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Home My WebLink About8697-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No .... Z8988. ·. Date .. April .. 20. .............. , 197~2. THIS CERTIFIES that the building located at .7/~80. G.t,. Fac,. Bay..Bl~d. Street Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office March 1, 197.6 8395Z dated .May .2,$,..197o ...... , 19 .... pursuant to which Building Permit No..8697Z. March 1, 1976 dated ..... July..2,..1.976 .... , 19 ...., 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 ...... PRI~[ATE. Oh.~,. FAi~ILY .D~ELL~NG. WITH. AgCESSORY. BUILDING...... The certificate is issued to ..... John..ar~..E~n~la. Gat~usi ........................... ( owner, of the aforesaid building. Suffo]k,~eunty Department of Health Approval .................................... UNDERWRITERS CERTIFICATE No..House..N.3~22]S.,-,~-,-Gara&e .NSZ00~0. .... HOUSE NUMBER .. -7~-80 ...... Street .. Gr.e~.~ .P¢¢ont¢. 5-ay. Blxrd. ............ ........................................ Laure.~ ~ .New .York .................... Building inspector FORM NO. 2 TOW~q 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? 8697 Z Date Permission is hereby granted to: ..... 5,.o..~...~..?~..~...~?.~..9.~:~.~..~ ................................ ~8 Gle~ore Ave Brentwood ~. 4h~ml,~ .ew ~rivate zarage (acce ~.orv bu~].d hz) (apprgved by Bd A~peals) at premises located at ....:~.~...~.~?,~.~...~Z.,P~. ....................................................................... La,.ret (i4attituck P.~o) pursuant to application dated .......................... .!~.,a.,y......~:.~ ........ : .... 19.~6...., and approved by the Building Inspector. Fee $,!.0..:.~..O. ........... / ' Building Inspector 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 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 oil 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 Ui~derwriters, 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 os 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 3. Copy of certificate of occupancy $1.00 New Building ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. L~tion O~ Property ................................................................... ~ .............................. p ...................... , ........... Owner Or ~ner, Of Prope,y ...~.¢.~...~.%.%~.~.....,~d.¢.f.~..f ........................................................ Subdivision .................... : ........................................ bt No. Bilk No. House No 7 ~ O ~o~sc ,~-~'~ ~v~ /)/¢74 ............................ Perm~ .................... Date OfPerm ~. / ................. App hcant .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Un~rwr'~e~s Approval At~, Z ¢o Vo .............................................. Planning B~rd Approval ........................................ Request For Temporaw Ce~ificate ........................................ Fin~ Certificate Fee Submitted $ .................................... Construction on above described buildiog~an~, p~miy~-m~ets albopplicable codes and regulations Apphcant ..~7...~ ............ ~.L....~..T..~ ........................................................... Sworn to before me this ~.~.. day of ....A.~ ~,:./...,...LC.:,~. (stamp or seal) , , ' Nota~ Pub,'c ............. Z~/~. CounW C ~~ ~ ~OTARY PUBtIC, Stat~ of Na~ York ..... ~ -- - V / NR. 52.8125850, SU~IolI( COUDty ",".' :, :i',i.:: THE NEW'YORK BOARD OF FIRE UNDERWRITERS' ~y,t~ electr&ai equipment ~ ~s~rib~ below a~d in~duced by ~ ~pilcant named on ~h'e above appllcatio~ numar in the premls, of ' ;" . '. John Gabusi~ Peconic Bay Blvd';,' ,239' west,o2_ B~ay. Ave;, Laurel, .L.I. ~ ~*~.~o~:. January 6, 1977': anayound~beincomplia,tc~w~th~heFeq.~rem&ntkofz~isBoard. ~T. K.W. OIL H.P. O~ H,P. A~T, NO. A.W.G. ~T. ~P. ~T. ~PS. TRANS. A~T H.P NO. OF FEET This cedi - ~ g~ , ~ ~ ~ TOWN CLERKS OFFICE ~'~ ~ ~ '~ ~ ~ ~UTHOLD N. Y. ~ ~ ~p~ed ~~9~. Peqm,t No..~.....<... ................. u~sopprovea a~ .~~....~)~j~_~...~.~ ...... ......................... ~ .).' , ~ t~q~ ,-~ (Building lnsp~tor) f /1~ ~< /:~. APPLICATION FOR BUILDING PERMIT ,, ~ .......... INhTEU~IONS a. This application must be completely filled in by typewriter ac: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 p an showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram wh ch is port of th s appl cat on. 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 shoU be occupied or used in whole or in port for any purpose whatever until <3 Certificate of Occupancy ~, shall hove 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 Lows, 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, buildir~g code, ho~sing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Si~na~re o~plicant, or name, if a corporation) - //7/7 ............ ...................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, englneer, general contractor, electrician, plumber or builder. · ........................................................................ If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~ .................. Plumber's License No ................................................. Electrician's License ~o. Other Trade's License No ............................................... Location of lend on which proposed work will be done. Mep Ne.: ....................... : ................ Lot No ......................... Street and Number ............................... Municipality State existing use and accupancy of premises and in~ended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy ............................ .(,~. .................................................................................. 3. Nature of work (che'~lk~which applicable): New Building' ......~!~. ..... Addition .................. Alteration ............... Repair .................. Removal .................. Demolitior ..................... Other Work .................................................... ~ (Description) (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. tf 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 ~o ~ z ,, . ..................... Height ..... ~.~Z~..~.... Number of Stories ..........( ........................................................................................................ 9. Size of lot: Front ..... ]:~.( ......... ................................... Rear I ~/ / 10. Date of Purchase .~.5 ~..~. ~. .......................... Name of Former Owner gcc~b 11. Zone or use district in which premises are situated .................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~ ........................................ 13. Wdl lot be graded. ........................... Will excess fill be removed from premises: ( ) Yes__ ( ~ No Name of Architect .............................................................. Address ................................ Phone No ...................... Name of Contractor ............................................................ Address ................................ Phone No ...................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing o[ pfoposed, and indicate all set-~ck dimensions fron property lines. Give street and block number or description a~or~ing to deed, and show street names and ind~cat~ whether interior or corner lot. ~/ C OUN . above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du]y authorized to perform or have performed the said work and to make and file this application; that al~ statements contained in this applicction are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this ff~ , ~ ~ x (S~noture of opplic~nt)