The URL can be used to link to this page

Home My WebLink About6822-zTOWN OF SOUTHOLD BUiTI~INC. DEPARTM~.NT Town Clerk's Ol[iee $outhold, N. Y. Certificate Of Occupancy No. Z~ ...... Date ............. THIS CERTIFIES that the b~g l~at~ at ~. ~d. & .~t~. P~t M~ No.. ~ ........ Block No .... ~ .....~t No.. m.. G~en~rt. R,Y, ......... co~o~ subs~y ~ ~e App~cation for B~ Pe~ ~tofore ~~ o~ce dat~ .......... ~. · 2~..., 19~3. p~u~t dat~ ........ &u~...2~ ....... , 19.73., was issue, ~d ~o~ to ments of ~e ap~c~le pro,ions of ~e law. The occup~cy for wM~ ~ ~ . ~r~vate. ~. f~. ~. .................................... ~e c~cate h ~u~ ~ Gaorge..Sab~o ....... ~e~ ........................... (o~, lessee or ~t ) of ~e ~ores~d b~d~g. S~olk Co~ty Dep~ent of He~ Approv~ .. ~ee..~...1.~7~...b~. R, .Y~a. · · U~ITERS CERT~ICA~ No, Rt3~7~ ...... Ja~ ~...1.9~ ............... HOUSE NU~ER... ~0 ........ S~eet .... ~tt~ .Pl ........................... NOel ~Jeet to correet~on of ~ont doo~ 8~p to ~reh B~g ~r FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 6822 Z Permission is hereby granted to: · .~.~ ...... :~...~..at ..................................... ...... · ,~.~erhm~d .................................................... ro · ~u~ 3~ · .~ew.. · Rrm. · .f. ae~ $-1.y.. 4we~- .1.$~ .................................................................................... at premises located at .S~uml...Ra~d..&..~tte,n..Ptaee ............................................................... ..................................... · x"~e~Fox'~ ......... .1~.~.~-, .................................................................................. pursuant to application dated ..................... AI~" ......... ~ ............. , ]9.~3.., and approved by the Building Inspector. NOT~II (~hoO]~ &~'OF&fO "Otb&OttO Fee $~.~.~ ............ FOItM NO. $ TOWN OF SOUTHOLD Building Delm~tment Town C:lerks Office Southold, N. Y, 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Inst~ructions A. This apphcation must be filled in typewriter OR ~nk, and submitted ~n duplicate to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate Iccation of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept of water supply and sewerage d~sposal--(S-9 form or equal) 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buddings, Industrial buildings, Multiple Residences and similar buildings and installabons, 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-exist~ng" land uses: 1. Accurate survey of property 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 inspechon of buildings or premises, or other pertinent in- formation required to prepare a certificcJte C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 ate New Building ..... X ......... Old or Pre-existing Building .......................... ~ Vacant Land ................. ~ ........ Health ~pt. ~pprovol ............................................ kobor ~pt. Approvol ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ........ ~, .............................. Fee Submitted $ ...~...:...~..?. ............... Construction on above described building and oermit meets oJ~ applicable codes and regulations. Applican~-)~i~'~c'~ ''~''/. ..........................................// ]"Jomart Sworn to before me this //' ~/2~ ' ,.,__/ ~' --~-' 1139 W. i~L,~in 5~rc, t ...... ./..& ..... day of ........ ............... Cstamp or seal N. Y. Notary Public ........~.. ~..u...F...~.q../:. ,/..~ ..... County S- 246806 0 TEST BORING SURVEY FOR REFERENCE: GEORGE ~ MARY SABINO AT GREENPORT TOW~if' OF saul'HOLD GUARANTEED TO' ~ut~or~z~ ~eml/~ or a~hon lo t~s INTER-COU~ TI~ GUARANTY ~ MORTGAGE CO. SUFFOLK COUNTY~ sechon 7209 o~ t~e New York Sfa/~ EducohT~~a ~Y S~"IN~ Copies of Ih~s su~ey map not b~ lng Ihe land su~eyo~s ink~ SCALE: 1"=50' dULY 16s 1971 JULY 20,197:~ secl or embos~cd seal shall no~ be cons,de.ed ~ be a vahd copy, or c~rhflcohons md~cated hereon ~aI~ run only lo the ~ ~ ' - ~ '~r ~, ham the survey ~s prepared, and ~n h~s ~haE to the LAND SURVEYOR N.Y.S, LIC. NO. £B?E5 RIVERHEAD~ N.Y. 246806 SUFFOLK HEAY~TII TEST BORING SURVEY FOR All &stances to well~CestP~°!s am by locahon from house ownerS and field d~mens{onl~ ,e!s are not v,s~ble these GEORGE 8t MARY SABINO AT C:;REENPORT TOWN OF SOU'/HOLD SUFFOLK COUNTY~ N.Y. SCAL, E : 1"= 30' JULY 16, 1971 JULY 20,1973 SEP'I~, 24, I97,3 NOV, 5, 19 73 ?x. lnC .~"~ honzed alteration or additton to th s su~ey is a ~ seclmon 7209 oi the New York Stole Educa on Law ~ Cop~es of this su~ey map not beanng the land su~eyo~s s~bl or embossed seal shall not be conmdered to be a vahd cc ~'~ maes or cerhhcahons m&cate~ hereon s~l .r~n only to '~' ~ - ~l.~m the survey ~s ~pared, and on h~s behal~ to d company, governmental agency and lending ~nshtuhon REFER~N~, c~d to the assignees o~ lhe Jen&ng mshtuhon Guarant- or cerhflc~hons are hal lmns~erable to addH~onal Inshtufloni SUARANTEED TO' US*LIFE TITLE iNSURANCE COMPANY OF NEW YORK SOUTHOLD SAVINGS BANK GEORGE ~ MARY ' SABINO LAND SURVEY*OR N.Y.$. LIC. NO. £87J~5 RIVERHEADt N, Y. ~ $- 246806 All &stances to wells and cessgggJl 'by Ioc, ition from house owners and field observl',hons~ since most wells and cess- pools are not ws~ble these dimensio¢~i o~nn~ b~ cerhF~d.. 3. TE. ST BORING Unauthorized alterahon or ad&hon to Ihrs survey ti a viola sechon 7209 of the New York State Educahon Law. Copies of th~s survey map not beanng the land surveyor's seal or embossed seal shall not be cons*dered to be a vahd Guarantees or cerhficahons indicated her~cm SURVEY FGR GEOF?GE 8~ MARY A T G REENPORT TOWN OF SOUTHOLD SUFFOLK COUNTY~ N. SCALE: I"= 30' dULY IG~ 1971 JULY 20~1973 SEPT' 24, 1973 NOV 5, 19 73 SABtNO person for whom Ihe survey ~s prepared, and on h~s behalf R£F, irR~:-N~,,t~Ie company, governmental agency and bndmg ~nshtuhon '~ereon, and to the assignees oF the lending mshtuhon Guar¢ or cert~f~cahons are nat transferable to ad&honat mshtut~ subsequent owners. ~UARANTFED TO USLIFE TITLE INSURANCE COMPANY OF NEW YORK SOUTHOLD SAVINGS BANK GEORGE ~ MARY SABINO LAND SURVEYOR N,Y$, LIC. NO. RIVERHEAD~ N Y *~THE NEW YORK BOARD oF F!RE UNDERWRITERS BUREAU OF ELECTriCITY ~ .JOHN STREET. NEW YORK. NEVV YORK 10038 ~ CE~IF~S T~T NJIINAC~ MOTORS SE~AC~ S E I v I C , .' ~ m mAIIATU~ E~eei~oom heater., l~3.0kw, 1-2:Sk'w, .~21~5k~,' 2-.?Skw George Z~mlinchaus, ~ Ps~k Pl&ce, Patcho~ue, L.I. 11772 BUILDING DEPARTMINT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MM4NIR. SUFFOLK COUNTY DEPARTMENT OF HEALTH Heal th Oepartment Reference Number APPLICATION FOR APPROVAL TO CONSTRUCT ~--~- A PRIVATE SEWAGE O~rSPOSAL SYSTEM AND A HATER SUPPLY Applicant/~//~4~- ~-~'/~ ~ _ Pho~e~~. Subdtv. A~d~ss //~' ~- ~/~ /~//~ ;/~- -~ 6. ~ctt~ ~ ~ - 8. Prtva~ ~11 Village' Township j ~///~/,~, g. Publlc Water 3. Public Hater Company Name /~-~,, ~.~ ~-~ F-/., ~Otstance to mtn 4. Lot stze: N1dth feet Length feet 10. Sewage_~DisPOsal System: '~ A. /~OJ~-gatlon septic tank: PrecastL'// Equivalent Block (For Health Dept. Use) B. Leaching pools: Number of pools Precast/~1 ock Special / ~ 11.If private well, fill in the following bla~ks: A. tllnk c,p. ci7 ,allo.s ,.,,,_ _ __C. ~t~) well depth ~ -"i - ~.O. ~th tO ground water__ ~E. ~unt of water in well Tl~under~llned CERTIFIES: ' "construction of authorized' installations wtll be in accordance wt~ the :~folk County Oeparteent of Health's current standards thereto. This &pplicatlon will be valid for one year from the date of approval indicated below and mey 'be renewed a current local ~uflding Department Permit is in effect. Date . '~.~7 Signed~~.~ mlml~l.~llmmmmmmmmmmmmmlmmmmmmmmmmmMmmmmmmmmmmm mmmmmmlllmmlllllmlmll FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department'that an adequate and satisfactory Sewage Disposal System and Water Supply can be installed on this plot. APPROVAL DATE ~/~_"L.,~'~/~, SIGNED _(:-"'- ~ .,..,,. , ' S-15 Rev. 4/1/73 I~ ~,,/ IU~N~ ~A~T ~. ~ ~ '&' ~~~, ~U~, N.Y. ~ , ...... ................................. ::~~% ........ ~ ~ APPLI~TI~ F~ BUI~ING~ KblT ...... ~,¢ .................... , ~.~ --~ ,. ~. T~i~ ~i~ ~ ~¢etel~ fill~ in by ~wri~r ~r i~ i~ and ~b~i~ed 8 ~ of ¢~, ~r~te ¢~tPl~~ to ~1~. F~ ~i~ to ~1~, b, Plut ¢~ ~i~ I~i~ of lot and of ~ildi~ o~ ~i~, r~l~fion~i~ giving · detailed description of layout of property must be drawn on dia~am which is pert of this application. c. The w~k covered by this application may not be commenced before issuance of Building Permit. d. Upon ~al of this eplflication, the Building Inspector Will issue a Building Permit to the applicant. Such permit shall be kept on the pr·mira Ivallable for inflation throughout the work. · . No buililtfl~ shall be occu~ et used in whole or in pert for any purpose whatever until a Certificate of et·up·ney shall have been ~ranted by the Buildin~ Inspector. APIH. ICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pum~nt to t!~lt:.~ .~ldt~ Zone Or.d.i..nam:e.of ~ Town of Southold, ~ffotk County~ New York, am:l other ap~Micllble I.~ws, OrdinanCes or Re~ulation~ ~1~'.~ of bm!dings, ~t ..m~ ~r literati.ohs, or for removal .or ~lnolition, .as herein described. The applicant a~rees to mY wt~l~e taw~ ordinances, Ix~ildtn~ ·ode, housing code, and re~ulat;ons, and to admit authorize in buildin~ for ~ Inll~ctiom. d i nspectori on premises and_in bull (Signature of applicant, or name; if a corporation) .......... ....... ~ ,- ,.(Adc~ of I~oltcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder; ............................... :,e~....~ .................................................................................................................................... Name of owner of premises ...~.~.......~...~,~....~.....~./...~....~.. ....................................................................... , ........ 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~ .................... Lot No .............................................. 2,State existing ua and occupancy of premises and intended use and occupancy of proposed ~truction: a. Existing use and occupancy ....... v~.~.Zk'.~,,%'~.. ........................................................................ ~ ................................ o,~upa,cy ..... /..~..~,,,z~.,,:~./. ....... m.~.~..--~.,~,A...,~........., ....... : ............................ :.....,, In'l~nded Use lind ¸8. 10. 11. 12. 13. 14. Nature of work (check which applicable): New Building ........../..v.... ...... Addition ..................... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) ............... Estimated Cost ....... -~'~ .-~...~....., ................... Fee ............ :.,,...~. ......................................................... (to be paid on filing this application) If dwelling, number of dwelling units ..... ~ ..... Number of dwelling units on each floor ......................................... If garage, number of / cars ............................................................................................................................................ 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 ........................................ Dimensions of entire new construction: Front ...~..~...~.~....~...... Rear .......%~..~......~....~...... Depth .....~...~..:.~...'. ............. Height .............. ,~.~'..../..-.~.. .................... Number of Stories .......... ../. ............................................................................ iSize of lot: Front ....,~..4~..; ...................... Rear ........ ~.~....'. .................... Depth ...... ~'...~'..~....~.. ............................. 'ght ~ " Hm ............................................. .. ..... Number of Stories ...................................................................................... Date of Purchase ..................................... Name of Former Owner ............................................................................ Zone or use district in which premises are situated ..................................................................................................... Does proposed construction violate any zoning law, ordinance or regulation: ....'.......~..~. ......................................... Will lot be regraded ..... y~. .................. Will excess fill be removed from premises: [ ] Yes [~J No .Name of Owner of premises ......~.....~....~...~'~....,..~,~f,~..~. ....... ,~t~.~t~.....,~....'~.......~.l~.,..~.l.~...~.i~.l,~,. (Address) t(Phone nlOj Name of Architect ..................................................................................................................................................... (Address) (Phon,~_No.) Name of Contractor .,//~..~..,~1;.~..?~....,~.~..~..,t~.~ ......... ~.~.,.~.~..; ..~,~.....~1.~1~../~..~'_~ ....... ~..~.~.~. ...... (Address) (Phone No.) ~" . PLOT DIAGRAM Locate clearly aod distin~c,tly,all buildingS, whether existing or proposed, and indicate all set-back dimensions from property line~. Give street'a~id bfocl~ number ~r description according to deed, and show street names a~d indicate wheth- er interior or corner lot. STATE OF NEW YORK, r~ -- ) cOuNTY OF ................ U_~7~ ............... ) ~ .... "~'"~''' , (~Verr~ o~di~iEu~ siS~inff co~ztrect) " being duly sworn, deposes and,,~ s,ays that he is the applicant above named. .e ,s th, ........... ...................................................................................................... ;.; .................................................... ( Cor~tr~lctor, ~8~r~t, corporate o.f]Tcar, 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 ap~.lication are true to the best of his knowledge and belief; 'and that the work will be performed in the nmnner set forth in the applicallkm~ *~; ................ County ............................................ APPROVED AS NOTED DATE: J~L~l:~/~..~- FE~:~ ~ BY J~L./ ' NO~FY BUILDING DEPAI~TMENT AT 765-2660 9AM TO 4PM FOR RI~QU[R, ED [NSPECTtONS: 1, BEFORE BACI(FILL]NC FOIINOA- TION OR SCART 2. BEvORE COVERING piPELINE 3, FINAL WHeN JOB COMFt '% L~FT ~/~£ ELE~4T/O/V ITl ~E/~ ELEH4TIO/V Ii' --U UJ~ E X'C.4 ~,,4 TE ~ -~ /?OMAR UN£X'OA. FA 7'-~'Z? ' FOUAfD4 T/0~, PLA Al · Sc~z_~- y4"~.,,,-o"