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Home My WebLink About10184-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No....Z..1.Q292 ....... Date ..... D,acember..~0., .............. 19 ~ THIS CERTIFIES that the building ............................................... Location of Property .... '165. ~he. Short. L~ne, ...... East. Marion ................. House No. ~ Street Ham/et County Tax Map No. 1000 Section .. 0.~2 ...... Block ... 2 ........... Lot ..... ~ ........... Subdivision... P.e.~b~l.e. ~Beach .Faraa8 ...... Filed Map No.. 6266..Lot No. 2 ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated .. M~reh .lO .......... 19.79pursuant to which Building Permit No ..... ~.0..i.8~ .Z. ......... dated . gla~3.Z .'19 · ................ 19 .'/9, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occt~pancy for which this certificate is issued is ......... ..... A. 99.es.~. 9Ty' .S. ~.o.r.a.g.e..~.ul.l.d.~rlg..a~d. F.e. noe. l~nclo~.ure. ~or. cl,~g, run ..... The certificate is issued to ....L&rldB..and. 0'.oselah .Scko. enst.ein ..................... ~owner, I~ of the aforesaid building. Suffolk County Department of Health Approval ...l~l/l~ ................................... UNDERWRITERS CERTIFICATE NO...N./.R. ...............................................~...~ ~/~~.....~~ Building Inspector Rev 4~79 FOR~ 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) 10184 Z Permission is hereby,gr, al~tedt~' /,m ,,/~ 1',. t ¢. ..? I: ..................... ':;4'~':':f:'>'E~ .......... :':'?' ~ ~ 9 ................................................................~ ~* ~ ................ ~/¢ E: ........... ~'~'/ ....... l ~,;"':"%¢ ~ ¢ .......................................... / ~ ~f premises loc~ted ~t ............................................................................................................................ ...... 7'*~ ........* ................. ~'~"/w'~.-'**~ ............ ~ ....................... ~"*'.~ ...................................................... .................................................................................... ~'~":"~'~ ......... ~' .................................... pursuant to appflcation date~ ........................................................ , ]9./....., and approved by the Building Insp~4~tor, ! F ~ Building Inspector FORM NO. 6 TOWN OF SOUTHOLD 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 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 propertv 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 2. Certificate of occupancy on pre-existing dwelling or land use $5.Q~ 3, Cepy of certificate of occupancy $1.ee Date .... ~ ~ /i0'//iiiii /.~a~d !i i· New Building ............. Old or Pre-existing Building............'~ Va Location of Property .. ,~.~,.~.-~....-~.~.~..t.~.~)/C,/.'~. ~/~..W.~-~ ....... .~.4) ~.7'- ~',~,~..".~d~: o~' ?~2 ..... House No. Street Hamlet Owner or Owners of Property ......... .......... County Tax Map No. 1000 Section ............... Block ............... Lot Subd,vision '~.~ J~(¢.~l..~....~.q ~....~...~..~.S..F,led Map No ........... Lot No .... .'~..~...'.-T.. Permit No..-.~., . .~.Y. ,~13ate of Permit .......... Applicant..~.(~.....~.c.~.~.~./.~,,.~ .~-~1. · · Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval .................... Request for Temporary Certificate ..................... Final Certificate .. Fee Submitted $. ~.¢J C) Construction on above described building and p~rmit meets all applf~es and regulations, Applicant . ,~.~,'~.~/ .... ~,.~ ............ Rev, 10-10-78 ~/ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 Joseph Schoenstein P. 0. Box 226 East Marion, N.Y. 11939 Dear Sir: This is to notify you that Building Permit No. issued ___~/19/79 to same will expire on 10/1~/80 If more time is required to complete the job and obtain a Certificate of Occupancy, you may apply, by 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. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 qjb~ ~f'~ 7q TEL.: 765-1803 Approved ............ ~,.~,.~. Permit No ............ Disapproved a/c ............... .[... -..... ~.. · ·..~., (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No ................. a. This application must be completely filled in by typewriter of in ink 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 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 c, ode, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. /'~ .~ ~ ~, ,~,~Signa~ure of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, gen6ral contractor, electrician, plumber or builder. Name of owner ofpremises ]-.JW.~..O...~.,:-.HOgP(6'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 .................................................. 1/ ,55. .T.,SLff . Fo e-,T. . . /¢ iq , o , ........................................... House Number Street Hamlet County Tax Map No. 1000 Section ... b .~. · .~-~. ....... Block. f..~x... ........... Lot...c:>~..._. ............ Subdivision .~)~ b)~].c-..'~. E/4~.~,.~/q~g.fO. $ ....... Filed Map No..~...~ ~..~ .... Lot .... ~ .......... (r~ ~ 2. State existing use and occupancy of premises a mten~and occupal~y ofpro~>osed c~onstruct a. Existing use and occupancy ........ b. Intended use and occupancy . . .~..b.o.£..,.~.bJF./~ .................................................... 3. Nature of work (check which applicable)' New Building .......... Addition .......... Alteration Repair .............. Removal .............. Demolition .............. Other Work./~.a. ~ (Description) 4. Estimated Cost...~..//O.e~tO.Q.: .......................... Fee..~..~.~.~* ~. , (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 6. If buslness, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure With alterations or additions: Front ................. Rear .................. Depth ................... :... Height ...................... Number of Stories ...................... 8. Dimensions of entire new consiruction: Front . . ~ ~.'..7'ff. ...... Rear ...~"~..~. ...... Depth . ff.~..~.. ...... '.~.. Number of Stories Height . .~.~ .............................................................. 9. Size of lot: Front .......... i ............ Rear ...................... Depth ...................... 10. Date of Purchase J-Jom~.~.a(..~. c3 /a~ Name ·...~. ............. of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction viqlate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No ' .72. 14. Name of Owner of premises .................... Address ................... Phone No. -. ... Name of Architect ......... [ .................. Address ................... Phone No ................ Name of Contractor ........ i .................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all 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. being duly deposes and that he is the applicant sworn, says iS the ........" '~i~r', agent, ........ cora;rate ......................................... officer, etc.) of said owner or owners, and is doly authorized to perform or have peffo~ed the said work and to m~e ~d file this application; that all statements co~tained ~ this application are true to the best of his knowledge and belief; and that ~e work will be perfomed in the m~er set forth ~ the application filed ~erewith. Sworu to befor~e this ~ --i g~l~ ~er SUpPlF ~o ~[ A VAU~ r:,u~ d~Sposa for I~ION GU~S ~E NOT TRANSFEraL[ g~iof o~ ~neral En inoerin$ ~6 ;m *ss~o~s o~ ~:~ 0 / / p,:/. ~. · / ~