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HomeMy WebLinkAbout7248-z· 0~' NO. · TOWN OF SOUTHOLD BIU~.DING DEPART~'NT Town Clerk'~ Office Southold, N. Y. Certificate Of Occupancy No. g.~.br, c) .0 ...... Date . .,T.~.a~..v~..x~...27., .............. , 19..7?. THIS CERTIFIES that the building located at .C~.r.d..i.n.a.1...D.r..~..I~..t.t.i.t..u.c.k.. Street Mattituck Map No..Estates... Block No. XX ....... Lot No .... 1.9..&..20 ...................... conforms substantially to the Application for Building Permit heretofore~ in thts office dated . .g~..13.)..197.bc ..... , 19 .... pursuant to which Building Permit No.7.2.~..8.Z... dated . .~a~..13.,..197.Lk. ...... , 19 .... , was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which thi.~ certificate ts ~sued is .Pri.v. ate..one, family..dwslling, with. addi.tlo~..of. ~la~4~Y..r.o..o.m... and storage are~ The certificate is issued to . .Vincent;. ~ial~ki ................................... (owner, lessee or tenant ) of the aforesaid building. Su~olk County Department of Health Approval .Nm ............................... UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER..695 ......... Street $1.o.~89)..]~q~l..&.. ~ ~.7.~..C.a.r.d..i.n.e,1...D.r.i.v.q. Building Inspector INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan shOWing location of lot and of buildings od premises, relationship to adjoining premises or public streets areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is p~rt of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit ~_." shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY 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 of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary )~spections. . 1/ //77 ........... ........ ,:~r~- ! / - I ~(Signorure at oppuconr, or nome, iT a corporafiom .......... J.zml..DzJ. e .......... } eJfl t.tna ...................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner -b ll er Nome of owner of premises .J~J;e.l]~...~tla.l.e=~l, .............................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) Builder's License No ..................................................... Plumber's License No. 9/. Electrician's License No ............................................. Other Trade's License No ............................................... I. Location of land on which proposed work will be done. MapNo.: ......... ..}~....~..t;...t.~..~..~..~........e.~L~l;~l~'........................10 & 20 Street and Number ...... ..C.~.~.~..~...p..?.~..v..e. .............. ..~..~...~.~...~..~...O..~........~..'..~..... ........................................................ Municilxflity 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy dwe].'ll~ b. Intended use and occupancy ;&ne ~:l. th &~ ~dttlo~ :~. ~Jature of work (check which applicable): New Building .................. Addition ..;J;;~l~ ......Alteration ............ ~... :' Repair Removal Demolition .................... Other Work (Description) 4. Estimated Cost ...~ ..........1..~....l~....:.~+: ............................ Fee ~..~....~.0.. ........................................................................... (to be paid on filing this application) 5. If ~lwelling, number of dwelling units ......... .1. ................. 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 6tories ................................ 8. Dimensions of entire new construction: Front ............ 6 ...................... Rear ....... ~ .................. Depth ....~(~ ............... Height .................... Number of Stories ........ ~ ....................................................................................................... 9. Size of lot: Front ........................................................ Rear ....................................... ,~. Depth ................................ 10..' Date of Purchase ........................................................ Name of Former Owner ...~...~..........~.....~z~t........c~_ .................. # # ! 1. Zone or use district in which premises are situated ...... ~,.....(],;,t, Jj.lj;. ............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ,l~.¢LI ............................................ 13. Will lot be regraded ....J~l .................. Will excess fill be removed from premises: ( ) Yes (Z) No Name of Architect .............................................................. Address ................................ Phone No ....................... . Name of Contractor .~.......~...e..?..~..~...o.~.:J: .............................. Address ......J~....t;.~.~..,~. ....... Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from prpperty lines. Give street and block number or description according to deed, and shew street names and indicate whether interior or comer lot. STATE OF NEW YORK, i ¢ c COUNTY Of ..~1~ .......... ........................... .l[:L12cP.~.~...]~La.TLe-~ir:[. .............................. being duly sworn; deposes and says that he is the applicant (Name of individual sign'ing' controclO ._ ?bore named. t (is the ......................... .~...~..e. ~....O.~...~.e..~ ................................................................................................................... (Contractor, agent, corporate,pfficer, etc.) \said owner or owners, and is duly authorized to perform or hqve performed the said work and to make and file ~s application; that all statements contained in this application 'are true to the best of his knowledge and belief; and · ~ the work will be performed in the manner set forth in the application filed therewith. ~m to before me this ............ day of .................. Pub,,c,. ................................................... ..... ............... '~1 / (Signat~u re ~lt~c~licant) TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 72 8 Z Date ......................... ~41.~' ......... '1'3 ......... , 19.~/~,.. Permission is hereby granted to: S~e;~ .~.. t~e~.eet~.~. ............................................ ................ ~a.t,t ~.t,a~.~ .......................................... to h~L~,l~L..am..&ddi f, iozm..om.. ~,x.~ ~;:Lnl~ ..d~ ~3,1~ ................................................................. pt lo% 19 & 20 ~attXtuek $~tates at premises located at ............. . ............................................................................................................... ....................................... .~az~t.~..4~a ........... ~t.t~.guek ..................................................... pursuant to application dated .........................H..a.~. ....... .1..~. ............. , 19~...tt....., and approved by the Building Inspector. F~ $1E.:...OP... ............ l~OltM NO, 6 TOWN OF SOUTHOLD , Building Department 'town Clerics Office Southold, N. ¥. 11971 APPLIGATION FOR CERTIFICATE OF OCCUPANC~Y Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector 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 installations, 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: 1. Accurate survey.of property showing all property lines, streets, buildings and unusual natural or topographic featu~s. 2. Swom 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 in- formation required to prepare a certificate. 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 Date ...~. ~,~... ~. e .. 3, ~.~. J. ...... New Building ................ Addition ...Y...~.. ......... Old or Pre-existing Building ................ Vacant Land .............. Blossom Bend & Location Of Property ~am.d~na~...II~i~.s.~....~.t.t~.~k,..i~.,...Y .............................................. Owner Or Owners Of Property ........ ~.~ell..a..~aal~.aki ........................................................................ Subdivision I.<a.~.~,~.~.~k..~ska.~.e.s ........................ Lot No. 1.9/2Q. Block No ............. House No..~9.~.~.1 Permit No...7.~qSZ ...... Date Of Permit ..~..t.%../.7..~Applicant ....~.in~D.r~..D~.alaaki ....................... Health Dept. Approval .....~./...~. ................................. Labor Dept. Approval .......... .~./...~. ............................... Underwriters Approval .............................................. Planning Board Approval .... ~/.B. ............................ Request For Temporary Certificate ........................................ FinGI Certificate ....~ ................................. Fee Submitted $ .~......0..0. .......................... Construction on above described building and permit meets all applicable codes end regulations. ............................