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Home My WebLink About14172-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..4 ] .3.6.9.~. ......... Date ..... ~..u.g.u.s.~...~ ................... 19~..5. THIS CERTIFIES that the building..a.c..c .e.s.s. ? .ry..s.h..e.d .............................. 7955 MAIN ROAD Location of Property ....... ......................... ._ ....... EAST MARION t~ouse lye. b'treer Ham/et County Tax Map No. 1000 Section ...0.~.1 ....... Block ....0.2 .......... Lot ....0.27. .......... Subdivision ............................... Filed Map Ho ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated .... ? / 3.0./. ............ 19 ~ 5. pursuant to which Building Permit No. 1 4 ~ 7 2 Z dated ., ,Z/3 O ..................... 198.5., 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 ......... .... ~.c.c.e.s..s p.r.y.. ~ .~p,r:a. gg..s.h..e .~..~.n,..~.e.a.v., y.a.v.d.: ................................. The certificate is issued to S t e v e M o r a i t i s (owner, of the aforesaid building. Suffolk County Department of Health Approval ....... N/A UNDERWRITERS CERTIFICATE NO .................................................. Rev. 1/81 Building Inspector FoJr, H NO. ft TOWH OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 14172 Z Permission is hereby granted to: ........ .7...L.x..~ ....... ~.~).~ ...... ~.~.~ ................... ........ .~."...~!.....~...~....~.~ ..................... ,o .......... ~.~.!.!.~.~. ......... ~..o.~.. ........ .~.~..~ ......... .:....~../... ....... (~ ........ ..t.~.~....y.~ County Tax Map No. 1000 Section ......... ...~...~ ....... Block ........... ..~-... ...... Lot No ...... .~.....~. .......... pursuont to opplication dated ................... Z..~....'~....?. ...................... , 19....?.~-and approved by the Building Inspector. Fee,.....~.~.~ ..... Building Inspector Rev. 6/30~80 FORM NO. 6 TOWN OF SOUTHOLD Building Deper~men~ Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions A. This ~3,aHcation must be tilted in typewriter OR ink, and submitted in duplicate to the Building inspec- tor wire the following; for new buildings or new use: 1, Final su;','ey of property with accurate location of ail buildings, property lines, streets, and unusual 2. Fina~ aooroval of Heaitn Deer. of water suoolv and sewerage dispose --{S-9 form or equa)). 3. Ar:2;c.,,al of electrical installation from Boded'of Fire Under~/riters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buifding~ and instaila. tions, a certificate of Code compliance from the Archite'dt 'or Engineer responslble for the buildine. ~u,,,.,~, Planning Board approval of completed site plan re,~ulrem~nto where applicable. g. For existing buildings (prior to April 1957), Non-conforming uses, or buitdincs a/~d "pre-exist'rig land uses: 1. Accurate ~n]ey of peoperty showing all prooerty lines, streets, buildings and unusual natural or toco:jraphic ;ea~ures. ' 2.S;~','orn statement of owner or prev{ous owner as to usa, occuoancy and condition of buildings. 3. Da(e of an,,, housing code or safety inspection of buitdinos or premises, or other pertinent informa- ticn required to prepare a certificate. / C. Fees: 1. Ce~ificate of occupancy 2. C.r, ca.~ of occupancy on pre.existing dwefling or land use $5.00 3. Cop,,, of certificate of occupancy $1.90 ,',"o',.~ ,va.'" ' ..... 2;,~¢% .... ' ....... -' ~'" '"'" ..... Ccun,,l Tax Mae No..1000 Section ... 0.~l ...... Block . ~ ~ Lot.. Subglwsion ................................. Filed Map No ....... Lot No. ............. .................... ~ .A~,,o~= .%.~(..~¢~Z:. 2~ .... He~hh De2t Approval ' ......................... Labor Dept. Approval ......................... Underwriters Approval ......... Planning Board Approval .................. Request for Temporary Certificate ' ..................... Final Certi¢icate ........ - ......... Fee Submitted S ............................. Construction on above descrH)ed building an~meets all app[ip~des and regulations. .......... . .... 'FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 8OUTHOLD, N.Y. 11971 TEL.: 765-1802 7/3 Examined .... 6 ., 19 . ~'~ ..... ...... Disapproved a/c ..................................... TOWN OF $OUTHOLD Received ........... ,19.. (Bnilding Inspector) APPLICATION FOIl BUILDING PERMIT Date .................... 19 .' INSTRUCTIONS a, This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, witt ~ets 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 stre. 0r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this ap[ ~ation. c. The work covered by this appfication 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 pen ihall be kept on the premises available for inspection throughou~ the work· e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan ~hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New Yo~k, and other applicable Laws, Ordinances Regulatious, for the construction of buildings, additi, ons or alterations, or for removal or demolition, as herein describt The applicant agrees to comply with all applicable laws, ordinmlces, building code, housing code, and regulations, and dmit authorized inspectors off premises and in building for necessary inspec~ti0_as (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 builde (as on the tax roll or latest deed) ~lf applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ........................... Phimber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... · ,.° .................. Location of land on which proposed work will be done.. '....,:-:-.. :.---.: .-. · · .. Z. .... ............................................................ House Number Street Hamlet County Tax Map No. 1000 Section ........ ;~..( ...... Block ...... '.~'-.. ......... Lot....~...7 ......... Subdivision ..................................... Filed Map No. ' Lot .............. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ~ a. Existing use and occupancy .. ~:~'~-:d~:f:~?~'~-~.~: :::L ..... ~.. h (. ~.. ~ '. ~.,, b. Intended use and occupancy ................................................................... 3. ,.N/~fi,i'e of~vbrl~ (check which applicabl, R~bpair .............. R~moval .. 4. Est~ated Cost ~,~H,. ;].~ .i ..... New Building .......... Addition .......... Alteration ...... ........... Demolition ............. Other Work..g.C?'?.{~.o.r.~..~.) (Description) {to be paid on filing this application) ........ ' ' Number of dwelling uhits on each floor If dwelhng, n~hibe~' of dwelhng umts ............................ If garage number of cars If business, commercial or mixed OCCU[2 Dnuensions' of existing structures, if Height ............... Number of Dimensions of same stmctnre with alte: Depth ...................... Hell Dimensions of entire new construction: ancy, specify nature and extent of each ~ype of use .................. · Front ............... Rear ..... . ......... Depth ......... ~tones .......................... , .......................... ations or additions: Front Rear fit ...................... Number Of Stories ................... Front Rear ! Depth Height Number of ;tories ~ ' Size of lot: Front Rear ' Depth 10. Date of Purchase ................ 11. Zone or use district in which premises 12, Does proposed construction violate any 13. Will lot be regraded ............. 14. Name of Owner of premises .. ,~'e. ¥.~. Name of Architect ............... Name of Contractor ............... Locate clearly and distinctly all buildir property lines. Give street and block numbe~ interior or corner lot. . STATE OF NEW YORK, COUNTY OF ........ S.S (Name of individual signing corn above named. He is the ........................... of said owner or owners, and is duly auth( application; that all statements contained in work will be performed in the manner set for Sworn to before me this ............ Name of Former Owner ........................... re situated ....................... ~ ........................... zoning law, ordinance or regulation: .. ~ ........................... ~ ..... ~...:... W~ll excess fill be re ed from premises: Yes i' y.~.o.r.g. ~.~.~?, Address~..?~..~ ~.A,I~.~, .I?.,L ,~...~q Phone No. ........... Address ................... Phone No .............. ........... Address ................... Phone No .............. PLOT DIAGRAM g, whether extst~ng or proposed, and, ,tndtcate all set-back danensmns fro or description according to deed, and show street names and indicate wheth ........................ day of ...... Notary Public, ....................... 'act) ...... being duly sworn, deposes and says that he is the applica~ Contractor, agent , corporate officer, etq. ) ' ized to perform or have performed thel said work and to make and file th this application are true to the best of his knowledge and belief; and that th :h in the application filed therewith. · .. ........... ,19... ......... County (Signature of applic~at