HomeMy WebLinkAbout2533-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
CERTIFICATE OF
No Z-24640
Date SEPTEMBER 19, 1996
THIS CERTIFIES that the building DWELLING
Location of Property. 60 GRANGE RD.&2070 M.BAYVIEW I~D. SOuTHOLD, N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 78 Block 1 Lot 5
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 1, 1964 pursuant to which
Building Permit No. 2533-Z dated OCTOBER 1~ 1964
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 ONE FAMILY DWELLING WITH ATTA~D GARAGE *
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
JOHN S. BUFFA & HENRY P. FRIEDMAN
NOV. 9, 1964 - R.
N/A
N/A
*THIS UPDATES CO Z-2068 DATED FEBRUARY 2, 1965.
-' / ~Buflding Inspector
Rev. 1/81
NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
-'~ r
THIS CERTIFIES that the building located at ..... G~.&~g~,..~..&..]~¥...~,~e1~...~:~ad ..... Street
~outh Harbor Homes
Map No ...................... Block No ....................... Lot No ..:~.~ .......... ,~o~tko~d~...N,~.~, ..................
conforms substantially to the Apphcation for Building Permit heretofore filed in this office dated
..................................... .~.~,¢~?D.~t~ ..... ~...., 19.~.~... pursuant to which Budding Permit No..2~'~'3...~
dated ............................ 0~e~oh~r.....[...., 19..~.~k., was ~ssued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which thzs cerhficate is issued is ........
...... ~.£v.~.t~..~...£,~mi~ ~..dw~,.~,.~.ug. ........................................................................................
The certificate is issued to ..~O~,r.~..~ .... 0~.t~,~ ................ O~:r-~..r. .................................................
(owner, lessee or tenant)
of the aforesaid building
H,D,Approv_~_~. Novenber 9~
by R, Villa
.../..~::~. ~t.c.,... t, ....... ~.~az~ ..............................
' ' Building Inspeqtor
FO~M 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? 2533 z
Permission is hereby granted to:
Retle..~e~dl~....~,t....~a~e~...P.~,...O~i;e~..~.r
.................... Jame~<~ .....................................
to ...]~u~. I.d.. ~e.~.. m2e..£a~tl~r...(hee:h].~a~ ....................................................................................
ct premises located at ..:[~t..~Lt..J~l~..TE~l~]3o]~...Iz,~]=~ ..........................................................
~.~U~. Jkl..&..~'J,,lr...~ie~..P~3ad[ ~ .......... 8cm~,ho~
pursuant to application dated ................................ 01~,~.....3~ ..... 19...6~, and approved by the
Budding Inspector
Fee $...1'0.0~ ........
TO~.W OF SOUTHOLD
BU!LD ING D E?
TOWN
765-!802
~&PPLICATION FOR CERTIFICATE OF OCCUPANCY
This appi!catzon must be filled zn oy typewrm~er OR ink and submltted to the buz!dmng
Inspector wLth the following: for new building or new use:
1. F:nal survey of property with accurate location of all build,nas, property !znes,
streets, and unusual natural or topographic features.
2. F~na! Approval from Health Dept. of water supply and sewerage-dmsposa!(S-9 form).
3. Approval of electrical instal!at,on from Board of F~re Unde~gr~ters.
4. Sworn statement from plumber certifying that the solder used in system contains
less taan 2/10 of i% lead.
5. Commerc~a! building~ industrial building, multiple residences anc simllar buzldmngs
an~-installat~ons, a certificate of Code Complmance from archmtect or engmneer
responsible for the bumldmng.
6. Submlt Planning Board Approval of completed site plan requirements.
For existing buildings (prior Co Aprml 9, i957) non-conforming uses, or ouild~ngs and
"pra-exzstmng" land uses:
1~ Accurate su~ey of property showmng all property l~nes, streets, bumldmng and
unusual natural or topographmc features.
2. A properly completed applicatmon and a consent to ~nspect smo~aed by the applmcant.
If a Certificate of Occupancy is denied, the Buildmng Inspector snail state the
reasons therefor zn wrmtmng to 5ha apptmcant.
Fees
!. Certificate of Occupancy - New dwell~ng $25.00, Additions Co dwelling $25.00,
Alterations to dwellmng $25.00, Swimmmng pool $25.00, Accessory building S25.00,
Additions to accesso~/ building S25.00. Businesses S50.00.
2. Certmficama of Occupancy on Pre-~xmstmn~ Eumldmn~ - $100.00
3. Copy of Certmficate of Occupancy - .25~
4. Updated Certificate of Occupancy - $50.00
5. Temporary Cartzfmcate of Occupancy - Resmdentzal $15.00, Connnercmal S15.00
............. .................
~ew Construction ........... Old Or Fre-existznE Buildzn~.. k .....
................ .........
~ouse No. StYeet ~amlet
cou=~ z~ ~ap No ZOO0, Section. ........ '/~.. ..... .~lock.. ./ .......... ~ot ..~5 .... ..... ......... .
Subdivision ....................................Filed Map ............ Lot ......................
~erm~ ~o..~T.g.~ ....... ~ate O~ ~e=~t ................~p~ca~t .............................
Health Dept. Approval .......................... Underwrmters Approval .........................
Plann~nE Board Approval ........................
Request for: Temporary Cert3_ficate
Fee Submmt:ed: $ .'37f7....~.~. .....................
Print Key
5738SS1 V2R3M0 931217
Town Hal4 53095 Mare Road
Displ~yOL~9~itY~ . . · :
Us~thol,d, N, ew,Yor~ 1.197.1 . :
473889 SOUTHOLD
78.-1-5
Page 1
09/19/96 14:52:01
Fax (516) 765-1823
Telephone (516) 765-1802
NYSRPS ASSESSMENT INQUIRY DATE : 9/19/96
SCHOOL SOUTHOLD SCHOOL ROLL SEC TAXABLE
PRCLS 210 1 FAMILY RES TOTAL RES SITE
OFFICE OF THE BUILDING INSPECTORTM COM SITE
ACCT NO 08
60 GRANGE RD TOWN OFSOUTHQ/D ASSESSMENT DATA
= OWNER & MAILING INFO T==:=MIBC ! ...... --
BUFFA JOHN S & ANO ~ !RS-SS ! **CURRENT** RES PERCENT
PO BOX 688 ! 1 !LAND
WINTER PARK FL ! BANK !TOTAL 6,70
32790-0688 **PRIOR** 6,70
! !LAND 6,70
! ! TOTAL
==DIMENSIONS ===! SALES INFORMATION
ACRES .56 !BOOK 9179 SALE DATE 00/00/00
!PAGE 00111 PR OWNER
900 **TAXABLE**
6,700 COUNTY
TOWN
900 SCHOOL
6,700
TOTAL EXEMPTIONS 0 1== TOTAL SPECIAL DISTRICTS 4
CODE AMOUNT PCT INIT TERM VLG HC OWN CODE UNITS PCT TYPE VALUE
!FD028
!PK070
!WW020
!SW011
Fi=NEXT PARCEL
75.10- 03-016
F3=NEXT EXEMPT/SPEC
F6=GO TO INVENTORY Fg=GO TO XREF
F4=PREV EXEMPT/SPEC
F10=GO TO MENU
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, 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.
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 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 informa-
tion required to prepare a certificate.
Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use
3. Copy of certificate of occupancy $1.00
$5.00
Date . .A~.~..~..2.2. ,...[.9.8.2. ........
New Building ............. Old or Pre-existing Building ...~. ........ Vacant Land .............
Location of Property .... c.o. ~F.e.~...o?..g.~..a.~.qe...~.o.a.~..a.~..~.ay.v.~ .e.~..~.o.a. ~ .... ~..op.~.ho..~~ ......
House No. Street Ham/et
Owner or Owners of Property . ?.o.s. ep.h. ?..e~.e.~...a.~.~..~..a~.h.~e..e~..~.....o.a.~ .e.s ..................
County Tax Map No. 1000 Section . .0.7.8. .......... Block . .0.~ ........... Lot....0.0,5. .........
Subd,vision.., .~.a.~...o?..S.o. ~.b:..~.a.r.b.o..r..~.o.m..e~iled Map No. ?.0..9.6 ..... Lot No, . .]: ..........
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate ............ .~. .........
Fee Submitted $...]:: .0.0. .............. ....//.~
Construction on above described building an~~meet~l?ppl~ble~o~es/~o~egulations.
Ap p licant/. ~.1~/: .~. ~ ..........
R.v. 10-I0-78 ~U~O lph ~~ ~ s attorney
s-9
SCHD
SUFFOLK COUNTY DEPARTMENT OF HEALTH
Building Permit NO. ~ Z
TO WHOM IT MAY CONCERN:
The sewage disposal facilities for a structure located at
' (Give ~eed lo6atto~) ...............
have been inspected by this Department and found to be satisfactory.
NOV 9
District Engineer
1964
FO~M NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Exam,ned.... .t ............
Approved ........................................, 19 ........ Permit 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 propertymust be drawn on the diagram which is part of this application.
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 Deportment 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 and regulations.
............... ....................................................
(Signature of applicant, or name, if a corporation)
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
............................................. ~on~.ac.to~. .............................................................................................................................
Nome of owner of premises ....,I..os.e. ph..P.....Oa.t~ ............................................................................. [ .................................
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: ..S. Qllt~.~Z'.bD~...l~omeSLot No: ...~ ..............
Street and Number ....G.~.aD.&e...fi.o~c]...~...~&'~...~.~.ew...~o.~.t .......... .qozlt~'~ ~l .......................................
Municipa ity
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....~.&~l.~t..'lo~ ........................................................................ : ...............................
b. Intended use and occupancy ........ .G~e...~'.a~l.~.~l~...~lwe~].'~.~. ..........................................................................
6,
7.
3. Nature of work (check which applicable): Now Building ..... ~.... Addition .................. Alteration ..................
Repa?: .................... Removal .................... Demolition .................... Other Work (Describe) ......................................
4. Estimated Cost ...... ;JJ;;~.....~.O..~.~...O...O. .................... Fee ....,~Q. ................................................................................
(to be paid on filing this application)
If dwelling, number of dwelling units ....gZtJ~ ................. Number of dwelling units on each floor ............................
If garage, number of cars ....... ..q~A .................................................................................................
If business, commercial or mixed occupancy, specify nature and extent of each type of use ................................
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 ...... .6~. ................ Rear ....... L~- .............. Depth ............... .~.0. .......
Height ............................ Number of Stories ..gD,~ ...................
9. Size of lot: Front .,l~J~'~...~.g.Q ....... Rear ..i....,],~J~t. ............. Depth ...,1.J~1 ......................
10. Date of Purchase ................ ..~.9,....6~.. .............................. Name of Former Owner ....... J~.t...~.~T..9~ .........................
1 1. Zone or use district in which premises are situated ....... ~,."...~;J,,%~; .......................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation? ................. J~ ................................
13. Name of Owner of premises ...... ~',~la.1;e~..,T~. .......... Address ............................................ Phone No .....................
Name of Architect ...................................................... Address ............................................ Phone No .....................
Name of Contractor ....... .~.~...~.~113,(;1,~.9Z1 .................... Address .....~TJ~II'e'JU;)~ ................. Phone No .....................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fram
property lines. Give street and block numbers or description according to deed, and show street names and Indicate
whether interior or corn~,~ot.
STATE OF NEW YORK,
COUNTY OF ..~:L1..~Z'.o-1~- ............ ~ S.S.
.~..e..~.e.. G.~.~..l~..gX~ .......... being duly sworn, deposes and says that he is the applicont
(Name of individual signing application)
above named. He is the ......... ~,,Ot3.t,~'&o.to~' ........................................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or. have performed .the. said work and t.o make ~n.d ..file
this app ication; that all statements c. ont.ained in this ap. plJ.cat~on_are t.m.e to toe. .De.st of his know~eage and verier;
and that the work will be performed ,n the manner set torth n the app~ cat on filed therew th.
Sworn to before'1 me this ~..~__1~. ~~
.......................... of ............ .......... ,
Notary Public,~.~l~a~,~.. County~"~'~.~'' (Signature of applicant) ........................ Gomm*ss~on [xp~res Marc~ 30.