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Home My WebLink About10183-z FOI~ NO. ~ TOWN OF $OUTHOLD 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) 10183 Z Date . . // ...... , ....... Permission is hereby granted to: ~l'/t at premises located at ................................................................................ ;; .......................................... pursuant to application dated /~)-~?~/q~ /'C~ 19Z,~** and approved by the Building Inspector. ~o Fee $...../..?. .............. Building Inspector TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 Lawrence Kirk Fishermans Rest Main Road Cutchogue, N.Y. Dear Sir: This is to notify you that Building Permit No. issued [4/19/80 to Lawrence Kirk will expire on ~10/'1~780 ' " 10182Z & 10183Z 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 of Occupancy not issued after the six (6) month extension period, you are than required to apply for a new building permit. Very truly yours, GEORGE H. FISHER Sr. Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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 Resider~ces and similar buildings and installa- tions, a certificate of Code compliance from the Architec't 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 property 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: Additions $25.00 POOLS $25. 00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling~$25.Q0, Accessory,~$10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewConstruct, ion ...... Old or Pre-existing Building ............ Vacant Land ........... . . Location of ProperW .......................................................... ........ . House No. Street Ham/et Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No ...... Permit No. /.d./, .~.~ .... Date of Permit .......... Applicant ........................ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ............... Request for Temporary Certificate Final 'Certificate Fee Submitted $ ........................... .../~ Construction on above descmbed building and per~.eets all applicable c. od/es a~r egu lations. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMEN" TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ....... /. ........ ,19./. , ~' K r2---- ~p_~:_cr.~ ...... o ...... Approved . ,. ~.../..&.... .... 19... Permit No..l. *' ~. .a~_.~ Disapproved a/c ..... ~ ..................... ~)~.,/4~ ct ........................... .... ...... ;..~':. C25.~\ Z ': .......... & _~ (Building Inspector)---')~'~/ ~.~__~ ).>.G. APPLICATION FOR BUILDING PERMIT Date .................. , 19..:~ i UCT ONS a. This application must be completely filled in by typewriter or in ~nk and submitted in triplicate to the Buildin¢ 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 street.~¢ 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 regulahons, and to~ admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicaB,t, or na_,me, if a corporati.on) _~, .................................. (Mailing address of applicanty{]~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.; Nameofownerofpremises {,,~ ~o~,C~,~ ~': [c~! (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and htle of corporate officer) Builder's License No. /3 lPe. c-/2t~ t C o~~ ~ Plumber's License No ......................... Electrician's License No ...................... Other Trade's License No ...................... 1, Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section .................. Block .................. 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 /~X I ~)~ ~ b. Intended use and occupancy ......................................................... , .......... 3. Nature of work (check which ahplicable): New Building .......... Addition .......... Alteration .. 1~.,,~... ........... Other Work ............... Repair .............. Removal .............. Demolition . :..~ (Description) '~ ' ~70 ~ ~', ', t~ (to be paid on filing this application) 5' If dwelling, number of dwelling 'units. ./. .... Number of dwelling units on each floor ........ '.'.'. ..... number of cars · /~.q} ~,, ~ If garage ' 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structures, if any: Front ....... I.~. ~'~.,. Rear ..... v.g. *~m.. Depth .... 2~' r~ '/..- Dimensions of same structure with alterations or additions: Front ~. ..... xCrtd,~.~, ,.... Rear ........... Depth .... ~..O.v~..W- ....... ~.. Height ...................... Number of Stories ........ $;a.~.~,-- . 8. Dimensions of entire new construction: Front ............... Rear ............... Depth .............. Height ...1.~o. p-..'rT. .....Number of Stories ........................................................ 9. Size of lot: Front .......... ; ........... Rear ...................... Depth ...................... 10. Date 6f Purchase .. .,l&r-/. il.q .~.5:. ; . Name of Former Owner .. u'. .... ~ .... 11. Zone or use district in which pr~mises are situated ............ .q~! ...................................... 12. Does proposed cohstruction violate any zoning lhw, ordinance or re~gulation: ....... to ~O ..................... 13. Will lot be re~ded ........ ~ 4~. o ............... Will excess fill be removed fro'm premises: Yes Name of Contractor ........ i ................. Address . .t~4~.w-r, }'rvc~¢f~.~t; Phone No ................ : PLOT DIAGRAM '~ .. ~ .... Locate clearly and distinctly al! buildings, Whether existing or proposed, and, indicate all set-back d,~enstons from property lines. Give street and block! number or description according to deed, and show street names aLad'~lhdicate whether interior or corner lot. STATE OF NEV~ YORK, ~q~ z:P*v,,~w- ~.~¢-d-'r~,,,.~ {>~o.. ~ cou~Y OF. ~ ff~.~,. S.S .... .... 7_ 4 ................... being duly sworn, deposes and says that he is the a~plicant (Name of individual sighing contract) above named. He is the O~ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is dgly authorized to perform or have perfo~ed the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his kfidwledge ind belief; and that work will be perfo~ed in the m~ner s~t forth in the application filed therewith. Sworn to before me this ...... ~ ............. day 6f.. ~.ri/ .......... , 19~.ff Nota. Public, . ............... i ......,~.~ County , A/ No 52-8125850, ~uflalk Bounty r-m Fxmr~q MarCh 30, 1~