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HomeMy WebLinkAbout1160-zI~,ORM N~O. 4 TOWN OF SOUT~"IOI~D '~OW~ CL~RI~*S OFFIC'~ SOUTI"IOLD, ~. CERTIFICAT~ OF OCCUPANCY No. ,.~.:~.lk. .......... Date .......................... THIS CERTIFIES that the building located at ~1~.~'.... ~}tt:[:L..~o~d..J~ano. ............ Street ~v~pr.~on.a?... ~C.r...e.~... siook No. ~XX ................. ~ot ~'ro .................. 0r.o~m~o~,......m.~:, ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... ~ll:L~r...,.X~I ................... 19.~0.. pursuant to which Building Permit No. ~l~k6.0. ....... dated ...................... ~T.~rle....,.j~.~ ........ 19..61., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...... P.l~,~a.l;e...One...Eam$1¥.. d~aellfng ............................................................................ 'l'his eertilieate is issued to ldl,:[3,~.~l~.....[l'b]a~[lllg ..................... 0.lqlrlel~. ...................................... (owner, lessee or tenant) of the aforesaid building. FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT N? (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 1160' Z Permission is hereby granted to: Date ......................... ,,~g.~ ........ u,,~ ............ 19...~.~. ......... fl ~een~cr.% ................................................. to ...... B~114-~e~..e~e...~. aml-ty-..et~e~-l.~.mg ................................................................................ at premises located at .......... I~...~2.~....Fo~lcl~}..AepeS ................................................................ ..................................................... ~/.S..._~UZt..P. en~..RoaO. ............................................................. ................................................................. G~e~zpo~..~ ......................................................................... pursuant to application dated .................................... ~.~-~'L~.....~.~ ........ 19..(:~0., and approved by the Building Inspector Fee $...10~.00 ........ First American Title Insurance Company of New York 210 Court Street, R iverhead, New York 11901 EAST SUFFOLK (516) 727-5700 WEST SUFFOLK (516) 42L3020 Town of Southold Building Department Main Road Southold, New York 11971 March 10,1982 RE: Title No. PREMISES: OWNERS: TAX MAP~ 111-S-3190 1595 Gull Pondlane Greenport Ubbens, William & Margaret,His Wife 1000-35-4-14 GENTLEMEN: Please furnish us with a cQpy of the Certificate of Occupancy covering the above premises. Enclosed please find our check in the amount of $ 1.00 a copy of the survey and a self-addressed stamped envelope for your convenience. Very truly yours, FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK ENCLS: ~MILES ~ Survey Department P.S. Please inform us if there are any additional C.O.'s on record. Member of New york Board of T~tle Underwriters--New York State Land Title Association First American Title Insurance Company of New York Title No. 111-S-3190 SCHEDULE A ALL that certain plot, piece or parcel of land, situate, lying and being at Greenport, Town of Southold, County of Suffolk and State of New York, known and designated as a parcel of land belong- ing to William E. Ubbens as shown on a certain map entitled, "Map of Fordham Acres, Section 1", filed in the Suffolk County Clerk's Of- fice on March 7, 1962 as Map # 3519 and being more particularly bounded and described as follows: BEGINNING at a point on the easterly side of Gul~ Pond Lane where the division line of premises herein described and lot #4 on said map intersects the easterly side of Gull Pond Lane; RUNNING THENCE North 60 degrees 00 minutes East along the south- erly line of lot #4, a distance of 347.97 feet to the highwater line of Gull Pond; THENCE southerly along the highwater line of Gull Pond to the northerly line of lot #17 as shown on said map; THENCE South line of lot #17 a Pond Lane; 60 degrees 00 minutes West along the northerly distance of 300 feet to the easterly line of Gull ~TII~NCE northerly along 'the easterly line of Gull Pond Lane, 100 feet to the point or place of BEGINNING. ATTBRNEY AT LAW February 5, 1982 Mr. George Fisher Building Inspector Town of Southold Main Road Southold, New York 11971 Dear George: Enclosed is an application for a certificate of occupancy on premises of William E. and Margaret Ubbens located at 1595 Gull Pond Lane (Fordham Acres). To the best of my information, the dwelling on the premises was constructed in 1961 or 1962 and, accordingly, there should be an existing C.O. on file. If it is necessary for you to have access to the interior, a key may be ob- tained from John Nickles, the broker. Yours very truly, ROBERT W. TASKER RWT :aa enc, FOI~M NO. ~ TOWN OF SOUTHOLD , Building Department Town Clerks Office Sou~hold, 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 Inspector with the following; for new buildings Or new use: 1. Final survey of property with accurate location of dl 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 installations, a certificate of Code compliance fram 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 property showing dl 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 in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Dote ...~., .e.~ ~..~.~ ~ ~... ,.5..,.,..3-.,.9.~ .2. ........... New B~ilding ................ Addition ................ Old or Pre-existing Building ..../... ........ Vacant Land .............. Location Of Property 1595 Gull Pond Lane Owner Or Owners Of Property William E. and 1V[arEaret IIbbens Subdivision ................................................................ Lot No..,...~. ...... Block No, ,,,1,~ ...... House No...~..5..9,,5.... Permit No ..................... Date Of Permit .................... Applicant .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Find Certificate ...~. ................................... ' 0 Fee Submitted ~ o. 0 Construction on above described building and permj~'i~ets all ppp~cable c_odes and regulations. Applicant Sworn to Before me Itti~ /~ /~//?~ ~f_,f S,~olk Coun~ No. 4748183~ ~ Term Expels March 30. 19_ ~ / fl~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......... ,~.'<~ ¢;f2 .~...../...... 19..~.E. ~' App roved....~.....~...~. ....... 19.~..f".Permit No ........... Disapproved a/c . .~,e,A..~,~....~2~ .~....~...c~....~...<~....~..e...~....~..~.,.~... ..... ........ r/ (Building Inspect~ Application No .......~..j~....(..). ...... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su/omitted 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 o 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 port for any purpose whatever until a Certlfica~e of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance 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 demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ........ .......... (Signature of applicant, or name, if a cor¢oration) ....... (Address of applica6t) ~ State wheth.er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................................ .................................................................................... Nome of owner of premises ............ .c~-.~.......~.~.__~..,~¢.~.~ .................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No~Z.~...~.(.....~t No: ..~ Street end Number .............................................................. 2. State existing use and occupancy of pr, emises and interMed use and occupancy of proposed construction: b. Intended use end occuponcy ............................................................................................ 3. Nature of work (check which applicable): New Building ....... I~./:,. ......... Addition .................... Alteration .................... Repai r .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost...,..~,,/',~..~..,6.~.'..../.,. .................................. Fee ..... ./.,..~.. ............................................................................. / (to be paid on filing this application) 5. If dwelling, number of dwelling units ........(~-2',~..~.,~........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 ....... ~,~2..'~,?.. .......... Rear .......... ..Z~...~.. Height ............................ Number of Stories ....... ~.7%....?,,,~....... 9. Size of lot: Front ./....~-. ('~... Rear //~ ~.... Depth .~,.~.,:~ 10. Date of Purchase ................................ f Form . II. Zone or use d/strict in which premises are situated ................ : ..................................................... 12. Does proposed construction violate any zgnin, g~lo~, ordinance or regulation? .......... ~.~.~ ........................... 13. Nome of Owner of premises ...... ~'..~..~., ..~,~.,. (.~,,.~.,AJ~fr~ss ............................................ Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Name of Contractor ........... ..~:, ........ ~ ....... Address .i ................................ .......... 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 oi.~.~o~: lot. STATE OF NEW )~'ORI©, /2,2' S S COUNTY OF ..~.c.~)~ . i'j~''~'~'~~~'of i~~ arian) ............. being duly sworn, deposes and says that he is the applicant abow named He is t~e'' :~..~ ~ i.~,.~....~..~....~...~.. ~.~... ..... : ........................................ · " ' ............. ~ .......... ~>~-""('(~'~ntractor, 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 oil 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 forth in the application filed therewith. Swor ~ to before, me this / :~4~v of ~ ]~...~...~. ' k,~,,-~ '" ~,(Signa,~re/o~ applicant) ' ' ............. :' ....... ::2 _:..:.. Notary P u b I i c~..-~~' '~:~'' "" '~';~Gi~t!x-",.----._,~._.~_