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Home My WebLink About12923-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...g.'l 3../~.~ ......... Date ........... .l~.ax .'l..4- ............... 19 .8.5. THIS CERTIFIES that the building__~ 9.~.e.~ .s .o?x. ¥ .~.i.l.d...~.~ ........................ Location of Property ...5.6.59 ........... ~.o?.~..h..R. qa..d..~.q. ~.a .;?y..i..e.w. ......... .S.o.u.~.h...o.l.d. House IVo, Street Hamlet County Tax Map No. 1000 Section . .0.~Q. ....... Block ...... 0..~ .......Lot . 008 Subdivision ........ ~ ...................... Fi]ed Map No. , .~. ..... Lot No...~ .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... lV~2ch. 8. ........ 195./L pursuant to which Building Permit No...fl.2.9.23..Z. ........... dated ...... YL~ch. l~. ............. 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 ......... ...... an. a c.aes s omy. b~ilding ................................................ The certificate is issued to RO]3Z~R~ McCJL,R~HY {owner, levitt ut ~lTgrhT) of the aforesaid building. Suffolk County Department of Health Approval ... ~/t~ ................................... UNDERWRITERS CERTIFICATE NO ........... .~/.~. ................................... Rev. 1/81 Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. N.o BUILDING PEIU~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLL~ION OF THE WORK AUTHORIZED) ~ ~ ~o~......~.~.~.....~. .................... , ,~.~.~ Permis$,on iS hereby grant~ ~ ~A I~ ~ L.J.~.~ ....... ~..~....L~ ........... ~.:...o...: ...... ~.~......~.. ................................................ ~ ~.~~...~..;.~.:....~.~.1. ..... ,.....~.....~~ ...... ~.....~ ...... ~ ............... ................. ............. ................ .......... .; .............. ~,,.,i~.~,~.~ed,~ ..... ~.~......M.~....~..~.~~...~ cou.~ Tax Mop No. ,000 Sec,io~ ..... ~..qt. .......... ,,~k .... .~ ............ Lot,o ...... .~ ............... pursuant to application dated ...... ..~...~.~...~ .................. , ]0~...~..., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted 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 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 p~.~operty 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 occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling $15.0 0 3. Copy of certificate of occupancy $I.00 4.Vacant Land C.O. $5.00 2~- / (~----" Date ...~...~'/..~.~'...~', ........... New Building ............. _Old or Pre-existing,B~ilding .......... ,~. Vacant Land ............. Location of Property ;k .*: .~ .~./2~. ~¢~.. ·..' ./~.~.~ ...... ,.~ · J~. 7~-~.'/~. ........... Owner or Ow"ners of PrOSPOrt7' ,~. ~, ~. · ./~. · ~.~ ~.g. ~...~..~.~ County TaxMapNo. 1000 Section ...... .~..~ .... Block ....... ~ ..... Lot .... ~........~' / . Subdivision ......................... r ....... Filed Map No ........... Lot No .............. Permit No../...~. ~.%:/. ~.~ate of Permi . .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 an( Rev. 10-10-78 FIELD INSFECTION FOUNDATION 1st) FOUNDATION (2nd) ROUGH FRAME & PLUMB~ INSULATION FERN DATE COMMENTS STATE ENERGY ~ODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ,~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Permit Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... a. This application must be completely filled in by typewriter or in ink and submitted 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 giving 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 issued 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 Southold, 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, burg code,~housing code, i~Id reg~ations, and to admit authorized inspectors on premises and in building for necessary ila~l~e'd}tbns..~ (.}. [4 .~ .~ /fl .._J_/~..,2 .... .......... (Signature ot~oplida~, or name, if a~/6rporation) (Mailing address Of applicant) State whether applicant is iowner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..... ..... .......................................................... Name of owner of premises.. ~~.~. ~~~...J~:~. '.~..~,~.E.~: ........... (as on te t/(x ro~rlJ~:t~B.p' ,-~ ~ If applicant is a corporation, signature of duly authorized officer. FEE:.~L_ ~ BY: NOTIFY BUILDING DEPARTMENT AT (Name and title of co,orate officer) 765~]802 9 AM TO ~ PM FOR THF F~i..LO~d NG ~NSPECTIONS: Builder's License No.. ~ .......... 1. F~I~I~ATION ~ TWO REQUIRED FO~ ~'~'~D CONCRETE 2. RO~(~N - ~RAM1NG & pLUMBING Plumber's License No ......................... 3. IN~[u A' ~N A-, F~t C:'h? .....;: ~','-~1 MuST Electrician's License No ....................... ¢:: '7 "**: J' r [~R C. Other Trade's License No ....................... FHF RF ...... ;'*.WNT5 OF TVc N.Y. fiTATF COxd"rRUCTION & FNF~G~ 1. Location of I~d o~ whioh proposed ~rk will be do~ ............ ~- ,-~ · .m ~m' .~Eg~N&~gk~..[:~! ...... . .z .... ..... .... ':'7: ................ House Number Street Hamlet County Tax Mhp No. 1000 Section ...... 7~ ....... Block ...... ~ ......... Lot Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and ~ccupancy ~f prem~es and intended use and ~ccup~c~f pr~p~sed c~nstructi~n: a. Existing use and occupancy .... 1~ ................. b. Intended use and occupancy.. ~~:~. .......... 3. Nature of work (check which applicable): New Buildingv(~t~.~..~)fl(~ddition .......... Alteration .......... Repair ............. : Removal .............. Demolition ............ Other Work ............... : (Description) 4. Estimated Cost ..~~ ......................... Fee ..................................... ~ '-. (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ................ If garage number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. D~ensions of existing stmeture~, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ......................... . ................................ .... Front ' Rear D~ensions of same structure wi,~h alterations or add~tmns: .......... ; ........................ Depth .................... ~.. HeiSt ...................... Number of Stories ..................... 8. Dimensions of entire new const~ction: Front.../:~ ........ Rear.../~ ........ Depth .. 2~ ....... Height ............. Num:ber of Stones ..... [ .................................................. 10. Date of Purchase .. ........... ~e Foyer ~wner ...-~.~ 11. Zone or use district in which pr~mises are situated..~ff.O~ ............................... ' ' 12. Does proposed construction violate any zoning law, ordin~ce or re~lafion: ............................ 13. Will lot be regraded . .~..~' ........... ~ .... ~. ~Will exces~fill~e remRved from premises: Yes ~ No N~e of Architect ............................ Address .... ~~.. Phone No ................ Nmne of Contractor ......~ ................. Address ................... Phone No ................ PLOT DIAG~ Locate clearly ~d dis~nctly fll[ bufldhgs, whether existing or proposed, and. indicate fll set-back d~ensions from prope~y ~nes. Give street and block humber or description according to deed, and show street nines and indicate whether STATE OF NEW YORK, cou JY OF . ~.'~...~..~..~......../f~..W.~.,~..,~r.~. '. ........ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .......... ~ .... : (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perfom or have perfumed the said work and to m~e and file this application;that all statements contained ~ this application are true to the best of his knowledge and belief; and that the work w~l be perfumed in the m~n~r set forth in the application filed therewith. Swum to before me this ~0~ ~[~,$1~ ~ ~ ~0~ .... t' ~ ~' ' ' ~ ~'~ .... ~' ~ ~ ~ ' ~ ' ~ ' ' '~. ' ' ',~ OualJfl~ In Suffolk C0.,~.~101~ [~gnature o~appj~c~t) Commission Expl~eMareh 30.19