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Home My WebLink About5227-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ]/S M~t~ ~(1 (~,~2~) Street Map No.. I~ Block No. ~ ...Lot No.~ ~/ ~eo~pO~ conforms substantially to the Application for Building Permit heretofore filed in ~is office dated .... ~ ~ .... , 19 ~ pursuant to which Building Permit No. dated ...... i~t~ .~ .. , 19~ , 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 . ~,~O~ .~d~ (~&~t) ......... The certificate is issued to ~fftO. C~te~. ~e~...(G.~ella~ termini) (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . ~,~ ........ .... ~.~. Building Inspeet{r 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.° 5227 Z Permission is hereby granted to: · .: ..... .~ .............................. . ............. ti .Z,e~l~z~ ........ tN-~, ................................................................... pursucr~¢ to application dated ................................. ~jl~J~....j~ ....... , 19...~, and approved by the Building Inspector. Bo FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - 1802 ! BLDG. DE~'T, ~ TOWN OF SOUTHOLD. APPLICATION FOR CERTIFICATE OF OCCUPANCY '~--"~-'~- Instructions This application must be filled in typewriter OR ink, and submitted m lammmmma 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 pzoperty 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. C. Fees: 1. Certificate of occupancy $25.00 -- BUSTNRSS $50.00 2. Certmficate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certlficate of occupancy $ _5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5 .Updated C.O. $ 50.00 Date ....M.a..r.c.h..2..2,..1.9..8.8 ...... NewCons %ruction ...... Old or Pre-existing Building . .a.d.d.~.t.i.o.n.. Vacant Land ............. Location of Property Main Road near Greenport House Ho. Street Hamlet Owner or Owners of Property .... .~.o.~.e.~...~....~..e.a~e.¥ ..................................... County Tax Map No. 1000 Section .... 3.5. ......... Block 2 Lot. 8 Subdivision ................................. Filed Map No ........... Lot No .............. Permit No..~.2.2.7.~.... Date of Permit .4../.[.3./.7...~.Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate Fee Submitted $.. 1..0...0.0. ..................... Construction on above c~escribed building and~~ations. Applicant .... ~~,.,. ............................... ~-W~i~m H. Prlce, Jr., Attorney/Agent Rev. 10-10.78 for Robert J. Heaney 3 ,-/t./I I f NO, I 'toWN soUT,o'D BUILDINr. DEPARTMENT TOWN CLERK'S OFFIC! ~OUTHOLD, N. Y. Examined .....~....../~......, 19..7/. Approved ........................................ , ]9 ........ Permit No ................. Z ........ Disapproved ale .............................................................................................. ................. y? ....... !¥'~'t* ............ t "~ .............................................................. .... (~,~ ~ ~).__~ q .... INSTRUCTIONS . a, .This ~l~l[~ti~l~ must be completely filled 'in by ~wrJ~r Ot in ~ink' und s~mJ~ in~ ~l'l~te ~t~"t~ Buildi In~r. b. Plot plan s~win~ I~ation of lot a~ of builder-on ~reml~s, r~lationship to adjolnl~ pmmi~ or publiC Itmets or -ar~r,~O~g~~[l~t,~.g~mmt ~ drawn on t~di~r~ ~t~h ~ ~ ~a~catl~.~ d. Up~ ~roval of this application, the Building Ins~ctor will i~ue a Buildi~ shall ~ kept on the premises ~ailable for inspection throughout the p~ress of the work. -- e. No building s~ll be occupied or u~d in whole or in pa~ for any pu~e whate~r until a Clffiflcate of ~c~ncy shall h~e been gmnt~ by the Building Inspirer. APPLICATION IS HEREBY/v~DE to the Building Department for the i~suance of a Building Permit pureuant to the Building Zone Ordinance of the Town of Southold, Suffolk County New/~'ork, end other applicable I. awl, Ord nonces or ~.egulations, for the construction of buildings, additions or alterations,/0'J/for removal or demol t on, al hem n dolor bed /ne applicant agrees t° c°mply wtth all applicable laws, etd nonces ild~~cld, e, and ,gulatlorl,. o, ........ (Add,ess of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, eJe{trl¢lan~ plumber ar builder. Name of owner of premises ............. Kif&e..=ritc-hlr~w ................................................................................................. 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.: .......... ~..i ................... L~t hl~i: ~ ·. i, ~ . ~,~;J~:; ~.., ..... + ~$ti~d~t~br~ J~LJmbt~r .......... J~/,.q..~..Ro~cl~...Gr.e~p~c.~,,...~le~.. ~.Cll~ ............. ,, ....... ~ ~ 4545 ~ ~nl~l~ii~, ....... ' .......... House 2: 'St~t~, e~is~t~o'u~"0~:~ ~:~cy of ~m Sos and intended use and ~cupancY of p~ Comtmcti~: b. Intended use and ~[=~ ....... ~..~..a~[z~ ........................................... , .................... 3. Nature of woik (check which applicable): New Building ~ ................. Addition ....~[~(. ...... Alteration .............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ...................................... 4. Estimated Cost ........ $~.~5.Og..-. ................... ~ ............... Fee .........$5..00 .................................................................... (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 ........ 2..4.'. ............. Rear ..... .~..~.'. .................... Depth .... 22.'. ..... Height ....... 12.~ ...........Number of Stories ....... ~, ................................................................................................ Dimensions of same structure with alterations or additions: Front ........... ~O.~. .................. Rear .......... ~-0.; ........... Depth ............ ~.~.! .............Height .......... 12,! ............ Number of Stories .............. ,[ ................ 8. Dimensions of entire new construction: Front ........ 16.~. ..................... Rear .......16.! ............... Depth ...~.~. ................ Height ......... 1~.~. .... Number of Stories ....... ]. ............................................................................................................. 9. Size of lot: Front ..... P.i~. ............... Rear .........8,~.~. .................... Depth ..~5.Q~ .................... 10. Date of Purchase ........................................................Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ........ DQD.~.CO~.£n~:~i~..~U~.~e.S~, ..................................... ~2. Does proposed construction violate any zoning Iow, ordinance or regulation.;> .......... ~.o ......... : ................................... 13. Name of Owner of premises ~.~E~e..C,~£tc,~lr~....Address ...... ~e~_P~,r..~.~.o.. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ..~o~e;~.'c..~t~.~,~, ................ Address ..C~[ohQc~u~...~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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, icc COUNTY OF .... $.u~.fo.l~ ........... ~'~' ................................ .GP.Q=~e...bJe,.1.1~.s ................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing applicatioh) above named. He is the ................................ ~e~,lg~ ................................................. .~ ....................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work end to make and file this application; that ali statements contained in this application are tru~ to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the applicatig//filec~_tJ~rewith. Swam to before me this // ........ ~.'l;h ......... day of ....,~p~'£1 ............................ , 19..~1.. Notar/ Public, . ......... Co icant) ~ ELIZABETH ANN N~/ILLE ~ ,~ ~"'""~J'~-~' - C/ IqOTARY PUBliC, State ~1 New York · r- , No. 52-8].25850, Suffolk