The URL can be used to link to this page

Home My WebLink About9124-zNO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupnncy No..Z59fi~t ..... Date ...April ... 20 ............. , 19..7.8 THIS CERTIFIES that the building located at . i~/S. J. aoobs..Loae ........ Street Map No... 5~99 ..... Block No ........... Lot No ...... 28 ......................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .~Iaz~oh.. 25 .......... , 19.77. pursuant to which Building Permit No.. dated .Yl~ch.. 25 ........... , 19.7.7., 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 P.R.~:~:~.E 0.N.E F~MILY DWELLING The certificate is issued to ....... G~.e. nb~i.~. HO~e$. ;~0.. ......................... (owner, 1~) of the aforesaid building. Suffolk County Department of Health Approval .......... .~.':~0.-.~.8. ................. UNDERWRITERS CERTIFICATE No ..... P. gn..d.i.~.g ............................... HOUSE NUMBER ...~/~ ........ Street ........ .J.~.c.p.b.s..L..~.e. .................... .............................................. S. outh~%d,. New. Xo. rk ............ Building Inspector ]FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N'. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: G~eeabz,$a-~,..~omee..tne .................................. ............ 8~11-. .l~t~bi.a.. ~t' ....... Ba..l:dwin.-.. ~ .~ .Y ~ to .....~....i.~..c)...l).ff[~...~.l!e....~.~P,i~....O.~e, llin._~ ................................................................................... at premises located at ..I~i;..2~, ...... ,Le. ewa~ii..,~.e~e,s ..................................................................... .................................................. F./S...lae~bs...Lan~ ......... ~outhet& ............................................. pursuant to application dated ........................~ ......... ..2.~. ......... , 19...~.[/., and approved by the Building Inspector. Fee * .~. ~.?.~..0. ........... FORM NO, 6 TOWN OF SOUTHOLD Building Depmtment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instrucfioes A. 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: I. 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 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 D~te New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ..~.~.......~..~...~..~.~..~,..~,.~..~.....~.. ...... ...~...~..~..f, ~....~...~...~....~../~...~., ,~._...~..~........~...o..t.~.~.~ Owner Or Owners Of Property ...................... 'j~'jS'.~( ................................................................................... Subdivision . .~....~...~.;¢?.z~..:..~.~.-~......Z..~.....~....~?...~,...,~'.~.~...Lot No..~.'..?..... Block No ............. House No ............. GREE I R A[ Permit No..~../.~.....~.....Z.... Date Of Permit ........... ';?'..Applicant / .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval ............................................. Planning Board ~pprovol ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ .................................... Construction on above described building ozt_d_g.e_rmit meets all applicable codes/and regulati~s,~ ................................................GIIEENSRfAR HOMES NC. Sworn to before me this Applicant (/ ...~,w~c...r.r..mc...,m.~....*.~,.-..w .~..[~,/ Notary Public .................................... County ~,_4~,, ~>~ ~'~ / ,-/ / / BUILDING DEPARTMEHT TOWH ~LERK'S OFFICE ~UTHOLD, N. Y. ~ Examined ........~....~..~., 19.~.~. ~ ~proved .................. ~ .......... ~ :9.~.~., Permit No ..~ ( ~ ~ ............................... Disapproved a/c ............... ~ ............................................................... Date .................... ~ ........ :.&. .............. , 19..~.~.....~....qb INSTRUCTIONS % a. This application must be completely filled in by typewriter or'.in ink and submitted in triplicate to the Buildingl~) Inspector, with 3 sets of plans, accurate plot plan to scale. Fee accordfng to schedule. b. Plat plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Buildlng 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, Ordinances or gl 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,rdg~!alti~s, and to~ admit authorized inspectors on premises and in buildings for necessary inspections._ J~JJ~;~[~J~ ~jJj[~,~ ~ ............ ........................... (Signature of applicant, or name~4r a corporation) (Address of applicant) - State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... ................................................................................................................................ Name of owner of premises ...... .~.~,~.JJJJ~[~.JJ~, ................................................................................................... applicJnt is a corpor.,C:e, ~ignature o-f duly authorized officer. Builder's License No ..................................................... Plumber's License No. ~-¢'20--/~ Electrician's License No ..... Z~i....?...~.'.~..'.::...~.~, ....... Other Trade's License No ............................................... 1. Location of land on which ~proposed__,,,~ work will be done. Map No.: ..........-~..;~..~..~...¢.¢~.. ........... Lot No... ~.~..d.~. ............. Street and Number ...... .~.:/.~-~......q~/..¢.¢.~..~...~........~..~..~...¢.~..'. ....................................... ..~..~..~.,~.~.~.~..(TJ~. ........... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ~..~.../~..~.~..2~.~..~..~.~..~7..~.~.'.~...~7....~./~.~(..~.:~.~.~.~ ................................................... b. Intended use and occupancy--~ ................ ~% .................................................................................................. / 3. Nature of work (check which applicable): New Building' ....J~..... ..... Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior, .................... Other Work ................................................ .-. ~ z~ (Description) - 4. Estimated Cost ...... ~.Iz~...~..~..O..~. ............................ Fee ..I~. ...... :...... ........... i..~P.~....;..;.k.r;b...; ...... ; ....... ¥~.....~ ..... (to be pa a on r ng 1pjlis appl cation) ~ '~' C~6~, 5. If dwelling, number of dwel lng units ........~ ............... Number of dwelhng un,ts 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, Jf any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ ~u/,/~/ber of Stories ............... ~ ............ 8. Dimensions of entire new construction' Front .......... · .~.,.. .............. Rear ...... ~ ................ Depth ...~....c~... Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ............... ./...,~... ................................ Rear ......./../..~ .................... Depth ......~....~.. ................... 10. Date of Purchase ............ ../.?..?.~. ............................... Name of Former Owner .~...'~...~.f~..~.......,'~,~./'..'~..~(.,~..../~... ............. 1 1. Zone or use district in which premises are situated ....... .~.<~-,~,ff..~..~-...~'.-.'~.. .............................................................. 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. Name of Owner of premises .................................................... Address ................................ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate dearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dimensions fram property lines. Give street and block number or description according to deed, and shaw street names and indicate whether interior or corner Int. tooI 1 Sq'ATE OF NEWYODI4~ _~ I~ COUN'FY OF .... ..~...~... ~.~. ........ .~..~...~".~.~T..~...., ~¢.,..~....~....~...~.....~ ................................ be ,g duly sworn, deposes and says that he is the applicant (Name of individual signing contracf) above named. He is the ....~.~:~.~ ...................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and Js duly authorized to perform or have performed the said work and to make and file this application; tha~ aH statements contained in this application 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 file~ therewith. Sworn to before me this ,~ / ......... ........ o, ............ ..... Not - P.b c, ........... Co,,U ......... .............. ., .,~.; ' () ~ ,,4 ~. ~ (Signature of applicant) // ~BRAH~ ~. ~'ORWoOD NOT~RY PUBIJ0, State of New No. 30-29~0700 Qu~lJfie~ in N~ssa~ ~oa~ty ~ommissi0~ ~pir~s ~ar~h 30, ,% l) A THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD O~RERVATIONS AND OR FROM DATA OBTAINED FROM OTHERS NO7'E~ · = MONUMENt' SUBDIVISION MAP FIlED IN OFF/CE OF THE CLERK OF SUFFOLK COUN~'Y 0 N dUNE 4, 1971 AS FILE NO. §599 WAT'EN ~E~VICE = PRIVATE ~ ~ STA~E APRIl B, 1977 APRIL 4, 1978 YOUNG & YOUNG 400 OSTRANDER AVENUE, EiVERH£AD, NEW YORK ALDEN W. YOUNG HOWARD W, YOUNG ,SURVEY FOR: GREE~B~/~ HOMES, I~C. LOT NO. 28 "LEEWARD ~C~ES AT BAYVIEW " AT GUARANlEED FO' BA YVIEW USLIFE TI~INSUnANCE C~NY OF ~ OF , ~ INEWYO~K SOUTHOLD ~ .... - SCALE ,, , I DATE _ I THE LOCATION OF WELLS AND CESSPOOLS FIELD OBSERVATJONS AND OR FROM DATA OBTAINED OTHERS A ,% NOTE: / / / / / / o / 0 / · = MONUMENT SURDIV/$10N MAP F/LED IN OFFICE OF THE CLERK OF SUFFOLK COUNTY 0 IV dUNE ~ ~ /971 AS FILE ND. §599 NEAREST PUI.'~LI¢ IIIATE~ 1~41N = 4l &'lILY'S ~ THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE SUFFOLK COUNTY DEPARTMENT OF HEALTh FOR APPROVAL OF CONSTRUCTION ONLY APPROVED ~" ~ - YOUNG & YOUNG 400 0STRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W, YOUNG HOWARD W. YOUNG SURVEY FOR: GREENBRI4R HOMES, IHC. LOT )VO. 28 ' LEEWARD ACRES AT AT 8AYVIEW TOWN OF ' SOUTHOLD SUFFOLK CO., N.Y. SCALE: / APPROVED AS NOTED !i J -I