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Home My WebLink About9044-zFOuM NO. 4 TOWN OF SOUTHOLD BUILDI1NG DEPARTMENT Town Clerk's Office $outhold, BI. Y. Certificate Of Occupnncy No. Z??.~.i ...... Date .............. ~..~. 9. ., lg.~.. THIS CERTIFIES that the building located at . .~..ay~.~:~.a.U..A.v.~. ~..~Q~9~. ~treet Map No.S~er~venBlock No ........... Lot No. ,1.18~.1.9~ ~20 .... .Greenpo~ ... conior~ subst~tially to the Application for BulldOg Rermit h~etbfore filed ~ ~is offi~. dated ............ F~b.. ~., 19'~ ~F, pu~u~t to which Building Petit No,9~Z.. dated ............ Fab... J.6., 19. ~.~, was issued, and conioms to ~ of ~e req~ men~ af the applicable pro~sio~ of '~the law. The occup~cy for w~ch this ce~ificate ~ issued is .. 2~iva. t~. ~. faily. ~,~ell.~g. ..................................... The certificate is issued to .Vic.tot. C~aso... of the aforesaid building. Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE No~3.1tQ.l.~.6. (owner, lessee or tenant) .l~a-y.. 2~...1977. - .by. a,..V, illa .... J~e.. 6...197.7. ..... i ............... HOUSE NUMBER .... .1~.0.0 ..... Street . .Bayvie~..ave ................... 1365 Colony ~ Building InsPector FO~M NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, H. Y. BUILDI~4G PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N? 9044 Z Date ......................... li'e~ ......... .'16 ......... , 19..77 Permission is hereby granted to: ........ .[~!~t :l:;.t ~netc ................................................. to. 2~Ll~L..r~r...one.. £ami17_ ~welling .................................................................................... at premises located at ...~9..~..q..J..'J....8~..~..~..0.. ......... .~..~.~.~li~.~.~ ....................................................... .............................................. .Colony..~,d...&..Bay~.i~w..A~,'~ ............ 6~.eenp.cJr.t ........................ pursuant to application dated ................ FeJ~ .......... -~ .................. , 19..~.~.., and approved by the Building Inspector. Fee $~'¢ ,~.,..Q.Q..... (, .~...~':J.o o~' ) TOWN OF $O~TNOLD , Building Depmtment 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: ]. Final survey of property with accurate location of all buildings, property lines, streets, end 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 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 te.. ... New Bqilding ..... ~.. Addition ................ Old or Pre-existing Building ................ Vacant Lend .............. Location Of Property .................................................................................. .~ ............. ~ ......................... Owner Or Owners Of Property ..........;V...i.~;~9.~ ....... ~.~.~.,.o. ...................................................... Subdivision ..~.i~...~....~....~.)Z.~....~.~,~,,t~... ......... ;....Lot r~o ............. Block No ....... House,No ........ No ?.( .~ ..~..~..~..... ~.~.~....~..:....~..~....~. Permit ~ote Of Perm,t ..., ................ App,cent ......................... ~ealth ~. ~pp~o~* ...~.~.~..~.~. ....................... ~o~ ~. ~o~ ................................................ Unde~riters Approval ..~ ........................................ Planning B~rd Approval ........................................ Request For Tempom~ Ce~ificate ........................................ Fin~ Ce~ificate ~ Fee ~bmit~d $ ....... ~...~ ............... Construction on above described building andZ.~,, ~ ("~.r~C'permit meets all applicable ~odes and regulations. Applicant ........ ~~ .......... t~...J~... .................. Sworn to before (ne t,is\ ...... · .(~....A. day ~ ~....(../~..~../. ........ (stamp or seal) ' /.~ /.//~ //?.~/~0 ~- THE NEW YORK BOARD OF F~RE UNDERWRF~"ERS !- C/R~ BUREAU OF ELECTRICITy 85 JOHN STREET, NEW YORK, NEW YORK /~"'" Juao 6~ 1977 THIS; ctm'r~mes THAT 905666 "'"~ "'""'"'"~ .... May 26 ~ ~977 '"' ~'"'"~ "' ~'"'" '"'"'~'"'""" '"i'~' 0 TIERS ~FCEPTACLES SWlfC-I~s [ D~YERS ~ FURNACE MOTORS l~ba~oke PoOo Box 991 ~a~:t i~:L~Ck~ LoI~ 11952 ~ic~1845-E TOWN OF $OUTHOLD ,~, t) ~.~ ..~-./; ,/4- . V TOWN CLERK'S OFFICE ~'~/~/{~ *,~..':,-~_~-J~2~"l' .............. Examined .. Application No, .~...~..~...~ ............... ~ App,oved . . , . ....... Pemit No..g_.<....L...* ............... ~~~~ ~ Disapproved a/c ....= ............................................ ~ .................. ~ . ~ ~ _,, o ............. ............ .... ....................... ~'~[;~ ..... [¢~JY~'"'7~ ~ ~r~4 ~ APPLICATION FOR BUILDING PERMIT ~ Kq $ a. This application must bn completely filled in by typewrilor or in ink and $ubmilted in trip[i~ate lo the ~uilding InsDe~ith 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 of property must be drawn on 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 Permit to the applicant. Such permit?hall 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 bee 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, bnilding cod~, housing code, and regulations, a~d to ~dmit ~uthorized inspector~ on premiss ~nd in buildings for ~ecessarv ins~ctions. (Signatur(} of applicant, or name, ~f a corporation) (Address of applicant) State whether ap~ant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................... :15~..~.~.~..~.~ ............................................. ...................................................................................... Name of owner of premises ......... ?./..i...(~...'~...%..~.--.. .......... ..~...~..~OU.'.~...~...,,~. ............................................................................ if appl~ti]t is a corporate, signature of duly authorized officer. .......... ........................... I Name and title of corporate officer) Builder's License No ........... ~ .............................................. Plumber's License No.....(~....~_'.?.....~.~.!.~..,,~.!..t~..~.~.. .............. Electrician's License No. ~"~'~"~'~" ~-~re~"il'~x% ................................................... G,. ~._....__ ~.. ~.~ ~.=~ ..~ ~.¢~:14 i i~'~ i [~' Other Trade's License No 1. Locat on of land on which proposed work will be done. ~ap N~ ........................................... Lot No ......................... Street and ..................................................... · ............ r.., / ........ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................................................................................................................................... b. Intended u~.nd occupancy ' ~.~.S~.~.Sg ........................ N'~i'ure 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 floor If garage, number of cars ......................................................................................................................... ~ .................. 6. If business, commercial or mixed occupancy, specify natqre 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 .....~.~. ................. Neight . '~ ........................ Number of Stories ..................... ~.~ ............................................................. ~, I~O 9. Size of lot: Front ......... .~......~ .................. Rear ................ ~ ................... Depth .................................................. 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ 1 1. 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 ..... ~.~ ................. Wilt excess fill be removed from premises: [ ] Yes ~ 14. Name of Owner of premises .............. :~...~ ........................ ~. .............. .~ .................................. ~ ............................. (AddresS) (Phone No.) ~7 Name of Architect ..................................................................................................................................................... ~ (Address) (Phone No.) ......................................................... [~dg;~') .................... ~ ............. (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 street names and indicate wheth- er interior or corner lot. ~0r~4 ~, ~ ~ ¢~ ~t ~ t STATE' OF NEW ~(~1 K_, ~ j ~, ) COUNTY OF, ,./,~,,~.~=~..(~.1.~; ................, ) ~q,~ ~.~ ~ ..... ...~.~...~..~?......~... ......... .~-~'...~,...O.~.~....~,....~..J..~'. .............................. being duly sworn, deposes and says that he is the applicant above named. (Name of individual signing contract) He is the .................... i...~.'..,~::..~......~..~ ........................................................................................................................................................... (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 application; that statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner- set forth in the application filed therewith. ELIZABETH ANN N~VILLE ~ ~:~ day of ' ~'~J~' ..................... 19 ! ! No 52-81~5850, Suffolk ................................................................................ l~rar"Drfirf~March 3O, 19,5~,,,1~_ . .~, .o a,y ................................. :::::::::::::::::::::::::: ................................... THIS RE%' ~Et,CE ~it_L ADDRE~5 ~ CN~RK~ ~O THE ~hq~ ~O~k~ ~ Hb ALTH SERVICES I ,~. ~,LE l"= zt-O* [,A][ : JULY 27, IqTG HAROL[) F, TRANCiION JR ['(. NORTH COUNTRY ROAD WADING RIVFR NY 473 3~2~ ALT CA~ ~ s~- N.~7°~O'OO"W. ~&SO' . , / / ~ ~ 'v~' / . / ~ 5-11- 1~77 FIN~ SURVEY Services SUFFOLK COUNTY DEPARTmeNT ~ WATER SUPPLY ~ S~WA~ DIS~SAL FOR O~ H~ALTH SERVICES THIS R~SID~NCE WILL ADDRESS FO~ APPROVAL OF CONSTRUCTION CON.PM TO TH~ ONLY STANDARDS OF THE SUFFOLK COUNTY DATE ........ HSREE NO._._ ] DEPARTMENT APPROVED HEALTH SERVICES ....... _ , ~ TELEPHONE ~HOWN ~EREON FROM THE SHALL RUN ONLY TO THE PER~O~ JOB NO: 7~325 FI~ NO: OR kH' ~'""" ~ff~tPltCTlON- NOTiNsTiTUTioNsT~ANSFERA~LEoR ?0 ~SEqUENTADDITION~ Si UATE T: ' SoutHOLD ~.~w. S~LL aOi a~ CO,SJDEREO TO ~ SCALE: I"= ~0~ DATE: ~ULY ZT. IqTG ~ILED MA~ NO: 1133 DATE: ~ULy 5. IqBB ' GUARANTEED ONLYTO: B~K NO: ~ L~F PAGE' HAROLD E TRANCHON JR, P.C. LAND SURVEYOR SUCCESSOR TO WILLIAM G. MEIER ~ F. ~~ ~ NORTH COUNTRY ROAD- WADING RIVER HAROLD F TRANCHON JR ~ENNNYS LIC.LicNO.No.O4 899 22: il 5-E (5t~ 473'3~25 ALT CALL.