HomeMy WebLinkAbout10077-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N.Y.
Certificate Of Occupancy
No...Z.9.5..6.5 .......... Date .............. June. 1.4., .......... 19.79
THIS CERTIFIES that the building ................................................
Location of Property .5.7.47.5..COlznty. Ko. ad. 2.7., .................. Greenpor.t: ........
House No. Street Hamlet
County Tax Map No. 1000 Section ...... .4.4....Block .... ~ .......... Lot ..... 5 ...........
Subdivision ........ XXX ................... Filed Map No. XXX .... Lot No .... .~;XX ......
conforms substantially to the Application for Building Permit heretofore Fried in this office dated
·.. l;).o.c, erabcr ~19., .... , 19 7~. pursuant to which Building Permit No...10 0.7.7. g ............
dated ........... .D.o.a.o..m.b.~.r....1.9.,... 19 7 9., 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 .........
........... .P. I3IV&~.~. 0N~ .I?/L~IXL¥. D.~ELLING ....................................
The certificate is issued to .. t[anst.w, dolf..Kaes.ar ....................................
(owner,
of the aforesaid building.
Suffolk County Department of Health Approval ....... kl/A ...............................
UNDERWRITERS CERTIFICATE NO ............... [,l//x ...............................
Rev 4/79
Building Inspector
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 PI~EMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
No. 10077 Z
,o ...~~.... ,~ .~Zz....~~....~.....~(/~. ~ ........
at premise~located ot ~.-..~/~..~.....) ........ ~~~.,..~ .....
Building Inspector.
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 occupancv on pre-existing dwelling or lend use
3. Copy of certificate of occupancy $1.00
$5.O0
Date .~.~. ~, ~. ,I. ~ .... J.~ 7. ,~..
New Building ............. Old or Pre-existing Building .... ~¢'.. ..... Vacant Lend ...... ;~. .....
Locetion of Property~.~ '?::'..~..~'. · · ~'~.~-.-~(~-=~.~-~..--~7. ..... -~¢~ .~, ~ .~, ¢"~'~, ." .......
House No. ~ ~(x~ ?~ Street Hamlet
Owner or Owners of Property ,~'.~/¢~.~.~,~.;: .~. ?,. ,~.~?,?:~-~.~.~/ · .'/-~..~.-~?..-~.-.~, ................
County Tax Map No. 1000 Section .. ~ ?. .... Bloc~ ...... ~ .................... ;
Subdivision ~ ' , p N ..............
................................ Ma o .... -;-:-~-,-. ...... Lot No.
Permit No.~' .o. ~. ,?. 7, .'Z-Date of Permit ,~.~. ~.~.~:).~.App{icant ./~,~L~., .-~.., .~.¢..~.,~,~ .,- .~,-~r, .~ ~..-~.-~ ,
Heelth Dept. Approval /~/'~' .Labor Dept. Approval ~' ~
Underwriters Approval ........ (b./..~. ........... 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 ~': .~..~.~.~~-~.~.'~....'=77~.. ................
Disapproved a/c ............... ,~-:z:.....; ............... .~ ....................................
...... '(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ........ ~..../.:: ................. ,":~..
INSTRUCTIONS
a. This application must be completely filled in by typewriter oe in ink and submitted in triplicate to the Building
Inspector, with 3 sets o~ plans, accur~e p ~t plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on prem,ses~ relationship to adjoining premises or public str.'eets 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 Building Permit. .
d. Upon approval of this apl~licotion, the Building Inspector will issue a Building Permit to the applicant. Such perrnlt
shall be kept an the premises available for inspection throughout the work.
e. No building shall be occupied ar used in whale or in part far any purpose whatever until a Certiflca~e of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Deportment 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 construct on of buildings, additions or a.teratlans, ar for removal or demolition, as herein described.
The applicant agrees to comply wlth ali appilcable 1owe, ordinances~ bui ding code, housing code, and regulations, and to
admit authorized inspectors an premises and in buildings for necessary inspections.
State whether ap. plicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
,&.,m/.~.,. ........................................................................................................................................
hame of awner af premises ....... .~..~(~:k.~d~2.~ ........ .~...~3Ze.~. ................................................................ i .............
.........,f ~ ~, ~ ~;~. ~ ~.~,~ :~o,~ed of~;,~.~~ ~... ~ ......
(Name and title of
,.~,~,~ ~;,~ No .................... .~;~-~...~...
Plumber's License No .................................................
Electrician's License No ....... ~ .......................
Other Trade's License No ...............................................
1.
Location of land on which proposed work will be done. Mcp No.: ........................................ Lot No .........................
~d~ .~.,4 ... ~,4.P,.,...~ ~,,,~ .......................................... Munlcipal~
~ ~ ~, .. ~- -~ ~3 .........................
State existing use and occupancy of premises and in~ended ~e~ occup~ncyRf proposed const~ction:
~. ~,~,,,~ .~ ~., ~~.~...~..~.~.~...~2~:.~f ............................
' ~ /' ¥~ ' - / . /
,. ,.,~.~ed.~.~.~o~¢.~o~, ......... p~..:.,'.;.~~ .....................................................................
/
· 3.. 1'4¢ure of work (check which applicable): Nevi Building .................. Addition ..];;;~,,J~.. Alter0t[0rl ................
Repair .................. Removal ...... : ........... Demolition .................... Other %~/o rk ............... : ................................ . ....
(Description)
........... .................... : .............. ....... ............................................................
~ (to be paid on filing this application}
5. I¢ dwelling, number'o¢ dwelling units ............................Number o¢ dwelling units on each floor ...........................
If garage, number of c~rs ..........................................................................................................................................
6. ]f business, commercial or mlxM occupancy, specify natdre and extent of ea=h type o¢ use ...........................
7. Dimensions o¢ existing structures, if any: Front ............................ Rear ................................ Depth
Height ........................ Number of Stories .....................................................................
Dimensions of same structure with alterations or add;dons: Front .................................... Rear ...........................
Depth ................................ Height ............................ Number of S~ories ................................
8. Dimensi=ns of endre new construction: Front ................................... Reef ............................ D~th ......................
Hel;~t ...: ................ Number o¢ Stories ......................................................................
9. 51ze ¢f Io~: Front ........... 7~'~ ...................................... Rear ........... ~¢¢9 ............... Depth .~ ...............
10. D~te o¢ Purchase ........................................................ Ngm¢ o~ Fo~ner .......................................................
11. Zone or use district in which premises are situated ....,,?~:~¢~;,~Z~ ...............................................................
12. Dces proposed construction violate any zoning low, ordinor~ce or regulation: ~r.<'
13. Wifl lot be regroded ............................ Will excess fill be removed from premises: ( ) yes { ) No . ·
14. Name o~ ~ner of premises ...~.~...~¢~.,.. Address ¢..¢.M*x'~.~..~¢~none ~o .....................
Name of Architect ...................... ~ ....................................... Address ................................ Phone No
N~me of Contractor~~.~.~o~...~....t.~... Address ~.~¢~"~0~'~--~, Phon~ No.
PLOT DIAG~M ¢~'¢~' ~
Locate cleaHy and distinctly all buildings, whether existing or proposed, and indicate oil set~ck dimensions fror
¢rope~y lines. Give street and block number or description ~ccording to de~, and show street names and indlcot
whether interior or corner lot.
STATE: OF N~cW~)RK! /2 1/~
....... iT~~~;;[;;..~;~;r~.~.). ................ be,ag duly sworn, deposes ,nd soys that he is the
cbove/nQmed.
,, ......................
,",e i~ t~e ("" rector, agent, ccrporete office,, .tc.)
of said owr. er or owners, and is duly authorized to ~erfo~m or have performed the said work and to ~ke and
in
~-~-~:cahon'~p,,, t~is applicztion are true to the best of his knowledge and belieF; a
. , ¢ ~ ~ ~~ ......... : ............................
,CNATION
lOOn
844. oo
02,00
!005 o 00(
IN PILF.~ENC~ OF:
IND made the , nineteen hundred and seven~y-elgh$
RE'iWEF~ HELEN POOLE, residing at 549 west 123 Street,
New York, N. Y. 10027 '-
.~ ~x~0xxaztx executrix of
IJosephine L. Merolla
68 Floral Boulevard, Floral Park, New York
wh°.,~o~d~en~e 9th. dayof july . .ninetee~hundredand
par~ st part, ~no
HANSRUDOLF KAESER and MARGRIT KAESEi{, his wife,
side Drive, New York, N.Y. 10025
Seventy-six
residing at 380 River-
/
pared of me second part,
'WFI'NF..SSETH, that the party of me first pa~, to whom left.s
testamenm~ were issued by me Surro~te's Coup, Nassau Count0 ~ew York
on Dec ember 14, 1976 ~d by vinue of the ~wer ~d authoH~ ~ven in ~d ~ said Mast ~11
~d testam~ ~d/or by A~cle 11 of the Estates, Powers ~d T~sts Law, ~d ~ consideration of
Seventy-five Thousand Five Hundred
. do,ar%
($75~ 500~ ' " p~d by the party of the s~o?d ~, does h~re~Krant ~d
rel~se unto t~e pa~y of ~e second part, ~e thstr~ut~s or successors and asst~s of ~e party o[~e
ALL that cerS~n ploh p~e Or' ~cd of ~nd, wlm me bdl~s and ~provem~ ~mn er~td, sltuat~
~n~d~i~eat or near Arshamoque in the Town of Southold~ County of
Suffolk, State of New York, bounded and described as follows:
BEGINNING' at a point on the northerly side of Middle Roa~ (North
Road) where the same is intersected by. the. westerly, line of land
of Remy; said point of beginning being distant ~01.08 feet
westerly as measured along the northerly side b~Mfddle-Road
~from land £ormerly of A. M. Tasker; running thence westerly ~ong
the northerly side of Middle Road south, 70 degrees ~5 minutes
west, lO0.18 feet to land of Frech; thence north 16 degrees O0
minutes 30 seconds west along land of Frech, ~15 feet %o the
ordinary mean high water mark o£ Long Island Sou~d; thence along
the said ordinary mean high water mark of Long. ISland Sound on a
tie line south 72 degrees lO minutes 10 seconds eas~, 120.39 fee~
to iand of Remy; thence south 16 degrees 00 minutes 30 seconds
east along land of Remy 342 feet to northerly side of Middle Road
at the point or place of the BEGINNING,
being the same premises conveyed to Bernard Merolla and Josephine
Merolla, his wife, by deed recorded on November 26, 1952 in the
office of the Clerk of SuffolE County at Liber ~42, page
TO,GETH.ER .Mm ~ MS. hi, ~tle. and ~terest, .if any, of me pared of me first rt in attd
roa,~s,a~u~n.g, the above aescrmen prermses to the center lines thereof. TOGE~Hr~v -:.,- -~ any streets and
ann mso an the estate wtdch me said decedent had at the t;m~ -t .~--~ ~, . *~.-%~- -~p,~ me appurtenance,
the, estate therein, w$ich the party of the first nart~ g~-h~s"~o,.S,e~e~ea-e-n-t s o, eath,}n sma ]>remises,
uahy, or by virtue ofsald wil~ or otherwhe; ~6 HAVE AN~ ~g[~.e~ or a~s~.se o,, whebher m~d-
thc ~' ' ' ~ me prermses herein granted unto
pa ed of me second part, the dlstn'butees or successors and ass{ins of me party ,of the second part~ forever,
-&ND the patter, of the first part cov~ants that ~e party of the first part has not done
~e.reby the sa~d premises have been incumbered la any wa~, ~,~.t* .... . · or suffered anything
ibject to the trust fund provisions of section thlrteen-~f ~h-g I"~,'~'~;~'J except as axoresa~d.
e word pared shall be construed as d it read 'parties" whenever the s
IN WITNE. SS Vv2-1F. REOP, ttie part/of me first part has duly executed this deed the day and rem- first alcove
~elen Poole ~Executrix
under the Last Will and
Testament of Josephine L,
Merot!e., deceased
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