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Home My WebLink About7132-zTOWN OF SOUTHOLD BUr[.nl~G DEPARTMENT Town Clerk's Office Southold, N. Y. Certificete Of Occupancy THIS CERTIFIES that the building located at ...~/.S.. ~.or.~.h., .R.o.a.d...(.C..R~...). Street Map No.. ~x ........ Block No, .. xx ..... Lot No, .xx~X .0r.e.e.r~p~)~'.~...N.o.Y.., ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. ~ar...2~, 197)t. pursuant to which Building Permit No...7.1.~..~.. dated .........l~'...2~. ..... , 19..~.., was issued, and conforms to all of the require- ments of the appl/cable provisions of the law. The occupancy for which this certificate is issued is . .P. ri.va~..oAe, f~ly..4 .v~.~ .t~..w.i.t.h...a.d.d.i..t.i..~....(.~.:C. :.0.f.f..l.e.e.). .... \ The certificate is isled to .. ~e..n:..~...a...~. ;..~....~.e.l.:e.~. ...... . .0~n..e.~.~. .............. (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval . .~. :.R: .............................. UNDERWmTERS CERTIFICATE No...~..2~..~.~. ..... .~.~...~....~.~..7.~ ............... HOUSE NUMBER ... ~27~. .... St~t ..... .C.o..~..t.~...~.o.a.~...~.... ~..~.o~ .th.. ~?,..d.)... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT trillS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7132 Z Date ......... ~; ................. ~'~,Ve.~ ....... ~.~ ....19..~.. Permission is hereby granted to: ~enl~a..&.. ]~e ~..:e;L~e ~. ........................... .... )~or.~lt.~ ........................................................ ........... G~ee~p~ .............................................. to ...~.....~......a.~.4 .t.:~.t..e..~....o.m..e..x..Ls..~ ~...~:.~.~;~ ............................................................. i at premises located atN/~...~e~k~..~.....g_~f'/. ................................................................................. .......................................... ,...O.~.~ g~ .o.~.t; ....... ).~..,.~.,. ............................................................................. pursuant to application dated ....................... ~;~' .......... ~..~ .......... , 19~.)~...., and approved by tl~e Building Inspector. / I"' Building Inspector TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..~!~ ........................... ~- ,19.?...~.. ........................................ , 19 Permit No.../?./. ......... ~ .......... Disapproved a/c ................ Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trnde's License No ............................................... 1. Location of land on whicl~prapo_~d work. v~ll be s:lone~N~_~Jp N~,:~ ............. .~ ........ ~ ...... /:~.~ Lot No ...................... Street and Number ..... ~....~.....~..~.../..~..-~...~.-.~.~.~..~-...!...~.....: ....................... State existing use and occu~ncy of premises~ in,ended use and ~cupancy of p~d c~stmchon: o. ~isiting use a~ ~cuponc~ ............................ ~ .............................................................. 'b. Sntended use ond ~cu~ney ....................................... : ................................................... INSTRUCTIONS r~~ a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Buildi Inspector, with 3 sete 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 areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this apptication~,~-~ c. The work covered by this application may not be commenced before issuance of Building Permit. ~j 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 Occuponcy~. 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, O. rdinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as here,n 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 ir~ buildings for necessary inspections. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder; If applicant is a corPorate, sign~tulFe of duly authorized officer. (Name and title of corporate officer) 3. Nature of work (check which applicable): New Building :.: ............... Addition .................. Alteration .................. Repair .................. Removal .................. DemOlition .............. .'.....'Other Work .................................................. ..- (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 f oar ,..>?t/"~I/..~.. ............... 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 ................................................................................... t .................................. 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 violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises:(: )Yes ( ) No 14. Name of Owner of premises .................................................... Address ................................ Phone No-. · ..' .......... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... 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 st~catl, - whether inte~ ~ I ~~ .................. being duly sworn, deposes and says that he is the opplicam e homed. s the ~ ~v'~/'~. (Contractor, agent, corporate officer, etc.) o ' owner or owners, ~plication; and is duly authorized to perform or have performed the said work and to make and file statements contained in this application are true to the best of his knowledge and belief; and that thor the work will be performed in the manner set forth in the application filed therewith. Sworn t~ b_~e me this ~~_~ ....... ......... , 97<4..- , Notary Publi~ ~..~..'.~..~n~ .............. ~.~~(_x/ t,,gnarure or appi,canr, ........................... JUDITH T, I~OKEN Notary Public, State of New York No. 52-0344963 SW%Ik CornrnJ~ioi~ Expires March 30, 19~ THE NEW YOrK BOARD OF FiRE UNDERWRITERS ~- ak BUREAU OF ELECTRICITY HI ~,il. 85 JOHN STREET. NEW YORK. NEW YORK 10038 D.~ May,,l'; 1975 ~ppllcatlo,,~o.o,Sile 766980 THIS CERTIFIESTHAT N2 2 2 5 ? 4 only the electrical equipment aa described below and introduced by the applicant named on the above application number in the premises of Ben &'Regina Telsey, 620-55 North Road, Greenport, L.I. In the following location; [] Basement ~.~.~i..do. April 28, 1975 'DRYERS ~ 2nd Ft. outside Section Block and found to be in compliance with the requirements of this Board. Lot rCOOKING DECKS I OVENS DiSH WASHERS I EXHAUST FANS O~HER APPARATUS: NO OF CC. COND. . C E A. W G. NO. O~ NEUTRAL5 A W. G 620-55 North Ro~L, G reenyo~--t; L. 1~.- 11944 ~~, ~ This certificate must not be aJterecl in any manner reTurn 1o the office of the Board il incorrect. [nsoectors identified by FOl~I NO, 6 TOWN OF SOUTHOLD Building Deportment 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 DUPLICA'FE to the Building Inspector with the following; for new buildings or new use: I. 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 disposol--(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 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 .... ,~.u~e .. 2. 3.,... ~.97~ ............ New Building ................ Addition ................ Old or Pre-existing Building ..~, ........... Vacant Land .............. Location Of Property .... ~.~...~.~.~....~9..a.~s....~.'e.`~.~`...~..~...~..~..~.~..~J~:.~.~...~..~.q/..S....~.~.~..~.'.~.~.~..~.~. ............ Owner Or Owners Of Property ...~.e.~.s.g..~....~:....~....C.,.e.~....£.¢~,,S.¢~. ........................................................ Subdivision ................................................................ Lot No ............. Block No ............. House No.(~2-O.~.~..~ t~ortia Road, L~reen~oz,t, N,Y. Permit No..Z,],3~, ......... Date Of Permit .~/~,5/.Z~h..Applicant .~.z.e.~.~.~...~....?..e.]...s.e.~ .................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .~i....2..2..~,~,.~.~.-..~/.~/..~.~ .......... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ....X.. .................................... Fee Submitted $ '~-~ Construction on above described building and permit meets all applicable codes and regulations. Sworn to before me this