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Home My WebLink About8389-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No..Z...~.0.2.~..~ ........ Date ..... ~.e.Q~lll~.e.l?.. ~1 .............. ,19..8.0 THIS CERTIFIES that the bmlding ............................................. Location of Property .... 6/*72.5 · Ymin. goad, ......... 8ou.~holc~ ................... House No. Street Hamlet County Tax Map No. ]000 Section · .56 ..... Block ...... /~ ......... Lot .... ~,3 .......... Subdivision ............................... Fi]ed Map No ........ Lot No .............. conforms substantially to the Appbcabon for Building Permit heretofore filed in this office dated ·..~...e.'p..~4a..r3r' .2.6., .... , 19.7.6pursuant to which Building Permit No..83.8.9..Z .............. dated .. ~.~t~l,a.~r. ~.7.. ~ ........... 19 76, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ..... .A.c.c.e..s.s.ory. ti. se. t.o.M.a.i.n.S..t.r~..q .tu. r.e. ................................... The certificate ~s issued to . ...ff.q~..e~.h..C..~.~.d.:l:.~...ertl...0..L.u.:l..s.a..C.a.~d...~.a. ................... (owner,~ of the aforesaid building. Suffolk County Department of Health Approval ... ~/.R. ................................ UNDERWRITERS CERTIFICATE NO .... .1}I/.R. ....................................... Building Inspector Rev 4/79 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8389 Z Permission is hereby granted to: ? ........................................................................ i' .................................................................................. ; ~-~ -.' - .~}: ;~ .... pu.uaht to a~lication doted .......................... ~e~. .......~ .......... , ,,-,19"~', and opproy~d by the .... 6h'~fi ................... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions Ao This application must be filled in typewriter OR ink, and submitted in duplicate to the Bu, ilding Inspec- tor w~th 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 installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed rote plan requirements where applicable. 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, Co 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 $5.00 Date ..... ~.//.Z./¢~..O .............. Addition to: New Building ............. Old or Pre-existing Muddim§ ..... X. ...... Vacant land ............. Location of Property . .n,o, .¢.~,,' .M~.i..n..R.o.a..d,..S.o..u.tho.]:..dp..N.e..w..Y.o.r..k ........................ House No. Street Ham/et Owner or Owners of Property Joseph Cardia and Luisa Cardia County Tax Map No. 1000 Sect,on ....5.6. ......... Block., .4. ........... Lot..2..3 ............ Subdivision ................................. Fded Map No ........... Lot No .............. Permit No..8 ~.8~) ..... Date of Permit 2./.2.7/.7.6...Applicant . .J..o.s.e~.h...C.a.r.. d. Sp. ................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Fmal Certificate X Fee Submitted $..5. · O0 ....................... Construction on above described bu ild,ng and F~tf2t~l app~;~ codes and regulations. Applicant · · .~/~u. · .'~--/5~)~ ~c{~"~-.~ ................. Ray. 10-10-78 MAP OF LAND JOSE:PM ,SALANID tq..~I°37'ZO"E:. 5.51' 37'Z0' W. MAIN I~OAD .~CA L E; ,,,~'=, I" BUILDING DEPART ,~ '~.~ L~ . ~lic~i~ ~o .................................. ......................... : ...... ....... . .. , ............ ....... ~ ~ ~ (Buildi~ I~r) ~ ~ ~ b,~ ~' *PPLI~ ~ BUIWIHG fE~. a~ ~ ~,~ a. This a~lic~i~ mu~ ~ c~pl~ly fill~ in ~ ~ter ~ in i~ a~ s~mi~ in tripli~e In~or, with 3 ~ of p~, ~um~ pl~ pl~ ~ ~le. F~ ~J~ ~ ~ule. b. Plot plan ~ing I~atJon of lot and of buildings ~ premiss, relationship to ~joining premiss or ~lic str~ ar~s, and givi~ a detail~ d~ripti~ of I~ ofpr~ must ~ dm~ ~ t~ di~mm which is c. ~e wo~ c~er~ ~ ~ a~li~ati~ ~y n~ ~ ¢~me~ before i~uance of Building Pe~it. d. U~ appeal of this a~Jic~Jon, ~e BuildJ~ I~tor will J~e a BuJldi~ Pe~it to t~ ~lica~. S~h shall ~ ~t ~ ~e premiss available for in~i~ ~h~t ~ e. No buJldi~ shall ~ ~cupJ~ or u~d in ~ole or in ~ for any pu~e ~er until a ~ifJ~ of shaft h~e ~n gmnt~ ~ ~e Building In~or. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of o Building Permit pursuant to the ~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other opplt¢.oble I.e~s, Ordinenc~s or ~. Regulations, for the construction of buildings, additions or alterations, or for removal or demolit.on, es herein descri~ ~bec~ The applicant agrees to comply with oll applicable lows, ordinances, building co~, housing code, ~ regulations, end to admit authorized in~ectors on premises and in buildings for necesso~')in~ections. ~r~ture~f applicant, or name, if a co~oration) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, .electrician, plumber or builder. ................................ ......... , ..................................... ...................................................................................... ~a~F~l~a~ ~ra°fc oPrerpc~ ic~eel '~;'~g~ature~l'' of duly a ut'~'~';~'''c~'''~ ';;'"';' ................... i ................................................ (Name and title of corporate officer) Builder's License No ................. ~ ........ Plumber's license No. ................................................ Electrician's license No ............................................. Other Tmde's License No ............................................... 1. Location of land on whic~h prapo~ work will be done. Map No.: ...................................... Lot No ......................... Street and Number....~'~..~.~ ~.P~.~.~.,~..~...~.~..~.?"~.~/~..~....r.....~.~,~.J~...~..~.~. ............ t $ Municipolity State existing use and occupancy of premises and intended use and occupancy of proposed comtruction: a. Exisiting use and occupancy ...L~...T..i.~.~..-J~...~ ......... ~C:>.~.s.~,,.~.~.i.~..~. ......................... ~ ............................................... b. Intended use and occupancy .....C~...~...~.~....~...S. ......... ~...~.J~.~l......~...~...~..~..~...~. ....................................................... 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... 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. If business, commercial or mixed occupancy, specify nature and extent of each type of use~:~l~tC.(,~..~.?...~..'.~Uc~ 7. Dimensions of existing structures, if any: Front ...... J~.~. ................ Rear ..... L.~. ...................... : Depth .~.5. ............. Height ...../.~..i. ........... Number of Stories ..... ./ ........................................................................................................... Dimensions of saree structure with alterations or additions: Front .......... [..(¢..I .................... Rear ...... ./~..~ ................. Depth ....... ~.~../. ................. Height ......... J.(~.~. ............ Number of Stories ....... .I ........................ 8. Dimensions of entire new construction: Front ....~.i..O, .......................... Rear ...... ~.'...0. ............... Depth ..x~.:..O.. ............. Height ..... .~.~..O.. ........ Number of Stories ..... I ............................................................................................................... 11. Zone or use district Jn which prereises are situated .~U.L~N......~. ......... .~. ................................................................... 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 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 street names and indicate whether interior or corner lot. STATE OF NEW' YORK, I ¢ c COUNTY OF .... ............................ ~D~..C~O ...................................... being duly sworn, deposes and says t~t he is the applicanz (Name of i~ividual signing contrac~ above name. He is the ........................ : ................. O~ ................... L ...................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have per~ormed the said work and to ~ke and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and t?~j t~owb:r~il~:rformed in the manner set fo,h in the a~lication filed therewith. .......... o, ....................... ~ot*~ Public, ....................... ~.g~lk ........ Coun~ ~ ....../.~..r..4.t.~ ....... ,.~.~~ ..................................... ~ , / ~ ~ I ' (Signature of applicant) ~ARY PUBLIC, State of Hew York ~ ~-812S8~, Suffolk Coun~