The URL can be used to link to this page

Home My WebLink About11185-zFORM TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Z.1.1.3.5. 9 ........ Date .... .D.e.c.e.m. pp.q..1.4 ............... ,19.8.2. THIS CERTIFIES that the budding ................................................ Location of Property . .375..G.a~'den .Couz'.l: ......................................... House No. Street Hamlet County Tax Map No, 1000 Section . D.6.3 ....... Block .... 0.7. ......... Lot . . 1.7.8 ........... SubdivlsionS. o.uJ;.hq>ld. ,q~pd.e. rls ............ Filed Map No,65%.2. .... Lot No, 8 ............. conforms substantially to the Application for Building Permit heretofore filed in this office dated · . .4 .uri.e..%$ ...... , 19~. pursuant to which Building Permit No...1.%%~5 .............. dated ...4u. n.e..25 .............. 196.2., was issued, and conforms to all of the requirements of the applicable provisions of tlte law. The occupancy for which this certificate is issued is ........ ...b.u.L~qt.ia..pp%y.a,g¢ .o.n.e r~raz&y..c~eJ-J-.ing .................................. The certificate is ~ssued to .. H.ohrLg~g .Ea.t,e~.pr'i.aes ,. Znc ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .... .#.1 ~.--8.0=45.,..1.a/. ~ 3/.8.~ ,. ~R.q b..~....~.~.. V±lla, P.E. UNDERWRITERS CERTIFICATE NO. N 547664 Building Inspector Rev 1/81 TOW i H U-', ? SOuTHO~D, N, Y. ~ ~ (THIS PER~IT MUST BE KEPT 0N ~H,E PR~I~ S UNTIL I:ULL AuTH~RiZED~~ ~ ' COMPLETION OF THE WORK ' ~ No. Ii185 Permission is hereby grar~ted to: Z..//: .................. · ~ ~ ................. ....................................... ,, ............. ~ ............ ~...: ...... ~ ~: Y~ ) ~ Counw Tax Map No. 1000 Section .......... ~..~.. BI~E ..... ~..~ .......... ~Lot No. '.../.....~ ...... , ' J 19....~..., and approved by the p~rsuant to application idated Building Inspector. Fee :$(.,,~,,..,,~- ............ Building inspector FORM NO. 6 TOWN OF SOUTHOLD 13uiiding Department Town Hall Southold, '" ~/~ APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and subn~itted 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 topograohic 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 bu(ld~ngs, 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 (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 topographrc 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 occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or lend use $5.00 3. Copy of certificate of occupancy $1.00 Date ..... , .. New Building . .~¢.? ....... Old orPre-existing Building(~) ........ ~ /Vacant Land ' . ......... House IVo. , Sc[as ~ Hamlet o o fP ty wneror wnerso roper . .. ~.,. / County Tax Map No. 1000 Section .~.~,~ ......... Block .. ¢.~. ......... Lot./'~.~' .......... s,~.,,~o~ .~0.~.'~/~¢.¢... ~/z2¢~¢....~,,~d M~, No. ~ .S ¢.~...~o~ ~o:~. ~ .......... Health Dept. Approval ~. ................... Labor Dep, Approval ...................... ,.. Unde~riters Approval ........................ P~anning Board Approval .................. Request for Temporary Certificate ..................... Final Certificate ~ - Fee Submitted S ............................. Construcuon on above described building and per.r~i,,,~mee/~ all appL~cable~code.~and regulations. FONNDATIO~ (lsS) ' ~ ' FOUNDATION (2nd) PLUMBING INSULATION PER N. Y. FINAL ADDITIONAL 3. Nature of work (check which applicable): New Building ...~. ...... Addition .......... Alteration .......... Repair .............. Removal ........... Demolition .............. Other Work .~.~./~0; .~.O. Fee / .~. ?. _~'O (Description) k Estimated Cost ............................................... ~ ........... (to be paid on filing this application) L lfdweliing, numberofdwelling~nits...~ ........... Numberofdwcllingunltsoneachfloor .............. If garage, number of cars .... ~ ................................................................ L If business, commercial or mixed occupancy, specify nature and extent of each type of use .................. L Dimensions of existing stmcturqs, if any: Front ............... Rear .............. Depth ............ Height ............... Number of Stories ..................................................... Dimensions of same structure with alterations or additions'. Front ................. Rear ............... nepm '. ...................... Height ...... ~ ............... ~m~er o~ Sto~s ....... L Dimensions of entre new construction: Front,.~.l .......... Rear .... --~. .......] ~t~'~ ] ....... Height.... ~ .......... Nmnber of Stones ~ ...... ). Date of Purchase ............................. Name of Fo~er Owner ........................... ~. Zeno or use dist~ct in which prsmises are situated ................................................... L Does proposed construction viohte any zoning law, ordinance or regulation: . ~. ........................ ~ Will lot be regraded .. ~ ~,.., .... ~,,~.: ....... Will exce~s flit be removed from premises: . Yes Name of Architect .. ff~.~ .~.qq~t ....... Address . .~ .~9.~ ...... Phone No. ~ 7/~.~.~ ... N~e of Contractor ~~ ff~.~Address .~.~e'~ PhoneNo~Z~.. . PLOT DIAGRAM' Locate cle~ly ~d distinctly ~1~ buttings, whether existing or proposed, and, indicate ~1 set-back d~tensions from 'ope~y fines. Giw street ~d block ;number or description according to deed, and show street nines and indicate whether tefior or corner lot. rATE OF NEW YORK, S.S OUNTY OF ..... ~ .......... I .................................... being duly sworn, deposes and says that he is the applicant (Name of individual sigmng contraS/t) oove named. e is the .......................................................................................... (Contractor, agent, corporate officer, etc.) f said owner or owners, and is d~ly authorized to perform or have performed the said work and to make and file this pplication; 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 mannbr set forth in the application filed therewith. worn to before me this l 'r2' a o!f"7 19 rotary Public ............ , ...... County --f/~,~ ~ / / SURVEY FOR o~ ~ J ~ ~ ~. ~. ~. ~'~-~ LOT NO. 8, " SOUTNOLD GAmiNS" OC~ ' ~ .... :~ Y/~ ~ ~ ~"~r~7 ~WN ~ ~UTHO~ SCALE: /" : ~0 ' ~r' ~ SUFFOLK COUNTY, NEW ~RK NO. inspected b/ ~ ' · duF~.'t~:t a~ ~ , ** ~UTH~iZEO ALTE~TI~ OR ADDITION m ~ll ,.-.~" .:~ ~K~STATE E~CAYI~ LAW 6e~ices ~GUARAN~EES INDICTED H~EON ~L ~UN ~LY HE~ DEPARTMENT-DATA F~ APPR~ ~ C~STRUCT ~.~ ~R WHOM THE SU~EY tS PREPARED ~ ~ ~'/~.~ (~ ~ ~,* N ~F ~. TUM~ ~TIoOO SECTI~OM~ ~K o~ LOT IT8 H~E~, ~O TO ~E ASSIGN~S OF THE LENDING ,~,,......,...,T.,. ,oo ,., o, .., ..o..,,, ..,,,.,,...u...... ,,, ,, '-"'"'-./.,~;x ~ ...~/ OTHER THAN THOLE SHOWN HEREON, TO A~I~AL INSTITUTI~/OR SUBSEQUENT YOUNG YOUNG ~,~,.~ ~o~ NO~. I = MONUM~NF SU~Y F~ / //~r / ~TIE CON iiOE~O TO ~ A VALIO TRUE coPY ~LIC~T,___ . ~ P~}TY L~HES OR FOR ~HE E~ECIION ~ FENCE$ NOTE' B = MONUM~N~ SURVEY FOR ~OT ~, ~ "~OUTHO~D G~DEN~ " ~N ~ EO~THO~ SC*LE. /" = 50' DAT~ ..... ~5 ~ NO S~FO~ CO~TY~ NE~ ~ NO. ....~~j YOUNG ~ YOUNG ~ ~ = ~o~U~E~ ~ _ . ~VER~AO, NEW ~RK sgBOlVl~lO~ MaP FI~EO IN ~ ~FICE ~ ~E ~K ~ ALDEN W YOUNG, PROFESSIONAL ENGINE ER SUFFOLK C~N~ QN ~Y 7~ /9~9 AS FILE NO.~I2 AND LAND SURVEYOR N Y.S UCENSE NO, 1284 HOWARD W. YOUNG, LAND SURVEYOR