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Home My WebLink About9609-zFO~ NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certi icnte Occupnncy No .... Z' 9'101' ' Date ...... July. 10 .............. , 19...7.8 THIS CERTIFIES that the building located at 25.00. Sound. D~..~,v..e ......... Street Map No ............. Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated ... Janua~r' ' 5 ...... , 19.. 78 pursuant to which Building Permit No. ...... 96g~Z.. dated ... 'Janu~r~r' ' G ....... , 19.. 7.8 was issued, and conforms to all of the require- ments of the applicable provisions af the law. The occupancy for which this certificate is issued is ...... PI~IYA~E .0N~ ~FAM-ILY .DWELLING .................................. The certificate is issued to ..... Geoz~ge. Pav].~.¢in ................................. (owner, ~ of the aforesaid building. Suffolk County Department of Health Approval ....... ?..~80,-.1.85 ................... UNDERWRITERS CERTIFICATE No ....... Pen4~.l%g ............................. HOUSE NUMBER ....2500 ...... Street ........ Sound .D~'~..v,e. ..................... .............................................. Gr.e. enpo~. ,..N...Y... ....... BUILDiHG'~ PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 9609 Z Permission is hereby granted to: ,~'Z'~,; /~//z/:' ....... pursuant tO application dated ',.JJ'~/V 5' .~,...~... ........................................................ , 19 , and opproved by the Building Inspector. Fee $ ........................ TOWN OF $OUTHOLD ~ Building Depmtment 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 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 end "pre-existing" land uses: 1. Accurate survey.of property showing all property llnes~ streets, buildings and unusual naturot 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 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 New Building ....~ ......... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. ,~ - 2500 ,..ound Dr~ve, Greenpor~ Location Of Property ..................................................................................................................................... Owner Or Owners Of Property ...~.e..~.~.e....~...~..~.[~.g..~.~ ................................................................................ ....... Lot ...... No ............. House Permit No..~.~ ......... Date Of Permit~/~.~7.~ ....... Applicant George Ah/e~s, ~a~Z~e~, ~c. Health Dept. Approval ...... ~/.~. ..................... ~r ~pt. Approval ................................................ Underwriters Approval .............................................. Planning Board Appro~/al ........................................ Request For Temporary Certificate ........................................ FinoJ Certificate .......................................... Fee Submitted $ .................................... Construction on above described building and permit meets all applicable codes and regulations. Sworn to before me this Applicant ........ P~~.~~ ~~.,..~~ ................ day of ............................................ (stamp or seal) Notary Public .................................... County THE NEW YORK BOARD OF FIRE UNDERWRITERS I $ BUREAU OF ELECTRICITY ~ 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CERTIFIES THAT or~y tAe e~e~tr~ eq.~tt ~ ~r~ ~e~te ~ i~tt~ ~y t~e ~p~l~tt ~t~r~N~ O~ I~te ~oo~e ~t~o~ ~t~m~r ~n t~e prem~es Of Pavllcln,Sound Dr.(Eastern Shores~,GreenportR L, I. in the followlng location; [] Basement ~< ;st Fl. [] 2nd FI. OU '~$ ] d e Section B~ock Lot was exarnlned on July 6, Iq?8 and found to be ln corapliance with the requirentents of th~s Board. 28 Iq 24 24 DRYERS FURNACE MOTORS I FUTURE AffqJANCE FEEDERE AMT. K.W. O H.P. GAS H.P,I A/~AT. NO. A.W.G. RANOES IC~!~.KSI ~VEN~w* IDISu~TH, WAKe, WE~ I 1.2 TIME ~KS ~ U'T HEAT~ M~ SERVICE DISCONNECT 1 NO. OF I S METER OTHER APPARATUS: R V I C Electric room heaterstS-I.5,2-1.25,3-1.O kw G,Folo 2 Smoke de*actors 4.5 kw hot vat®r heet®~ EXHAUST FANS DIMMERS E 227EBreakwater Rd, LIc,152qE This certificate must not be alte~d in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATi MUST NOT BI ALTERED IN ANY MANNER. Hc (n TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTNOLD, N. Y. Approved .............. ,/~--~ .......... , 1~ ....... ~. ....... ~ .................. Disapproved o/c ..~~~ ............. (¢uildin~ APPLICATION FOR BUILDING PERMIT ....-/] ........ ............. Date ~,~. C~.~. ~ , INSTRUCTIONS o. 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 Jot and of buildings on premises, relationship to adjoining premises or public streets o~ 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 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 pa rt 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 o 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 o~terations, 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. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .,,~...~.~j~j~......~.'¢':~...I~<3~''~¢r''"~'' ................................................................................... If applicant is a corporate, signgture of duly authorized officer. (Name and title of corporate officer) Builder's License No .......... ~../. ................................... Plumber's License No ......... .,~,..?..~-...~?. ...................... Electrician's License No ...... ~...~....Z..~.-. ............... Other Trade's License No ............................................... of land on which proposed work will be done. M,~p~,N,o.: ...Z..D.....Z~.....~. ................... Lot No..../_~,.. _,~.......~..-- 1, Location Street and Number ......... ..~..,~...~..~...,~.~-~:.,..~ ......... ~ .......... ~.?,,~':~.~~'~'"'~' ~ ..... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ......................1~ .......................................... { ............................................................. b. Intended use and occupancy .......... ¢ ~. ........................................................... 3. Nature of work (check which applicable): New 8uil~ihg ..~....... Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) 4, Estimated Cost ,..~'../~..~...~'...~.:.....~..~ ........................ ;Fee .......................................................................................... (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, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. [)imensions of same structure with alterations or additions: Front .................................... Rear .......................... Depth ................................ Height ............................ Number of Stories · tr ....... '~"~ ...... 'ii ......... · 8. i')imensions of entire new construction: Front ....~7'.,~...~ ........ Rear ..~4.~,.....~. ............ Depth ..~...~......~ ...... Height ...../.~. ......... Number of Stories ........ ~ ....................................... .~. .............................................................. 9. Size of lot: Front .... /..~,...~...t.' ....................................... Rear ....... /,.~..~.. ........................ Depth ....~...~.,../.. .............. ]0. 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: ....... ~ ....................................... 13. Will lot be regraded ............................ Will excess iii be removed from p. remses:( ) Yes (~ No ~/////////'~' '~'~' "~'4~//i"~ ~x~' ' ' ' ' Address ~t1¥ Po~,~-L'~,. ~'/~." ~-t~ -."~'~'1" 14. Name of Owner of premises .-~..-~.~.~.~.~..-,,.......~...-~..~.~,,.r..~.../~.~.. h~'~.~:..m/,/'~j', ,~.)] ..... Phone No.~.~..~ ...... ~..~. Name of Architect ..............................................................// Address .......... ; ................. Phone No ....................... Name of Contractor .~T.~/P~, ~...4t./~k"'.~.~... ..................... Address .~.~.;C..C,~.~r~..~..... Phone PLOT DIAGRAM Locate 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 whether interior or corner lat. STATE OF NEWYJDRI<,z ~ ~ '[SS COUNTY OF ' ...................... ~/.~..~..~../~./.~.r~.....x~././..~d.~./...~.~...'~....~.....'~....~.. ........ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .............................................................................................................................................................................. (C~nt ractar;-agent, car of said owner or owners, and is duly authorized to perform or have performed the said work and to make and this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be perfor~e~ in the manner set forth in the application filed therewith. Sworn to/before me this .........day of ................. , Notary Pub 'c, Z~. ..~. ..... HOT,\'~Y PIJBI.1C, Sh~l~ of Now Yor[~ TOW. OF SO.T.O ~H~D, N.Y. ~/~/~- Examin~ .., 19 ........ ~phcot,on No. ,. ........ .~....,... ........... ............... r ...... ..... ~pr~ ~ ,y ........ ,.~,t,o..., ....................... Di~ppr~ a/c ..../~ ..................~....~ ...................................... .................................................................... ....... .............. .......... APPLICATI~ FOR BUILDING PE~IT ~te ...,.,~.,~ ........ ~ .................... , ~9.~...~ INSTRU~IONS a. This application must be completely fill~ in by ~ewriter oe in ink and s~mitt~ in triplicate to the Building~ Insp~tor, with 3 ~ of pl~s, accurate pl~ plan to ~le. Fee ~co~ing to ~h~ule. b. Plot plan showin~ I~otio~ of lot ond of buildings on premises, relationship to adjoining premiss or public st[~ts ar~s, and givi~ a detail~ description of layout ofpr~e~ must be drown on the diagram which is c. ~e work covered bY this a~iication may n~ be comme~ before i~uonce of Building Pe~it. d. Upon approval of this applicati~, the Building Insp~tor will issue a Building Permit to the applicant. Such permit~ shall ~ ~pt on the premis~ ~ailable for in~ti~ ~r~h~t the work. e. No building shall be ~cupi~ or u~d in ~ole or in pa~ for any pu~ose whatever until a ~ificate of ~c~an~ shall have been granted by the Building In~ector. APPLICATION IS HEREBY ~DE to the Building De~ment for the issuance of a Building Pe~it pumu?t to Building Z~e Ordinance of the Town of ~uthold, Suffolk CounW, New York, and other applic~le ~, O~monc~ or R~ulations, for the co~truction of buildings, additi~s or ~terations, or for mm~al or de~liti~, ~e applicant agrees to comply with all a~licable laws, ordina~, building c~, h~si~ c~e, a~ r~ulatl~s, a~ to~ admit authoriz~ inspectom on premises and in buildings for n~es~ i~ti~. .... - - ..=.:..%.. ...... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~/ ~ · . Name of owner of premises ..,~...,.~......~. ........ ,..~,<,.,,~;'--~.~,~.,at.~ .................................................................................. : If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .............../. ................................... Plumber's License No ........... ,.. .................................. Electrician's License No ....... ./..:.~?,.~,¢':..~.-~ .............. Other Trade's License No ............................................... 1. Location of land on which proposed work wi!l be done. Map No.: .......................................Lot No ~.'/..~..~... . Street and Number ............... ~..C..~.. ............ · .................. ~.......,.~. ............................ .~ .............. ~,~..~ ....... N(unlcipality 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 ' ' -.' / .- · Office Gordon Of ~~. K. Ah]ers, P.E. ~, "^Iteration of tills Document I1 I ! excepf by o Licensed