The URL can be used to link to this page

Home My WebLink About11351-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT. Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..g.1.1.5..3.1 .......... Date ......... ~l~cl~ .8, .............. 1953. THIS CERTIFIES that the building ...~ .o.o.e?.s..a.I'?. .................................. Location of Property ..... ~.0, 7.~..' .~.d.:[fi.n...~.e.o.k...~.~.n.e. ....... l~e o or~± o, ~T. Y. House No, Street .................... h~t~iei County Tax Map No. 1000 Section ~3G ·Block O~ ...... Lot OflZ~ Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..~.~. ~ .u.~.~., 2.~ .........19~.q. . pursuant to which Building Permit No. '1 'I 55fl 7, dated . .A.~.~u,@ .~..2.~. ................ 19~.~. . , was issued, m~d conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ....... .~.n.. ~. 9.e.e.~..~.~?.~..~.~p.~.@~.e. shed The certificate is issued to . . ?.e.~.e.~...R.... S..~.o.~.~. e..n.~! .t~.~.h ................................ (owner, 4esece-o~-te~) of the aforesaid building. Suffolk County Department of Health Approval ...~l.z/.-A-. .................................... UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 TOWN?O BUILDING, TOWN HAL!. souTHoL:Dj N~ BUILDING" P~ERMi? (THIS PERMIT MUST BE KEPT ON THE PRE/~IS~S COMPLETION OF THE WORK AUTHOR'IZED) N°. 11351 Z Date UNTIL ~ULL ................ ~ ..................................................................... ;. ..... ,. ,.~ ~ ..~,~ ....... , ..... County Tdx Map No. 1000 'Section ;., L.... Blo¢~k; ...... ~ ...... i}Lot No. ;..,~...~, ...... ~ur a t 0 application dated ....... ~.. · L..L...;...; ...... 19 ;, and pproved by the Building ~spector. ~ ;!: Fee ............ Permission is hereby granted to: '~"~ ....... ....... ,o...~o:~m~ ....... ~o:~.~_., ..... '~...: ........ ~., ....................................... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outbold, FLY. 1 i.971 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 with the following; for new buildings or new use: ' 1. Final supzey of property with accurate location of all buildings, property lines, streets, and unusual natural or topograoh c features. 2. Final approval of Heaith DepT, of water suoply and sewerage disposat--(S-'9 form or equal). 3. Approval of electrical instaiiation from Bo'ard of Fire Underwriters. 4. Commercial buildings, Industriel build ngs, Multiple Resi?ences and similar bu IdJ.ng~ and installa- tions, a certificate of Code comol ance from the Architec, or Engin~or res onsi 5. Submit Planning Board approval'of eomnto?,~d . f= . ,v, p ble for th~ buiiding. ...... ~- .......... p~an requirements where a;plicab!e. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and ...... land uses: pre-ex~s,t mg 1. Accurate survey of peoperty showing all property lines, streets, buildings and ~nusual natu al or topograph ic 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 tion required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 New Building ......... Old or Pre*existing Building(Z) ........ = Vacant Land ~. ......... Hou~ /Vo. · Owner or Owners of Property . . ~" ..... .'~.-, ~ ~_..~L..._?<. .... %~ .............. CountyTax Map No. ~000 Section ......... Block ...... .O % Lot. Health Dept. Approval ........................ Labor Dept. Approval ...................... ,.. Underwriters Approval ........................ Planning Board Approval .................. Request for Temporary Certificate../ ................... Final Certificate'.. Fee ~ubmitted $ ..... 9~.. :"'-~..(~.....~,. ...... ~ ............... Construction on above described b~ilding ,,a//-~d~Perm.*/rn~le~,codes and regulations. 0,O, II- t FIELD I~ R~r I ON FOUNDATION (1st) FOUNDATION (2nd) 2. COMMENTS ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY q~ODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 " TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Examined ~...~.~.... 19 Appr°ved ~' '~'7' ' ' f' 1 ~} Permit N°/'/' 57ff' f' ' '~'' Disapproved a/c ............................ ...................... . . ... APPLICATION FOR BUILDING PERMIT Application No.//~.' ff.~/. ......... 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 ~ving 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 Southotd, 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, buil~ code, h~l)~/c~, e,/~nd regulations, and to admit authorized inspectors on premises and in buildings for necessa i ns. ~~cors~ration) .G. ~.'2..~.. Z~. ~. ~d,.....~.... ?~. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises...~..~..~...o-4c ..... .~.,....~..~....~..~..c~-2..& ............................. (as on the tax roll or laeest 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 ............................... ,~ .................. .... ~.,..?..s"7 ............. .,7.. ~.~... ~. ~ ~,,-. ':~ .......... . ~..~..~.. ~,;.~ ..... House Number Street Hamlet County Tax Map No. 1000 Section ....~...~..~. ........ Block ....... 9 .~7 ..... 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 .... .~..-~...~..~ .?.~...'~.~..~- .... ~....~ . · .OM~..--~. · · .~ ...... b. Intended use and occupancy ...I(Q-~.. ~ I~ .qL..IL~,,~...C,2--J-f~x,.~ .... .,~..~,. ............