The URL can be used to link to this page

Home My WebLink About11488-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold, N,Y, Certificate Of Occupancy No...7~0~0.¢ ..... Date ....... Fs~.mlar'7.'.33 ............. 19 .~2 THIS CERTIFIES that the building . a. cld :t :b.'Lon ..................................... Location of Property .. ~ ¢;].5. .............. F.].e.e..t.~p.o.d.. gp. qd. ............ ~.u?.qh. 9~.u.q.. House No. Street Hamlet County Tax Map No. 1000 Section . . l 3 7 ....... Block ... 0..~ .......... Lot . .. 0. ~3 ~ ........... Subdivision .... ~ .......................... Filed Map No..X. ...... Lot No. , ,~, .......... conforms snbstantialty to the Application for Building Permit heretofore filed in this office dated .1~ o.v~qr0be~'., l ~ ........ 19 .'~ ~ pursuant to which Building Permit No.. 3..1 .tL[}[~' .g ............ dated ... D.~.CO~!~.~.P.. ~ ............. 19 .gfi., 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 ......... .an. ,a d cl;i..t~.$ orL .1~o. ~ti~..~x ~.g.~,¢~..qr~q.-.f'.qr~$.~y'..d..w.e.l.l.~..ng.. ....................... The certificate is issued to ........ lq$ Z2.~,~t~n. g.... ~.e~rl~ .dy..&. g~?.q ..................... (owner, ~ ~r"t~,~rrt~ of the aforesaid building. Suffolk County Department of Health Approval .... .nd?. .................................. UNDERWRITERS CERTIFICATE NO ............ ?,./?. .................................. Rev. 1/81 Building Inspector (THIS PERMIT MUST BE KEPT ON THE P~E~ COMPLETION OF THE WORK AUTHORizED) Per~nissio~ is hereby granted to: UNTIL FULL i~SEs D6te 19 _~=.__~; .................. , qspectot : 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- tot w~th 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 unusua~ natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any Ilousing 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 $5.00 3. Copy of certificate of occupancy $1.00 Date ......................... New Building ............ Old or ?re-existing Building ............ Vacant kand ............. co~tv ~ ~p ~o. ~000 s~tio~ ~3.7~.P.O ..... ~o~k 0.%.~o ....... cot ~.~.o ..... Subdivis~oa ................................. Filed MaO ~o ........... kot ~o.~ ........... ~ermit ~o.I ~ .*.. Date of ~ermit~.~.}...Applicant ~.~ .~ .............. Health ~ept. A0proval ........................ kabor De~t. ~p~roval ........................ Underwriters Approval ........................ Planning Board Approval ,.... ~,~.. ~ ............ Request for Temporary Certificate ...... ". .............. Final Certificate ... ~ .................. Fee Submitted $ ~.~. ~. ~, ..................... Construction on above described building andS. rm..mit 7eets all applicable codes and regulations. eo~.~o-~o.~ . ~ o, z lO~8'q , FIELD I~tSPECTION · FOUNDATION (Ist) COMMENTS FOUNDATION (Snd) ROUGH FRAME & PLUMBING INSULATION FERN. STATE ENERGY C~DE FINAL ADDITIONAL COMMENTS: E×alnine~ . .~...'"~.... ~ .... 19. 6~/. . Approved ~.--~.,.. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, H.Y. 11971 TEL,: 765-1 ~02 ?.'~. .... 19, .. Permit No.. .,. APPLICATION FOR BUILDING PERMIT './ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Build 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 stre or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon apprc.'al of this application, the Buildi.ng Inspector will issue a Building Permit to the applicant. Such pen shall be kept on the premises available for inspection throughout the work. e. No buildiag shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupar sl'.aJl have been granted by the Building Inspector. APPLICATION IS IIEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to Building Zone Ordinance of the Town ~f Soutbold, Suffolk Cotmty, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ Tl'.e appticant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessaryt~inspections: - 'e~ '(oignature of applicant, of~ame,'if a corporation) ~J (Mailing address of applicant) ~ State whether applicant is owner, lessee, agent, arc!~itect .engineer, gefieral contractor, electrician, plumber or build (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co¢orate officer) Bnilder's License No. I i ~ Plu ~ber s Lcens. Other Trade's License No ...................... 1. Location of land ou which proposed work will be done ................. , .............................. ....... /. /. . .(. ........... ¢..a. ......... ................... House Number Street Hamlet County Tax Map No. !000 Section .[ ~.TA ~ J~ ....... Block .P.~.~ ~ .~ ....... Lot. h 3 .~ ~ .~. Subdivision ..................................... Filed Map No ............... Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy . . .~~~ .............. Repair Rem~oval Demolition Other Work 5.) ~ (Description) - c.)I0 - : (to be paid on filing this application) If dwelling, number of dwelling units .. I Number o~ dwelling units on each floor..~. If garage number of cars If bus ness, co ~ nerc a or m xed occupancy specg~ n~tt re and extent ofeac ~ type of use ................ Dm~ens,ons ofex~stmg stmctur'es, if any: Front~ ~....~..., ..... Rear l.q.= ~ ....... Depth ,.~.~.' .... lle =bt . 1~...O ...... Nt tuber of Stones ..................................................... ............... Dimensions ofsame~ structure With alterations, or additions:~ Front , . Rear{..~ ............ Depth ...................... He~t ...................... Number of Stones .......... , ........ Dm~ensmnspl =nt~r.~now construction: Front ~ ~...~ ..... Rear 1~.~.O ..... De~th 1.0...~ . . Height t.~.... ~...~.. ~umber of Stones ......................................... , .......... S~z=oflot Front ..... ~..~ ............ Rear...~.~ .............. D~pth .~.O ........... Date 6f Purchase ~!me of Former Owner ' .......... ................. Zone or us~ dis;riot in which premises are situated Does proposed construction vi61at~ any zoning law, ordinance or regulation: .~ .~ ........................... WiUlot be regraded ........ ~..' .................. 'Will excess fill b~ remowd from premises: Yes Nc Name of Ownor of premises . ............ - .....Address ................... Phone No ................ Nam~ of Archkeet ~ . Address Phone No N~e of Contractor ~ Address Phone No PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions frorr roperty lines, Give street and Nod, number or descdption'according to deed, and show street names and indicate whethe.: =terior or corner lot. rATE OF NF, OUNTY OF ~~._..~.'.. $.8 (Name of i~dividual si ,ning cor/qd'act) ...... ' .... being duly sworn, deposes and says that he is the applican_ ~ove named. e is the (Contractorl agent, corporate officer, etc.) f said owner or owners, and is duly authm4zed to perform or have performed the said work and to m~e and file ~plication; that all statements co~tained i6 tb~s application are true to the best of his knowledge and belief; and that tl~ :ork w~l be performed in the man,er set forth ~ the application filed therewith; worn to before me this .................... daybf ..... , 19 ~%*~ublic, . ~..~ ..... .~ .... County /).,