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Home My WebLink About13396-zFORM NO. 4 TOWN OF 5OUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Sept. 7 No.....Z12759 ...... ....... Date ................................ ,19...84 THIS CERTIFIES that the building . .A.c,c.y. :, ,8.h.e.d. ................................... Location of Property .... .3.6,0 ........... ,R.i. 1..e.y, .Ay.e: ........ M.a..t.t.i.t.u..c.k. .............. House No. Street Hamlet County Tax Map No. 1000 Section . , .1.4..3 ...... Block . . .0.5. .......... Lot 008 Subdivision... X .Filed Map No ..... Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated Aug. 29 19 .8.4. pursuant to which Building Permit No. 13396Z dated .... .A.u.g... ..... 2. 9. ............ 19..8.4, 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 ......... Accy.. s,h.e d The certificate isissued to ..... SAUER, ARTHUR & KATHERINE ................ ?o¥,,'0;, '~e'~i/ t~;,a'~'O ...................... of the aforesaid building, Suffolk County Department of Health Approval N/A N/A UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev, 1/81 FOBM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13396 Z Permission is hereby grante~j -4~/'/ ~ · at pr~mises Io~at~d at ............................................................................................................................ pursuant ,o application dated ...~....L:~....~.......~....c[ ........... , 19..~...~., and approved by the Building Inspector. ........... Rev. 6/30/80 FOR~I NO. (~ TOWN OF SOUTHOLD Building Department Town Hall ,(]outhold, N.Y. 31971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submittecNi~--d~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, 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 topographic featu res. 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. Co Fees: 1. Certificate of occupancy $5.00 ! 2. Certificate of occupancy on pre-existing dwelling/ land use 3. Copy of certificate of occupancy $1.00 --?re-ExistSng C.O. $15.00~/ Vacant land C.O. $ 5,00 ....... Date .~. ·~ ..... .~.... ~.~..~. New Building ............. Old or Pre-ex st ng Building ....~.. '. .... Vacant Land ............. Location of Property ...Z:~. ~ ,~ / ' "'~. ~:~. I-Iou~e No. S~ree~ ~ Hamlet Health Dept. Approval ...................... Labor Dept. Approval .. Underwriters Approval ..... .~j.f~.: ............. Planning Board' Approval Request for Temporaw Certificate ..................... Final Certificate . Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.~/.,~.~?.?;~... Date of Permit .~J?.~/?.~...Applicant .................................. F., Submitted $. ~ ........................... ~ ..... ~ ~ ~ Applicant . .~7~..Z., :"~T.%~ .... ~T~ ./ .............. ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 :~xamined ~ ~' ~,.t~.x~. · ~h.., 19~.~. Permit No. 1 · .. ~ ..... \pproved ~.t~9~' .~..~..~ 19~.t~. · %':k~ 3isappmved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ~19o.. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ets of plans, accurate plot plan to scale. Fee acco~xting to schedule. b. ]Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets ~r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. 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 issued a Building Permit to the applicant. Such permit hall 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 :hall have been granted by the Building Inspector. A~PPLICATION IS ItEREBY MADE to the Building Department for the issuance of a Building Pemfit pursuant to the ~uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~egulations, for the e: ,nstruction of buildings, additions or alterations, or for removal or demolition, as herek~ described. ?he applicant agrees [o comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) ?.....2.,. ia. ?..e?.. a. ¥., .... (Mailing address of applicant) .*,sl 1 ~,5 2 State whether applicant is owner, lessee, agent, arc!fitect, engine, er,, general contractor, electrician, plumber or builder. Applicant is owner : Nameofownerofpremises............................,...'.'"Arthur W. and Katherin~e Sauer ................................... .. (as od the tax roll. or latest deed) If applicant is a corporation, signature of dul.~,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. 3. 6..0..g.~. k..ey..k, ygp.u.e' ~. ~.4.a.~.g. ~_.~.v, qI~,. NX ............. 360 Riley Avenue l}.~[.a.g ~. g..~ .t ~ q h: ..................... House Number Street Hamlet County Tax Map No. lO00 Section .... 1..~..5 ....... Block ....l~b..~..~. ........ Lot..C])~b.]~. .......... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy qf prop6s~d construotion: Storage of lawn and garden e.Quipment, a,nd ~ools. a. Existing use and 9ccupancy ...... : ................................ ................... ;' ....... b Intended use and occupancy ........................................ : ................... ; ....... ppli ) Ne~r Addition Alteration 3. Nature of work (check which a cable: New Building ...... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost $1500.00 ........... Fee ...................................... ........................... ~*- (to be paid on filing this application) 5. if dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ If garage number of cars ........................................................................ ' of each type of use 6 If business commercial or mixed occupancy, specify nature and extent ..................... 7. Dimensions of existing structures, if any: Front. · Rear .............. · Depth ............... Height...............NumberofSt°ries ........................................................ Dimensions of same structure with alterations or additionS: Front ................. Rear .................. Depth .. Height .................... Number of Stories .................... ....... . ..... . .... lO,_On~ n..~ 10'-0". . .Depthl~2.[7.0.'. ........ 8. Dimensions of enhre new construcuon: eron~ .... (j~...: .... ~x~a, ............. Height 1 2 ' -0" Number of Stories ..... 0 ' " 3.5 0 ' 9. Size of lot: Front ...?Si ............ Rear ~ ................... Depth . - .................. · ]~.~ '' 0. Date of Purchas~........-.March .~ ........... ..... Name of Former Owner James y 1. Zone or use district in which premises are situated ..................................................... 2. Does proposed construction violate any zoning law, ordinance or regulation: ... LQ .......................... Will l,,t be reoraded Y..es ............ Will excess fill be removed from premises:. _ Y~s _ xXNo :4. Nam~Vof Owner of premisesh~7!;b.u'v' · '~''' .~a..u??... Address ~.6.0...E.z.l.qg...gp.q... Phone No. 2..9,8..9. !2...6 ...... Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ PILOT DIAGRAM Locate clearly ani distinctly all buildings, whether existing or proposed, and. indicate all set-back din~ension~ from ~roperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or corner lot. ' STATE OF NEW YORK, COUNTY OF ................. S.S (Na~ne of individual signing contract) above named. ......... being duly sworn, deposes and says that he is the applicant He is the ..................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application arc true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ............ .... dayof... ........ $otaryPublic,....7~... ~.',. f~t:r"~,, .... .ar ?tv0 ' N01a. Y PUBLIC. ~tate 0l ~e~ v0r~ Ill,. 4101878~ ,SullOIk [~ounty,,. ,/ ['erm [~0,ms ~k, lch 30.