The URL can be used to link to this page

Home My WebLink About9918-zTo]IrN OF $OUTHOLD BUr[.~l~G DEPARTMENT Town Clerk', O~ice $ou~hold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the buildln~ located at..25.~..Bri.clg~. I4~t~ ....... ~ Map No ......51~.2.. Block No ........... Lot No ...........B ..................... conforms substantially to the Application for Building Permit heretofore ~ed in thi~ office dated .... .A.u~....~ .... 2..8 ..... , 19..7.8. pursuant to which Building Pe~nit No ..... 29..18Z ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ........ ~l-~.va'ce. 0ne. F.~.%y. D~.e~,1~ ............................... The certificate is issued to... o,~eyrme .Construction .Carp. ....................... (o~r~, ~ of the aforesaid building. Suffolk County Department of Health Approval ..... .~..~.0.-. ~..0.~. ..................... m~wmuums c~rn~cAr~ ~To ........ .~.~j.q..~..o. ............................ · .......... Building Iaspector Coun't'y Tax Number 1000-85-2-2:~ N? 9918 FO~M N~, ~ BUILDING` DEPARTMi~T ! TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Permission is I'iereby granted t~: (THIS pERM[T' MUST BE KEPT,-O~ ~I~I:E PI~IEM'~SE~ !JNTI~ ~ , ,, COMPLETION .OF THE'WORK ~U,T.,~IORIZED~ ,, ' at premises ,'Building Inspecfor.-..-- ,, Fee ,~ FOltM NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks 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 u~e: L 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-g 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~ 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 $1.00 Date ...],~/....../.~ .......................... New Building .~ ................ Old or Pre-existing Building ............................ Vacant Land ............................ · ocat a. Of Property .................................................................... Owner Or Owners Of Property ~.G.'.~.~.e.~c.~...~..S.~.~.~?.:.C.~.~.J:.~...~.~C..~.~..t../..~..~.~ ......................................... SubdivisionI$~..~.%~'.~...~,~.~.7..~ .......................... Lot No...~ ........ Block No ............. House No ............. Permit No...c~9.~8...Z.... Date Of Permit ...... 8./.2.9./.7,~pplicant .G~n~...Cat~.~.io.a...C~D.~..p., ..... Health Dept. Approval .~.~/...1..~./..7..8. ........................ Labor Dept. Approval ................................................ Underwriters Approval ..... [.I..I..L~..I...~...?.. ................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......................................... Fee Submitted $ ..~,~...-..~P..'/. ................. Construction on above described building and permit meets all applicable codes and regulations. Gwvnne Co~ti~ Co~o. ~.~ Applicant ......... ~'~~...~ ....... .~.,..~..~.;~<7_.,~l ......... Everett J. F~' Vice President Sworn to before me this ................ day of .~.~.[~.~ ........................ (stamp or seal) , Nota~ Public .~.~.~.~ .................. County THE NEW ~ORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRIGI'T~Y * I-- el' 85 ~OHN STREET, NEW YORK, NEW.YORK 10038 · .ms c=~mm=s ~T in the f~ing ~at~; ~ J~nt ~ IsiS. ~ 2~ FL ~t~ J~k ~t ~exami~on ~ove~ev .~ ~7~ ~f~ndtobeincompl~withthe~ui~tsofth~d. ~3 43 ~ot or~: ~t- f~;~o;;e Detector Joy ..~l ..... Service 5~I Stratler Dr. This certificate not mammr~ return to the office of the Board if THIS C OF CIERllFICAll A Lic.712~ FOB, M NO. I // ~//~~,~ .j..~ '~ ' TOWN OF SOUTHOLD ///"'/.~/--.~~~.,-/~'~? BUILDING DEPARTMENT TOWN CLERK'S OFFICE E×am,ned ..... :...:..._/....a.?. .......... .... ~ App',cot,on No. .... ~proved .... ~...a~ .......... , I~.Z..X ~e~m,t No ..... '.~'.~/...~ ..... ...................................... ............ :/ ...... ................ APPLICATION FOP. BUILDING PERMIT" Date ................... ...<~./~.0~.. ............. , INSTRUCTIONS 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 or areas, and giving o detailed description of layout ofproperty must be drown on the diagram which is port 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 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 pa, ri for any purpose whatever until o 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 in buildings for necessary inspections. ........... ~~l...:~...~..l/~ ..................... (Signature of d~plicont, or nome, if a corporation) EVER~ J, [~1JClIS,V:[C]E PIIlt$IDF.~T 't63A' .l~me, aak-..~.lta~p, .~r~:l~py~ ..................... //~aaress OT applicanT) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ...J~l:ie...CO~ll~.~lJc~on,.~l~Jple .................................................................................... If applicant is a corporate, signature of duly authorized officer. ............ ~"~..~....~'....~"..~"~"~ /l. Z> . f~"~. ?- :o-/o: (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ........ ]/.~.0.?.~ ............................. Electrician's License No. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Mop No.: .~8.~.2. ............................ Lot No....~. .................. Street and Number ............. ~E.~.~...][~jB~.~...~ti~i~[~.~.][Mi~A~..~,jff~t~,!? ................................................... Municipality' 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...~Ke,~...~ .................................................................................................. b. Intended use and occupancy ........ o,a~..~.jr, lt.,d~la.l.l.:j, tl~[; .......................................................................... 3. Nature of work (check which applicable): New Building' .....J¢,~ ........ Addition .................. Alteration ................. Repair ..... Removal .................. Demo riot. .................. Other Work ................................................... ............. -~ / ,.~ (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 .............................................................................................. ~ .............................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, Jf any: Front ............................ Rear ................................ Depth .................... ~ei~lht ........................ Number of Stories ............................................................... -,.....-' ......................................... Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new ~onstruction: Front ....... ~JJ..3,~, ................ Rear ...~ ................... Depth ...~,g ................ Height .................... Number of Stories .~ .................................................................................................................. 10. Date of Purchase ..; ..................................................... Name of Former Owner ...... JJ,~llj~Jr~. ................................. 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 ....~.~.~ ................ Will excess fill be removed from premises: ( ) Yes (~4~) No PLOT DIAGRAM Locate clearly and distinctly all 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. sr^-r aP Olk !SS COUNTY OF ................................ ~ ' ~V.~..~..~..~.~..~..n...JL~JJ~l . be ng duly sworn, deposes and soys that he is the opplicam (Name of individual signing contract) above named. V ce Pree deu 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~' the work will be performed Jn the manner set fo~h in the application filed therewith. to before me this (Signature of applicant) FRANK E. JANNRLLA m J, S,Vlce Prel den BUII.DI~R'fl[; ji N0. d : ~ITU~ ~NO. 5- · ,./'"~1"~ ~--"'z~7.~'~'~"- ~ ~.~ ~'--~' _~,-,~'_ ,.... ~: ~ :'h~ ~vm~o disposal and Water supply Ln4pocued by %h~s department ~d foun( . ~ ......... ~ ~ ~ ~ m~'~'~, . ~L~ '~ , 'Cf~? ~N O~ PR~SSIQNAL LAN~ SL ~Y~YORS. ' ' ,f BHRTON a HAND BUILDER'S JOB NO..~:)~ TITLE: NO. ,,::~ .~:.~ ~ ~c ~/7?~TE~ . , z.~:~( ...~ [HE EXISTENCE OF RIGHT OF WAY~ AHD OR/IA~M[NTS~ O~ R[CORD, ,~~ ~ I~ ANY, NOTGuA~NTEED.SHOWN ARE NO1 ~: - ' THIS SURVEY WAS PREPARED IN ACCORDANCE ~ITH THE EX~STING CODE OF ~RACT]CE FOR LAND SURVEYS ADOPTED BY TNE N~ YOR~ STATE ASSO- C~AIlON OF PROFESSIONAL LAND SURVEYORS. UNAUTHORIZED ALTERATION OR AD01TION TO THIS SURVEY IS A VIOLATION OF S~CTI~N 7209 SUBDIVISION 2 OF THE NEW YORK STATE EDUCATION LAW, COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL O8 EMBOSSED $~L SHALL NOT BE CONSIDERED TO BE A VALID TRUE COP~, CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERS~N, FO~ WHOM THE SURVEY IS P~EPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTA~AGENCY AND LENOING INSTITUTIgN LISTED HEREON AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. CErTIFICAtIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSE~UEN~ OWNERS. 5UFFO~K COUNTY TAX MAP DIET.--/~SECT.--~B~.-~ ~o~:~e ~N ~ HAND AVE. BUILDER'S JOB N0. ,.~'~:~)~::~ 'tITLE 5U~O~K COUNTY T~X MA~ DI~T.--/~ ~CT.--~ BLK.--~ LOT--~ ~~ HAND AppRO'V~D AS, NOTED DATE:~ 71 ri -- .FL I