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HomeMy WebLinkAbout9482-zlrOK~ NO. & TO~N OF SOUTHOLD BUILIHNG DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupancy No.. Z89.~2 .... Date . Februa~r .... 1~ ........... , 19. THIS CERTIFIES that the building located at 3300. l~eVe. Rd, ........... Street Map No. )+682 ...... Block No ........... Lot No, ...7. ............................. conforms substantially to the Application for Building Permit heretofore filed in this office dated . .10/.3/7.7. ........... , 19 .... pursuant to which Building Permit No..9~r82Z. dated .. 10~/?.7. ............ , 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 ... PRIVATE. 0NE .FAI~L~. D~I~LI, INC~ .................................... The certificate is issued to .... G~O~rm .¢ol~tlxlc.tiol~ Co3~p, ...................... (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval ..... ?,.q0,,13[~ ..................... UNDERWRITERS CERTIFICATE No ..... ll. 37.3.9.9~ ................................ HOUSE NUMBER .. 33~Q ....... Street ....Re.e.v.e..R.d,, ............................ ......................................... .~.~.~t~.~. ~.e.~, ~ork ................ ./:./.,,'~.~...../,>::~... ......... Building Inspector · .': - ,..,." .' t;:~,.;~':.'~"";:....:; ~ .'.. '.. ' . . . ~,.;,x;.;,. :',', , . .. . :.. , .': · , . ., . . . - . · . , , .~,': .,....,,?, ',', ,. >~'_~ .: .:' : . ... .:.-'..'.. . '..': .....:. : .. . ' ' ".?" :.;." !/'" '. '.'~:.. ~.~.: ..,~. ..... ,. ' ~ · . .... ~... - .. , . , : · . . y. · · ,, .., :. -',' _ .' · ~i.,' .' , , ~', ~ ;,?.:, N? ... . ..... ..... · ..... ..... .._..?. .... '-: ~' ',. ~.'_' ,~ ... ~* '.. _ .:: '.. ,. . .... ? j.' .'../.:' ":,:;.' .., :. ' ..,_. . ~?,~:.,:? ~..?~.{'~. .~ PermiSSi6 · '":..'[ ..~. ~. 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":'" ' , '. ' -,,"' ~' ,'.". :. -~ '. --' : :" ". '?~,;'~. ~'~-. ~.~..~ :~":~:',~ ,' ,,'"',?'".; '.' :." '~';"?': ~:",,. ~:,.:.1'~-':~-~.'.~ ~-, .:< ,'2 ...,~,~t '3,~ ,; ..~ ~',~ ~. ':?;,-, L:~ ,,~,' ~.~' ;:' ~, ~ '~;2,- .... -' ~.V:':'' '::'.(: '; :. ~ ~, ,'.'" ,: ..... : ,~/?~ L~ - .'.? '.: .~ :'- '., .i~' ~: '%? ~- ~ .,~ ~? ~.:~. '~, :, '~'~ , ,L: ' ': ~. ' F '~ ~':~ .~ ,, .~'..,: . · ~: 7.~ .: ~ ~'~ ~-'.. ~ ,, ~ ~,. :;: ,'..~h '~.'~ .' '.' ~;-~ ', ~' .~';~.'¢::" ';"~'~77., ~:,~ ;~ '~ ~,~ '...L~'~L~; ~-' .i '? ~:; ~?~ ~::: ~ :~ '.::,~. ? ~ '.,~:~ ~-~ 7:;:~ ~ :~;~ ,,, ~,,~,;' FOEI~ NO. S TOWN OF $OUTHOLD Building Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in triplicate 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey mc 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 formation required to prepare a certificate. Fees: I. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date . 2 Z<.~.., New Building ......... ~.. ........ Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property Reeve Rd. , Mattituck Owner Or Owners Of Property ...... .G..~.rt...e.....C..o_rt..~..t....r~....c..t..'.~QD....QQ.~.p.~ ..................................................... Subdivision ..... ~.~.]~/~.~'.e~..,~s~a,~.(~.s ..................... Lot No....7. ....... Block No ............. House No.~.~...°...c? Permit No ..... .9.~,~.2Z... Date Of Permit ..],O./.~/.~.7..Applicant -.G~zYe. e...G~.a$.t,m:z.e.~.:be~..Go~,..p;. .... Health Dept. Approval ...... . .~. ./ .3. . [ /. .7. .8. ..................... Labor Dept. Approval .............................. i ................. Underwriters Approval ......... '..~.//../.~.~. ..................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and ~mit meets oil appJ~coble codes aad regulations. Sworn to before me this (stamp or seal) IT THE NEW YORK BOARD OF FIRE UNDERWRITERS Brien K~ller, Peeve Road, 508? n/o Bailey I~tecD,. ,~"~ftltuck~ L.I., ~otors: I-3/4ho I G.F.I. I S~oke detector. Ted Ch~$h!re Jr. R,R. 1, Sound Ave. .. . q Per ..... J ~ BUILDIN~ PERMrr ', . U3 · ~' '-~.h '"' ~ ...... .oZ3Z7.z ......................... , ............ RUCTIONS a. This application must .be completely fjl~ed in by, tyi~llffii~r,.~r~.,'~u~..;anFI ~l~jtted in triplicate to the Building~ In~Wlth 3 sets c~,pla~,ua~i~te Ige~n ~-t~i~.' P~e'~"to'~ch~dule:- r b~..~l~o_t ~ showing Iocati0?~o~f~.q~..z~l~ .of buildings on premises, relationshipfi5 adjoining-Premises or pub c streets areas, rdHctgit~ng a detailed desc'r,j~fa~i bfla;/out ofprpperty must be d~awn ~ ~t _h~q cliagy~gm ~ch is part of this application.~ c. The work covered by th s app icatl~ may not be commen~c~ ~uance of I~u Id ng Permit. d. Upon approval of this application, the Building ~w iJLssue a Building Permit to the applicant. Such permit shall be kept on the premises available for impection work. e. No building shall be occupied or ueed in whole or in part for any purpose whatever until a Certificate of Occupancy 'shall have been granted by the Building Inspector. B .A.P. PLI ~CATION IS HEREBY MADE to the Building ~rtment for the issuance of a Building Permit pursuant to the ui~aing ~one Ordinance of the Town of Sauthold, S~i,;~k County, New York, and other applicable Laws, Ordinances or ~egulati,.ons, for the construct!on of buildings, addltlem or glterations, or for mmaval or. demolition, as herein described i ne .a. ppficant agrees to comply with all applicable laws, mdineneel, building code, housing code, and maulutions and t~ admit authorized inspectors on premises and in buildings for necessary Inlpactions. -~'- ' '~) G~e~f-rme C:oaet~tct~.on ¢oz~)/ (Signature of applicant, or name, if a corporation) 163 A Mon~auk V .................................... · gA6 (Address of ~licant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ lde3: .............................................. Name of owner of prem sss....G.~.e.....~..o...~..~...~.~...c..~...~..o...~....~..o...z'p.:. .......... ..~...f?.../4 ..~......~4~.~....~.....~......~.....~../...~...~.~. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) J~j~s ,Z. SchwArtz, Pres. er s License Ho ..................................................... Plumber's License No. 770-P , Electrician's License No. 712-~- Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ..... .~..6...8..2. .......................... Lot No....7. .................... Street and Number ....... 7~'~:%~' G- ~'e a-~> · , . -,' ~iclpatity 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occUj:xmcy ..~f}.~.~.~...:~.~. .......................... b. Intended use and occupancy ~1~.. fsrm~. ..... ..................................................................... · .3.. 'Nature of work (check which applicable): New Building...~C ............ Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work 4. Estimated Cost ............. ...'~...~..Z.~....~... .................. Fe; ~/,x,~, ? (Description) (to be paid on filing this application) .5. If dwelling, number of dwelling units ..O..~...e....~...~..m..t=.]..~....Number of dwelling units on each floor ............................ If garage, number of cars one 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 entire new construction: Front ...6~1 ............................ Rear ...~{~ ................... Depth .2~1, .................. Height .................... Number of Stories .-.4)lP~..-~.ala[.]:.y. .............................................................. 9. Size of lot: Front ].00.].7 ........................................................ Rear .]:..0..0..s..0..iff. ........ Depth ....2..0..~a..2..3. ......... 10. Date of Purchase ........... S~;.e;l~.e~...~..7. ............... Name of Former Owner 11. Zone or use district mwn ch prem,ses are situated 12 Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be regraded .......~..O.. ................. Will excess fill be removed from premises: ( ) Yes ~: ) No 14. Name of Owner of rem see .G.~e Coast;~ucttotl ............. .["]~one No. 7..2...8....?..2...2..]. .... P .......................................... qQ~ess .~..6..3...A......~..n~auk . Name of Architect Ed l~.~':i, cksoB .............. Address ..g,ttO=J,~)~e~. ...... Phone No.82.~.-..~.§9.Z .... Name of Co,tr,octor .;,~.~..,1~ ,,.~...~.t;~.~.~. ~.....~,,~,~,,.. ~. ~, ,? ~cPEeflii?N'o;~ ;.;;.~...../. .......... whether interior or corner lot. ,,,- ...... ~-HpHun accoramg._;~,.~,d~l~, t~h~t~;~o~Jtlt, l.~e,~_,.t~l~t~:~/~ffi~ STATE OF NEW ~..~.~.,//~' ~ S S ................ "* .... ..... "' COUN~ OF~ ........ ~ ' ~ ..... ,'.;.' ~?'~ ~ c :~,m'~ ........ ...................... ,, ....... .. of said owner or owners, and is duly authorized to perform o~ ~age D~f~ed the.:~,'~d;:'td ~k~and. file this applic~t~n; t~t oil statements contained in this applic6tio~ are ~'~e to th~ be~t of his knowledge and belief; and that the work will be performed in the manner set fo~ ~n-the 9PP icat on fi~ ~herewi~b, , , .... Sw~re me this ~... , :.._ , ~ ,... ................... ~.-:;.::,'x ,~.-r.~?' ............. ..... ................... Nota~ Pu lc, . ............................ C~n~ ........................ ~ n~ ............................ BUILDER's ,JOB NO. ~00 TIT]LJ~ NO. ~OTS ~ SURVEYED: ExcAVATION IHSPECTiON THEEXI~;r~CE OF RIGHT OF WAYS AND OR/EAS6~dTS OF RECORD, IF ANY~ NOT SHOWN ARE NOT OUARANTEED 2 100,t7' ,SCALE: BLOCK NO. 'l'q - ~J)t~ 144 MEDFORE , Lie. NO: 47401 516-475-0349 I AND f~E EXISTENCE OR/EAsEAENTS OF ~tGHT OF OF IF ANY,:NoT SHOWN A~ NO~ Loys . ~ Shock , ' ' " 144 MEDFORD AVE. lJ772 GUARANTEED TO: S~~Y ~ ~~y ~. -- .L __1 ,'1 0 © Ltl ,,o '0