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HomeMy WebLinkAbout10061-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No... 9.6A? ......... Date ...... .A. LlgUS~..6 ................ ,19.7.9 THIS CERTIFIES that the building ................................................ Location of PropertyHouseSq' O. No.'H°ld'en. A.v.e,. &. 280. Dicks.$tr~tEt .. P~ ......... Cute ho/~f~meie County Tax Map No. 1000 Section .'] .q 0.. ....... Block . .5 ............ Lot ,l~ar/; .of. lot. Subdivision...XX. ......................... Filed Map No. -Y ...... Lot No.. ~ .......... conforms substantially to the Application for Building Permit heretofore fried in this office dated ·.. December./, ..... ,19Z.@. pursuant to which Building Permit No....qOO61Z ............ dated ... Ilecemhel~. 6 ............. 19.7.~, 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 ......... ...... 9r.i.uate. one..family..dweLq.iRg .......................................... The certificate is issued to ................. F~..~O ~.,~ .l~ols.a .l-loin. es,..T22C. ............. (owner, of the aforesaid building. Suffolk County Department of Health Approval ~.-.50 .--6.~ ~. ~-1~,. ~,..~979.,..Roke3~t. k...Villa UNDERWRITERS CERTIFICATE NO ........ ,tgi2'] 0~. .................................. Building Inspector Rev 4/7~ 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) No. 10061 Z / Permission is hereby granted to: ./~ __ ~- ~ // .......................................................... at~ ; ............................................................................. ~ ~ ~ .......... ~ .... at premises located ........ ~~.~.~~...~-.~ .............. .............. ................ Building Inspector. Fee ,.~./...~.~.. ~uildJng Inspector THE NEW YORK BOARD OF FIRE UNDERWRITERS DNI BUREAU OF ELECTRICITY ~- 85 JOHN STREET, NEW YORK, NEW YORK 10038 ..,e July 19, ~9 A..,,c.,,o. No.o./,,e 0nS3? N 442103 THIS CERTIFIES THAT Cu~chogue, in the following l~ation; ~ B~nt ~ 1st FI. ~ 2nd FL 8~tlo. Bilk ~.~.~o. July 16, 1979 and found to b~ in compliance wlth the requlrements of this B~rd. RXTURE [ E~A ~ ~ [ FIXTURES [ RANGES [C~KINGD~KS[ OV~S [DISH WASHERS ExHAusT FANS OUT.TS ~ C SJ SWTCHES IiNCAN~SCENT FL~ESCENT ~ ~T. K.W. ~T. K.W. ~T. K.W. ~T. K.W. ~T. H.P. DRYERS ~ FURNACE ~TORS ~ ~TUREA~A~E~EDERS m~latR~' TIMECL~KS ~ BE~ IUNITHEATERS MULTI~UT~T DIMMERS 2 F 1 3 8 ETHER APPARATUS: Motor/$: 1-F 1-G.F,I. 1-Smoke Detec$or 350 Lake Ave, . Nesconset, N.Y. 11767 Lic.307 E ~ ~ .'il COPY FOR BUILDING .~M~. THIS COPY OF CERTIFI~T' ~" NOT "~ IN ~ ~N~ 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 survey of peoperty 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: 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 ~ _. , Dale- '.~'~''~''''~'~''''~''' New Building . .' .~.. ....... Old or Pre-ex~st~ng Budding .... .~ ...... ~'ant Land ......... ~,... ~ ~ ,. f ,. Co. .... 2 .... .............. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. /..~..~..~./~ Date of Permit .......... Applicant .................................. Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... --, H/;,~ Request for Temporary Certificate ..................... Final Certificate ...../-~......'. .......... Fee Submitted $ ............................. Construction on above described building anq~ermit meet~ oil applic~le~cpdes and regulations. Rev. 10-10-78 TOWN OF SOUTttOLD Building Inspector's Office Town Clerk Building Southotd, N.Y. 765-2660 ,,~ .//-~.~r.-~/~'r.Z~ ~ ate ................................................ , ~ y ............ o ' ~e completely filled in by typewriter Inspector, with 3 sets of plans, accurate plot plan to ~ale. Fee accor~g~ ~hed~le. b. Plot plan showing location of lot and of buildings on premi~es,~h~oi~~streets o~ areas, and giving a detail~ description of layout otproper~ must be c. The work covered by this application may not be commenced~ance 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. Ho building shall be occupied or used in whole or in part for any purpose whatever until a Ca,if(cate of ~cupancy shall hove 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 in buildings for necessary inspections. FINANCES RO~E HO~S, I~C. (Signature of applicant, or name, if a corporation) Ben ~Iendozza, *Pres. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buiJder. Builder Nome of owner of premises ..?,.~.,.?.~.,?..e,,?,...,~,,o,~,.e....}.~,.o,,,~,.e.,~.!....~,.~,?,..t ........................................................................................ If applicant is a corporate, signature of duly authorized officer. Ben ~e~eo[~C~Jtl~zg~Sfi~e officer) Builder's License No ..................................................... Plumber's License No ....... ~,.~.~.,~, .............................. Electrician's License No ............................................. '~ O Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ................................ ./...... Lot No ......................... Street and Number S,W,Corner Holden Ave. & Diok.s. Point Rd., Cutcho~..e, N.Y. ................................... ................................. ............................................... ~ ¢ ~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ............. ~-/~.,~J,/~.'~.., ......................................................................................... b Intended use and occupancy ................ .1...-.?...~..m...:1...1.~.....g.?...e..1...1.~..~.~. ...................................................................... 3. Nature of'work (check which applicable): New Building~....Y. 9 .... Addition ................. ~ Alteration ................ Repair .................. Removal .................. Demolitior ..................... Other Work .................................................... ¢ $o/ c.x~ (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars '1 ...................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimeqsions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8.Dimensions of entire new construction: Front .......... .~......~,.~..~ ........... Rear ........ ~....~...~...'.... Depth ...~ ................ Height i~...1...8. ............ Number of Stories i .................... 11. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........ !~..O. ........................................... 13. Will lot be reflraded ....Y. 9..S. ................. Will excess fill be removed fjrom~ore~ises~(~), V~s (~) No - ~'ran~es Rose Homes,Inc. ~O0.9)ran~ ~.v~. 14. Name of Owner of premises ]B. er&,~/~.eT~l,f~.al~.,...R~'~a~ ...... AddresstX..,~..$~Q~'.~l~.l.~.. Phone No Name of Architect .............................................................. Address2.9.8-5288 PLOT DIAGRAM '~' ~ J'~ Locate clearly and distinctly afl 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 or corner lot. STATE OF NEW~YORK~ / c c COUNTY OF ..~.~.f~f.O..~k .............f¢'¢ B.~..r..~...~.]..e..n..d-..~..z...z..~.:.?.r..e..s...*~.~...~.F...r.~.~..~q~.~..`~.~.~ duly sworn, deposes and says that he is the applicam (Name of individual signing contracf) above named. Builder - Corporate Officer 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 afl statements contained in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set foRh in the appllcgtion filed therewith. Sworn to before me this : FRANCES ROSE HO~ES, INC. ....... ~,t~, ....... day of ..~X~=~.,t,.Z.~..x: .......... , 19..q.~:~ ,-" ~, , t,:, No a r ................................. Co? ......................... ~'~ '/ ~,, / ~ /I ~ . .~ x~'/ Den ~le~Gozza, ~'~ : '-~'/' ~"~' E~t ~/'ANN N~'"E[[ ~-'"' ~- ' "" ' '"'~ NOTAR~ p~B u No ~2.~125850, Sutio~k County / FOR APPROVAL OF COH~U~ONlY ~ ' " ' ~'~,.., _. ....... ~ .~:~ c..--~ ~. -. ' ~: i.~ ~,: ~.~ ,~ ii" . A~: / ~ENT OF I NT'~NT SUPPLY A~ ~EWAG~ iY~MS FOR THIS R~I. pL-