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Home My WebLink About7449-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Oiilce Southold, N. Y. Certificate Of Occupancy No... Z.7.7.49 .... Date ......... 3..u.n.e. 2 .9 ........... , 19.7.7.. THIS CERTIFIES that the building located at . .~..z.l~.n.d.. ~'.~.e.~..L.~.n.e. ....... Street Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ..... ~. ~.]..y.. 3. 0 ......... , 19..7.4. pursuant to which Building Permit No..7. 4. .4.9.~.. dated ..... JU~.Y..3..0 .........., 19..7.4., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...d.e.q.k. ~.d.d$~:~.o,n...tg..t~.~.~.v.a.g..e. o~.ke.-.~]~y, d.w. elllr~g ................. The certificate is issued to ... ?l.~.qh. a.e.~..c..~.~.u, qg~ .~. W.~: ........................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .................................... UNDERWRITERS CERTIFICATE No ............................................. HOUSE NUMBER .... 870 ....... Street .. I.~lan~ .V. ie~,. ~,an~,..Gr~enpor. t ,. N.,.Y, Building Inspector FOKI~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N;. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISE COMPLETION OF THE WORK AUTHORIZED) UNTIL FULL N? 7449 Z Permission is hereby granted to: ................... .6x'aenp ~.t~ ..................... ................. at premises located at .... 6reen~.ort pursuant to application dated .........................¢~.~r. ......... .~Q..~..,, 19.~.~.,,, and approved by the Building Inspector. Fee $...J.~.%.O?.. ........ '"'"'"'"'""'"'"'"'"'"'""'"lBuilding Inspector FOBM NO. S TO~N OF $O~TNOLD Building Depaffment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF DGCUPANCY instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildings or new 1. Final survey of property with accurate location of all I:{uildings, 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 ,~ "tua e ....... /. ......... )z.....~ .................... New Building Jg,~C /-~ t~t'~,~/Tl~ ~ .................... Old or Pre-existing Building ............................. Vacant Land ............................ Locution Of Property ~ '~SL~p V/~ L~W~ ..... ~.~ o~ ~.e~ of P,op~y ........... ~ ~ r ~e ~;' W ? ~;'~"~'~ Subdivision ................................................................ Lot No ........... ~, Block No ............. House No ............. .o .................... o, ..... ...................... Heolth Dept. Approwl ............................................ kobor Dopt. Approwl ................................................ Underwritors Approval .............................................. ~lonnin0 Bo~d ~provol ........................................ Request For Temporary Certificate ........................................ Final :Certificate .......................................... Fee Submitted $ .................................... Construction on above described building .and perr~t meets all..g~plicab~le codes and regulations. 'J A ;,, l/,, . O . /I.. App,icant .................... Sworn to before me this ' ................ day of ............................................ , (stamp or seal) Nota~ Public .................................... Coun~ /- ~ J . /'~,. THE NEW YORK BOARD OF FIRE UNDERWRITERS l~t. September N184255 THIS CERTIFIES THAT onl~ the e~t~ ~nt ~ ~ ~ ~ int~ ~y t~ ~t ~ on t~ a~ ~a~n ~um~r ~ t~ p~m~s of Frank Carlucci,sou~h/slde o~ ~sland~ View La.,eas~ of Baysh~e Rd., Oreenpor~ ,L. I. inthefollowing~ation; ~ B~e~nt ~ lstFt, ~ 2~ FL O~d~tion Bilk ~erami~On ~e~t ~ ~Q~Q~ andfou~incompli~e~iththerequi~mentsofth~. BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 100"48 24,197~ ~ppticationNo. onflte 7~898~' ; IIAN~ES MULTI-OU'rIET SYSTEMS NO. OF EIET EXHAUST FANS DIMMERS 1 1/o SERVICE DISCONNECT I NO. OF I S E R V .~*T. AMP. ~PE ~J~ 1.~'2W t,~'3Vl3,ff3W 3,~'4W ~.~CC.C~D. A.W.G. 1 15~ CB ~ 1 1/0 OTHER A~ARATU~ COpY FOR,BUILDING DEPARTMENT. 'THIS COPY OF CERTIFICA~E~...~[.I~!S.T-NOT BE ALW. tH~ANY MANNER. INSTRUCTIONS a. This application must be completely filled in by typewriter aa. in ink and submitted in triplicate to the Buildings Inspector, with 3 sate of plans, accurate plae plan to male. Fee according to schedule. ore~s aPr~t ~n i oS~lLoc~tion o.f lot a?:l, of b. uil, dings on premi.ses,.I;elationship to adjoining premises or pub c streets o,~ · g' 'ng ¢lel~' ecl clescrJpvion at layout orp~rty 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. U.pon approval of ~is application, the Building k~oecto~ will issue a Building Permit to the appticont. Such permit shall be kept on the premises ava labia for inspection throughout the worl~ 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. ~ ~T~.A,P..PLIC~ATION !S HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the uua~r~.. :on,e O .nd~nance of the Town.of Southold, Suffolk Cou.n. ty, New York, and ..other app~able Laws, Ordinances at ~. gu,a~,.o, ns, .~or the c.onstmct!on o.f. bu~!ding?., additions or a!terat,ons, or for removal or demolition, as hem_in described. ~. e appucant agrees ~o comply with au apphcable laws, ordinances,, building code, hoaslng code, and reguletJor~, and to ~' admit authorized inspktors on premises and in buildings for necessary inspections. - t:~g~?re at_ app~.lcant, or name, if o coq3erotion) (Address of applicant) (Name and title of corporate officer) Builder's Licon~e' No ..................................................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................ Name of owner of nrem: .......... se~i' iii::'""".......:'"'....::: ~ .~m.//"'4~:'''...::.'.~T'.' ~:~::::::::::::::::~1' ~', *~, ~,:::i:::: / .'.~.': .': ::::::4::::::::::::::::::::~"/a~""' :::::::::::: :::: :::::::::::: :::: :::::: :.. If applicant is a corporate, signature of duly authorized officer. ,~ Plumber's License No. ................................................ Electrician's License No ............................................. Other Trade's License ~No ............................................... 1. /oo o o57- Location of land on wh ch_oml~aeJ wojl/,t~ill be.dgne. Mgp No.i ,': ..~ .............................. Lot No ' . .. Street and Number ..... ~.....~..~.~C..~.../~..~...~.~....~.~..~..'.~....(*~1.~.~..2~.,.......~..:..../.:.'.'"'"'.'"'.'.''-''---- ---- - ---------Munidpallty State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy . &~/,~'.~. ........ ~ .................................................... - ......... b. Intended use and occupancy ..................... ..~. ................ .~......'~"~"..~.~./..q.G. '/~ .~...~X~t~..~.....~..... / -- 3. Nature of work'check which applicable): New Building.. ................. Addition '. ................. Alteration ................. Repair .................. Removal ................... Demolition .................... Other Work .......... .' ..................... ~ .................... .~oo ' 1.. z......~ , ~'"T- ~. (Description) 4. Estimated Cost ....~%....,.~. .......................................... Fee ....... (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 ............................ Poor ................................ 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 .................................... Pear ............................ Depth ........................ Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ...................... .~ ............................. Rear ....................................... Death ................................. 10. Date of Purchase ..;.; .........../...~...6......~.... .................... Name of Former Owner ...?~.~..,~.~.~.....~ ................. 11. Zone or use district in which premiSes are situated ..................................................................................................... 12. Does proposed construction 'vioJat, e~ any zoning law, ordinance or regulation:~,,~,,~, ,~ ,.~ ....................................... ................. 13. Will lot be regraded ............ ~ ...... 9~{jll excess fill be removed from pre~es~.'~'~)'VY~~' ( ) No 14. Nome of Owner of nremi~< ...~....~.~..~/~"~ ~'N Name of Contractor ............................................. Address ................................ Phone Nc~ ...................... 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. Swam to befGre me this Notary Public, ~.~.~~t~ ~ ~- ....................... ~ ....................... '~ ~ % (Signature of applicant) JUDITH T. BOKEhIsuffoik No art' PubJic, State of New York N~, $2.0344963 ~ml~ten Expires March 30, 19_[.~ STATE OF COUNTY OF :.= ................................. .~..,..beh~g duly sworn, depqses~and soys that he is the opplicon~ (No~, signing c~f~ o~e nam~. ~, He is the ................................................................................................................................................................................. (Contractor, agar, co,rate officer, etc.) of ~id owner or owners, and is duly aut~rized to ~orm Or h~e performed the ~id work a~ to ~ke and file this application; t~t all sta~men~ contain~ in this. a~licotion are tree to the best of his k~ledge and belief; and tha~ tbe work will ~ perfor~ in the ~n~r ~t fo~ in the applicati~ fil~ t~i~.