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HomeMy WebLinkAbout8463-zTOVN OF SOUTHOLD BUILDING DEPAFFMKNT Town Clerk's Ofiee ~ Southold, N. Y. Certificste Of Occupancy No.Z?.9.J? ....... Date ............. {~.e.~t.: 27. ..... ,19. ?~ THIS CERTIFIES that the buil&in~ located at .. ALbo. D~.ve ..............Street Map No...X~ ....... Block No... :xx ..... Lot No..T...La~e]. .................... conforms substantially to the Application for Building Permit heretofore filed in this u~ce dated .............. 3/21..., 19..76 pursuant to which Building permit No. 8~.6~Z.. dated .............3/...31..., 19.?~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which $hi~ ceff:ifleate is issued is..P, r~L.v, el~e..~-.~..~.~s, p. qQ~, ~.~,~;i~ .fence. ~. ~oce.asory~ ................ The certificate is issued to . .F.~n~.n.k..&.. ~9~..~l'.ti~?~O ........ ~mer~ .......... (owner, lessee or temmt) of the aforesaid building. Suffolk County Department of Health Approval Ii~Y, ................................ UNDERWRITERS CERTIFICATE No...N.~3O~.~ ..... .~r...~...t~??.. ............ HOUSE NUMBER ...... 1000... Street .......A~ba .Dr~.xe ....J~au~ ........... N.I~TE ~. ~LnaJZ .~rad~Lng..to .be..done..by. o~ner .................... ~ ............ ....... Building Inspector FOR.]~ NO. 2 TOWN OF SOUTHOLD BUILDING 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? 8463 Z Dote .......................... ~h ....... 3.t ...... 19..26. Permission is hereby granted to: .~.~:~..~..~...o.r..o.~...~,~t.~.o. ................... .................... ..~...k.o...P.~. .......... ..~.~.t.], ................... at premises located at ..... ~]~.0...~.,~..~.~1 ............................................................................................... pursuant to application dated ........................... ..~.B~.~]~......~I ....... , 19.~.~..., and approved by the Building Inspector ]JOT~I lleed ~ctez~'lters certifieato Fee $..1 ~ ~1.~.~ ........... Buildin~ '~ ................. FOF*M NO. 6 TOWN OF ,$OUTNOLD , Buliding Department Town Clerks Office Southold, bi. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Iflstructlons 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 ]957), Nan-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 Dete ......................... New Building ................ Addition ....~. Old or Pre-existing Building ................ Vacant Lond .............. Location Of Property ...~T~.:7....~..'......~..~ ......................................................................... Subdivision ................................................................ Lot No ............. Block No ............. House No./~..~...O.,. Permit No. ~..'..~.~.~....~.... Date Of Permit :~'~..,..r-Y~...:~/...1?,~;plicont ~,...~.~ ....... Health Dept, Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .~..~....~./v..../.~..7...?. ............... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Find Certificate Fee Submitted $ Construction on above described building and permit meets all applicable codes and regulations. Applicant . .~-. ~,..~..~/////////~....~ ......................................... Sworn to before me this ~'~;;'~ ';~blic ~..~...C ... County (stamp or s_e~l), THE NEW YQRK BOARD OF FIRE- BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK, NEW YOR~ THIS CERTIFIES THAT Frank Marturano, A~bo D~ive, Mattltuck, L.I. '¢"~"'"'"'""'~ .... March 21, Z977 andf°undt"b~inc°'t'Pl~a~o~ithtl~ere'luir~m~ts~'ft~}s~, (Swimmln~ Thls certificate cove~s ~ompliance inspection only. ~ecause to have frequent test and/or ~omas HOrn & Sons, Main Street, Examined ..... .~.../..L.~ ....~ ..('. .... Approved .................. t.~ ........ ~.~...., 19...2.~Permit No ..... .~..~...~.. ................... 'row. OF souT.o ? .UILDINm OEPAR'rMENT TOWN CLERK'S SOUTHOLD, N. Disapproved a/c ................. ~ (Building nspec or APPLICATION FOR BUILDING PERMIT Date .................. ~"-...~ .4~... 192..~...-. INSTRUCTIONS a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building Inspector, with 3 sere of plans, accurate plot pian 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 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 shah 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 LO 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 cede, and regulations, and to "~ admit authorized inspectors on premises and in buildings for necessary ir~oections. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ {4/ff'~:'~9 .................. Name of owner of premises ..../~-.Y~..d,:.~......~...~).CY~..~.~..~.~. ....... /J~.~.~..T.~.,~.~{~..C) .................................................... If applicant is a 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.: ...y../c~...~..~.~....~ .............. Lot No ................. ./...~.. Street and Number .~.,~./~.....:..~..~., ........ ~-~'~?.~'.,~,. ....................................................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ......... ~..A~.4~,/.././~..C~.. .......................................................................................... b. Intended use and occupancy ~.~<'..Z.~9:?.F.,'TZ.~......~.~.~, ....... ~..X,2..~.....x~.~A'.~'....GT~.~.C~4~..~. ....................... 3. Nature of work (check which applicable): New Building'. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior. ....................Other Work ...,~'....~...~...,??./...,~...~.......~.£.o..~. ............ ~ ["~00 (Description) 4. Estimated Cost ....... ~..~.~.....'......~..; ................................ Fee I~"- o~ (to be paid on filing this application) 5. If dwelllng, number of dwelling units ............................ Number of dwelling units on each floor ..... ; ...................... If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, spec/fy 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 ..................................................................................................................... 9. Size of lot: Front ..... ./...~...O.. ......................................... Rear ..../...O./. .............................. Depth ....... ../.~'..../.. .............. 10. Dote of Purchase ........................................................Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ........................................................ 13. Will lot be regroded .......~.....~. .............. Will excess fill be removed from premises: ( ) Yes (~'No 14. Name of Owner of premises .................................................... Address ................................Phone No ....................... Nome of Architect .............................................................. Address ................................Phone No ....................... Name of Contractor ............................................................ Address ................................Phone No ....................... PLOT DIAGRAM Locbte 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. /OO STATE OF NEW YORKL COUNTY OF ...SuJ~£D-!.~. ............ ~ ~'~ ........................ ~8.tct~[.-~t,t~.B-13,O ..................................... being duly sworn, deposes and soys that he is the applicant (Name of individual signing contract) above named. He is the .................................... a~e~.'J;., f'O~...C. QT~;~.~,G~O,~. ............................................................................................ (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 all statements contained in this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........... ..~.l.s+,,... day of ....... Notary Public,. ...................... ~u~ ~'o,].~. ........... County ......c~..~..~..~ ....................... NN NEVILLE I~OTARY pUBlIC. State of New York No. 52.8~2585fl. Sull01k Cop,.n,l~ Term Expires March 30.