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Home My WebLink About14326-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of [he Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No ...... Z. 1.6...6 ).9 ...... Date ........... .g.u.l.y...2.6 .............. 19 $.6. THIS CERTIFIES that the building ......... .a .c.c.e.U .s p?.y...b .a?.n. ...................... Location of Property .... ~ l $ 75 ........... .C.q Un..t.~..13 ~.. . .#. q g3 ........... ~ .o.u. h t~ o ~.d ...... House No. Street Hamlet County Tax Map No. ] 000 Section ... 5.~. ...... Block .... .3 .......... Lot ...... 2. '[ ~ ~ ...... Subdivision ............. :~ ................. Filed Map No... ~ ..... Lot No ...... ~ ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·..S.e.p.~.e.n~ t~ .o r.. 1. 6 .... , 19. $ 5 pursuant to which Building Permit No .... 1.6.~ .2 .6.Z ............ dated ...... .O.c.~.o.b..e .v..2. ........... 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 ......... Accessory barn ±n rearyard The certificate is issued to .~.~ D..E.L.E.~.~ .E..H~INISCH ....... of the aforesaid building. Suffolk County Department of Health Approval ............... [~/.& ....................... UNDERWRITERS CERTIFICATE NO ....................... [q/A ....................... Building Inspector Rev. 1/81 FO~ NO. ~ TOV/N OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO_ 14326 Z ot premises Iocoted _t ............................................................................................. v ............................. County Tax Map No. 1000 Section ~-~ Block ~ Lot No. 0~)'~ pursuant to application dated ......................................................... 19 ........ , end approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANC~ Instructions This application must be filled in typewriter OR ink, and submitted m~ 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. Fina~ approva~ 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 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. Fees: 1, Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4oVacant Land C.O. $5.00 5. Updated C.O. $15.00 $15.00 Date ...................... NewCOns truc tion ...... Old or Pre-existing Building ............ Vacant Land ............. /¢/ / .::. . .??. . ,l: s . . :. Location of Property ...................... .~, ...................... House No. Street Ham/et Owner or Owners of Property .......... /~N/Z~_ .... ;. ............................. County Tax Map No. 1000 Section .~"--3 Block ~-~ Lot g/. -' '~.~., Subdivision ................................. Filed Map No ........... Lot No .............. PormitNo./,~.~ ~' Date of Permit Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificat~ ,//.~¢~ .~. Fee Submitted $ ............................. Construction on above described building and permit meets all applicable codes and r§gulations. ~,,f0,~ :~' I/~/~9(~ Applicant. ,..~. ,-~4~',,~_,..~].....~..~~ ................. · 'OUNDATION {1st) "OUNDATION 2. (2nd) ,~OUGH FRAME & PLUMBING £NSULATION PER N. Y. STATE ENERGY CODE ADDITIONAL COMMENTS: 765-t80~) BUILDING DEPT. INSPECTION [ '1 FI~MING ~]~INAL INSPECTOR 765-180Z BUILDING DEPT. INSPECTION FOUNDATION 1ST []ROUGH PLBG. FOUNDATION 2ND []INSULATION []FINAL [ ] FRAMING REMARKS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ~,,amin~d ..... /~./.~ ...... ,~f Appro,,~d ...... /0../.~ ..... 19?..r. Permit~o./.q~4~..~- Disapproved a/c ..................................... '" (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BLDG. DEPT. TOWN OF $OUTHOLD Received ........... ,19., . a. Tiffs application must be completely filled in by typewriter or in ink find 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspectio..n,s. · (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. fp · .~ Name of owner o rem~ses .............................................. (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 .... ."=*~7¢:~ .~. ............... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License. No ........................ Location of land on which proposed work wilt be done .................................................. · 4,. ~..~.r. ........ c~?..~..~.~...~ .4...~.x. ............... ~. ~ .~...c4 .. .......................... House Nurnber Street Hamlet County Tax Map No. 1000 Section ..... ~ .~f ........ Block . .3 .............. Lot ..~1. ~..2.%./3 ........ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: use and occupancy .... ]....~.~..i~.~..~.....{.~.~..~ ............................................ fl. Existing b. Intended use and occupancy ................................................................... 3 tt~ k ( h ok whi ppli abl ) tiding .~..1~).. ' ati · Na reofwor c e ch ~ c e: NewBu .... Addition .......... Alter on .......... Itl~.~ i~...' ..... Removal .............. Demolition .............. Other Work ............ 4. Est~atedCost.... ......... .................. .... Fee ... (to be paid on filing this application) 5. If dwelling, number of dwellidg units ............... Number of dwelling units on each floor ................ If garage, number of cars ... ~ ~ . 6. If business, commercial or mi~ed occupancy, specify nature and extent of each type of use ..................... 7. D~ensions of existing structures,/fang: Front ............... Rear .............. Depth ............... Height ..... ' .......... N~mber of Stories ................................... D~ensions of same structure ~with alterations or additions: Front ................. Rear ................. Deptg .................. i ....Heiet ..... ~ ................ Number of Sto~es ............ } ........ '8. Dimensions of entire new con~tmction: Front .. 3~. ~ ....... ~ . Rear . ~.~ ........... Depth .~.~ .......... 10., Dat,'of Purchase ./"~ .~*. ~ ....... ~ ~ j~ ..... 2. ~; Y77'~. :.T ~.~: ::::::;:::::; 1 1. Zone or use district in which ¢remises are situated / ~&~ 4 ¢/ ............... 12. Does proposed construction violate any zoning law, ordinance or regulation: . .~ ~ .......... :.. 13. Will lot be ~6graded .,. ~P',x..~: .. ........ IP .... ~ill ex~e~s fill be remove~ from premises: 14. Nme of Owner of premises ~g~ IB~. ~ress ~4~t~r .... Phone mo.'~ Nme of Architect ........ ~ ................... Address ......... ~ ........ Phone No ................ Nme of Contractor Address Phone No .-i P~T DIAGR~ Locate cle~ly ~d dist~ctly ~1 bufldhgs, whether existing or proposed, ~d, indicate ~1 set-back d~ensions from prope~y fines. Give street ~d blodk number or descdption according to deed, ~d show s~eet nines and indicate whether intedor or corner lot. t STATE OF NEW YORK, i S.S COUNTY OF ................. ....~/[.¢~ ./?..'~:t..M./.~. 56~. .... ............... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d¢ly authorized to perform or have performed the said work and to make and file this application; that all statements codtained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manfier set forth in the application filed therewith. Sworn to before me this t t t i mo. 30'4763007 , k U t f 1/ QUalifiedr. ,~.... co (Slgnat re of apphcan ) Cc -,,, °N sV WALTER L. WATSON ARCHITECTS MEMBERS A. I, A. ~:86 COLD SPRING ROAD SYOSSET, N,~'. 11791 ,