Existing use and occupancy .... ~ .6'.q~..//?../...~..,~. ~ ~.,'. ....
b. Intended use and occupancy ......................... i :: :'.. .............
3. Nature of work (check which applicable): New Building .. ~ .... Addition .......... Alteration ..........
Repair .............. Removal .............. Demolition .............. Other Work ...............
~ (Description)
4. Estnnated Cost ............ ~O/.q.~..o ................... Fee . f. ~..'..'7.. ...........................
i (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 or mixed occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing structures, if any: Front ................ Rear .............. Depth ...............
Iteight Number of Stories .~...~../~...~.
Dimensions of same structure with alterations or additions: Front ................. Rear ..................
Depth ................... i · · Height ............ >...; ...... Number of Stories ............... i ......
8. D~mens~ons of entire new construction: Front ..... 7. j~. ...... Rear ..... 7~...~. .... Depth-.....~...~. .......
Height ............... Number of Stories .... d.~/~. .................................... ~ .........
9. Size of lot: Front ...... .~..o.?( .~ ........ Rear ........ .7.~.t. ~ ........ Dg~th, ...2. f.~-~,/.~ · · ~. ......
10. Date of Purchase . .~. i ' '/'~' ?~' .......... Name of Former Owner . ./.~... · .~..~ .....
11. Zone or use district in/which pr~mises are situated ........................ £ ./ ..........................
12. Does proposed construction violate any zoning law, ordinance or regulation: .../MO ..........................
13. Will lot be regraded ...... /~.4> .................. Will excess fill be removed from premises: . ~ , , o
r ' ~../~,~ bJ~, Address ~/D~b~r't¢;
14. Name of Owner of p em~ses ... ................. ;,... ~ ~ ....~ ...................
Name of Architect ......... . .................. Address .,?.~q.r.~..~. ........ Phone No ................
Name of Contractor ' Address Phone No
PLOT DIAGRAM
Locate clearly and distinctly al! buildings, whether existing or proposed, and, indicate all set-back dimensions from
property lihes. Give street and block number or description according to deed, and show street names and indicate whether
STATE OF NEW YORK, I S.S
COUNTY~F ................. ,
..... j,,~.,~.Z. ~z~-t-....~...,~.. ~,,~-~ ................. being duly sworn, deposes and says that he is the applicant
(Name of individual sig~ing contract)
above named.
He is the '
~ (Contractor, agent, corporate officer, etc.)
of said owner or owners, ~d is ddly authohzed to perform or have perfomed the said work and to m~e and file t~s
application; that ~1 statements contained h this application are true to the best of his ~owledge and belief; ~d that the
work will be perfo~ed in the m~er set forth in the application filed therewith.
Sworn to before, m~ ~his
Nota~Public, '"~'~'~~: m~n~ m,~ .... Co~~~~
. No. 03~4~734~
~mea ~ ,~,on~ C~ ~ o (Signature of applicant)
0 --~0w
Y. State Li,~ (: :d S
TOWN OF -~OUTHOLD
I~UILDING DF.P,~RTM~NT '
$OUTHOLD, N. Y.
Application No .................................
Approved .................................. ,......, 19 ........ Permit No .....................................
APPLICATION FOR BIJ1LDING PERMIT
Dote /.~..//~ , , 19..?. ~'
INSTRUCTIONS
o. This application must be completely filled in by t~/pewriter 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 p,emises, relotionshlp to adjoining premises or public streets o~
areas, and giving a detmled description of layout ofproperty must be drawn an the dmgrom which is port of this oppllcotion.
c. The work. covered by this application may not be commenced before issuance of 8uildlng Permit.
d. Upon approval of this application, the 8ui~dlng Inspector will issue ~ Building Permit to the applicant. Such permit
shall be kep~ on the premises available for inspection throughout the work.
e. No building shall be ~cupied ar used in whole ar in p~ far any purpose whatever until o Ce~ificote of Occupancy
shall have been gront~ by the Bui[dlng Inspector.
APPLICATION IS HEREBY MADE to the Building Deportment 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 ar alterations, ar for removal or demolition, as herein described.
The oppllcant 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, x~-,
........ of ........
....................... ........... ..........
State whether ~p~licon~ is owner, lessee~architect, engineer, ~eneral contractor, electrician, plumber or
builder.
Name of owner Of premises.
If applicant is a corporate, signature of duly authorized officer.
2
(Name and title of corporate officer)
Builder's License No. '"'.:~ , ~,
;~,,~:~:.~ .,~ ~,._.7z /
Plumber's License No ............. ;~ ...... ?~. ....... :~ ..............
~lectrmian's License No. / ~_~.. t ~./,, ~-~... ,~
Other Trade's License No ...............................................
Location of land on which proposed work wdl be done Mop No ' . .............................. Lot No .........................
Stree~ and Number .............................................................................................................................................
Municipality
State existing use and occupancy of premises and in'~nded use and accupercy at: proposed construction:
o. Exisiting use or~d occupancy · .~'. - ·..'7~... -~- .~--~ .T-- '~' '-- -. · .~~(/~ ............................
'' ,,~ /~ ~,-. v~
· .........................................................
3. Nature of work (check which oppfiooble). New Budding .................. Addition~ . ........... '. ..... Alteration
Repair .................. Remgyal Demolition .................... Other Work
,, , (Description)
4. Estimated Cost ~ ~ ........... Fee ............................... ~ ..........................................................
............... ~ ............ (to be paid On filing this application)
5. If dwelling, number of dwelling units .......... ./. ................ Number of dwelling 9nits on each floor ............................
!f garage, number of cars .................................................................................. : ..........................................................
6. If business, commercial or mixed occupancy, specify nature and extent of, each type of use ............................
?. ,,,~Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth
~Height ........................ Number of Stories ................................................ ..-...~
Dimensions of same structure with alterations or add;tions: Front ................ ; ................... Rear ............................
Depth ................................ Height ............................ Number o~F Stories ....... ~ .........................
8. Dimensions of entire new construction: Front ........ 'Z..%/.. ..... ............ Rear .'~,~'. ~. . Depth ........ .xS. .............
/, .'
Height ..,: ...... ~'. ....... Number of Stories .............................................)'~ ...........................................................
9. Size of lot: Front ................ ./...~-'~.~ ............................. Rear ................. 7.....~,....: ............... Depth ............. ./...7..~../. ........
10. Date at: Purchase ........................................................ Name of Former Owner ........................................................
~ Zone or use district in which premises are situated ......................................... : ...........................................................
12. Does proposed construction violate any zor~ng law, ordinance or regulationi
]3. Will let be regraded ........... .6.~..~.,... ........ Will excess fill be removed from_prerni, ses~,(;K),,,Ves ( ) No
14. Name of Owner of premises (4, ......... .~.,~.~...~.~..u...~.. ................... Address '"~',~'~'~n';'~' Phone~ ....................
Name of Architect .................................................. Address ......... ' ...~.. f/,.~..~...~.. Phon~ No .......................
Nome of Contractor ............................................................ Address .............. , .................. Phone No ........................
PLOT DIAGRAM j
Locate clearly and distinctly oil buildings, whether ex~stmg or proposed, o d ind,eote o1! set--back d'mens aris from
properi'y lines. Give street and block number or description according to deed, land show street names and ~nd~cote
whether interior ar corner lot.
\/ (Nome of individual signing contract) I
above named,
He is the ...... ~7' ........ (Contrc~ctar, agent, corporate officer, etc.; i
of said owner or owners, and is duly authorized to perform ar have performed the said work and ta make and
this appllcatian; tha~ all statements contained in this apptic,:~ on are true to the]best of his knowledge and belief;
thor the work wdt be perfarr ,ed in the manner set fadh in the application filed the~ewlth
Swam to before me this / _ / ~/~ ~
....~. /7~ ~ / IX .-~_ ~~~~
............ ............................
IZCAYAIlOIi INSP[CllON REIII~IIED ~
Y. S~' "e ' '
b
The water Supply
' *
Y S~tc> ! 1c. L 4 '7. ;',',?,, ....
~"' J ~''r' APPROVED AS
1. BEFORE B~CKFIL[I~ FOUNDA-
' 3. ~EFORE COVERING PIPeS'OF ANY KIND
4. FINAL wHEN JO~ ~OMPLETED
Zr~¢_'
-1
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