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Home My WebLink About10031-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy Date ...... ~Y..33 ................... 19.79 THIS CERTIFIES that the building ................................................ Location of Property .. 55.~,185 .... Connty. Road .... 27 ................ Gre.ealpor.~ .... House No. Street Hamlet County Tax Map No. 1000 Section ... ~ ...... Block ... 'l ........... Lot ....... 8 ......... Subdivision ............................... Filed Map No; ........ Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated November 21 19 78 10031.Z ......... ..................... , ... pursuant to which Building Permit No ............ dated . .N.o.~..e.m..b.e.r.....2.1 ............ 19..7.8, 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 ......... Private One Family Dwelling Bertha S. Rockefeller The certificate is issued to ..................... [o~,n'o'r ........................... of the aforesaid building. Suffolk County Department of Health Approval .... .Mgy..2. ,. ~.~7.9 ....... .8.-.~0.-.'1.~.~ ........ Robert A. Villa UNDERWRITERS CERTIFICATE NO... N43.~3.2.~. ...................................... ........... (n'd, idt'o' ............. Rev 4/79 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 10031 Z Permission is hereby granted to: pursuant to application dated ...................................... .,~.~...~-......., ]9...?.~,.and approved by the Building Inspector. Pee I VPO - ¥'/-I- Building Inspector FOItM NO. 6 TOWN OF SOUTHOLD Building Delm~tment Town Clerk~ Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions 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: 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 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. 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 Dote .......... ~...Z..~. ~.Z~...~. ........... New Building ...... ..x. ........... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ~5.,~.],8.5...~.QllQI=.y...I{.dA...2.7..-.G.~r~D. Qr.~ .............................................................. ~ - Bertha S. Rockefeller Owner Or Owners Of ~roper~y ....................................................................................................................... Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No .....1.O031...ZDate Of Permit ..1-1,,/.2]L/.~.gApplicant ..Gl~y~l~.e...Co~ta:~l::Uctiolo,..C~rp. ..... Health Dept. Approval . .5. ../. .?. ./. 7. .~ ............................ Labor Dept. Approval ................................................ Underwriters Approval ....~.../.~.~5./.7...c). .......................... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ...... ,'?'~,,,,~./~.,.~,~ ............ Construction on above described building and permit meets all .apiplicoble co~es and regulations. gwynne Co~struCtio~ Corp. App,,cant ........ .. ................. Sworn to,before me this Everett J. ~hs~,Vice President ....... ~.~... day of ...(%~%...m~...~ ......... [.~.~..~..~.. ....... . ..(~tamp or seal).. NOTARY PUBLIC, State of New York No. 52-452765B, Suffolk County Term Expires ~¢h TOV~ OF SOUTHOLD Building Inspector's Office Town Clerk Building Southold, N, Y. 765-2660 TO~N OF ~OUTHOLD OFFICE: OF BUILDING INGPECTOR TOWN OLE:RK'E~ OFFIOE !BOUTHOLD, N. Y. 11c-:J'71 TEL. 765-266D TOWN OF SOUTHOLD Building Inspector's Office Town Clerk Building Southold, N.Y. 765-2660 JAMES Z, SCHWARTZ BUILDER CIRCA DESIGNS CUSTOM HOMES 163 A Montauk Hwy, W, Hampton Bays, N,Y. 11946 728-9221 P.o. Box 765 6355 Main Road Mattituck, N.Y. 11952 298~{407 EVERETTJ. FUCHS BUILDER December 7, 1978 Southold Building Department Main Road Southold, N.Y. 11971 ATT:G. Fisher, Dear George~ Please find enclosed survey for our Job located on North Road, Greenport. Building Dept. #10031 Z EJF/rs encl. VeT Everett J. Fuchs Vice President FOII~[ NO, 1 TOWN OF $OUTHOLD BUILDING DEPARTk~,ENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. Exam,ned ............... .................. L. ...................... = ............. Disapproved o/c ......................... ~......~ ....................................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ...i~o. we~b~r ......................... , 19....7..~. .... INSTRUCTIONS o. 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 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 commepced 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 oil applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. Gwynne Construction Corp. (Signature of applicant, or name, if a corporation) 1.6.3 A..Man.t~ftw~k .. i~. ,.., .[~ f~..t..o...n.., iB..a.y..s.., ........................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Builder Name of owner of prem see ..~.e...r..t...h..a.....S..t...~.,o..c.k.e..f...e..1...1..e...r ................................................................................................ If aj;zp~icant,is a corporate,,~ignature of duly 9Nthorized officer. . .... Evere t[Najr~,e ~[~¢lf ~i~8 ~ Builder's [~cemse No ..................................................... Plumber's License No ...... .7.ZP.~ ............................... 710-E Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Mop No.: ........................................ Lot No ......................... Street and Number North Rd., Greenport Municipality State existing use and occupancy of premises and Jn~ended use and occupancy of proposedconstructJon: b. intended use and occupancy ._.O~...~.....E. fl.m..$~.....d..~..e..~.'.z..~.~ ................................................................................ 3. Nature of work (check which applicable): New Building.......,~ ......... Addition .................. Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) 4. Estimated Cost ......... _. .. ...:.. ~.O..O..?. .............................. Fee (to be paid on filing this application) 5. If dwelling, number of dweliing 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 ..../...~.n..~-: ...... Height ........................ Number of Stories .... .[ ........ ~-~.¢.~.~. ....... ),~..q.~'/,~. ............................................................... Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ../~.9.: ............................ Rear ..... 4,9!. ................ Depth ..&7.;. ............... Height .................... Number of Stories 9. Size of lot: Front 75' Rear 101.24 ..... Depth273 & 340 . 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: ,r{,.,o. ................................................... 13. Will lot be regraded . ........................... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ~_,e,,r_,t,,h,,,a,_,~,:,...R.,°-.c.~e.,.f..e..].~.l...e..r... Address .5.0.,.0...-B..1..a-..u...v...e-l...t...l~one No ....................... Name of Architect ..];2,.]~Zi.C,k~.QD, ................................... Address ~,~k4Q;r.~,~,tl.~ ....... Phone No. ~.~..-.~..(~.O..7.... ? - Name of Contractor .G.~t~'ztr~e,...QQDa~,......CQ:r.p., .............. Address }[~D,p.t;.Ql~..~.~,y..~... Phone No. _.2,~...~.2~;~.. PLOT DIAGRAM LocQte clearly and distinctly ail buildings, whether existing or proposed, and indicate all set-back dimensions frorn property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW~Y~gI(~, I c ¢ COUNTY OF ...b...~.~..~..o...i. t5 ............. ~"-~ .................. .E~t;~..J.....~.~l.g~l$ ........................................ ~eing duly sworn, deposes and says that he is the applicam (Name of individual signing contract) above named. He is the ............. .~.~..2~.~.~.¢.~. ................................................................................................................................. (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~ the work will be performed in the manner set foffh in the applic6tion filed therewith. Sworn to before me this ~ ..... ~.G~ue Construction Corp. .......... ~..~ ........ day of .................... , 19...L~. ~~ ~z~ ~~ ~ /1 ~ -- c, ........ co, .......... ............. ~ ~ ~ ~/ . ~ (Si~ature of applicant) ~~~:~~," Everett J. Fuchs,Vice Pres. _r l I ,,4 'CLIVE E. REED P.E,. ~ L~EN SED PROFES,SiONAL ~PA TE;HOG, UE, ## 'o .! I -t . 0 'i ~b r T-i