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Home My WebLink About11377-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certi[icate O[ Occupancy No.. Z1~041 ...... Date October 27 ......... · .............................. 19 @6 THIS CERTIFIES that the building A c c e s s o r y s h e d Location of Property 2000 Pike Street, Mattituck, New.Y°rk House No. Street Hamlet County Tax Map No. 1000 Section 14 0 .... Block 3 .Lot.. 22 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated September 17, 81 11377 Z ...................... 19... pursuant to which Building Permit No ...................... dated September 17, .8.1. ............................ 19 , 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 ......... ~.c q~ ~ s.or ~ ~hed The certificate is issued to R i c h a r d & T h e r e s a E n d r is (own~r, ~.&,~'~i~'ff ~ .................... of the aforesaid building. Suffolk County Department of Health Approval ......... N../.~ .............................. UNDERWRITERS CERTIFICATE NO ................. IxJ ./g ...................... '.. Rev, 1/81 ToWN iOP BUILDIN~ TOWN HALL $OUTHOLD, Iq,. Y. BUILDING PERA41~, (THIS PERMIT MUST BE KEPT ON THE pRj~/Vt S~S uNTIL ~ULL COMPLETION OF THE WORK AUTHORIZED) N°. 1377 Z Date .....;, ...... ....... 19 ./ Permission is hereby granted to: . ,141: , t.. '. ~. ............................................. ~ ...... ~'"~'"'t? .............. itt '. ................................... ,.,...q ........ ................ ~ ........................................... ~ ............ ~ ....... : ........... ........~ ................ ~ ................................ c~t premises located at . .~'~ /-- (~. .~ ~: IL ::. . , .. couhty Tdx . i V 0 ~ Map No 1000 Sect o~ ...... Block ..... ............ ~.., Lot N ........................ and approved by the~ pursuant ~0 ~pplieation dated ............................... , ....... ...: ....... 5"-'", !9 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall m ,u ~,~ ~°our"o'-', "'.''. 11971 765- 1802 APPklCATION FOB CERTIFICAIE OF Instructions A. This application must be filled in typewriter OR ink, and submitted ~a ~ 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, B. For existing buildings iprior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property 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. C. Fees: 1. Certificate of occ_upancy $5.00 2, Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 5. Updated C.O. $15.00 ,%%v, - ' ...... Old or Pre-existing Building $15.00 Date., .... ............ Vacant Land ............. House No. Street Hamlet Owner or Owners of Property ~.%.C~.~,.,,.,.~,..~..~.f.<~.f.6%.. County Tax Map No. 1000 Section ..... ~..~..O ..... Block .... ~ .......... Lot...2.2. ......... Subdivision ..... ~ ................... Fi~/,,M~p No ........... Lot No ..... ~ Perr~[t No .......... Date of Permit .-.. ...... Applicant ...................... Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ Construction on above described building and permit meets all a.pplicable co, des and regulations. Applicant . . ~. ........................ Rev. 10-10-78 30 Sq q The newest in the der line, As the name imphes, it is 10' wide, This barn is also 8' high and boasts an 8' wide door opening. Lengths can also be extended to 16' 765-1802 BUILDING DEPT, INSPECTION [ ] FRAMING [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION :~ND []INSULATION []FINAL REMARKS: DATE FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 Approved ............. fit No..(...;..... ( '~77 7 -- Disapproved a/c ....... ~ .................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No. f { '-~ 7 V INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi 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 descriptiou of layout of property must be drown on the diagram which is part of this apl: cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon appro-~al of this application, the Building Inspector will issue a Building Permit to the applicant. Such pern 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 Occupan 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 t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspectiol~, f ~ (Sig~ant, or name, if a corp ration) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build~ Nmne of owner of premises ... LI~S...~, .~,, ,~,,t ,~.,1~ ,~: ................................ (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 ...................... Location of.,land on which proposed work will be done ................................................ ..... o..o ............. ..-.: ... &;?.. ............. /t/. ,. ,,/. . c ...... House Number Hamlet County Tax Map No. 1000 Section ../..~..O. ......... Block ....... ~ ......... Lot....~...'~. · ....... Subdivision ...................................... Filed Map No ............... Lot .............. (Name) 2. State existing use and ~ccupancy ~f premises and inteuded use and ~ccupancy ~f pr~p~sed c~nstructi~n: a. Existing use and occupancy ................................................................... b. Intended ~se ,ud occupancy... ~ 0.k..,. ~.~ d.~.~...r~..~ t,... s.~/0. ........ 3. Nature of work (check which applicable): New Building ~ Addition Alteration ... Repair .............. Removal .............. Demolition .............. Other Work ............... ~J ~ t] ff D ff--~ (Description) Estimated Cost ................. ~ ............... Fee .......................... -. ........... (to be paid on filing this application) ;. If dwelling, nulnber of dwelling units ............... Nmnber of dwelling units on each floor ................ If garage, number of cars i. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... I. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ' Number of Stories ........................................................ Dimensions o£same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories ................. ,~ .... L Dimensions of entjre new construction: Front ..... .~..~I}../.... Rear· .... ~.tt..?...Dep~h '".~.'5 .... Height .... ~..~ ....... Number of Stories ......... * .............. :;..'~. ................ i.i.i ). Size of lot: Front ...................... Rear ..................... . Depth ...................... ). Date Of Purchase ............................. Name of Former Owner ............................. 1. Zone or use district in which premises are situated ..................................................... 2. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 3. Will lot be regraded ............... · .; ......... Will excess fill be removed from premises: Yes No ). Name of Owner of premises .~.,,~4~].~1~ l~lalt~. Address .... ~Jt~,~;.~¢.~.. Phone No.~,~. ~'.?.~.~,.~.. Name of Arcbitect ........................... Address ................... Phone No ................ Name of Contractor ...... ~'~g,l~. ............ Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set'back dimensions from roperty lines. Give street and block number or descfipti terior or corner lot~ rATE OF NEW YORK. S S O.UNTY OF ~-~q.' ~-'..~0..~../( ..... ./- ~ .... ........ (Name of indMdual signing contract) )ove named. ~n according to deed, and show street names and indicate whether being duly sworn, deposes and says that he is the applicant e is the ......................................................................................... (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this )plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the 'ork will be performed in the manner set forth in the application filed therewith. worn to before me this i7. .......... .......... day of ....... ~.-~, .- .......... N'OTARY PUilLIC, State of New York No. 52-4524711 .... · ......... ~ualified in Suffolk Cou~y (Signature of applicant) Commission Expires March 30,