The URL can be used to link to this page

Home My WebLink About11301-zFORM NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Z. 1.9.6.6.7 ......... Date ... $.e.P.t;. 0!a.b.e.e..8 ................. 19.8.1. THIS CERTIFIES that the building ................................................ Location of Property ... 3.2,5. O,a.k .~¥fLn.'4~ ........... $9.u~.h.q .1.d.,..~9¥..Y. QF.k .......... House No. Street Hamlet Connty Tax Map No. 1000 Section .... .7.7 ...... Block .......... 2. ....Lot ..... ! .1 .......... Subdivisiorpp. qs..e..B.a..-{...E.s.'q.a..t;.e.s ............ Filed Map No. 1,1.7,6. .... Lot No. 11 conforms snbstantially to the Application for Building Permit heretofore filed in this office dated ,lu ].y 20 19 81 pursuant to which Building Permit No. 11301 Z dated......duly .... 27........... ....... 19 .8.1. , was issued, and conforms to all ofthe requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... .......... s.n..c.~.o.s. ~..a..~.x.~ .s.t~.q~.. Porch The certificate is issued to ..... .ld.a.]~ .~.~?..L.: 0oebel (ownerd~JFll~Sr~q~t~ X of the aforesaid boilding. Snffolk County Department of Health Approval .... ~/.It ................................... UNDERWRITERS CERTIFICATE NO. ILAR ............................................. Building Inspector Rev. 1/81 No. 113O1 7 Permission is hereby granted to: TOWN HALL I" SOUTHOLD, N~ Y. ! BUILDING P,ERM!Ti ~ (THIS PERMIT MUST BE KEPT ON THE PRE~IS~S UNTIL I~ULL COMPL~iON OF THE WORK AUTHORIZEB) } tO at' premises located at ...................... ~,.., ............... ~. ................................... . .~ ............. ~.,.: ........ Couhty Tax Map No. 1000 Section ......~..,~.~,..~..,.. Block Ii .... purduant to application dated .~.~,~......~..'~" ............ i .... Building li~spector. ............. ...i~. ....... Lot No ....................... ..... , 19.~~, and appr2~ed by the/ Inspector Rev; 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. Tbis application must be filled ~n typewriter OR ink, and submitted in duplicate to the Building Inspec- tor w~th tile 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 buddings, 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 comple[ed site plan requirements where applicable. For existing buddings (pr~or 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 reqLnred to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelhng or land use 3. Copy of cmtlficate of occupancy $1.00 $5.00 Date New Bu*tchng ........... Old or Pre-existing Building ............ Vacant Land ............. ,oe t,o, of Pro ,erty . )?'.C ............ Hous~ No Street Hamlet Owner or Owners of Property .... .~?. ).'~.,/:-.~...~.:...~..O. ~.~...-~.~.....L7 ............................ County Tax Map No. 1000 Sect,on .., ~..C)..~..-Z. .... Block ...C?.?~,. ........ Lot..C~. ! 1 ........... Subdw~sion ~¢~.~-~ .'~/~,":(.. '..~.~.Lk,.t~.. ~ ....... Filed Map No. I. !.~..~. .... Lot No. / 5~'(g.~. (5?.l)l.k~.C.' L Permit No..I. !37.).'Z..~. 'Date of Permit .7.-..~..?: .~. JApphcant ..... .~.~..t~.'..~. O. ~..~.~..L, ...... Health Dept. Approval ........................ Labor Dept. Approval ...................... Request for Tempora_~,~,.Certifieate ..................... Final Certificate .... ~ ....... ~' 't Fee Subm,tted ~'~.'~ .......................... ~'~ ~. \ (~ ns ruction on /~-'") ~ '~ ~' Cot above described bu,lding an~'mit/~yll~~ a~e~ions. ¢l~ ~ App cant . ....k,=~,...'.(%~.¢..-, . ./.*..~.~¢..~.~. ................ Rev, 10-10-78 F ]' E L D.. E[iS.~ECT lOiJ FO UIi'DflT ]'Oil ( 2nd ) ROUGH FRAME & PLUMBI~IG INSULATIOI,I PER N. Y. STATE EHERGY C.ODE FIUAL ADDITIO~IAL COI2.IE~]TS: FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Di.pp,-oved ;c ....... :. ...... %. ........ ........ :' .2 A?PLICATION FOR BUILDING PERMIT Application NO, ././.-~.~.~. INSTRUCTIONS a. Tlus application must be completely filled iu by typewriter or in ink and submitted in triplicate to the Buildi Inspector, w~th 3 sets of plans, accurate plot plan to scale. Fee according tc schedule. b. Plot plan ~howmg location of lot and o£ buildings on premises, relahonsh;.p to adjoining premises or public stre~ or areas, and gNm§ a detadcd descnptmn of layout of property must be drawn ou the diagram which is part of this apr cation. c. The work covered by this .application may not bt commenced before issuance of Building Permit. d. Upon apprc.'al of this apphcat[on, the Building Inspector will issne a Building Permit to the applicant. Such pern shall be kept on the prennses available for inspection throughout the work. e. No bmldi;~g shall be occupmd or used m whole or ~n part for any purpose whatever until a Certihcate of Occupan sball bare been granted by the Bnildmg Inspector. APPLICATION IS IIEREBY M^DE to the Buildiug Department for the issuance of a Building Permit pursuant to t Budding Zone Ordinance or' the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulatmns, for tl~e constructioa of buildings, additions or alterations, or for removal or demolition, as hereiu describe The2 applicant agrees" to comply with all applicable laws, ordinan~e,~usin.gfiod~and regulations, and ad mit au thor~zed insp ec to rs on p re m ~ses and in bu ildings for ~sary in s~g~4'f~J? . .'--:~. ?. ?..~..~ ~.'x.. _ .~...~.~ .-q .tT!o. ~ .~ ..... (Mailing address of applicant) State whether applicant i~essee, agent, architect, engineer, general contractor, electrician, plumber or bnild (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 ...................... 1. Locatmn of land on which proposed work will be done. '~P,.F:> /W 6 ~_ov5 1~~16 ~.)c± ................ .......................... House Number Street Hamlet County Tax Map No. 1000 Section ......... Subdivision....~.t::Tg:7.Y~. ~.5~.~..7[~...~. '.~. ....... Filed Map No ............... Lot .............. ,(/Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: E i tilg nd ccupa cy ..~..?~.1..~)..~..[.~_~. a. x s i use a o n b. Intended use and occupancy .................~.. ,W'..~ ~ .,~.G/.~.. ~ ....... ~ ~ ./.k, .................................... Nature of work (check which applicable): New Bt,ilding .......... Addition .'. ~ .... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... ~'t9~5> ;~ ~ (Description) Estimated Cost ....................................... Fee /.~ ...................... .~ ........... (to be paid on filing this application) If dwelling, number of dwelliz~g units ............... Number of dwell/no, units on each floor If garage, number of cars ........................................................................ If business, commercial or mixed occupancy, specify ~oture and extent of each type of use .............. Dimensions of existing structures, if any: Front ..... : .L .2x. ..... Rear .... [.7%. ....... Depth. i i~.'~, i ....... tleight ............ '... Number of Stories ............... ' ........................................ Dimensions of~me structure with alterations orTadditions: Front .... 5~. ........... Rear .... ~. ........... Depth ..... .~ ............... Height ...................... Number of Stories ..................... I)imensions of entire new construcfion: Front .... .o~.~. ....... Rear ....c~./ ........ Depth . .'~.. f ......... tteight ...-~ ./ .......... Number of Stories ........................................................ Size of lot: Front ...................... Rear ...................... Depth ...................... Date of Purchase ............................. Name of Former Owner ............................. Zone or use district in which premises are situated ................................... ' .................. Does proposed construction violate any zoning law, ordinance or regulation: ............................... Will lot be regraded ........ ' .................... Will excess fill be removed from premises: Yes No Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address ...... '....' ......... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ PLOT DIAG RAM Locate clearly and distinctly rdl buildings, whether existing or proposed, and. indicate all set-back dimensions from roperty lines. Give street and block, number or description according to deed, and show street ,lames and indicate whether terior or corner lot. rAT OF ,' (Name of individual signing contract) )ove named. being duly sworn, deposes and says that he is the applicant is the ............... ~ ............................................................ (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have per, formed thc 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 m~n~r set forth h~ the application filed therewith. worn to before me this ' -~- - ~- v / BOTARY PUBLIC, Stato Of NeW~* ~* .% .... ~. ~ .= · · · ~..( .............. NO. 52-8125850, Suffolk Co~ (8~grlatul*e o~ aopIic~t) ~ I~ ~lres March 30, 19 ..... PAINTING CONTRACT PA1N?S 19__ PROPERTY OWNER LOCATION OF PROPERTY__ INTERIOR WORK ITEMIZED ROOM ROOM Walls Woodwork Ceiling Price Walls Woodwork Ceiling ~. Price COLOR FINISH SURFACE PREPARATION MATERIAL NO. of COATS ! ROOM ROOM - COLOC fiNISH "SURFA~ PREPARATION MATERIAL NO. of COATS EXTERIOR WORK Material Coats Color ~urface Preparation Price HOUSE Body Trim ~ Roof Sas~ Metal Work Shutters ~ Doors (Exterior) Foundation (t~) Valleys - Gutters PORCHES ~ Floor Railings Steps GARAGE or BARN Body Trim Sash -Roof "EXTERIOR EXTRAS: J TOTAL PRICE EXTERIOR WORIG TOTAL PRICE INTERIOR and EXTERIOR WORIG CONTRACT The undersigned contractor agrees to do, in a tboroughly workmanlike manner, the work specified on this sheet. All labor, material, tool and equipment to be furnished by the said contractor. Work to start ......................... and to be completed on or before ................................ , weather and other conditions beyond contractor's control permitting. Contract price $ ................. Terms of payment; After first coat is applied $ ........... ; On completion of job $ ............ ; Accepted ..................................................... Signed ................................................... Property Owner Painting Contractor