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Home My WebLink About10835-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENI Office of '[he Building Inspector' Town Hall Southold, N.Y. No. Z11526 Certificate Of Occupancy Date ........ ~arc~.9 ................ 1983. THIS CERTIFIES that the building Addition Location of Property ,.. 9.9.~,. Gar. dner.'.s · La.Iae ...... ~['r'e~t' .............. S~u~ho~d .... House/vo. Ham/et County Tax Map No.-I000 Section . ...0~0. ..... Block ) * 08 .Lot 04'7 Subdivision. 2?a .4 r. view..t?.a rk .............. Filed Map No...3 .3.8.8...Lot No .... 2..5 ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ...... .A.u.~.u.s .~..'1.~. .... 19.8..Opursuant to which Building Permit No ....... ~. 0835Z ........ dated . .-¢.u~u.s..~..~.9. ................19.8.9, 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 ......... a...o.n.e..9.a.r..garage; living room; £oyer; sewing room addition The certificate is issued to . . .8.o..hn.., .&. · '--(owne'r, lesse'e o'r'te3ant) ..... of the aforesazd building. Suffolk County Department of Health Approval . .AhT../'.fi. ..................................... U~DERWRITERS CERTIFICATE ~0 ..... 55?.7.2.? ..... Building Inspector Rev. 1/81 TOWN OF ~OU H~ BUILDING D~E PART~/~R~ N' TOWN HALL SOUTHOLD, N, Y. BUILDING PE~I~ (TH~S PERMIT MUST BE KEPT ON ~THE P~E~I~ COMPLETIbN OF THE WOR~ AUTHORIZED) N? 10835 z UNTIL FULL Permission is hereby granted to: .......... ~"~....,--d,~- ./..C, ....... .......... ,o ..... C'~.,~.z,~.~.....~.~.~,...~..~.---o?.~.....~.z~.!~..~..~.s~.'~,,,,,,~ .......................... ~, 1.~,~. ~k ..................................... ,..,..~....~ ................. ~ ........... ~ ....................... ....... ~t premises located at .... ~ ~: . .~..~2..~.... ............ COunty Tax Map No. 1000 Section ....~...'7-.(~ ..... Block i. ~. ...........~Lot No. '(~'~"7" ....... pursuant to application' dated .. ~.~......./....~... ........... i'"'i'"'"' 19 ~ and 'approved by the Building Inspector. ~e,~./..~.....--.. ...... R~v 6/30/80 FORM NO. 6 TOWN OF: SOUTHOLD Buiidin~ Depar~mem; Town Hall ou~nol~, ~. ~. 11~71 APP~,C~,T,ON FOR CERTIFICATE OF OCCUPANCY Instructions Thru apohcat(on must be fWed in typewriter 017 ink, and subn~lttad in duplicate to the Building Insc: tot '.vl(h [he following, for new buildings oF new use: 1. ~[naI sum/e,/ of pFo¢er~y w~th accur~e Ioc~don of an budd~mqs pro~grty I~nes, stree[s, and unu% 2. Fmal approval o~ He¢;~h ~ept. of wa~er supply and Sewerage dispose --(S-9 form OF equal). 3. Approval o¢ 818ctF~c3~ mstallation from Board of Fire 4. Commercbl buildings, Indus[r'al budd~nms, Multiple Residences and slmilar buildings and instml tlons, a ce t~,~c~ of Code compliance from the Architac~ or Engineer resoonsible for the buildin 5. Subm~[ Planninm Board aoprova o¢ completed S~e p an r=~ ~ = Fcr ex~s~mg bulldogs (prior [o April 1957), Non-conforming uses, or buildings and pra-ex~s~mc 1. Accurate ~m/ey of peoper:y showing ali prooerW Hnes, ~ree~s, buildings and unusual natural c topographic features 2. Sworn s~a~men~ o~ owner or prev¢ous owner as ~o use, oocuo~ncy and condition 3. Da~a oF 3ny housmg code or s~fa~y IRS=Cd,IOn Of bufldmcs or premises, or o~her perdnen~ inform tion required to prepare a ce~flca~e, s 1. Cartffmate of occuoancy S5.00 2. Cartlflcata of occuoamoV on pra-ex~s:mg dwellFng or lano use 3, Cooy of certificate of occupancy $t,00 $5.00 Ne',v't~-t~PcE.rrr~ ~ . Old or Pre-existing Bu;lding(Z) ........ = /Vacant Land Locat,onofProoerty . ,~;F.%~. ' - z, - /,., ' ........... ~ ¢'72 .......................... LOt :(t(/z~... ;; % ......................... ~,~ M~¢ .o..-2.~ ~;: .Lot ,~.~ Health Dept Approval ......................... Labor Dept. Approval ...................... ,. UndeP, zr~ersApprova ,~ ~ ~ ............. . ......... .......... Request for Temporary Certificate .................... Final Certificate ................ ................ 0'7 ..... .... ~..' t :.., .... :.. . - . , -. ~- ~ ¢.. ~oouo~ THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY t~ 85 JOHN STREET. NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT ~ ~ ~--~" and found to be in compl[ar[ce with the requirements of this Board. 9 1i 14 4 1 F ~m~ld, N.Y. 11971 Th~s cerhflcate must not be altered in any manner; return to the office of the Board if ~nco~rect. Inspectors may be ~dentffled by ~r /redentials ANY MANNER. FIELD INSPECTION FOUNDATION FOUNDATION 2. ROUGH FRAME & PLUMBING ( st) INSULATION PER N.Y. STATE ENERGY CODE FINAL COMMENTS ADDITIONAL COMMENT~: ~CUPANCY OR USE iS UNLAVG'UL WifHSi~T CERTIFIC~TE (iF OCCUPANCY FORM NO. 1 TOWN OF SOUTHOLD · BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 .'3 TEL.: 765-1803 .~ ...... ' ....... Disapproved a/c .................................... / APPLICATION FOR BUILDING PERMIT /'~ Date./5~..i~.../..¢. ..... 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 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 ~ssuance 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 premises and in buildings for necessary/i~spections. .... .......... · ~)~nature of appl~ant, or flame, if a corporation) ' '~'" ~.?.~7..~,9./.4~. ~?...z.~:..&..,?../~x,P... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises (as on the tax roll or latest deed) If applicant is a corporation, s~gnature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... Plumber's License No Electrician's License No.~.--.~.'~....~...C~..C..()?..(..t..~. Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................... y, ............................ ............... .q'..~.¥ ..... ~ ~:~..? .... z,.~......,~.. ~.~..~. t.-:~ .......................... House Number Street Hamlet County TaxMal~No. 1000 Section..c~...7)~.d~. ...... Block ....~...~.~' .......... Lo~..~..Z ............ Subdivision....~.~. ,.P.~..'.~?.~. '.b .~. .... '.~.~>.~. ~.~'.. ...... Filed Map No..."~...~..?~ .~.... Lot..~. ~.. ...... (Name) 2. State existing use and occupancy of premises and inte~nded use and occupancy of proposed construction: a. Existing use and occupancy 35 ]f b. Intendeduseandoccupancy // ~' /~l f'~. .~ f.~./.(??. ~.~. .~. . . ~ .~,. . ,~f :~.C.~.~ ~. ./,.~. l. . ,.% ....... ........................ 3. Nature of work (check which applicable): New Building .......... Addition t'// Alteration Repair .............. Rem6vai .............. Demolition .............. Other Work ............ ~... 4. Estimated Cost .... ~ Fee (to be paid on filing this application) 5, If dwelling, number of dwelling .hnits [ Number of dwelling units on each floor If garage number of cars ' ! 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 .... ~ ..5~. ...... Height ............... Nur~ber of Stories ....................................................... _ Dimensions of same structure with alterations or additions: Front ..... ~. ~ J. ....... Rear ..... ?.~. f ......... Depth ..... ~.~z. ~. .......... '.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ...... .d.' .-%. '. .... Rear ..... ~.~-..' ..... Depth .... .~..6~..' ...... Height ........ Number of Stories .......... . ............................................ 9. ize oflo · Front /. t /~.~ , /~ S t ........ '~ ~.. .......... Rear ......... ~.. ........... Depth ........... ~. .......... 10. Date of Purchase ....... d'..~..~.~ ................ Name of Former Owner ....5~../.4-.L...~/',r4C(./~. ......... 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction viol~any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... , ................... Will excess fill be removed from premises: Yes 14. Name of Owner of premises </'~(..~.~). . .'~. {¢/v~.£'/(2.. Address .~.q~. S/~.~¥dff~,..k.'q.. Phone No. Name of Architect .......... ' ................. Address ................... Phone No ................ Name of Contractor ......... ' ................. 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. Lo7 He is the ..................................................................... - .................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements conthined in this application are true to the best of his knowledge and belief; and that the work will be performed in the manne~r set forth in the application filed therewith. Sworn to b~fore me t~ : , ............ Z./-~...'~. i/'/--/'~' .... day o~ ....... ~., 19 ..~. Notary Public, ~t{~m' 1'.' 1'£;~ '~ .... County ~ j ~,. ~ , ~ ' ~otary Public, S!ate of ,ewd. Y'ork , ,,/~'~'- ~ ""m"~I ~ ~ , ~m5i2-.03~_963 Suffolk County~,~/ ........ fl{ ............ [J ..... .._ .... ! ....2.... .... : I ~ ~p~res March 30, 19~// [/ (Signature et applicant)