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HomeMy WebLinkAbout9999-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17222 Date AUGUST 23, 1988 THIS CERTIFIES that the buildin~ ONE FAMILY DWELLING Location of Property. 670 GREE~ HILL LANE House No. Street County T~x Map No. 1000 Section 33 Block 03 GREENPORT Hamlet Lot 09 Subdivision EASTERN SHORES Filed Map No. 5234 Lot No. 143 conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 24, 1978 pursuant to which Building Permit No. 9999Z dated OCTOBER 30, 1978 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 ONE FAMILY DWELLING, CONCRETE WORK COMPLETED. The certificate is issued to HELEN M PAVESE (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 8-SO-106 2/16/79 UNDERWRITERS CERTIFICATE NO. N424110 2/28/79 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 Building Inspe~zor FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9999 z Permission is hereby granted to: ~o ...~,..g.t~.~.~ ........ ,~ ........ ~,V..~- ......... .~....4....Zf/~..L. ........ ~).~J.z:.~,/. ....... ~= ..................................... at premises located at ..................... ~:;~. ...... ~../~.~,~...~.....~..!...~...~. ........... ..L...~....~...~.. ............................... ........................................................................... ~.~(......~..~.~:Z ..................................................... ..],~.(....../..ff.~ ......... ~..~.~.~,z..~ ........ ~..~.~.~..~ ...................... A.~t..[. ............... ~,.~..Y.. ..................... pursuant to application dated .............................. ~...C..Z.....,~.,~..., 19.~'..~..., and approved by the Building Inspector. .~ t~-~ Fee $....Z~.~.~ Building lnspe'ctor NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z0l.~.~.~ ..... Date Febr a*' 26 ..., 19. THIS CERTIFIES that the building located at . .6.7,0...GF.~n...H.i:l:..l. ~L.a.r.~? .... ~gt~x Map No... 52-..~.I~ ..... Block No ........... Lot No ........ .~.43 ...................... confoms substantially to the Application for Building Permit heretofore filed in this office dated ... 0c,~obe:~'... 2f~ ...... , 19,7.8. pursuant to which Building Permit No.. dated ... 0c2ob~...~0. ...... , 19.78., 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 ............... ~va2,.. One. Family .Dwalling ............................. The certificate is issued to ........... M±¢haal. Pav. es~ ............................ (owner, of the aforesaid building. Suffolk County Department of Health Approval ...8.-.S.0.-. ? p.6. ........ ~./?.6../.7? ........ UNDERWRITERS CERTIFICATE No. P~nding f~ ~/~ ~/; / 0 .............. Green }U.11 Lane HOUSE NUMBER 670 Street ........... : ............................. Green~ort, New York ..~' t~//v~. .-" ." -'.: ? .49 Building Inspector County Tax Number 1000-5~-~-9 PE~DING COMPLETION OF CONCRETE WORK FORM NO. & TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. TEMPORARY Certificale Of Occupancy No.. Z9.~.~6 .... Date . F.ebrual~r. 26 ............. , 19..7.9 THIS CERTIFIES that the building located at .. 6?0. ~een..HiLl..L~e. · · tr~etx Map No...~2.~/~ ..... Block No ........... Lot No ............ 1/~ ................... conforms substantially to the Application for Building Permit heretofore filed in this office dated ... 0c.~ot~er...2/~ ...... , 19..7.~3 pursuant to which Building Permit No. · 9999Z' dated ....0.e'.~.°.b?.~...~.0 ....... , 19.7.8.., 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 ..... ~F.%¥.a~.e.. Q.n.e..F.~.m.i.]:y.. D~.e.l.l~,~g ................................... The certificate is issued to ........... .MiD. h~[..P, av.eae~ ............................ (owner,:~:~~) of the aforesaid building. Suffolk County Department of Health Approval ..... .8.-.S. 0..-.1.0.6 ..... 2/.1~/.79 ........ UNDERWRITERS CERTIFICATE No .............. .P.e..n.d.:[.n.g ...................... HOUSE NUMBER ....~.0 ....... Street ....... ~.v.e.e.n...H~I! .LO~e. ................. ............................................. Qv~.e~Dor.~,..New..York ............ County Tax Number 1000-~-5-9 pUll,lng Inspector 765-1802 BUILDING DEPT, INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION ZND [ ] INSULATION [ ] FRAMING [/.~INAL .~ %A/N~OF FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted m ~ 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. 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 informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1, Certificate of occupancy New Dwelling.$25;O0, Accessory.i$iO.O0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3, Copy of certificate of occupancy $ 5.00, over 5 years $]0.00 · 4.Vacant Land C.O. $ 20.00 $ so.oD Date .......................... NewC°nst'z"ucbzo6- ...... ~ld or Pre-existing Building ............ Vacant Land ........... LocationofPro r '?d ~'~ Y~, ,~Z, House No. Street Ham/et Owner or Owners of Property ...... ~.~;. ~.' .~y; .d~..~_. . County Tax Map No. 1000 Section ~ ~ ~', ............... Block . Lot ......... Subdivision ....................... Filed Map No. Lot No. Permit No ........... Date of Permit .......... Applicant ......................... .. ,..... . Health Dept. Approva~ ........................ Labor Dept. APprova~ ................... Underwriters Approval Planning Board Approval Request for Temporary Certificate ..................... Final Certificate, ................. ,., . Fee Submitted $ ............................. Construction on above described building a.n~ permit,me~ets all apptic~ble~co, des and regulations. ......................... 0.0.!. I1 NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. TEMPORARY Certificnte Of Occupnncy Nn Z9446X~ Da~e February 26 19 79 THIS CERTIFIES that the building located at Map No...52~A _ .kBlock No ........... LotNo ..... ./...1.~3 .... [ ....... [ ...... conforms substantially ~he Application for Building P~hit heretofore fll.e.d in this office dated... 0c~ob~...2~..~..., 19..78 pursuant to w~ich Building Permit No.. ~.999.~. dated ....----- '~ C.c.~.c.~. ?:r__ .~.0. _\. ~.'~, 19.7..~., was iss~,/and conforms t~ all of the.require- ments of the applicable provisib~s of the law. ~he occupancy for which this certificate is __ _ issuedis.....~r.$y~.~.~...0.n.~...~.~y Dw~.tg....._._' .... The certificate is issued to ......... ~ .~.~.e.1...P.ay.e.s..e ............................ ( owner, of the aforesaid building. Suffolk County Department of 8-S0-106 2/16/79 ....... .... ..................... HOUSE NUMBER 5.7.©. ... Street ....... .~.~?.~.n. ~}~..L.a.¢? ................. ........................ ./ ................... 9..~ .e.~p. qr. 3,. ~e..~. ~o. rk ........... ~oun~cy Tax ~mbe~ 7 TOWN OF $OUTHOLD Building D~tment Town Clerk~ OffiCe Southold, H. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY I nstructlons A. This application must be filled in typewriter OR ink, and submitted in ~ to the Building Inspector with the following; for new buildings or new use: l. Final survey of property with accurate location of' all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approvot 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, o 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 o'f 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 Date ...~e. ?...z~...~...z~.....2..~. ,...~.~.7.~. ............ ~'~"' Old or Pre-existing Building ............................ Vacant Land ............................ New Building ...... ~.~ ........... Y>TO ~zc~_e~ ~I1 I,ane~ greenport Location O~ Property ........ ;.,~ .......................................... · ......................................................... Owner 0¢ ~ners Of ~roperty Y~ic'Sael' I~ave~e ............................ Subdivision ................................................................ Eot No...~.~.~.,. 8~ock No ............. House No..~ ..... Permit No. r~c~Of Z Date Of Permit .~-.Q~.~).~Applicant Inlanr] Ftomes. Inc, . 8 S0-106 2/16/79 /~k.~ ..... ~ ..................................... Health Dept. Approval ...~ ............................................ ~pt. Approval Underwriters Approval .............................................. Planning Board Approval .~ ................................. Request For Tempora~ Ce~ificate ...... ---~.'. ......................... Final Certificate ...~ ................................. Fee Submitted $ .~.,.QO .......................... described building and permit meets all a~Jicable c~es and regulations. Ap p I i c a n t · .;.~~..~/~~...~.. ~ .......... ~ .......................... ....... ~.~. ..... day of .....~.~.~.~ ....................... (stamp or seal) Nota~ Public ......... ~9~ ............. County ]g'OIGM~ NO, ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ............... ~Z~...~....~., 197.~..' Permit No. ~:~ Z ....... ............................................................................ ........ f (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter o~ 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 lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c.. The work covered by. thais application may not be commenced befqre issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue o 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 Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described. The applicant agrees to comply with oil applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. .... /I,Lx[L~N]2..H.Q[4.',~",S .~ .I ~(~ ^ ..................................................... (Signature of applicant, or name, if a corporation) BOx tlTs M~-~%i¢~,ck~ N,y. 11952 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. of remises PD'~chael Pave, se Name of owner p .................................................................................................................................................... if applicant is a corporate, signature of duly authorized officer. ...!qp~er.~..~,...I-~i! J;.~ ................................................ (Name and title of corporate officer) Builder's License No. ~ Plumber's License No .... 5..];'.,.,.7.?:?. ................................. Electrician's License No ............................................. Other Trade's License No ............................................... 5234 143 Location of land on which proposed work will be done. Map No.: ...............................; ........ Lot No ......................... Street and Number Green ~{ill J.ane~ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy Vacant b. Intended use and occupancy 1 - FamrL3.y 3. Nature of work (check which applicable): New Building' .....X'~ ........ Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ................................................ . .... (Description) 4. Estimated Cost ~.5..~.0.g.Q,.0.Q ...................... 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 ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 73 73 8. Dimensions of entire new construction: Front .......... '~ ......................... Reor ............................ Depth ..~.~ ................. Height ...~..~. ............ Number of Stories .............1 ....................................................................................................... 9. Size of lot: Front 150 Rear 150 Depth 130 10. Date of Purchase .............. : ......................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... ~.~ .............................................. 13. Will lot be regraded ..... ~g.a ................ Will excess fill be removed from premises: ( ) Yes (x) No 14. Name of Owner of premises ..?~(~-g.~A~]...~.~g.~g ................ Address ................................ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... INL&I~) ~S~ ZNC.Bo~ llTAddre,, [,,~¢¢.ztuck~?.Y~hone No. 298-9696 Nome of Contractor ........................................................... ~ ................................................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from prope~y lines. Give street and bbck number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, [ c S COUNTY OF .....,~t.J.~g.1],f ........... ~"' ................ ~.q~.~:...~.~...~;f~.~ ........................................... ,.being duly sworn, deposes and says that he is the applicant (Nam~ df individual signing contracf) above named. He is the ................................... ~.~]~.~:~.~ ...................................................................................................................... (Contractor, agent, corporate, officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and tha~ will be performed ia the manner set fo~h in the application filed therewith. ~the work Sworn to before me this . , n ~oto~ ~ubhc, .~[~.~.}S .................................. Coun~ · ~ . o ................... TOWN OF ~OUTHrlLE) OFFICE OF BUILDING INSPECTOR TOWN P-LERK'S OFFICE c::E)UTHOLD, N. Y. TEL. ~L~ASFELD ,/&CANT