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Home My WebLink About10626-zFORM NO. 4. TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ..... g. 1. .07.1.3. ..... Date ........ [~t~.v. Ch. 9 ................. 19 .~..1 THIS CERTIFIES that the building ................................................ Location of Property/:/3tJs~ h/d ' 3 224.0 ....... ~.~la£n. 1t o.~td ~ ............. .0.~. l.e n.~;. ~. ~I ~ .¥.,.. Street Hamlet County Tax Map No. 1000 Section .... 3 9 ......Block ..... .1 ......... Lot .... .1.1.2. ......... Subdivision ............................... Filed Map No ......... Lot No .............. ? conforms substantially to the Application for Building Permit heretofore filed in this office dated ·../~.P.~:~ ~-. B .......... , 19 B.0. pursuant to which Building Permit No....1 9.6.2. 6., .Z ........... dated ....... ~ t? ?.:L.J... ~, .6 ............ 19 ~.0. , 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 ......... ............ ~..~.~$.~..t. 9.n' .~.o.. p.u.q 1.. 3..$.n.,~ ............................................ The certificate is issued to ...... .J. qy.c.o..B.u. ~.g.qn. ...................................... (owner~le~ee or-tene~t4.--- of the aforesaid building. Suffolk County Department of Health Approval ........... .N./.R. ........................... UNDERWRITERS CERTIFICATE NO ....... IqZR ....................................... / Buil~ih~'I~spector " ' Rev. 1/81 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPL£TION OF THE WORK AUTHORIZED) N? 10626 Z Date ................ Permission is hereby granted to: .......... :,~.~ ~. c,~......,4~ .,~'7-:..~.z,,r ................. .... ~...~..~../. ...... ..... .......................... , at premises located at ~-~'.~.. -.~(~ ........ ~.~3,~b.....~.~2...,........~. '~.~'~..~ .......... pursuant to application dated .~:~2/~':~ ....... ~ ................... , 19~....~.., and approved by the Building Inspector. Fee $, .~..~z~...~ .... ~ ~ FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 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. 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 .... /. ......... New Building ............. Old or Pre-existing Building .... ~.'. .... Vacant Land ............. Location of Property ,..~),~'2,:D~(-~¢'} ..~.gt. iLD. i-~?.~' .~.g'./..~.~2/'..? ...... ..... ' ........... / .... Hamlet House No, ~ Street Owner or Owners of Property .... .~.-./~: .~.<~- .~.,.:..~,~.~.'~.C.t~ ............................ County Tax Map No. 1000 Section .../.~ ......... Block ...... ./ ........ Lot.../. ?.,..'~- ..... Subdivision ................................. Filed Map No ........... Lot No .............. .. ..... Permit NO. /~ ~'.,~ (.~ Date of Permit .Applicant . .">,j~ f/.q ~ . .~.~7 ... Health Dept. Approval --~ . .Labor Dept. Approval ........................ Underwriters Approval .~Z.~../-~.~ ................. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ .......... .,~., .g.'~ ............... Construction on above described building and permit meets all applicable codes and regulations. Applicant . . . .~.~~_~ '.~.~. :~./~ .~.. ............. ~[~/1~ FOUNDATION FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING INSUIJITION PER N.Y. STATE ENERGY COpE FINAL ADDITIONAL COMMENTS: 'lu~, NO 7908403227 AMENDED September 18, 1979 ALL that certain plot, piece or !)arcel oF land, situate, lying and being in ~he Town of Southold, County of Suffolk and State of New York~ being more part- icularly bounded and described as follows. BLGINN1NG at a point on ~he southerly side oF Main State Road at the north- west corner of the herein described premises where the same is intersected by the easterly side oF land now or formerly of lerry; said point also being distant 3000 feet, more or less, as measured along Main StaLe Road from the corner formed by the intersection of the southerly side of Main State Road with the easterly side of Narrow River Road; RUNNING THENCE from said point of beginning in a general easterly direction along the southerly side of Main State Road along ~qe arc of a curve bearing to the right having a radius of 1900 feet a distance of 120 feet to land now or formerly of Koroleski; IlliN(,[ ~lonfl ,mid land Ih<, followJmt /wo (2) cm~rs~,,, and (t) 'a)u(h I{J degFec,!, U/ l:lim~l,e', [[) ,,e~md,, W~,',I IHd (2) NorLh :~,q degrer,,, 18 IninuLe'., ;,() ',ec~md,, WesL I00 ired, Lo land now or Iorm(,rly Im'r,y~ first ,.dJov(, mentioned; RU[iNING 1HENCL along said land North 5 degrees 41 minutes l0 seconds East 219.37 Feet to the southerly side of Main Slate Road at tile point or place of BEGINNING. FOR IHFORfIAFION ONLY: DiS'F. IOrl9 SIC. tq LEK. 1 LOT ll.2 DL'SCRIP1 ION FORM NO, 1 TOWN OF SOUTHOLD ' BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 (tluillfling Inspector) Application No.../.(?(.~.~.¢ ....... APPLICATION FOR BUILDING PERMIT Date ...4/8/~50 ......... 19... 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 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 promises 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 fgr 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. .... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. OWNER Name of owner of premises JOYCE BURTON (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. N/A (Name and title of corporate officer) Builder's License No. Plumber's License No ......................... Electrician's License No. Other Trade's License No ...................... Main Road, Orient, New York 1. Location of land on which proposed work will be done ...... ' :k .......................................... '~ Main Road, ...... .... ~.....Z.~..Q ................................ 0.~. $.en ~. ......... House Number Street Hamlet County Tax Map No. 1000 Section 1 9 Block I Lot 1 1.2 N/A Subdivision ..................................... Filed Map No ............... Lot ............... (Nmne) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Primary Reszde ce a. Existing use and occupancy .................... '...it .................... .' '7 ..................... b. Intended use and occupancy ...... Primary..Rosid~r~o e ..... .'~/.~..~?. ([~(.0..a~..~ ..................... 3. Nature ofw'~"rk (check which applicable): New Building .......... Addition ..... X. .... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... .'' ~ff,__....,~,,~ (Description) oo..o · 4 F ' dC $3 F · ,stanate est ..... , .......... .., ............. ee .................................... (to be paid.qn~.filing this application) 5. l'f dwelling, number of dwelhn2~ units Number of dwelling units on.each floor... '1 tfg ' cf arage, number o ars .... , .................................... , ........................... 6. If business, commerctal or mixed occupancy; specify~ure and extent of e~c~h~type of use ............. 7. Dimensions of existing structures, if any: Front .............. Rear ..................... Height ...1.7 .~..t;.q .P.eg~Number of Stories ............. .1 ................ ; ......................... Dimensions of same structure With alterations or additions: Front ..... .2.5. [. .........Rear .... 2.5 ~. .......... Depth .... 3 61 ............ . ,. Helgh ......... 17 ~ .*bo .1~ eak. ·. Numb,e]; of Stories ........ J' ' ' t ......... 8. Dimensions of entire new cons[ruetinn: Front ..... 8. ......... Rear .... ~. .......... Depth ...1.1. ....... Height .11 t ~;o peak Number of Stories 1 ' ,,i,eorlot:Front 'gW ..... Rear ........ 00.' .......... enth .... Date of Purchase '9:-.,- ~.,. '" _ Name of Former Owner . .S.~.~..Z.ez K.°..:F.°.~.e. 8..k.1 Zone or use district in which premises are situated..Reslrl, en:bJ, aZ-.agZ'¢ou%-b~.oXal ....................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded .~I9 ..... ; .................... Will excess fill be removed from premises: _yeslJnn ecN~o Name of Owner of premises 5.9 Yg.e...~.u.r.~.qn. ..... Address..EaA. ,.. 9.z%e.n. t~hone No..~.2.~...~79.7...... Same. i Address Phone No Name of Architect .............................................................. ' , * r ,. Address PhoneNo Nmne of Contractor ' ' .J ................................ 10. 11. 12. 13. 14. 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. po/e. ' being duly sworn, deposes and says that he is the applicant (Name o¢individual sig~ing contract) above named, i 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; theft, all statements conltained in this application are true to the best of his knowledge and belief; and that the- work will be perforn~ed in the manner set forth in the application filed therewith. Sworn to before me th!s~/, i , Ng. 52-0344.063 Stff¢olk Ooun ' Co~m,sslSn ~X,/te, March 30,