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Home My WebLink About523-zFO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFF~CE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY No...~.~.~.~.. ............ Date ......................................................... THIS CERTIFIES that the building located at.},~...,~.~.~3~...~..~(b.~,~.~.~..~...~..~,..~.o..~.Jc...Q..~ Na~.Pt, ~ Cutehogue~ Map No. ........................ ~*~ Block No ..... ~*~ ................... Lot No..~/,I, ............................................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated November 6 ........................................................ , 19...~.~.., pursuant to which Building Permit No .......... L~ .............. dated November' ~7 19~8 was ~s ue ...................................................... , ........ , ' s d, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .............. ........................................................... .................. This certificate is issued to .~...O.~f~..~.~....~...~.~..e.~l....O.~.~.~. ...................................................................... (owner, lessee or tenant) of the aforesaid building. ~Building inspector /~/ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 523 Z Date ................. ~[o~.e~zb.e Z'. _ .. &~. ............ t9%~.... Permission is hereby granted to: Gold s~l th .~.o~..... ~/~I.... Hoxcar~._..Palge ..................... ~ o.~.¢hc~ld.~..... ~, Z · .............................................. to ........ ~.~..l...]:.~, an ac]d.t..~.$...o..n.....o.R~ .e.~$§.~.~..~ et premises located at ~{..~.Z...~'~..~.~.....~...~.~.~.-~.*. ~..~.CQ.~XC. ~d ................ ......................... ~.~£...~.0.~ ...... ~¢~.r,~u ~iv..t~ ........................................................ ..................................................... .~..~....~.o.g.~.~.....?~.,.~, ..................................................................... pursuant to application dated ............... ~.0. V.~.~--~0-.~..~.....~ ........... 19~.~. , and approved by the Building Inspector FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall ~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitte~pHcct; 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. 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 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: C, 1. Certificate of occupancy ~ / 2, Certificate of occupancy on pre~~! 3, Copy of certificate of occupancy ~$1,0. 0 -'~,~ .... ~ land use --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 New Building ............. Old or Pre-existing Building ............ Vacant Land ............. At the intersection of the northerly side of Little Peconic Bay Road Location of Property . ~j1¢1..tJlB. ~$.te~r.l.v. $.i~e. ~).f. J~a~vw~.te.r$. J~o~d ........................... House No. Street Hamlet Owner or Owners of Property .. A]e,x~9~e~'. A.d~rrLs. ~l.d. JV[a.rcj~.re.t. J~... A~l~ts ..................... County Tax Map No. 1000 Section ....l.l.l..J)J:). ..... Block .... .1]..DD ...... Lot.., ~)2~..0~ ..... Map of Section D, a part of Section B. Nassab Point Club Properties, Inc. Subdivision ................................. Filed Map No..~(l& ...... Lot No .... 401 ........ Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor De, pt Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $...1.DO ..... - ................... Construction on aoove ~escrlDe~bu ing and permit meets all applicable codes and regulations. J~XCELSIOR ABSTP, AC¥,, INC, Applicant .............. J¥ ~.' ~(~X ',~7' ......................... Rev. 10-10-78 PROP;:RTY VILLAGE ' W DIST.I SUB. ,~ ~oT ~-~/~ / ,., TYPE OF BU1LD;NG ;.~) SEAS. VL FARM COMM. CB. M!SC. Mkt. Value LAND IMP, TOTAL DATE 7~a /~/4 ~,¢, . NORM. AL Acre qEW BUILDING COND}TION BELOW ABOVE Value Per Value Ac re AGE ~ARM 'iltable 1 REMARKS FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD DOCK 'iJJabJe 2 'ilioble 3 ¥oodland ;wampl~nd ~rushland douse Plot COLOR TRIM ExtensionExtension Extension Porch Porch Breezeway Garage Total Foundation Ext. Walls Fire Place Type Roof ~2~. "~c ~ecreotion Roorr I Dormer Driveway Dinette F!oors ¢~X.~¢ 0~'~< K. interior Finish LR. Heat Rooms ist Floor Rooms 2nd Floor DR. FiN. B. TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD', N. Y. Examined ................. 19. . Approved ................... J! .................. 19.~.....Permit No. ~..~.].,?..?. ........ Disapproved a/c ......~...] ................ .:5:,.~.~-.~ ............. .]~.~.(zt ............. ]~;~. ........ .................................... ...~.,;:d] ............ ~.~ ...... :~,~;::.~.....~:= ........... · (Building I nspecto(~// APPLICATION FOR BUILDING PERMIT Application No.....~...])~..'~. ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 location. c. The work cov. ered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant· Such permit shall be kept on the premises available for inspection throughout the progress of 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 issuanc.e 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applioable laws, ordinances and regulations. ....... ......................... (Signature of applicant, or name, if a corporation) (Address of ap.pli~cant) x/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~¢¢~, ~ ~ . .......... ....... :.¢. ........ ~..~.~ ....... .~.~. ........................................................................................................................... Name of owner of premises .... :.~,f..//~.~.-. ........................................................................................................ Jf applicant is a corporate, signature of duly authorized officer. ~ · p · ~ 1. Location of land on which proposed work will be done. Map No: ............................................Lot No: .................... 2. Stoto existino use ~nd occuponcy of p~emises ond intonded use ond occupancy of proposed construction: o. ....... .................................................................. b. Intended uso ond occuponcy....'....~ .................................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition ..... .~.. .......Alteration .................... Repair ....................Removal .................... Demolition ....................Other Work (Describe) .................... 4. Estimated Cost ............. ~.~..(~L,L,~,.....~... ....................... Fee ...~-..~.Z...~... ........................................................................ (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 ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specbCy nature and extent of each type of use ' ......... ............. 7. Dimensions of existing structures, if any: Front ........ .~.~. .............. Rear ~ Depth ..~.~. ................. Height ....... /~.../. ............. Number of Stories ............................................................................................................. Dimensions of same structure with alterations or additions: Front ........... .~Z/.~..~ ............. / Rear ....... ~--~ .................. Depth /7/~- / Height ......... ~..../. ............. Number of Stories / 8. Dimensions of entire new construction: Front ........ ,~ .~.. ............ Rear ........ ,~x~...~ ..........Depth ..... ./...~.. ............... Height ........... ./...~.../. ......... Number of Stories ........ ./. .................. 9. Size of lot: Front .~.~..~.~...../.,.~.~..'. Rear ..... x'..~./. ............. Depth ...... ~,,~2.( ........... 10. Date of Purchase ...6Z,,<~,.~.~.~ ....................... Name of Former Owner ....~¥.T ........................................... 1 1. Zone or use district in which premises are situated ............. ~ ................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? J~...~..~rgr~',....~ i3. Name of Owner of premises./-~~..~.~r. Addreee- ...:....~./~,~. ................... P~'o~e ~O ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor....~.~.....~....Address ..~... ~...~.'..,......Phone NO. c~42....~..7,,?.~?~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. I STATE OF NEW ,,YOI~K, F (N~me of individuol sionin~ opplication) ~bove nomod. He is tho....~ ........................................................................................................................... (Controctor, ooent, corporate officer, etc.) of soid owner or owners, ond is duly ~uthor[zed to perform or hovo por{ormod tho soid work ~nd to moke ~nd {ilo this ~pplic~tion; thor ~H stotements contained in this opplic~tion ~ro truo to the best of his knowledge ~nd belief; and that the work will be performed in the ~9nR~ ~in the application filed the~ewi~ Sworn to before me this /~ // do- of ~.~~ ~. ~:~0o /' (Signoture of =pp cont) Noto~ Public, ...,,..~.~.~=~,~ .......... County TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT.OL~', N. ¥. Examined ........... ...~....~'..~..../... ~ .~...... 19..~..~.'~'~ ,~ ,, r ' .~.~.....~.~...~. ..... Approved ........................................ 19 ........ Pe m~t No. Disapproved a/c .................... ~,~. ................................................................... ........... ................................. Application No....~ ................... APPLICATION FOR BUILDING PERMIT Date ....... /f~.....g. ................................... ~9...~......~.. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adioining premises or public streets or areas, and giving o detailed description of layout of property must be drawn on the diagram which is part of this IocaHon. 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 issue a Building Permit to the applicant. Such permit shall be I~ept on the premises available for inspection throughout the progress of 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 issuanoe 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 a)terotions, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ...... ....................... (,~nature of applicant, or name, if a corporation) ............ ..................... (Address of op.plicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....................................................................................................... If applicant is a corporate, signature of duly authorized officer. - / (Name and title of corporate off cer) 1. Location of land on which proposed work will be done. Map No: ............................................Lot No: .................... Street and Number ./~/~...,~....~f?~.~-..~ ................................................................ ~ Municipality 2. State existing use and occupancy of pr, emises and intended use and occupancy of proposed construction: o. Existing use and occuponcy...:~;,,..,f~~f~ ............................................................... b. Intended use and occupancy.....~ .................................................................................................. 3. Nature of work (check which applicable): New Building .................... Addition ..... ~ .......... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... (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 ............................................................................................................................................. 6. If business, commercial or mlxed occupancy, specify nature and extent of each type of use .............................. 7. Dimensions of existing structures, if any: Front ........... .~..~. ........... Rear / ' Height .............. ./..7. ......... Number of Stories .............. ./. ............................................................................................. Dimensions of same structure with alterations or additions: Front ........ :~..~...: ............... Rear ...... 5f.~.'. .................. Depth .......... ¢'....Z...! ............ Height ........... ./.~..../ .......... Number of Stories ..... ./. ......................... 8. Dimensions of entire new construction: Front .......... ~,.g. ........... Rear ....../~.. ............... Depth ....../ ............. Height .......... /.,7.. ............. Number of Stories ............................ 10. Date of Purchase ...~,z/,Y~.~/'.x'.x'.x'.x'.x'M~ ............................. Name of Former Owner ...... \' ................................................. 1 1. Zone or use district in which premises are situated ......... "';. ...................................................................................... 12. Does proposed construction violate any zon~ing/~).., law, ordinance or regulation? Name of Architect ........................................................ Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW~yOR~,¢_/~ ) S S COUNTY OF ... ~..-~,.~:...) ' "'~"~'~"'"'~'"":'~'~'"'~' 'i"~'~ia[~l .................... being duly sworn, deposes and says that he is the applicant / (Name of individual signin; app 'c 'on) above named. 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 are true to the best of his. knowledge and belief; and that the work will be performed in the manner set f~h ~e ~plication filed therewith. ~ Sworn to befo~ me this . ~ ~/,~ ~~ ~ ~~ ................... Zyday of ..... Z.~~~ ~ ~ ....... 19..~s~ ~?~6~0~O~nt~gnature~,res of appl,cant) No,, .................. · 402 12.03 N SI°44 .~'s L 0 T 401 CLUB PBOPERTIC5 SEC TION D AT CUTCHOGUE TOWN OF SOUTHOLD EUFFOL K CO., /NC. '°6' CO Ni C ~Ak' 4~z2. CERTIFIED TO: CHICAGO TITLE INSURANCE CO TITLE N-~ ~tlOe-57042£ BANK ~OMAS DESPAGNI 8 K~THLEE?v,~_ donack ~s~iates J140 west main street Il ri~rhead new york 1190l