HomeMy WebLinkAbout8454-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
No Z-22241 Date
THIS CERTIFIES that the building.
Location of Property 67480 MAIN ROAD
House No.
County Tax Map No. 1000 Section 53
Subdivision
Town Hall
Southold, N.Y.
UPDATED
CERTIFICATE OF OCCUPANCY
APRIL 5~ 1993
ADDITIONS ~ ACCESSORIES
G~F. NPORT~ N.Y.
Street
Block 2 Lot 27.1
Filed Map No. Lot No.
Hamlet
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 5~ 1993 pursuant to which
Building Permit No. SEE BELOW dated .......
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued for ACCESSORY BUILDINGS ~ ADDITIONS TO EXISTING BUSINESS
BUILDINGS ***
The certificate is issued to
of the aforesaid building.
GEORGE L. PENNY~ INC.
(owner)
***THIS CERTIFICATE OF OCCUPANCY UPDATES THE FOLLOWTNG
BP ~4123Z-C0 Z-3818 DATED 6/8/70 FOR ADDITION
BP #4739Z-C0 Z-6703 DATED 9/24/75 FOR ADDITION TO ACCESSORY LUMBER
STORAGE BUILDING
BP ~6963Z-& BP ~7687-C0 Z-6704 DATED 9/24/75 FOR ACCESSORY BUILDING AND
FENCING.
BP #8454Z-C0 Z-I4648 DATED 7/14/86 FOR ADDITION & ALTERATIONS ON EXISTING
BUSINESS BUILDING - UNDERWRITERS CERT. #N-756952 DATED 7/1/86
BP #10584Z-C0 Z-14641 DATED 7/14/86 FOR 2ND STORY ADDITION TO EXISTING
STORAGE BUILDING FOR LIGHT STORAGE-UNDERWRITerS ~2{T.#N-756950 DATEu 7/1/86
BP #10965Z-C0 Z-14639 DATED 7/14/86 FOR ALTERATION & R~I.OCATION OF EXISTING
STORAGE BUILDING UNDERWRITERS CERT. ~N-756953 DATED 7/1/86
BP ~12653Z-CO Z-14640 DATED 7/14/86 FOR ADDITION/~EXISTING BUILDING AS
APPROVED BY PLANNING BOARD, UNDERW~TERS CERT. ~Ny~756951 DATED 7/1/86.
~/Bu~lding Inspector
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
THIS CERTIFIES that the building . addition & alterations on existing business
................................ bf~iTdlh~'. .....
Lo ~' ~ ' 67480 Main Road Greenport, N.Y.
ca[ion ol rroperty ........................................
House No. S~ree~ .............
County Tax Map No. 1000 Section 053 ...Block 02 .Lot 27.1
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated March 29, ,19 7..6pursuant to which Building Permit No. 8454z
dated ...M.a.r..c.h._ .2.9.: ............... 19.7.6., 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 .........
addition and alterations on existing (mixed occupancy) business building
The certificate is issued to George L. Penny, IV
(owner,
of the aforesaid building.
Suffolk County Department of Health Approval ............... IxJ../.A ........................
UNDERWRITERS CERTIFICATE NO.. N756952
Building Inspector
Rev. 1/81
FOR~ N~o 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
CQMPL~ION OF THE WORK AUTHORIZED)
N.o 8 54 Z
Permission is hereby granted to:
~. · .;L ~- · .P~;~..;Z;[;~ .....................................
............... I~Lu..Bd .......... Gr~enpc~f. ................
~o ~..~..~$~..&..~e-.~!~rat~-.o~.-e~~..~B~..~up~a~)
......... ~ ~--b~-~d-~.~ .............................................................................................................
at premises l~ated at ..~/~..~..~ ..... ~S~q~-~ ..................................................
............................................................ a~een~o~ ...... ~..X. .............................................................
~[~,.~?u~uant to~ g~ppi, lcation dated ...........................J~'""~9 ............ 19.~.., and approv~ by the
~), ',~' Building Inspector.
~ ~,~ F~$;~.i.~ ...........
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
765- 1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
This application must be filled in typewriter OR ink, and submitted ~ ~ 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--(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 site 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 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 informa-
tion required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling $15.00
3. Copy of certificate of occupancy $1.00
4.Vacant Land C.O. $5.00
5.Updated C.O. $15.00 Date ...~...,~....~.--..../.~..~..~....
New Budding .~ .~..~.'.~ ~..~ !~... Old or Pre-existing Building ............ Vacant Land .............
Location of Property .... .~..7.7. ,~.~, ...../1~?, ! ,~...~?, .~.]~. ......~.~.., ,~,,, I?e, ,~, ,'~. ...........
House No. Street Hamlet
Owner or Owners of Property .. ~ ~.~..~...G,.~'....L:..' ."-~.. ~.~..~...-~ ..........................
County Tax Map No. 1000 Section .... .C>..~..~. .....Block ..... .~..'~. ...... Lot...~. ~.~.~.7 .....
Subdiwsion ................................. Filed Map No ........... Lot No ..............
Permit No..~.z).~..~.... Date of Permit .~JR. 9/?.(~ .Applicant..~.~e..z..~..~...~...~7~..~/.~....~.. ........
Health Dept. Approval ........................ Labor Dept. Approval ........................
Request for Temporary Certificate ..................... Final Certificate .......................
Fee Submitted $ . . . .~. '. ~ ...................
Construction on above described building ~.}~r ~mit meets all ap[~-'~ble codes andlm~u~ations.
Applicant .~ . ~x~ .~-~-~.. ,~.... ~. ~. ..........
Rev. 10-10-78
~oc~7~ THE NEW YORK BOARD OF FIRE UNDERWRITERS
r"--- BUREAU OF ELECTRICITY
I ['l~ aB JOHN STREET, NEW YORK, NEW YORK 10038
.a,~ aUW ~, ~'.~6 .pp.~a.o-No.,,.S.~ *~/~ N 756952
THIS CERTIFIES THAT
o~ly the electrical ~uipment ~ ~scrlb~ below and lnt~uc~ by the applicant ~med on the a~ve application number ~n the prem~e3 of
m the~ollow~ng locat~on: ~ Ba~ment ~ 1st ~7. ~ 2nd FI. ~ect~on Bl~k Lot
u~s examzn~ on J~ ~ ~ 1~ and found to be in eo.*pllanee u'tth the reqtt~retnent~ of this Board
FIXTURE ~E EPT I I FIXTURES r RANGES ICOOKINGDECK~ OVENS ~HER~EXHAUST FAN
DRYERS I ~RNACE MOTORS I ~TURE A~LIANCE ~EDERS IS"ECSA~ "~C'"Z~ ~"~ CLOCE~ [ sm TUN,~ HEATERS [MULTI-~T[ ~ Ol~Sn~
K W OIL "P ~S H P ~T NO A W G A~T ~P ~T A~PS "NS H , NO O~ F~T L A~} ~ WATT5
~RVI~ DI~ONNECT ~ OF S E E V I C E
~: .__ PER ~ OF ~ COND OF .1 tEG OF NEUTRAL
OTHER APPARATUS
Cl~les M. Hall Omni Service
760 tDng Creek Drive
Southold, N.Y. 11971
GENERAL MANAGER
Per ' ~ ~ =
Th~s certificate must not be altered in any manner, return to the office of the Board ,f ~ncorrect. Inspectors may be ,denhfied by thte,~ [
credentials.
COPY FOR BUlL. DING DEPARTMENT THIS COPY OF CERTIFICATE MUST NOT BE, ALTERED IN ANY /v~ANNER
Examined ............ , 19 ........
,~oproved ........................................ , 19.../..~
BUILDING DEFARTMEHT
TOWH CLERK'S OFFICE
Disapproved a/c~ ......................................... .
APPLICATION FOR BUILDING FERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or. in ink and submitted in triplicate to the Building
Inspector, with 3 sete 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 st?ets o~
areas, and giving a detailed description of layout ofpraparty must be drawn on the diagram which is part of this apphcatlon.
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, O. rdinancee or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as here,n described.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulatlam, and
admit authorized inspectors on premises and in buildings for necessary ir-~pectians.
~,~.L.~' ~ .,,.:,.,.:.X CO. INC,
......... ni.~,_ __. _, __ __ ._........_.......,.., __ ____.o.[ (~f~.o.:,'~e,L. Penny Inc.
......... ( i .atuTe ,,. ;' ........
greenport, L. I., N. Y.
......................................... · 1.:[~ ............................................
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises
If ap~icant is a corpor~)te, signature of duly authorized officer.
..... ...... ..................
m~--m(~a~ ~ e ~ei~ O~ officer)
Builder's License No..~....o.~......~....O....G...~..~ ....................
Plumber's License No .................................................
Electrician's License
Other Trade's License No ............................................... ~.~., ..,.~,..,.~[
Location of land on which proposed work will be done, Map No.: . .....--.,-,. ..... Lot
Street and Number ~ ~ ~ ~ ~ .%~. .~.)- ..~....C...~R~;~ ~ .~.~-~ .....................
Municipality
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy ..... ..~..~...~...(....7~......~....~..-~.. ....... ., ................................................................
b. Intended use and occupancy ......................... ,', ............ ~ .......................................................................
o. '7-"
3. Nature 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 nature and extent of each type of use ............................
7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth ....... .............
Height ....................... ~;iNumber 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 ........................................................ Rear .......................................... Depth ................................
10. Date of Purchase ........................................................ Name of Former Owner ........................................................
11. Zone or use district Jn which premises are situated .....................................................................................................
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
14. N a m e o f OW ne r o f p r e m ises .~'.-~...~'. i..?D..!. {..~2 .~.i~..~,..:. ~-~..~..~"....~'..; .~ ,~,-'~"ress . ./~-.. ::..~..,~"...( ../.'..~..../~....C. ~/. phone No.~..~.t~...~ ~
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.. (c c '
............................................................. ~ ................. being duly sworn, d~oses and says th~ he is the opplicanl
(Nome of individual signin~ ~trecO
above nom~ ~ ~ ~ ~ ~
' ~/~ ~ . ' I ~ ~ ~ . ~
H, i, .................. ..... , , ............
~ 0 (Contractor, ~nt, comorote offcer, etc.) ...................................
of said owner or owners, and is duly authorized to perform or have performed the said work and to ~ke and file
this application; that all statements contained in this application are tree to the best of his knowledge and belief; and
that the work will be performed in the manner set fodh in the application filed therewith.
Swam to before me this ~
....... ~.~ ....... day of ....... ~.~.~.~;~ ............ , 197..~ ~ ~)
No,o .......................... O.L( Coun .....................
[LIZAS~H ANN NEVIL~ York