The URL can be used to link to this page

Home My WebLink About4202-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMF2gr Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No. Z" ~636 .... Date ........... .0.q~;.. ~1. ........, 19.6.9.. THIS CERTIFIES that the building located at . Dazllla' Dl~J, gw ............ Street M~..~..~.*...C?.::.t B~c~o? .......... Lot No.. ~.~ ...... ~t~.....~:~ :... conforms substantially to the Application for Building Permit heretofore fried in this office dated ........... l~h' ' '1~' 19.1~9 pursuant to which Building Permit No... 14,202. z dated ............ )gi~lt ' ' 1~l 19.69., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. ' l~'i'~ti~' 'One' Ta~iil~y .d~tlLn~ .................................... The certificate is issued to ...j~es .6&.l.la~he~ ....... ~ ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk .County Department of Health Approval .0et...~l...1969...by. 1~.~;1~$ .... uildmg Inspector FOIUli NO. ~ 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) 4202 Z Permission is hereby granted to: .............. ,~..a.~.~., ~.a.;L~..a. ~..~ ............................. ............ 5.gE......8~r.~...P.~l~. ............................. ............. Oakdale .......... I'~.,~.,. ....... 1,1.?~9. ........... to ..... ~..u.~.~...~....o..n.~...~.~.m.~y....~..~.~..n..g. ............................................................................... at premises located at .............. .~.~.~..t.~..i.~..~.~.~.~.~.~...~..]`.~.e.~.c~.~?.~?..k.~..~..i:.a.~.i:~ ................................... .............................. )~l/~3,....Don~.. i1~. .............. J~a.t~£t,~ck....I~-.~ ............................................... pursua:n,t to application dated ........................ }~.ch ........1,~ ............ , 19...~.~., and approved by the Building Inspector. S-9 SCHD SUFFOLK COUNTY DEPARTMENT Date Bldg. OF HEALTH OCT 3 Permit No. TO WHOM IT MAY CONCERN: at The sewage disposal facilities for a structure (Give deed location) ~ located have been inspected by this department and found to be satisfactory. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in tvpewriter OR ink, and submitted aa ~ to the BuiJding 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 supplv 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: MC NULTY, DI PIETRO & SPIESS 1 585 130 OSTRANDER AVENUE RIVERHEAD, NY 11901 ORDER OF_ DOLLARS County f'ax Map No. 1UU0 Section .... ./L.~ ........ Block ,. ~' Lot Subdivision/~I.E/) ,¢/:: ~¢?~f.2/.//(~/d¢ ~(Z£/¥/~/rf pil¢a Map No. ¢~ .Lot Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .................. Fee Submitted S ~O'Og2 Construction on above described building and/.¢ermjt n Applicant .d[.?[.~{4 ,FORM ,NO. 1 ~ , ~ ~ ~ x ~ ~ ~ +~ TOWN'SO--OLD ., , ~ .~ ~ ~ ' ~_~ ~._ ~/~ BUILDING ~AR~T~/F/~ ~ ~ ~ ~ /; ..................... , ~ .... Ap~llCS~IO~ ~0 ................. pp~ved .................... ,19 . Pe~t No. . ~ ~ ~ ~ ... .................. /~ ~ ~ . ...................................... ~.../ ..... ~ .......... .~ / ~PLICA~O~ FOR B~LDING ~M~ ,ate ............. ..... INSTRUt,'i'iONS 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 o n premises, relatiomship to adjoining promises or public streets or areas, and giving a detailed description of layout of property must be drawn on the'diaKram which is part cd this application. e. The work covered by this applicatk~n may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building In spector will issue a Building Permit to the applicant. Such permit shall be kept .on the premises available for inspection throughout the proKross of the work. e. No building shall be occupied or used in whole oV in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building InspectOr.. APPLICATION IS ~ ~-~Y 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 cd build ings, additions or alterations, or for removal or demo- lition, as herein described. The applicant agrees to corn ply with ail applicable laws, ordinances, building code, housing code, a~d regulations. (~nature cd appl~)~2 01~ name ~ eorporation) ................ ........ i State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ..... . .(~....~..~e,-~...- .... . .~. ~--f~~......~...~..'~..~..~. .................................. If applicant is a oorporate, signature of duly authorize d off' . (Name and title of corporate officer) ~n: ~.~ ,~ ~, 1. Location of land on which proposed work will be done. Map No.~-~.. .. t No .... .~..) ..... Street and Number ..... ~. ~..~r~.~.....,~...~. >~.~..~ .... .~..~.T..-~. ~..-Tg.r,.j(~ .................. ~'~/ '~- // d~ /~ Munici~li~l~': 2. State existing use and occupancy of premises an d intended use and occupancy of proposed construction. a. Existing use and occupancy ...... V~.C..~.t4.'V ..... ..~...T.: ...................................... b. Intended use .and occupancy ...~..~.~....~...~7~..U~.."{...?.?'..?~..~..~. .... .~.%..~..~.., ................... 3. Nature of work (check which applicable): New Building ...~.... Addition ........ Alteration ........ Repair ......... Removal ........ Demolition ........ Other AWork (Describe) ...................... 4. Estimated Cost . .~..I.~.~., .~...O..~. ................ Fee ...l. 9.: .............. (to be paid on filing this application) 5.If dwelling, number of dwelling units ~ ... Number of dwelling units on each floor If ~arage, 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 ox additions: Front .............. Rear ............... Depth ................ Height Number of Stories ..................... 8. Dimensions of entire new construction: Front i.~..~; .......... Rear ..~...~.~ ....... Depth . ..~:.~..~ .... Height .. J..~. ...... Number of Stories ..... .I..: ................................... 9. Size of lot: Front .!.~.0.. ......... Rear .'!/.'~..~...' ...... Depth ~.~..~..T .... \ .~...'7. 10. Date of Purchase .. !..~..L .~..~.'...~.~. ............ Name of Former Owner ~....-~. ~l ..... 11. ~one or use district in which premises are situated .................................................... 12. Does proposed con~timction violate any zoning law, ~aDqe or regulation? ........................... 13. marne oz uwner.oz premises ...................... ~auress ........... .. ......... Phone No. ~.~..'-l..~.:. Name of Archit~~..~...~....~.- .... A~ldr~'~. · .~..~..x.~..~..t.~..z~..~e No ............ l~ame of Contracto~~'~-- ......... Addr~.e... ~...o~..~.....c:~....¢:_.~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 number or description according to deed, and show street name~ and indicate whether interior or corner iot. ~ } d~~ ,1 30 STAT~ OF ~Y )SS. _.i- ~Na~he of individual signing application) ~.~ ~ . cant .ab /named. is the .............................. (Oontractor, agent, oorporate officer, etc.) of said owner ~ owners, and is duly authorized to pedorm or have perf~rrned the said work and to make and file this application; that all statements contained in this application 0xe true to the be~t of his knowledge and belief; and that the w~ek will be performed in the mann er Set fortl/in the application filed therewith. Sworn to before me this ........... day0f .... '. · Not Public, .................... C nty,. 'flgl ......... [/ ~' I~OTgr,'~ F:!¢:.!". o*',~ of New Yorl~ NO, 5,-~:,:~:~, Suffolk Te~m ~xp;res Uarch 30, ~_.~ .\ It: DRAWN BY APPROVED BY RUDOLPH A. MATERN 'A. I. A. REISISTERED ARCHITECT design number / I~ ~I''L-I~ ~ ~ '" ~ ~~,,~,. '~ < ~1.~ :: ~: ~-: ~~,.~. ,,~: ~l. ~ , ' ~ : '~,'fit' i :. ]'T.; - ' , [-, :~'~ ~ n~ ;ll. , ]1..:1] , ~ ~. /[~.--...:-...~ ..-., ~. ., :~ .....-. i., : /,.,,I no DRAWN BY ~PPROVED BY RUDOLPH A, MATERN IA. i, A, REGISTERED ARCHITECT 89 E. ~IERICHO TPKE., MINEOLAi design number ? RUDOLPH A. MATERN 'A, I. A. sheet no. ? DRAWN BY APPROVED BY RUDOLPH A. MATERN a. I. A. REGISTERED ARCHITECT design number 4 j ' zOzL L!IY/~ //V ~ ~ /.4 ~ /-4 A /V1 .T ,j ...... ~ate :a~own here-am AIxhough {he h~.ve fulliilc~ :he:r purpo~ wcn ~ is accom]ali:he~, they are comple{¢ bLql~,n DRAWN BY APPROVED BY RUDOLPH A. MATERN fA. i. a. sheet no. design number