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Home My WebLink About7277-z,/ ,!' FO~M NO. 4 TOWN OF SOUTttOLD BUILDING DEPARTMENT Town Clerk'~ Office Southold, BI. ¥. Certificate Of Occupancy No.~.~i~9 ....... Date ........... JeJIIm~.... 9.. ·., lg ~. THIS CERTIFIES that the building located at I~/.8. l~,ltSeall .&~ ......... Street Map No..I~X ....... Block No. ~ ...... Lot No, ~ll~X.. 8ollthol~l.. li,Yo ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. May .. ~.~., 19 :?t~. pursuant to which Building Permit No..~.IF~I'~Z. dated ........ 1~.... 2~. ..... , 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 .Pr~.v.&te..cl~. f~ly..d¥~l:[:lj~, w:l.th, elldtttJan. & alt, .............. The certificate is issued to ...I~F~..Stt~l~el[~ .... .Otffiel' ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Ii oR, ............................... UNDERWRITERS CERTIFICATE No..N...~.~. ~..~. .................................. HOUSE NUMBER ... 27~[ ....... Street .. lk~ss®~,u .&v~ ......................... · · ·/~'JB~din~ ........ FOK~ bO. ~ TOWN OF SOUTHOLD BUILDIHG 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? 7277 Z Permission is hereby granted to: ................ 14a.tt~tuck .......................................... ~o ..I~..~...~A ..~.~I;U;~.~...~.. JkJ.. ~Jer&t~L~J..~t~ .~l~aj ................ at premises located at ...ff./..~...~.~lt~l~..&.~191t .................................................................................... ........................................................... ~e~,tl~...~t..~ ................... ~ ............................................... pursuant to application dated ............................. ..J~..~. ......... ...~........, 19.~......, and approved by the Building Inspector. FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 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 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.....~.....~....J/...C ......~ i..~....~....'.~'. New Building ................ Additi. on ................ Old or Pre-ex st ng Building Vacant Land Owner Subd v s on ~ ~ L ~ ~' ~ ..... ~ ~ .eolth Dept. Approvol .......... ~ ..............,.... ..... obor Dopt. Approvol ............. Underwriters Approv*l Request For Tempo~y Ce~ f cote F n ' ' ~ ~ . ....................................... ol Cortff~cote .......................................... Construction on above described building and ~mit meets all ap~i~?le~s~ Sworn to before m ' ~~~~~ Notary Public ...... ~¢.~ ............. County NOTA~ ~UBUC, st~t~ o~ N~ ~mmissi~ ~x~ir~ Ma ch 30, )- ,2 D "r 0 0 0 SURVEY OF PROPERTY SITUATED AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-62.-01-18 - SCALE 1.' =20' SEPTEMBER 6, 1997 ARE.& = 7,524.58 ~q. ft. 0.168 ac. ALJ. IA~tC[ AJi~TRACT OF NEW Y0~K, Inc. P & G HOLDING COPORATION - .~iOi~.,,aZU, zOS '~. Joseph A. lngegno Land Surveyor Disapproved a/c ........ ....................................................... Date l~'Z 2i~' lg...~.~ :~ INSTRUCTIONS (7~ 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 on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drown on the diagram which is part 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 'Pel:TnJt 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 Law~, 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 inspections. S.W.P~t~y Jr (Signature of applicant, or name, if a corporation) Mattituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general conffactor, electrician, plumber or builder. ~ail~er If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ............ ~ ..................... Lot No. :..~ ............. Street and Number ..... W/.~...~}g,1,~,,~e~,~,..A.~.e ............... ~.~l~t,~tg.l~ ..................................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ......... ~1,W~.1/33~ ..................................................... L..i ......................................... b. Intended use and occupancy ~.~me w~.th ..~ a~.~.tiom ... ! o o -t- ..... ......................................................................... 4. 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 .................................... ._ ........................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent af each t~pe of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Nurntier of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height .................... [ ....... Number of Stories ................................ 8. Dimensions of entire new construction: Front ................. L.~'..~...~-. ..... Rear ....(.~..~..~... ........... Depth ~.....~.. .............. Height .................... ~umber of Stories ...................................................................................................................... 9. Size of lot: Frontt ....~.~ ............................................... Rear ............... ~0. ...................... Depth .....~.~0 ..................... 10. Date of Purchase'. ....................................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..... ~,-.1 ......................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .mb ................................................. 13. Will lot be regraded'......ig~ ................. Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises .J~LeJaa~.&..~/,a~t~r..~,~pla~idltll~SS ................................. Phone No. ...................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor J~....~....~ett~' ~Tr Address .......H~...~..~.... ................ Phone No .................... ,. PLOT DIAGRAM Locate clearly and distinctly~ ~Jl'b~il~ings, whether existing 'or pr?posed, and indicat, e all set-back al!mens! .o~ property lines. Give street and block n~mber or description according to deed, and snow street names ana inaicclte whether interior or comer lot. STATE OF NEW YORK. COUNTY OF ...... 8.W.Pet~y Jr ................................................................................................. being duly sworn, deposes and soys that he is the oppliconl (Name of individual signing co~troct0 above named. Builder 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 app cat on; that a statements contained in this application are true to the best of his knowledge and belief; and thor the Work will be performed Jn the manner set forth in the oppl cation fi ed therewith. Swam to before me this Notary Public, .............. // (Signature of applic~t)/ THE NEW YORK BOARD OF FIRE UNDERWRITERS t&b BUREAU OF ELECTRICITY,' . · ' I~ 85 JOHN STREET. NEW YORK, NEwryOR. K i0038 ~ Sept®tuber 26, 197~ ~p~.~.~o.o.~ 737T70 N 184554 THIS CE~IFIES THAT ~1. ~ohael Stephen,Boxsseau AVe., ~e~..o~A Ave. &Naxn FIXTURE LK~~ I WIT I FIXTURES DRYERS PURNACE MOTORS FUTURE M~tJAHCE FEEDERS AMT. K, W. OIL H.P. OW H.P. A~T. NO. A.W.G. SERVICE DISCONNECT I NO. OF METER S V ' I C E R ICOO~ING DICKS J OVENS IDISH WASHERS ~T. ,.w. I ~T' K.W. ~,. ,~.W. T,ME~OCKSl ~U. JI MULTI~UTm TRAm SYSTEMS %c.c, ~.w.o. 1,,g~ 1~'3W 3,~3w 3,er4w NO. COND. (~; CC. CO~4D. HI-LEG EXHAUST FANS DIMMERS WATTS RR~i 227 E. B~eak~ate~ Rd. ~attituck, N.Y. 11952 11 COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST ~ BE*ALTERED IN ANY MANNI~R. ~