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HomeMy WebLinkAbout10012-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southotd, N.Y. Certificate Of Occupancy No...ZgR~6 .......... Date ...~.P?.~.~. ?.~. .................... 19.80.. THIS CERTIFIES that the building ................................................ 135 So'tmdview Rd. Orient, N.Y. Location of Property h[~[ts'e ~Jol ....................... 'S't/e;i ....................... County Tax Map No.,J000 Section .... '!9 ...... Block .. ?. ........... Lot Subdivision. 9Y.&?S. ~Y.. 97:°. . .s,f~ ......... Filed Map No..~.~./~/4....Lot No. ~'? ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated · .~ .c;~.°.~.~x.'...'~. ...... , 19 78 pursuant to which Building Permit No. 'lOO'l 2Z dated . .D?..c?.~.b.~ :r'.. ?? ............ 197.8. , 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 ......... .......... .e.~5.¥~.%~' .o. ~..~.-?:~..m.~.~.y..~,?~ .~.~.g/ ..................................... Anthony & Dolores" Avella The certificate is issued to ..................... /oWn'o),'/~s'sde'~r't~t~a'a't) ...................... of the aforesaid building. 8 SO ~2~ Suffolk County Department of Health Approval .......................................... N~75728 UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector Rev 4/79 FOIJ, M 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 CQMPLETION OF THE WORK AUTHORIZED) N? 10012 Z Permission is hereby granted to: '~')/~: J"/O~g' (~, CD ~.~ ~ ~U C~ . ~.:~.,. ~.,.,.~c~...~~ ~ ' ~- .................. .~:~.~,~....~..~.~..~.,~ ...................... ~ .... at premises located at ........... ~~.~T.~ ..... ~....C'. ..... ~:(/ .... , /-%__ pursuant to application dated ......... ~(~,./...--....~....~.. ........................ 19._.7..< and approved by the Building Inspector. Building Inspector THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF= ELECTRICITY [--- es JOHN STREET, NEW YORK, NEW YORK 10038 1980 064967 THIS CERTIFIES THAT o~[y the ei~tricul equipment ~ described b~Jow and introduced by the applicant named on the above application nutnber in the premises of Avella~ ~,ou~.dview Rd~ (~or~ R.yde~ Farm l~ Orien~ PoinC~.Y. 29 4(; DRYERS SYSTEMS NO, OF FEET OTHER APPARATUS: Elec. ~oom heaters 2 GFCI ~ E R I C NO' O~iRC~COND'1' OFA'wG CC COND NO OF HI-LEG AW, G OF HI-LEG NO OF NEUTRALS 1 AWG, Sat Prato Wiggims Lane 11944 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credenhals, COPY FOR BUILDING DEPAR~TMENT. 1.HIS COPY OF ~E~TIF~IC~, ~T: NO1' ,B~i~L;ER D IN ANY MANNER FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 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 survev of peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date,., .~../.~., .~ ./.~.'.c~ ........ New Bud ng ...... Old or Pre-existing Building .. Vacant Land ............. Locat.o' n of Property ~ .......... -- ~-~ C~- ./~ d,J~ .... I,/ [ .~ ...... .~..C~ ................... -- (~ /~' ~- ~ ( .......... ~/ .~ House No. Street / Hamlet Owner or Owners of Property ?.~./.~. ~-~. ~,~..~..N~... ~'~.~.~z,.~ I/T'..~. ,~- ..... ~ .I,~'?..~ ~ .~.~. ..... .~C '//~ :--' ' Block ...~.~, ......... Lot. :-2 ............ County Tax Map No, 1000 Section ...... - ......... Subdivisi°n '~' 'F'/~'~' '('--''' '~)'7 .... '-"~' '~' '~' ...... Filed Map No.'~..?. ~.y.Lot No... ?, .~.. ,~. .... Permit No.l~, ~./~x2..~,. Date of Permit/'¢~ 7fi/7.~/..Applicant .~,~.~...~. ~O~~--~..~ Health Dept. Approval. ~,.. '.~ .~.~../...~./. ....... Labor Dept. Approval ........................ Underwriters Approval..j~J..Z.~.~. ~...~. ,~.~.....Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ~ Fee Submitted $...~.~... ~. Construction on above described building and permit meets all applicable codes and regulations. Applicant...~... ~LJ~..~...~?~-~. ..................... Rev. 10-10-78 ,/,.j. '¢..% %.4. T~ I~- 'lk_l A ! ~~h'~-/2~~' ' ~ ~ -2~ ~ TOWN OF SOUTHOLD · '~,~ ,~" Building Inspector's Office ' '~ Town Clerk Building In the Matter of the laying out o£ : certain Town Highways in the To~,rn : o£ Southold~ County of Suffolk and : State of New York~ known as Plum : Island Lane: Park Vie%~-Lane~ Three : tffaters Lane~ Sound View Road: North : Sea Drive~ Ryder Landing and Ryder : Farm Lane in the Hamlet of Orient. : C O,~SE ~¢f OF T O%'~N BO&RD Upon reading and filing the dedication"and release of Woodhol!ow Properties~ Inc.: dated September 3~ 1963: duly 8c- knowledged~ dedicating and releasing the necessary lands for. the. proposed highways known as Plum Island Lane~ Park View Lane~ '.,,-i: Three Waters Lane~ Sound View Road: North Sea Drive~er Landing and Ryder Farm Lane in the Hamlet of Orient% in the Town of Southold~ more particularly CountY of Suffolk and State of New York: and described in said deed of dedication and re- lease: it is hereby BESOLVED~ that consent bey and the same. is: given that the Town Superintendent of the Highways of the Town of Southold make an order laying out the aforesaid To~ Highways to consist of the lands described in said deed of dedication and release: all in accordance with the provisions of the Highway Law of the State of New York. Co ' "~ustzce of the~eace ~ /' ~ J~stice of the' Peace~ .?i~man ~ ncitm~u u FOruM lqO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .................. ~prov~ ...~..~ ................ , 19~..~. Permit No. ~.~.~../..~..~. .......... ............. [ I (Building ~nspector~ INSTRUCTIONS Application No../..~...,~.../:..~,. ............ Date ....... ~. ................................... , ............ 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 lot and of buildings on premises, relationship to adjoining premises or public streets oF 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 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, 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 ir~ buildings for necessary inspections. (Signature of applicant, or name, if 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 ...?... ......... ~ ................................ ;~.. ......... .../..!.../.~'....~...../..6~. ........................................................... if applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No. ,X*~/A'¢ .~ /' Electrician's License No...:E~..~,¢~:~..~.?. ........... Other Trode's License No ............................................... Location of land on which proposed work will be done. Mop No.: ..~.~.~..~..~. .................. Lot No. ~-~--' Street and Number ~ /~ ~ = '(~"~.-*"'~'""" ;~ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: Exisiting use and occupancy ........ .~,..~....~.~..~.' ....... ./.--;.......~./~. .......................................................................... b. Intended use and occupancy .? ........................................................................................................................... 3. Nature of work (check which applicable): New Building,. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ................................................. (Description) 4. Estimated Cost ............... ./.. ........ ./. .............................. F ............................................................................................ (to be paid on filing this application) 5. if dwelling, number of dwelling units ...... .('?...J..J~ .......... Number o~units on each floor ....~ .............. garage, number of cer$ ................ .................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures~ if any: Front .......Z... ................ 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 ....... ......... ...... Depth ..... Height ....~..(~ ~ Number of Stories ....... ..~..~Z~..~..--. ~ ../... '":'" iiiiiiiiiii';.'.i i iiiii!i .............. ..... ;z ....... 9. Size of lot: Front ........ Z...O...~.....~ .............................. ~'; 10. Date of Purchase ............... ~ ................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated 12. Does proposed construction giolate 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 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 whetber interior or corner lot. STATE OF NEW YORI(, COUNTY OF ...................... ................ ., ................... ........... .................................................. being duly sworn, deposes and says that he is the applicam (Name of individual signing contract) above named He is the ................. ....w ......... ~ ......... .'._' ..................................................................................................................................... (Contractor, agent, corporate office[, etc.) of said owner or owners, and is duly outborized to perform or hove per¢ormed the said work and to make and file this application; that oil statements contained in this application ore true to the best o~ his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application flied therewith. Sworn to before me this , ....... : ....... ::~. ...... day of ....... ' ......... :...¢..~,; ......... z ........ , 19 ....... ~/~ Notary Public, . ......... ,.,, ................ : ........................ County ............................. ~.-. ................................................................. ,~ (Signature of applicant)