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HomeMy WebLinkAbout9075-z FORM NO. • TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. . . .29120. . . July' 20 78 Date . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 19. . . . THIS CERTIFIES that the building located at . 1435 West Cf'eek Ave . Street Map No. . . . . . . . . . . . . Block No. . . . . . . . . . .Lot No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office r 9075Z p dated . . Seember. . • •1'3. • • 9776• pursuant to which Building Permit No. . .8657Z dated . . �I;tember. . . .13. . . .�i9?76., was issued, and conforms to all of the require- R.""' ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . . . . . . . . . . .Private. One. Family.Dwelling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . . . . . . . . lamHenry . . .e. . . . . . . . . . . . . . . . . . . . . . . . . . . . (owner,' of the aforesaid building. Suffolk County Department of Health Approval . .7/jV77. . .6750m154. . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . . . . . . .N34.3 656. . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER . . . . . AA�'�. . . . Street . . . . .�JJ st Creek Ave . . . . . . . . . . . . . . . . . . . . . . . . Cutchogue, New York . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N49075 Z Date ......................March........<............, 19..77. Permission is hereby granted to: 3oseph Henri ................................................... .......................eve.S.t&k.Ave............QlAtOo-gue ................................................................................ to .91.11.1d...(...ma Pliate... dw?Ui-rl9..Peaaltl..MT7 .....9/1.3/..7.6... ....................................................................................................................................................... ......:.. at premises located atq.S.t.gzemk.Ame.....................................:................................................... ...............................................QSIAC hA 9uR............ ................................................................................ ................................................................................................................................................................. pursuant to application dated aB1dYl821dt'd1311 9�1. /7b 19,.,..,., and approved by the Building Inspector. 15.00 Fee $........................ 4 (.4..................`...........1, :.. ..... ............... Building Inspector FOSM NO. m TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFMCE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT-MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO 885'7 Z Date ..............................S® .....�z�....... . Permission is hereby granted to: ........................... a4t?it,. 39..............�u414R ............... ................................................................................ ro ... #t4lY...81fe ......................t..aPP.roeefl..b . ..APPeals.... # 2146) ................................................................................................................................................................ or premises located at ArS..West Creek„AYe ..... .................................................................................... CutghoR!u........................................................................................ ................................................................................................................................................................. pursuant to application dated .......................................PARI.....1319...76., and approved by the Building Inspector. Fee $911 .Q........... J. � . .......... Building Inspector 1 4u.<.�.L..._.0 r.c,.x L - tu. .� ...�.1._n:�.v�. .. �� m...� - .��...yna✓.v.�.� �.......w::v.._.�._ i FORM NO. 6 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 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-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 in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5,00 i 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 ` 3. Copy of certificate of occupancy $1.00 { { Date ................................................. New Building ................ Addition .. ........... Old or Pre-existing Building ................ Vacant Land .............. �••uLocation Of Property ..................•••..•••.-•.•• 'Owner Or Owners Of Property ................................. ...................................................................... / C-te Cr 1` vJ -'j ,p, I' 'Sub'divisiorp e-.s... ................................ ...rryf. ...........Lot No. ..........: Block No. '............ House No............. Permit No. .................... DI...t Of Permit ... . ................Applicant .................................................................... Health Dept. Approval ..........Labor Dept. Approval ........:.......... ............ ........ ........ ............................. Underwriters Approval ........ ............. ....................Planning Board Approval N. .......................I...... Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted'$ .................................... Construction on above described building and permit meets all aI ficabte .codes and regulations. Applicant ........................................:................................................................ Sworn to before me this ................ day of ............................................ (stomp or seal) Notary PublicCounty "' FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. TEMPORARY Certificate Of Occupancy Ip ' No. .27860 . . . . . Date . . . . . . . . . . .Aug . . 2.9. . . . . . . . .1 19 THIS CERTIFIES that the building located at . .West. Cxeek .Ave. . . . . . . . . . Stree.__. _ Map No. 7t7 . . . . . . . . . Block No. .??x. . . . . . .Lot No. . ? :�. . Cutchogue. . N.Y.. . . . . . . . . •ir conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . . . . Se-pt. 13 ., 19. 76. pursuant to which Building Permit Ne. dated . . . . . . . . . . . . . Sept. . .13, 1976. ., 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.ivate. .4z1e, .faPily„dwelling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to .Josepiz, Henry . . . . . . . . . . . . . . . . . . . . . . . . . . • . . (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .July 6 1977 by R. Villa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NoN 3656. . June 22. , .1977. . . . . . . . . . . . . . . . . . HOUSE NUMBER . . . . . .143.5 . . . Street . . .West, .QreeX .Ave. . . . . . .GUtehQgue. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector Commission EIP1res March 3% 18 j FORK NO. 1 TOWN OF SOUTHOLD� h7 dam *�4 A e✓, �oV�l�� BUILDING DEPARTMENT sJ TOWN CLERKS wOF.Y.4F.,I,C 77 ,a+SOUTHOLD, N Examined 9 � Application N.�o..� ,.aedTfre. +4rc�,.sW5 Approved ............rr .. 3 it No. ................................7 7' ......... .............. 19........ Permve"7 17 ..t. tr.. ` Disapproved a/c ..... ..... ................... a/"'l 7 /o"° i /tan- 0 1 ... ....................................................... �A 71aa,X T/c o ............................. . ..... ........................... ..... ........... .. (Building Inspector � l��GO �sf/�J/S`'7�`' APPLICATION FOR BUILDING PERMIT//eI.P- ®`L� 0-0 Date ...................St Pr....►.3........ .. ........ INSTRUCTIONS a. This application must be completely filled in by typewriter or, 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 lox and of buildings on premises, relationship to adjoining premises or public streets or (1 areas,and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. 76 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 /k 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'-0. shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment 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. l i W .:........................................... ( ' ature of applicant, o name, if a corporotion) tYRss! ! ....Or......... A.,....... �.�7cNoGv� .. .. .. .. .. ............. (A fi vS f plicont) 4(77_/773 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..............................awnrE,(.... Name of owner of premises ........ . . .............F....zy........ .............................. ................ ...... .......... ..................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ................[°IEl.►-10dN.rr............... Plumber's License No. ...........em.�.ro................... Electrician's License No. ...... ................. Other Trade's License No. .............................................. 1. Location of land on which proposed work will be done. Map No.: .... 9AAPf4?............. Lot No: ........................ Street and Number ........(............................................ST CEEK f}VE: P tlTCffOGU .......... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .................k RL'ANT b. Intended use and occupancy .........P!QIV/}TE ............. .. .. .......... ...... ....................... , ' ^ ' .� � ^ ° �� Nature of ^mdk (cho�kwhi�6 upp|i�ob|e>� Ne* Dui|dind� ..�'�—.. /\ddinon ...—....� /\hnrn�ion ........ 1 1 Repair .................. Removal .................. Demo|itior.......,.. Other Work ....................... ........................ ,' it (Description) � F�d,no�c6Co�� ���� (�(�[) ^ Fe ~ ' .~..��,.�`�..,..---.,.......—... � ..�����...—.. ...^~^.....—.~'~-...�— . . (�obopoi6onfi|ing ��isopp|icoMon) S. If dxr||in0/ number of dwelling units .....^/...............Number ofdwelling units oneach floor .... ....................... � |fgarage, nurn6ernfcom ..—........���...—............--..~...^......`—.,........,....,. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions ofexisting structures, ifany: Front ............................ Rear ................................ Depth ....,..... Height ........................ Number of Stories ..........—.....,........^...~..---......^—..''.... Dimensions ofsame structure with alterations uradditions: Front .................................... Rea r ................... ........ Depth ................................ Heigh] ..—.......... Number ,........,.. ' + ��... � 8. Dimensions new construction: Front .............^�5P/..��...� Renr ..—����.��7.—.� Deo�h .� �V,.—.—. Height ~� �� '... Number of Stories � ...��� .....--..,....—.. � -- � � .��. .`' ~...,....—.^..~~;.^,........ � 9. Size of (o1: Front ....................... ........................ Roor ........1*JA............. Depth Z���>.,q~.'/�`/. lO. Date of Purchase ............... ��..~.—......Name of Former Owner . ....~....,. ll Zone nruse district inwhich premises are situated .......................0..—.~................--..........— �� 11 Does proposed construction violate any zoning low, ordinance or regulation: ...^.���.........^..~.--,. 13. Will lot bcregraded ............................ Will excess fill 6oremoved from premises: ( ) Yes ( } No 14. Nnnoeof()w/ne, ofprenoisos .,��� E�A'.. up�u�����...—. /\ddxss �.° phone �� � Name ofArchitect .............................................................. Address ................................ Phone No. .°.~^...—, Non.e of Contractor ............................................................ Ax]d,oss —.~.........~.. 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 orcorner lot. / STATE OFNEW YORK, I SS COUNTY OF .,...8.0 ffulk....../ ' `,'^.,,,,,,,,JigoPP.bA.Q4nKy..........................................being duly sworn, deposes and says that he isthe opp|icnn/ (Name ofindividual signing contract) above named. Heis the ........................................Qw.nt\r............................................................................................................................. (Cont,nctor, agent, corporate officer, etc] of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this application; that all statements contained in this application are true tothe best ufhis knowledge and belief; and thaT the work will be performed in the manner set forth in the application filed therewith. Sworn tubefore methis .—..,],1t}\.... day nf ..SGpt.em]oer................ l9.]G.. Notary Public ./ y /� / �� .' .l - ...... ..f ..-...°`~...^..—^^-- unorenopp|icont) •UFR 00.HEALTH DEPT.APPROVAL H.S.NO. OWNER: '_10 SEPH f-/E/VZY G'.O. BOX 3Z9 COTC14000E,N.Y.. 11935 PNN.477-1773 AREA: 19,356 SOFT. DIUMU L 585Z . P.77 „ � . TODEBU5H W N.86°0340"E. v tiW.9'S6'ZD'7V.-MAI —�. As eiev. h O ('- 7 fer da��m 0 11} It) v O Q r X } >1 6 ol lu { 00 o u SCALE: 101= I ` 1 Ri W LIE W I p `, /� � UNAUTHf RI .ALTERATION OR ADDITION YO 3 hoax 1 SECTION 7309 OF THE NEW RK STATE EDUCATION LAW. + j 1 COPIES OF THIS SURVEY MAP NOT BEARING , THE LAND SURVEYOR'S INKED SEAL OR 1 EMBOSSED SEAL SHALL NOT BE CONSIDERED j .Q TO BE A VALID TRUE COPY. i GUARANTEES iNEESDN FRHEREON4SMALL RUN _ ONLY TO THE ✓H:SJ�J F02 YYHOM THE SURVEY j ®" wet I IS PREIARLD, Ai<D OL H.S KHALF TO THE TITLE COMPANY, GJVERi4YINIAL AGENCY AND LENDING INSTRUTION LISTED H.REON, AND TO THE ASRGNEES OF THE LENDING INSTI- 7UTION. GUARANTEES ARE NOT TRANSFERAEIE TITLE CERTIF TO ADDITIONAL INSTITUTIONS O0.SUBSEpUENT JWNE0.5. n MAP OF F�c �r'EE'7Y AT "LEETS NECK" Survejed ALq. Sri , 1976 RODERICK VAN TUYL. P. G. 7-OWN OF BOUT 0LO, N.Y. ^ iZ. t/o,—T-.. x LIC.LAND SURVEYORS.GRE 1tT. N.Y. TOT HOLE SU FF. CO. DEPT.OF HEALTH OlUmcm STATEMENT OF INTENT VV O' +e�j.s.i1 9„ FOR APPROVAL OF CONSTRUCTION ONLY sand y THE WATER SUPPLY AND SEWAGE I= , 116„ DATE: DISPOSAL SYSTEMS FOR THIS RESI- DENCE WILL CONFORM TO THE 54nd H.S. REF. NO.: STANDARDS OF SUFFOLK CO. DEPT. OF HEALTH. SERVICE'S. APPROVED: )� cal 17' APPLICANT r i rl I It We wa 6w .. N ;• '- < • •i ' 'M1 i !'4. ~ C .t , ,.� AASH 6 . ',;. . /z i-� •• ' � - � '�,' t. 1"• , , y.- - .. I � '+ - i431NNGT .E7/INiLFf II + . � : X, A, _ .y all ri r J3 +r w .'fAJi s I L R. ~ ri uEli L .r• F •~..X ��' a �c�_ {Ty Y ., /« _ Y ` M1 '•yl7. Ij ff �.Y,r - _ GFP.WE �NNKLsS "/Y"y Ex •aOOr+KF ,S '- t_ '.aIIIIJ — . � �' 7atlrt J17F - ? ` 1 71, For fi, "rpOJ' - - to"XB" t../G frar..f'" - o FP,©NT wE S C-V I , r Rl AP PRO ED AS NOTED ' DATE: 13 X9-76 FEE:. q3,�—° B7 .. -...- „ NOTIFY BUILDING DEPARTMENT P I ct 765.2660 SAM TO 4PM FOR REQUIF, ED INSPECTIONS: I,. 4 . 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