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Home My WebLink About8645-zNO. 4 TOWN OF SOUTHOLD BU~.nING DEPART~ffi~NT Town Clerk'~ Office SouthoM, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at ...fl..ul. ~..P.q.n..L..a~.9 .......... Street conforms substantially to the Application for Building Permit heretofore fried in this office dated ............~.u.p..e... 7.., 19.7.$. pursuant to which Building Permit No...8..~. ~.. dated .........J.une...1~ .... , 19.76., was issued, and conforms to all of the require. ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .. pr. lYa~;.e .accassor~.. (s.torage) humid.trig The certificate is issued to Fr~_~ Bisk 0srner (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .N. :R.: ............................... UNDERWRITERS CERTIFICATE No...N.:.R: ...................................... HOUSE NUMBER 20~ Street Gull ~ Lane Building Impee~ frills PERMIT MUll'BE KEF~' ON THE I~tEMISE$ UNTIL PdLL COMPLETION OF THE WORK AUTHORIZED) 8645 Z TOWN OF SOUTHOLD , 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 su. bmitted in DUPLICATE 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 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-con~orming 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 New Building ................ Addition ............ ..:,,Old or Pre-existing Building ................ Vacant Land ...... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ............ ~..~?.~ ...................... Fee Submitted $ .......~;..f.~ .................... Construction on above described building and pe~t meets al~l~plicable codes and regulations. App,cont ......... ..................................... Sworn to before ~Z~/~ ...... ~.... day of (stamp or s~ ~ ~ .... Nota~ Public ~ , FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,~outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR nk, and submitte .'.d-~- -~'~J~cct-~to_ , the Building Inspec- tor 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-iS-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 installa- tions, 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 peoperty 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 informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land 3. Copy of certificate of occupancy $1.00 use --Pre-Existing C.O. $15.00 Vacant land C.O. ~ Date ............ ,, New Building ............. Old or Pre-existing Building ............ Vacant Land .. ~ ....... L°cati°n °fPr°pertY~o~'' '~'~':''~'' '~' '~''~-~' t~'~''~'''~/'p' ' '~-'''~?''~''~' ''~'u~arvo. .... ~' ~ ..... ~ ~ Street Ham/et O~n~ o~ O~.~, o~..o.~ .. ........ .F~ ~/5~.. ~ ~¢~ .......... ~. ~.../~Z~ ............ County Tax Map No, 1000 Section.......~,~.... Block ....~ ..... · · . Lot...,~.. ....... Subdivison F~ ~ ~ ' ........ ........ ..... Permit No ........... Date of Permit .......... Applicant ......... . Health Dept. Approval ........................ Labor Dept. Approval ........................ Unde~riters Appr&val ........................ Planning Board Approval ...................... Request for Tempora~ Certificate ..................... Final Certificate ....................... Fee Submitted $. ~~ ................ Construction on above described building and permit meet~al~applicable codes and regulations. TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 Nov. TEL. 765-1802 16,1984 TO Whom it May Concern: The property listed on County Tax Map 1000-03~-04-004, situated at 205 Gull Pond Lane, Greenport is a single and separate lot. This property pre- sently contains an accessory building. This property can also have a single one family dwelling constructed upon it provided all set-backs and necess- ary permits are obtained. Yours Truly, Victor Lessard Exec. Admin. Building Dept. VL/dsm APPLICATION FOR BUILDING PERMIT ...~.:.?.. ............................ , ] 9..7...~. ...... Date INSTRUCTIONS TOWN OF SOUTHOLD '~'~4r~ ~ ~ BUILDNG D PAR M N ~ ~ ~ ~ TOWN CLERK'S OFFICE /~ ~ ,~-~ ~ ~UTHOLD, N.Y. ~ ~ ~ ~ ~ ~pplic~tion No .............................. ........ a. This application must be completely filled in by typewriter off, 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 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 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 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 code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (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. Nome of owner of promisos ..................... ~ ...... : .:i.9. ...................................................................................................... If applicant is a corporate, signature of duty authorized officer. (Name and title of corporate officer) Builder's License No ......... ~ ................ Plumber's License No ................................................. Electrician's License No ............................................. Other Trode's License No ............................................... ' ~6~ ~(~'~" ,~, c,~-"~-- Location of land on which proJ~gsed watt,will ~e dope. Map No.: .~.~. .......................... Lot No. ~. .................... Street and Number ....... ~....~.~.~{....~.~... ~,~ '~;~;~;ii~ ........ State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting ,se andoccuponcy ..... ~.~.....(~.~....~....~.....k~.~r. ...... ..... , . , , b. Intended use ond occupancy . .~ ............................ ~ .~...~ff.~ ............................... 3. Nature of work (check which applicable): New Building,. ................. Addition .................. Alteration .............. Repair .................. Removal ..................Demolitior, .................... Other Work ....... V..V..~(~.~,¢~.......~./~ ..... .~....~..D. ,~4 (Description) 4. Estimated Cost ............. ,,O....,¢.~ .................................... Fee ................. '.o.:../.~ ................................................................. (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 ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number,/~ of Stories .................. ¢ ,-.-~,~ ............. 8. Dimensions of ~ntire new construction: Front ........ [..o..~ ............. Rear ...... (..o..~.. ....... Depth .....9.~. ..... Height ...... .~.~.~ * Number ~/.~,f Stories ............... [ ............................................................................. ~ ~/'~' -- ,~, '~"'"1'¥ ............... 9. Size of lot: Front' ' ........~;.I~.QD.*~e~.' ................................. Rear ......... J..~..b...l..%'.. ............. ~,~.. Depth ...... '('T['"l~"~/ ........... Dote of Purchase '~l..~.. ..~.P..~ '.~11 Name of FormerlOwner ..... 'J~ 1 1. Zone or use district in which premises ore situated ...... .~..~.~.s..~..~C~-~v~.L-, ............................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........... .~...D ...................................... 13. Will lot be regraded. ......~,0 ............... Will excess fill be removed from prem, ises:,( ) Yes ( ) No 14. Name of Owner of premises ....-t;.t~¢c~l~.......~]~.)$.l~ ................ Address ...j-.,~,C-k/~.~4~-¢,~.~. Phone No. Name of Architect .........................................~// /" ,'~ ................... Address '"~'"="~'"*'~Z/2'''~'~Ph°ne,-L.~ t'l /44¢ No ....................... Nome of Contractor ,,,,,~-,,~,~?,-:..~.~,..~.~.,..-~.......~/¢...6~...J9 .......... Address ......q,~f....~....~C..'f.,.~F/ Phone No...~L.~.~.~ ........ 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. STATE OF NEW YORK, I¢ c. COUNTY OF ................................ f ""'"' ................ .'t;(z:~..~...~-.. ...... .d~..~..~..I..~ ........................................... being duly sworn, deposes and says that he is the applicam (Name of individual signing contract) above named. He is the .............. ~ ................................................................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have per[armed the said work and to ~ke end fi~e this application; that all statements contained in this application are true to the best of his knowledge and belief; and thor lhe work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this .~~ ~ .......... ......... of ........... .................. , Nota~ Public, . ............... .~M..~..~ ............... Coun~ ......................................... (Signature of applicant) MICHAEL p. KULAKI~ No, 4~-4604744 Oo~m ssion Expires March 30, ~978