HomeMy WebLinkAbout4702-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
UPDA'T~D
CERTIFICATE OF OCCUP~CY
No Z-23580 Date MARCH 30, 1995
THIS CERTIFIES that the buildin~ MULTIPLE DW~?~.IN~
Location of Property 475 YOUNGS AVE. & 275 ~C~NIC ST. SOuT~OLDf N.Y.
House No. Street Hamlet
County Tax Map No. 1000 Section 61 Block 4 Lot 28
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for~ Building Permit heretofore
· filed in this office dated APRIL 22, 1970 pursuant to which
Building Permit No. 4702-Z dated APRIL 22¢ 1970
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 AL-£~RATION TO I~AND 2 FAMILY DW~T.t. INGUNITS TO 3 F~MILY
DWELLING UNITS AB PER ZONING BOARD OF APP~,%LS ~620 DA'r~,~ 12/5/63 *
The certificate is issued to
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
UNDERWRITERS CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
PHYLLIS B. M~J~I~RAF & AORl~ls B. OLIVER
*THIS UPDATES CO Z-3871 DA'£aI~ JULY 21, 1970.
Rev. 1/81
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OCCUPANCY
No..~8.~.1 ............... Date ........................ ~.~ ....... ~.~ .......... , 19..~..0..
THIS CERTIFIES that the building located at ¥Oi3~&..~.YO....~...J[l~.[~tJ,~..~.t~. ........... Street
Map No...,ex ............... Block No..~ ............... Lot No...XZ ....... S.O~l.t,110~,....~[~., ....................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.......................................... A.~l~t.....2.2.., 19.~0.. pursuant to which Building Permit No...~.~.09~,...
doted ......................... &pF.l[~l. .......... 2~...., 19..~0., was issued, and conforms to all of the requirements
of the appiicable provisions of the law. l'he occupancy for which this certificate is issued is ........
...... p.~l. va.~..4~l.l.~..-...(...3...~.~ ....b~...p.~%.~...~..~.~...~......o..r.....*. p~ ~!.l..m )
The certificate is issued to ....~,~J.O~'J,0.....~,l$.~]~. ............ (~IW)~01'. ...................................................
(owner, lessee or tenant)
of the aforesaid building.
House ~ 27~ Heehan~c St East
~?~ ¥o~m~s Ave
Bui ding I~%pector
II*O~M NO. !
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ..... ~ ............... ,19 ........ ~) (~)
Approved ........................................ , 19 ..... Permit No ........................
Disapproved a/c ................... ~..-.~_.~ ..............
................... ........................
Application No. ~ ) O ~
APPLICATION FOR BUILDING PERMIT
Date ..~...~....~i .................. ,
INSTRUCTIONS/
o. This application must be completely filled in by typewriter or in ink and submitted in ~plicate to the 8uildin~
Inspector.
b. Plot plan showing I~otion at lot and of buildings on premises, relationship to adjoin ng prem ~s or public st~ets
areas, and giving a ~ailed de~riphon of layer of prope~ must ~ drawn on the diagram which is ~ of this application.
c. The work cover~ by this appli~tion may not be commenced before issu~ce of Building Permit.
. ~.., U~on ~proval of this applicati~, the Building Ins~ctor will i~ue a Building Permit to the applicant Such ~rm t~
snau oe ~ept on the premiss ~oil~le for i~pection t~roug~out the pr~r~s of the work. ' --
e. No building s~Jl be ~cupi~ or used in whole or in part for any purple whatever until a Ce~ificate of ~cupancy~
shall have been g~nted by the Building I~tor.
APPLI~TION IS HEREBY ~DE to the Building De~ment for the issuance of a Building Permit pu~u~nt to t~e~
Building Zone Ordinance of t~e Town of Sout~old, Suffolk Count, N~ York, and ot~er applicable L~s, O~i~nces
Regulations, for t~e construction of buildings, additions or alterations, or for ~moval or demolition, os heroin described.
The applicant agrees to comply wit~ all applicable la~, ordinance~uilding c~e, housin~ c~e, and regulations.
..... ........
...........
(~ddr~ o~
State whether applicant is owner, lessee,_aaent, architect, engineer, general contractor, electrician, plumber or builder.
If n ........................................
app 'can~-)s a corporate, signatu~re~of duly auJ~orized officer.
1. Location of land on which proposed wor. k will b~ done. Ma~o No.: ........................................ Lot No.: ........................
Street and
2, State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Existing use and occupancy .....~7-- ....... : ........................................................................................
b. Intended use and occupancy ............. ./.I. ........... :/ ......................................................
3. Nature of work (check which applicable): New .Building ~.~ ............... Addition .................. Alteration /'
Repair ........... :'~s,~' Removal .................. Demolition ....... ',~,'""t' Other Work (Describe) ........................................
4. EStimated Cost:~+ ...... ..~....~...?.....;..~....~.. ................................ Fee ....~...~...~.eF ........................................................................
(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 ............................ 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 .................................... Rear ............................ Depth ........................
Height .................... Number of Stories ......................................................................................................................
9. Size of lot: Front ............................ Rear .................................... Depth ................................
10. Date of Purchase ........................................................ Name of Former Owner ........................................................
11. Zone or use district in which premises are situated .....................................................................................................
12. Does proposed construction vic~late any zooing law, ordinance or regulation? ..... ~ .............. i ..................................
13. Name of Owner of premises~.'~//,~--~6~ddress"~ ~ ..~~..~ '---~ '-- .................... Phone No
~J ~
Name of Architect ...................................................... Address ........ ... ....................... Phone No .....................
Name of Contractor .~...~.~ .......... Address ..~...~.. ................ Phone No. ~..&.....~-Z.-~...~..~.?
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 ND6k~OI~, x/A [ ¢ ¢
COUNTY OF ~ ......... )'~'~'
~,.~..~:..:.J~,.~.....~ .................... being duly sworn, deposes and says that he is the applicant
................. '('Nefne of individual signing a~plication)
above named. He is the ............................. ~ ..............................................................................................
(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 and file
this application; that all 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.
Swam to before me this
..... ....... ddyof ....... ......... : ............
· ........ .... ................
Notary Publi~l,Z~,//~.Z.~ ._~u~F,~ ........ County~CJ/~<~,~ ~ (Signature of 0p~icant)
~./ NEVILLE
NOTRR¥ pUSLR;,
o 52-$[25550 ~lfolk BoUO~
STATE OF NEW YORK:
:SS
COUNTY OF SUFFOLK:
PHYLLIS B. MALLGRAF, residing at 500 Goose Creek Lane,
Southold, New York 11971, being duly sworn deposes and says:
Deponent is one of the owners of the residence on the
corner of Youngs Avenue and Mechanic Street, Southold, New
York, for which an up-dated Certificate of Occupancy is
being applied for.
Deponent further says that there are three (3)
apartments in the residence and that there is a smoke alarm
outside the bedrooms of each ap~~zi~~g~ __~f~ s~B~"M-/a/l~l ~
.?
Sworn to before me this
'/~day ALICE C. MacDONALD
~L/ Notary Public, State of New York
~ of March, 1995. No, 4879351
Qualified in S~ffolk Coun~ .~
otary ~blic
21-mallaff
Southold ~w~ Board of ~,PI~ale -5- DeCember $0 19~3
(There was no response. )
T~ CHAZRMA~ Th~Ls is cer~ainly an unusual case. We have
granted two fam/iy use~ in s~veral other cases and have lost or~
of them ~ a higher court, t~o~ever, the ~oint ]~ou make in thio
case of extension of a non-co~forming u~e is a ¢o~clusive ~e In
,~fter
appll~nt pre~ntly
un~. Th~
She ~ wXshes
X, S~tion 1007 (a)
effective ~te of ~e ~ce ~y ~ cont~ued, ~thoug~ such
s~h ~e ~y ~ ~n~d ~ugh~t ~e ~g ~fu~ly acquired
The Board finds that strict applicati~ of ~h~ Ozdinance
~hi~ crated ~ ~ ~d w~ld ~ ~ ~=ed ~ all
O~ ~otion of Mr. ~liliapie, serenaded b~, Mr.I~u]Lse, It was
York, ~ 9ranted ~ss~on to ~cz~se ~e ~cu~cy of her
Southold Town Board of Appeals -4- December 5, 1963
permission to erect a pole typ~ ground sign 21 feet ~n height
o~ the service statio~ I~xoperty of R. Josel~h wheeler, north side
~4idxile Road, Southold, ~ew ]~ork. This sign is to ~ located at
leau~t ~ feet f~om any ~roperty line.
Vote of the Board.
and F~r. ~lulse.
N~ Y~k, for a ~r~ ~ ac~r~ce w~ ~e Zon~g Ord~ce,
Article ZZ~, Section ~00,
202, for ~o~ ~ ~zeaee ~e ~Tu~uy o~ h~ h~oe~o
~ f~. ~a~ of pro~rty: ~st ~l~ ~gs A~nue,
$ou~old, N~ York, ~d
A~ue, s~ by ~n~ S~t, and ~st by Charles T~r.
F~ ~ld $5.00.
~ chairman opened the hearing by reading application for
m variance, legal notice of hearing, affidavit attesti~g to
publication in the official newspaper an~ no~ice to the
there a~ p~'e~ent who wishe, to speak
I~FFERTS ~. EDS0~. ~O. 3 X thin~ the epplication ~hould ~
~eed ~ Section 1007, S~ect~ (~) ~l~ ~erm ~e B~rd
~ ~ dimcreti~ to e~nd a ~n~~g use ~o~hout a
bu~d~g. ~ ~ ~ere ~ ~ questl~ ~at ~e t~ f~ily ~
of ~e Bo~ bu~d~8, Tele~ C~ny buil~n9 amd o~er
T~ CHAiRMAN: ~s there anyone elms pre~ent who ~,iahe~ to
would be willing to speak in £avor.
(at least 15 of Mxs. Baker's nel%u~rs appeared lnfavor
of ~he applicatio~.
/
//
Original for Municipal Building Department
STATEMENT OF REGISTRY
To be filed in duplicate with the municipal building department or local enforcement agency
by every owner of a multiple dwelling, as defined in subdivision 33 of section 4 of the
Multiple Residence Law.
Within 30 days after the filing of this statement, the municipal building department or en-
forcement agency is required by section 300, Multiple Residence Law, to file a duplicate
copy hereof with the State Building Code Commission, 1740 Broadway, New York 19, N. Y.
1. Location of multiple dwelling:
(a) Street and number ~../.~...i..~..~.?.,~...J)..~./~.../..C~......~....~...~...'.....~,../.~....J./..~..?'.....~..~..4
(b) Municipality ..........-- / ~~...~..~.....~..J~.~..~..J~. ...........................................................
2. Description:
(a) Type of construction ..... ~....~.....~.....J:~....~. ....................
(b) Height of building, including ~"~~ .........
number of stories ..............................................
(c) Type of heating facilities ....(~..!...~.. ~.l..J~...~-..~ ........ L.~..J..~......~.....~...T...~.....~.. ....
(d) Number of apartments ......... ~ ..........................................................................
(e) Number of living rooms ....... ~ ..............................................................................
(f) Number of kitchenettes ..... ~ ...............................................................................
(g) Number of bathrooms d:~
(h) Number of water closets 3
(i) Number of occu~nts for which building was designed or intended to be occupied
or used ................................... ~ ........................................................................
3. Age of
(a)
(b)
multiple dwelling:
Date when constructed ..... .~....~..../...~...../~.......~.'~...O.....~....~....~.....~ ..........................
Dates of substantial additions, alterations or modifications of dwelling, with
brief description thereof .. ~ ..............................................
(c) If now under construction, state when construction commenced and anticipated
date of completion ~
4. Use:
Describe the principal use made, or, in, the case of buildings under construction, to
be made, of the multiple dwelling (such as apartment house, hotel, apartment hotel,
lodging house, boarding house, school, convalescent, old age or nursing home, pri-
vate dwelling two or more stories in height with five or more boarders, roomers or
lodgers, or other classification of multiple dwelling including those specified in sec-
tion 33, Multiple Residence Law). ~
...... .....................................................
STATEMENT OF FILING
Filed with the
............ ~;].(~i~..~;[~.~..~;..~¢..~.~ · ~)~;~;~;. ~;~~ ........................ of the
..... ""~"'~e'~~"~'o[
{S~n~ture and Designation of OffiCial wi~h
whom Statement of Registry wasll~lled)
Form No. 6
, ~ TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
;'-~,~ ...... ~65-1802
UP-DATED
APPLICATION FOR/CERTIFICATE OF OCCUPANCY
This application muse be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of property with accurate iocat£on of all buildings, proper~y lines,
streets, and unusual natural or topographic features.
Final Approval from Health Dept. o~ water Supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation fram Board of Fire Underwriters.
4. Sworn statement from plumber certify£ng that the solder used in system contains
less than 2/10 of i% lead.
5. Commercial bcilding, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliance from architect or engineer
responsible for the building.
6. · Submit Planning Board Approval of completed site plan requirements.
For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
'.'pra-exi~ting" land uses:
1. Accurate survey of property showing all property lines, streets~ building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancyls denied, the Building InspDctor shall state ~he
reasons therefor in ~ritlng to the applicant.
C. Fees
1. Certificate of Occupancy- New dwelling $25.00, Additions to dwelling $2~.00,
Alterations Co dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-exis~ing Building ~ $100.00
3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00
4, Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
March %% 1995
Date .......... ,. ................. ... ...... ..
Residence
New Construction ........... Old Or Pre-existing Building..X.o(m®m,~emfe~mtng use)
Location of Property ............ ~qqqgs Avenq~
House No. Street ~amlet
Onwer or Owners of Property... )J~y.l%%~.~,.Mallg~(.~Dd.ddr$¢Do~.Bo,O~$~r ....................
County Tax Map No 1000, Section .... O61 ....... Block ........ ~. ...... Lot ....... .~. ............
Subdivision .................................... Filed Map... .......... Lot ......................
Permit No ................ Date Of Permit ................ Applicant,. Wiilia~Ni~kb~.,.F.~...,.A~orney
for owners, ~byllis B. Mallgraf &
Health Dept. Approval ............. ..-.- .. ...... Underwriters approva~ ..........
Planning Board Approval .................... ....
~ Request for Up-Dated C. O.
Request'for: Temporary Ccrtifica~e ......... Final Cert/cate.~~h~
,' ...................