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Home My WebLink About10176-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy Date November 12, 19 80 THIS CERTIFIES that the building ............................................... '19Z~ Willow Terrace Lane, Orient, N.Y. Location of Property ........................................ House No Street .................. 026 2 2t. of 2 County Tax Map No. 1000 Section ............ Block ............... Lot ................. Subdivision .............................. Filed Map No ......... Lot No .............. conforms substantially to the A~plication for Building Permit heretofore filed in this office dated ...... .~.p..r.i.1..77, .... , 19 J~ursuant to which Building Permit No. q0~76 Z 79 ' dated ...~.?.~?..1...1.7., ............. 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 ......... ....... ~.~..t.~, .~.~.o.k., .~.a.a.t.~..tg.n' ..~9..P.~ .~Y.a3!e.. 9.n?.-.~?.m.t.z.¥...~.e.Z..Z.t.n.g.: ........... The certificate is issued to .. ~q~..:L.n..O. :..fi:e.r~..i.C~joi,(,n.o.r,.l~~ .................. of the aforesaid building. Suffolk County Department of Health Approval lq/R UNDERWRITERS CERTIFICATE NO, N/R Building Inspector Rev 4/79 FOI~/ NO. 2 TOWi~ OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST DE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 10~.76 Z Permission is hereby granted ta: .L A- /- ,4 4~'x) D~ /-4~ . . . d/L . . ~: ~ ~ /~ . . ~/: ~ ~ ~ ~ ~ ..................... .~ ~..~~z z~...~ ~.~ ............ ..~.~z~z~.~.~.=..~:.~: ........................... ~o ...~.~.~.~.Zz~....z.~J~/.~.....~.~.... ~.~4Z.~: z~....~....~4~4~ ..................... .~ ................................ ~ .............. .~ ............... : ............. .: ........................... ....................................................................................................... ~~...~.:..~.;~.: ...... Building Inspector. ~uilding inspector FORM NO. 6 TOWN OF $OUTHOLD 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~ for 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. 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 $§.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date...NPY~..~ 1980 New Building .D.e.c..~ ........ Old or Pre-existing Building ............ Vacant Land ............. 194 Willow Terrace Lane, orient Location of Property ................................................................... House No. Street Hamlet Edwin C. Gerrity Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section . .q2..O .......... Block ..... 2....P?.r.t...O~_ot .... 2, ........... Subdivision ................................. Filed Map No ............ Lot No .............. Permit No. 10176 Z Date of Permit 4/17/79 .Applicant I.n.l~.nd Homes ~ Inc, Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .. X Fee Submitted $ 5.00 Construction on above described building~pei~,fri~.-~L~e~311 a~plicable code~d regulations. Applicant ....'">-~~~'J ..... ~ Robe£~ ~. Hiltz ' -~-,,~ ~ Inland Homes, Inc. ~ ,i)1~%{) Rev. 10-10-78 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765.1802 Inland Homes, Inc. 315 Westphalia Road Mattituck, New York Dear Sir: This is to notify you that Building.Perdmit.No. issued ... ~/17/79 to Edwmn errmty will expire on 10176Z If more time is required to complete the job and obtain a Certificate of Occupancy, you may apply, ~y letter, for a six (6) month extension. If the work is not completed and the Certificate not issued after the six (6) month extension period, than required to apply for anew building permit. Very truly yours, GEORGE H. FISHER Sr. Building Inspector of Occupancy you are CUSTOJ~ BUILDERS / ApPI~VED AS ~/cu , 1~3' ,' ~ '~7 ~[? BEFORE/COVERING p][ 4. JOB c( !IREMENTS OF N. AND TOWN HOUSING CODE TOWN OF SOUTHOLD TOW. CLnK'S omc~ MUTHOLD, N. Y. ~,~ ..... ~..z.Z ................. , ,~Z.~. ~¢,~.,o~ No../~..~ .......... ~proved ~ / ~ ]9.~. Permit No..~...~... s~pproved ~/c ............ ~:.z .................................................... ~.~ .............. .................. .......... ....... ( ui ding nspector) APPLICATION FOR BUILDING PERMIT 9 Date . ~p. ril 17 197... .......... 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 ofproperty must be drawn on the diagram which is part of this application. 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 msue 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 premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) 315 Westphalia Road, ha-&-~ituck,N.Y. (Address of applicant) applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder~ State whether Name of owner of premises ....l~.4W.i.~..!~t~.&..z.~ ...................................................................................................... If applicant ts a corporate, signature of duly authorized officer. ~1 ................. P,~b~ ~.l;..1~ ,.lt.i. 1.t.z ..................................... (Name and title of corporate officer) Builder's License No ..... ~ ........................................... _ Electrician's License No ........... -.~ff...~. Other Trode's License No ............................................... Location of land on which proposed work will be done. Mop No....,.~D.~..~,.r..v..e.x .............. Lot No?..a...r.~....°.,f...L..°...~.. Municipality State e isting use and occupancy of p :ses and in ended and.occupancy of proposed construction: 3. Nature of work (check which' applicable): New Building,, ................. Addition ...,,~,.~ ........ Alteration ................ I Repair .................. Removall ................ :. Demolition .................... Other Work ................................................ ,... , ,' ~ c-/~,.~ (Description) ! 000,00 , Fee .......................................................................................... 4. Estimated Cost ..~....~ ................................................... (to be paid on filing this application) 5. If dwelling, number of dwelliing units ............................ Number of dwelling units on each floor ............................ If garage, number of cars "-i ............. -...-..'..7 ................................................................................................................. 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 ........... .4...7. ................ Depth ....... .2...6. ........ Height 16' Number of Stories 1 Dimensions of same structur~ with alterations or additions: Front ............ ..6..2. ................... Rear .....6...2. ................. Depth ~ ' Height 16 t ,, , ............................................................ ixtumDer of Stories ................................ 8. Dimensions of entire new cohstruction: Front ...S...~,e....l~..~..i,q,~;. ............ Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ].02 ].02 ].:18 ......................................................... Rear .......................................... Depth ................ ........................................ Name of Former Owner ........................................................ 10. Date of Purchase ' 11. Zone or use district in which: premises are situated ................................................................................ ,t .................... 12, Does proposed construction wolote any zoning law, ordinance or regulation: ................ -..-. ..................................... nO . fill be removed from premises: ( ) Yes tx) No 13. Will lot be regraded ............. , ............. Will excess ,^ · iEdwin Gezrit;y Address ..R.°..?..k..a.?..a.~. ............ Phone No. ~3..-.~2,.~... 14. Nam,e at uwner aT premises .................................................... Name of Architect .............. I ................................................ Address ................................ Phone No ....................... M&~t~uck, N,Y,, 298-9696 Name of Contractor Inland }{omes, Inc. Address ................................ ~'none No. PLO.F DIAGRAM Locete clearly and distinctly dll buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot OF ...~...~ ~..~. ~..~. ............. Robert 1~. S.S ................................................................................................ being duly sworn, deposes and soys that he is the opplicom ; (Name of individual signing contract0 above named. He is the'. ............................. ¢2o~,~;z'm¢.t, or, .......................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dbly authorized to perform or have performed the said work and to make and file this application; that all statemen,ts contained in this applicotlon are true to the'best of his knowledge and belief; and tha~ the work will be performed in ~he manner set forth in the application filed therewith. Swo, rn to before me this i ~ 17%h' A rix , 9.7.9 . ........................ day of .................................... , ....... . Suffolk . . Nota ............................. 1 ................... Co.nt .............................................. .......... ' Robert: ~,Htl(~iJ~nature cf applicant)~x,,,_J Inland Homes~ Inc, APPROV{~D~