HomeMy WebLinkAbout3333-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDATED
CERTIFICATE OF OCCUPANCY
No Z-22242 Date APRIL 5r 1993
THIS CERTIFIES that the buildin~ ADDITIONS & ACCESSORY
Location of Property 12585 SOUND AVE. & 4140 CTY RD. #48 MATTITUCK~ N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 141 Block 3 Lot 38.1
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 5~ 1993 pursuant to which
Building Permit No. SEE BELOW dated ........
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 ACCESSORY BUILDINGS &ADDITIONS TO EXIBTINGBUSINESS BLDGS ***
The certificate is issued to
of the aforesaid building.
G.L. PENNY~ INC.
(owner)
*** THIS CERTIFICATE OF OCCUPANCY UPDATES THE FOLLOWING :
BP $3333Z-C0 Z-2757 DATED 7/20/67 FOR ADDITION & ALTERATION ON
EXISTING BUSINESS BLDG. & OFFICE SHOWROOM.
BP $5921Z-CO Z-6301 DATED 1/14/75-NEW BUSINESS BLDG. ,(OFFICE USE)
BOH APPROVAL DATED 1/14/74-UNDERWRITERS CERT. #N-57920 DATED 11/29/72.
BP #8938Z-CO Z-14636 DATED 7/14/86 ADDITION TO EXISTING OFFICE LUM~ER
YARD SHOWROOM - UNDERWRITERS CERT. #N734440 DATED 2/6/86.
BP #11202-Z-CO Z-14637 DATED 7/14/86-STORAGE & SBT.V.S BUILDING
UNDERWRITERS CERT. #N-734438 DATED 2/6/86.
BP #14066Z-CO Z-14634 DATED 7/14/86 - ADDITION TO EXISTING BUSINESS
BUILDING ( CARPET STORE).
BP #14071Z-C0 Z-14645 DATED 7/15/86 - ACCESSORY STORAGE BUILDING
BP ~14072Z-C0 Z-14646 DATED 7/15/86 ACCESSORY BUILDING - UNDERWRITERS
CERTIFICATE #N704533-DATED 8/13/85
BP #17285Z-C0 Z-17357 DATED 9/27/88 ALTERATION TO CARPET STORE,
UNDERWRITERS CERT. #N-038891 DATED 10/12/88.
~iTding Inspector
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
EIEI~TIFII~.ATE I-IF OI~.EIUPANI21Y
No. Z 2~7~ Date .... July. 20.. , 19 6?.
THIS CERTIFIES that the building located at N/8 ]BUIlIlCl. A~e Street
Map No. :~X Block Iqo. ' :KX Lot No. XX, l(~l;%ii;%ICk$, l~,Y~ ........
conforms substantially to the Application for Building Permit heretofore filed in this office
dated De~' 6 ' 19 (~6 pursuant to which Building Permit No. · 3333
dated De~ 6 ' 19 66 , 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 ~B~lain~s 'ButId!h~{ .ofr~iee. shawro~m et;~ .......................
The certificate is issued to {leO' 'I~' Pera'%y- ~ .......... 4)wrier .................
(owner,lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval .. /~. ,. ~.., ............
Building Inspector
FOEM 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? 3333 Z
D- December 6 19.....6~...
Permission is hereby granted to:
................ ~..e..o....~......~e...n~.. ~.....~..n..q. .........................
l~attltuek
to
at premises located at ....N../..S....S..o.~....A...v..e. ..........................................................................................
................................................... ..~e,. ~.~;t .t,.~.k, ...~,, )f.. ,. .........................................................................
pursuant to application dated .................................. ..D..e..q ........ ~ ......... , 19.~.., and approved by the
Building Inspector.
Fee $..~..,....og.. .............
Building Inspector/
FORM[ NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD,
N.
Y.
Approved ................. .t.~ .................... , 19 ........ Permit No ................................
Ehsapproved a/c ......................................................................
(Building I nsp~ztor)
Application No .... ,.~,,.?,.., ,~, ..,~,,, .....
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a Th~s application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildin
Inspector.
b. Plot plan showing location of lot and of buildings on premises, relationship to adloming premises or public streets ·
areas, and giving a detailed description of layout of propertymust be drawn on the diagram which is part of this applicatior
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of th~s application, the Building Inspector will issue a Building Permit to the applicant. Suc
permit shalt be kept on the premises available for inspection throughout the progress of the work.
e. No building shall be occupied or used Jn whole or in part For any purpose whatever until a Certificate of Occupan-
shall have been granted by the Building Inspector
APPLICATION IS HEREBY MADE to the Building Deportment for the ~ssuance of a Building Permit pursuant to tk
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances ,
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe,
The apphcant agrees to comply w~th all applicable laws, ordinances, building code and regulations.
(Signature of applicant, or name, if a corporation)
.......... ~.~i.~.uC k t.. I~., ~,, .................................................
(Address of appl,cant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde
O ~"~ e ~
Name of owner of premises ....C-...e..o..:....~........~...e....z~..~......Z.~.a. .......................................................................................................
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' . ..... ~'~T~ ............................ Lot No: .....~ ......
Street and Number .... ~T~.S ..... ~q...o.tzndb..~Lv.e.....~J~Ltur_k ....................................... .~ .........................................
Mumc~pality
State ex~stmg use and occupancy of premises and intended use and occupancy of proposed construction:
o Existing use and occupancy ...... .~..~...S.~.~.e..~.~...~..~..~.]...~g....(.~...L~..~.e.?....~,~,.~..c)..). ...............................................
b. Intended use and occupancy ............... .s...~..~..e..,.,w..~,?,,.~...~,~...,~,~.,.ct:~..~.,J:.o.,.~.. ...........................................................
3. Nature of work (check whJch applicable). New Building .................. AdditJon ...~ZF--_~ ....Alteration ............
Repair .................... Removal .................... Demolition ................... Other Work (Describe) ..................................
4. Estimated Cost ....... '.~ ........................... Fee .... ~'~,.00. ........................................................................
c] Se-~ ~ .~o G~ (to be pa~d on fihng this application)
5 If dwelhng, number of dwelling umts ...D, Q10,G. ............... 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 ...... ,~l-S.¢~e~..
7 Dimensions of ex~sting structures, ff any: Front .......................... Rear .......................... Depth ........................
Height ............................ Number of Stories ...........................................................................................................
D~mens~ons of same structure w~th alterations or aad tons Front ................................ Rear ............................
Depth .............................. Height .............................. Number of Stories ........................................
8. D~mensions of entire new construction: Front ........... .~6,,,8 ........ Rear .......... .~6--~ ........ Depth ......i!'...0. ..............
Height ............................ Number af Stories ..... Q~e~ ...............
9. Size of lot: Front ............................ Rear ............................ Depth ................................
10. Date of Purchase ........................................................ Name of Former Owner ....................................................
11 Zone or use distr~ct m which premises are s~tuated ...... !!~!!..¢1,.'1~.~; ....................................................................
12 Does proposed construction wolate any zoning law, ordinance or regulation? ........... ~.O. ..................................
13 Name of Owner of prem,ses ...G..*...~.*....~.e....t?~..~.....~..~..a...Address .............. ~.A~.l~.~.lA.a..~. ........ Phone No .................
Name of Architect .....G......j:klP,~.~.~A ............................ Address ...... .................. Phone No .................
Name of Contractor ....... 01~':teZ:. ................................. Address Mattit~c~ Phone No.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether ex~stmg or proposed, and indicate all set-back dimensions fr,
property hnes Give street and block numbers or description according to deed, and show street names and indic,
whether interior or corner lat.
STATE OF NEW ~YO,[~-.,. ~ '~ e c
COUNTY OF ~uzzo±~ ~:
Oeo. ~. Pe~ be ng duly sworn, deposes and says that he is the appl
(Name of individual s~gning application)
(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
th~s apphcat~on, that all statements contained m th~s application are true to the best of his knowledge and
and that the work will be performed in the manner set forth m the apphcation fried the~with.
Swam to before me th,s ~ ~//
~N0[r, RY; J ' '
~rm Expires March 3a,