The URL can be used to link to this page

Home My WebLink About9783-zFO~ NO. & TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No...Z9~ .... Date .. September .... 1 .~ ........., lg. 78 THIS CERTIFIES that the building located at 65.5 .Brawl .Ave ............. Street Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .. ,Tune...1.5 .......... , 19.78. pursuant to which Building Permit No .... 978SZ dated .. June...1.5 ........... , 1978.., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ....... Deck .addition ................................................. The certificate is issued to .... Joseph..Frank .7..imnoski. ~.~. ............. : ........ of the aforesaid building. Suffolk County Department of Health Approval ............. 'N/R ................... UNDERWRITERS CERTIFICATE No ....................... N./~. .................. HOUSE NUMBER .. 655 ........ Street ........ Brey. Ave ........................ .............................................. Laul, e~]..,..New- .Y. ork ............... Building Inspector FOEM NO. Z TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CL£RK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 9783 Z Date ........ June......'15 ............................. , 19...~7.~. Permission is hereby granted to: ........... ~Toz e~...F.r.e~k..Z.i~e~ki..III ........ to ..... add...'co., a.. ~,~£vat e...One.. E~mlly... ]::~e]3. tog ................................................................ at premises Iocoted at .............. 6.5.5***]~z.~3r***./~.e ................................................................................. .................................................. Laur. el.,... ~ew...Y. ork ........................................................................ pursuant to application dated ....... ~U,-~.......1..~. ............................. , 19...~..~.., and approved by the Building Inspector. Fee $'"'1'D;'O0 ......... ................... "'~'~'... ~'~" Z .... Building Inspector 1000-126-2-5 TOWN OF $OUTHOLD , 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 DUPLICATE to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of oil buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage dispasol--(5-9 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), Nomconforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey.of 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 ~,......~,j~.. J ..~, .~..8 New Building ................ Addition ....,~. ......... Old or Pre;existing [~uilding ................ Vacant Land .............. Location Of Property ...~b,.~.(~f~..,....~.~/...,..l~.~:.e.,j~.~..~..~,~.~.x,~).._ 1.~°1 -/1 4,J~ ' -- subdivision ................................................................ Lo, No ...... .rT.B, o ........ Permit No. ,.~,,,2.,~.,~.. Date Of Per__mit ...,~//,..~'lT~Applicant .~.~J~ ................. Health Dept. Approval ............................................ Lobar Dept. Approval ................................................ Underwriters Approval ................. ~ ........................ Plonning Board Approval .......... ~ ............................. Request For Temporory Certificate ................... u,...T. ............... Fined Certificate ......... ~ ....................... Fee Submitted $ .,..~.:.~..~ ...................... Construction on above described buildirt~F~and permit me,ets all, applicable codes~,,c~d-fq~ulations. Applicant ...;.~...~.; ................................ Sworn to before me this ................ day of ............................................ (stamp or seal) Notary Public .................................... County Co Z ~o~'~ .ELEV~'r/oN$ A'R6 ~'F~iRENC~~D 70 AN A$,C,U,~C.D,pATU'M NO WI, TER SUCVEY .FO~ ' .JOSE~HtF~ ~ ~ BARBARA ZIMNOSKi AT MATTITUCK ' ' ' TOWN OF.SOUTHOLD CU.'h~L~,*,'~S~.¢ 70. SCATS ;' JUNE 5~t97t ~' Examined .........~]~tte ....... '~f~ .......... Approved .........~Lli3,~ ........ Jl.~ ......... , TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~UTHOLD, N. Y. 19...r~8 19.?~.. Permit No ......... ~.1~,?~ ............... Application No ............ ¢~.~.~. ]. ........... Disapproved a/c ............................................................................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................................................. INSTRUCTIONS a. This application must be completely filled in by typewriter o~ 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 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 o Building Permit to the applicant. Such permitG'/ 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 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~J,., 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, os 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. ....... ~'j'~ ~'7~ ~'~'~ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or .................. .,., ............ ........................................................................................................................... Name of o~ro premises ........... ~ ............... .~. ............... L If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer)~ Builder's License No.~.~/ ...... /~.Z.....~./~~ ~ Plumber's License No ........... ~ ..................................... Electrician's License No ...... T ...................................... ,~ /~- Other Zrade's License No ....... ~ ...................................... 1. Location of land on which proposed work will be ~one. ~ap No.: ......... Street and Number~.~.~.~.~.....~/..~.~....~.~.~..~ ........................................ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................................................................................................................ b. Intended use and occupancy ...... ~ ~...~..~C~. ~...~ .................................................... 3. Nature of work (check which applicable): New Building. ................. Addition ..?¢',. .............. Alter~tioA .~ .............. Repair .................. RemoYal .................. Demolitiar, .................... Other Work ................................................... ,~ (Description) 4. Estimated Cost """""""""'~'~)(~ Fee /5 (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number o~ cars ............................................................................................................................................ 6. ~f business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any' Front ~.~.~...~. ........... Rear .~..~'~., .~ Depth .~...~..~ ........... Height ..~.~...~.. .............Number of Stories ..I ............................................. L/¢ r>~'"':~ .......................................... ,; .................. Dimensions of same structure with olterations or additions: Front _'T(..~......~[. ..................... Rear ...~..~......~. ............. Depth ..~....'~'......,'~. .................. Height ...~.~ ................... · ,, ,-~Number of Stories ..... ] .......................... 8. Dimensions of entire new construction: Front ..L~...~.....~' ................... Rear .../.~..,~....~ .......... Depth .../...~...'" ............ Height~.¢~ ................. Number of Stories 9. Size of lot: Front ..~..C~......~.....~. .......................................Rent' ? .~..~ ...~..: ......... De,pth ~ .~.../...~. ................ Date of Purchose ........................................ Nome ............. 1 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ....J~....O... .............................................. I3. Will lot be regraded .....~...?. ................. Will excess fill be removed from pre.raises: ( ) Yes (,~') No 14, Name of Owner of premise~.~.~.¢..~.)h..[~....~.).~.~...'..C~.!.~.'~. ........ Addre,sm~,~,~,.~,,,, ........... Phone No..~i....~.:..~../..~.....~ Narne of Architect ............................................................. Address ................................Phone No ....................... Nome of Contractor ............................................................ Address ................................Phone No ....................... PLOT DIAGRAM Loc(:te 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 OF EOUN-rv ................. ~._~~~.~.being duly sworn, deposes and says that he is the applicant ~me ~ i~dual signiB~contracf) above named. He is the ............................ ~.~~..~.2~--:- .................................................................................. (Contractor, agent, corporate officer, otc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; thal ali statements contained in this application are true to the best of his knowledge and belief; and that the work will be perfor~d in the manner set forth in the application filed therewith. Sworn~ before me th~ ,/ .. ......... ¢ .......... ~o, 52-970~725 Suffolk Counl~ ~mm. Expir~ ~arch 30. I~ '