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Home My WebLink About351-zF01~ NO. 4 TO~VN OF SOUTHOI. D I~UILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY uild,n~ lo-areal at THJ~ CERTIFIES that the b ........ Nassau Pt. ~u~c~e, ~ev_ zor~ conforms substantially to the Apphcat~on for Building Permit heretofore fded in this off,ce d~ted ............... ~...~ ...................... , 19..~.~., pursuant to which Building ~rmit No...~..~.~ .............. dated ......................~).~...~ ............... , 19..~., was issued, and conforms to all of the requirements of the apphcable provisions of the law The ~cupancy forwhich th~s certificate is issued is .............. PR~A~ D~ING This certificate is issued to ....... ~.~..~.~ ....... .C~.) ............................................ (owner, lessee or tenant) of the aforesmd building ......................... , 'JfJM'4' ,nspe tor FO~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 351, Z Dote ............... .~l;g;ll ........ ~ ......... lgr~ .... Permission is hereby granted to: C~es ter...Or.l~ws~L.. ................. ~u teho~ .............................. to .....'l~t~:~t ~t..new.. ~wet-} titg ................................................................................................. ct premises located at ..... ~a~l~.t,..~/~. .... Aet, j~ .~.~JO, .... N~IS~[--1~ ..~1~ .................................... '- .............. ~ .......................... //a~ s cU...Pt...Rd...Jr..V~n~ tc~" fid ......................................................... ............... : ....................................... ~zte~&,ue~-- · ~.¥~ ...................................................... pursuant to applicabon doted ................................ J~'::te-.1~. ........... 19. j~., and approved by the Budding 10spector Fee $'~0~ .......... Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall · %uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. 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. Bo 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 unusua~ natural or topograph ic 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. C. Fees: 1. Certificate of occupancy $5.00 / __..2. Certificate of occupancy on pre-existing dweiling/ land use --[~re-Ex±s tlng C.O. $15;. 00 ~__~J~opy of certifmate of occupancy $1.00 Vaca~b la~d C.O. $ 5.00 Date ...~.L[].~..3Ql~h,. t984 ........ New Building .... ~ ....... Old or Pre-existing Building ....-~ :.'. ..... Vacant Land I1~'0 I/R~I~T~NF(o~ Location of Property ... ~SA~ Pg.[A~,. L[.[~[.~ .EcG .~ecE .RQ~d ........ C~hcogue ~ .N~ ........ Hou~ No. Street Ham/et Owner or Owners of Property ....... L.y~r~ .Z... ~3~l.a~ger, ................................... County Tax Map No. 1000 Section . .1.1.1 ........... Block ...~. ........... Lot..6 ............. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No ........... Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labo~ Approval ........................ Underwriters Approval ........................ Plato, .rd Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $..1,~.00 ....................... Construction on above described building and permit meets all applicable codes and regulations. Applicant .................................................... GAR ,NNER OLSEN, ESQ. 2.0. BOX 706 CUT 0GUF LI., N.Y. H935 /7 OlD SlGHOND F. SARNOWBKI LEO DI K~IAN WALTER F HOGAN A'I'I'OHN~YS AT LA.~V 160-16 .ytMa~CA. AVENUE Jl~'alCA 32, NEW YORK ][~-~PLr BLI C 9-4830 August 10, 1960 EDWARD N, HERMAN MORTON H GOODMAN ALBERT J MAGIONCALDA Building Department Town of Southhold Southhold, New York Dear Sirs: Will you kindly forward to me Certificate of Occupancy or a duplicate copy thereof for the new dwelling house constructed at Nassau Point and Broad Waters Road, Nassau Point, New York on property known as the southeasterly one-half of lot 180 Amended ~p A Nassau Point Club Proper- ties, Inc., Map 156. The building was constructed for the undersigned by Chet Orlowski and was completed approximately June, 19~9. If there is any fee in connection with the issuance of this certificate, kindly advise me of the amount thereof. SFS:tl JSIGMOND F. SARNOWSKI FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .~ / 'L~ 19 5.~ .........................................(J 3 Approved...--... ..... i! ............ !.~. ....... 19...x.,.rermit No .............................. ....... ..... :..: ..... ................. .......... i'~uilding I~;sp;;~'~;r) ~7 ....... Application No ...... .?..!.i.! .............. APPLICATION FOR BUILDING PERMIT Date.......~. ~...... ?..../.Z ..................... 19...S..~...?.. 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 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 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 puFpose whatever until a Certificafe of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuanc,e of o 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 d~molition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) .......... ............................. (,~ldress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signaturd'bf duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ~.~/.:. .: ..... Lot No: ~.~../.;...o~.' ~"--'-- Street and Number ..,~(l~... ,~,,, .~,:,[~...~..,',c~,,,....~-,,.~...~...,?..-~ ................................ ,((... ....... Municipality 2, 5tare existing use and Occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................................................................................... b, Intended use and occupancy ........ ~t,~....~ ....................................................................................... V 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 mixed occupancy, specify 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 ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ ~,,..¥.. .......... Rear ........ J~....¥.. .......... Depth ...~.....~..:....~. .......... Height ....... /...~....'. .......... Number of Stories ....... {...~.r. ........... 1 ]. Zone or use district in which premises ore situated ........................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ' ~'J - Name o Architect ........................................................ Address .......................... ......Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly ail 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. I STATE OF NE'~I"~YO]~[~, ti ] ) S S COUNTY Of . ........................... duly sworn, deposes and'says that he is the licant (Nome of individual signing application) _ 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 conta~ed iL! this application are true to the best of his knowledge and belief; and that the work will be performed in thb'~,...~,.. ~set forth in the application filed therewith. Sworn to before me this C'~ ~ ~i~/~' ~,~'~t~ ~"n ~' ~ ~ '; J'~ -,:-,(~ ' ..... !...~.....'(..~.~.. day of .......... ~/..~....;:'Y..~ ~.~,~ ~>/~.~,~ ~0,~ '~_.,·")'~i~nature o-T applicant) Nota Pub,,c, OWNER STREET \q LLAGE FORMER OWNER i,/LsEAS. ~/ L. LAND DATE / / W :OMM. CB. ECO D CARD I DIST. ~,SUB. // ACR. - J TYPE OF BUILDING MISC. Mkt. Value AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Tillable 1 Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD LOT Value Per Value Acre House Plot DEPTH ~ ~ BULKHEAD Total DOCK FOI~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... !...i~...... 19..~..~. A '-' ,' t pproved ................................................ ermi No ............................ Disapproved a/c ....~(;;~ ........... ;~..~.~..... ~ (Building Inspector) Application No ............................. APPLICATION FOR BUILDING PERMIT 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 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 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 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 a Iterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) ................ ....................... (Addre(~ of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises...L,~~..~.f~ .................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which\ r~ '~_n~ ,I -~- ~')~pr°p°sed work will be done. Map No:~.grf~...~..~..'.~../k~..:~,Lot No:~.....t;~..~.../...~... Street and Number .~.~...J~..~'.....~-..,[,~..~..J-~..¢~'...: ......................................................... Municipality 2. State existing use and occupancy of pr,emises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................................................................................... b. Intended use and occupancy....i~....~ ........................................................................................... 3. Nature of work (check which applicable): New Building......K~ .......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ........... ~?..~..x..~ ........................... 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 ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .............................. 7. Dimensions of existing structures, if any: Front ............ i. .............. Rear ............................ Depth ............................ Height ............................ Number of Stories ............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ ,, 8. Dimensions of entire new construction: Front ....... /,_.~.....~. .......... Rear ....... ~....C../. .......... Depth ...~...~.:...~. ............ Height ..... /....~. .............. Number of Stories .../.....~ ................ 9.Size of lot: Front ...3...P,..~.~ ......... Rear ......~.....-,~,,.~.-]. ....... Depth .Z./.../..:...2.~.. ...... 10.Date of Purchase ............. /..~'...~T..Z ............................ Name of Former Owner .~./..~...~.....:..~~.~'. ........... 1 ]. 7one or use district in which premises are situated ...................................................... 12. Does proposed construction, violate any zoning law, ordinance or regulation? ...... ~.......-:'n.. ................................ 13. Name of Owner of premises'~'~'~?~f~Jlres¥~'~'~'':''~''l'~':'''Ph°ne'-'ll ~ NO Name of Architect ........................ .~. .............................. Address .~. .......................................... Phone NO ..................... Name of Contractor..~-~.~.~ ...... Address~~g..t...~..:...~:....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 NE~~4/~ ) S S COUNTY OF ...'%'....~//~/7.~'/. ......... ) " r'~ ................................................................................................. being duly sworn, deposes and says th he is the applicant (Name of individual signing applicoj~jon).__ above named. He is the ............................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly auth,!zeds.to perform or have performed the said work and to make and file this application; that all statements contai'~/~cJ~T~..~l~,is~gpplication are true to the best of his knowledge and belief; and that the work will be perfgrmed ir~th? ~.~..~h in the application filed therewith. Sworn~t~o b~fpre me this [ '~ r~,~. o , ~/}~,~ ' *~. ,-. ,' ,e ~' [ . · ........................~ · /2 . , _L,~day of.. ......... ~_...~..-...~..~.. ............. ~..~ .... ~..-'-(Sl~; of appl,cant) No,o Pub,,c, AFFIDAVIT Re: File 3823 Premises: Nassau Point Cutchogue, NY STATE OF NEW YORK ) SS: COUNTY OF SUFFOLK ) LYNN Z. BOULANGER, being duly sworn, deposes and states as follows: That I am the owner of the house described on Suffolk County Tax Map as 1000-111-1-6 ; That I believe that said house was constructed prior to the issuance of a Certificate of Occupancy and has been used for many years as a residence and is, in my opinion, suitable for single residential purposes. ~OULANGE~ / Sworn to before me this day of July, ~ 1983 rJOSEPH ~. FADDE Notary public, State of NeW No. 41.4615394 ua if[ed in KinS[s County ~Ce~ti~icate Filed in NeW York ~kln~ Commission Expires M~'. ~ ! TUT-NOT[ GARY FLANNER OLSEN COUNSELLOR AT LAW P. O. BOX 706, HAIN ROAD CUtChOGUE. L. I., NEW YORK II935 (516) 73~7666 i Southold Town Building Dept. Main Road SouthoId, NY 1197! Re: Boulanger File #3823 SCTM# 100-~i~11-~-u Enclosed please f!nd survey in re the above captioned matter as per your request of today. SIGNED DATE- GARY FLANNER OLSEN COUNSELLOR AT LAW P. O. BOX 706, MAIN ROAD CUTCHOgUe, L. I., NEW YORK 11935 (516) 73~7666 i SIGNED Southold Town Building Department Main Road Southold, NY 11971 Re: Boulanger File #3823 SCTM#: 100-~ Enclosed herewith please find a pre-existi~ Affidavit and my attorney check in the sum of $15.00, along with Application for same. Ellc. ~mj ~-/?"'~ DATE: 7/~n/84 SIGNED DATE'