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Home My WebLink About12571-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No, Z~139~0 Date October ~17 ....... ,19 .~.5 THIS CERTIFIES that the building ...... ~o..v..cl?,?$~.5.n.~,: .......................... Location of Property 300 Greenhill Lane Greenport House No. Street Hamlet County Tax Map No. 1000 Section ...... 3..3 .... Block ......... ~ .....Lot ....... q..2 ........ Subdivision Eastern Shores Sec. 5. .... Filed Map No..523~ .~ot No. 'lz~6 conforms substantially to the Application for Building Permit heretofore ~ed in this office dated ...~.u.g.u.~.~...2.6 ........ ,1955. pursuant to which Building Permit No ..... '1..2.57.'1.g. .......... dated .... S. @p~.e.m.~..o.:F../4:. ........... 19 .~.~, 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 ......... I~ew Qne-£~mily. d~elling. The certificate is issued to .............. ~-'~..t3.~.~..I.~. ............................. (owner,~ of the aforesaid building. Suffolk County Department of Health Approval ......... '13-S07-.'[ 3.9 N6763,62 UNDERWRITERS CERTIFICATE NO ................................................ Rev. 1/81 Building Inspector F~'ae' NO, ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 12571 Z Permission is hereby granted to:. ~ ~ ,_~., ~ .~~.....1.2..C~.~.' · o~ ................ ....... at premises located at ............ ~' ~'' ...... ~"'"~'...~'~....... ~.~,f~.-.q<~ ..~¢~.. ~. ,, ....~~ ......................... ;' ............................................................................. .... County Tax Map No. 1000 Section ....,(~,.,,~,.~>, ....... Block ......... ~ ......... Lot No ........ )., .~,,, ......... pursuant ,o application dated .... ~...~:~.....~.......'~....~. ............ '.., 19..~.~ and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall $outhold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions 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 featu res. 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. For existing buildings {prior to April 1957), Non-conforming uses, or b~ildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, oc0upancy 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. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 4.Vacant Land C.O. $5.00 $15.00 Date.../?]..~./.~..~.-~. ........... New Building ............. Old or Pre-existing Building, ............ Vacant Land ............. Location of Property .. 3..~.O ..... ~. ~C- ~../.( .~...L-....'4. f/, ......... ~. .¢. -(,t? /¢. ~./~ House No. Street Ham/et Owner or Owners of Property .... )(~?q./~././~... · f. ~: .7'. / ~za~. :~ .......................... County Tax Map No. 1000 Section ...~)?O.~. ..... Block ....~..' ........ Lot ...... /2 ....... Subdivision ................................. Filed Map No. ........ '..Lot No .............. Permit No.. J..~. Date of Permit .... pphcant . .~. ~ ~. O.f.~... ... Health Dept. Approval ............... .~. ...... Labor Dept. Approval ..................... Underwriters Approval.. ~ ,~..~..~..~...~..'~ ..... 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 ...~'~..~.~....~. ~,~ ~¢5'1 ................... Rev, 10-10-78 ! FIELD INSPECTION FOUNDATION 1st) FOUNDATION 2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY qODE COMMENTS FINAL ,, · 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND/~] INSULATION FRAMING [ ] FINAL REMARKS: FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved....~. ~ .~...~ .... 199.~. Permit NoJ.'.'~.~?..].-~... Disapproved a/c ................... . ................ .~ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received4.... ...... ,19... a. This application must be completely filled in by typewriter or in ink'and submitted 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, :~elationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. · " 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 issued 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 part 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 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 reguhtion_s, and to admit authorized inspectors on premises and in building for necessary~s. (Signature of applicant, or name, if a corporation) .2. .... (Mailing address of applicant) r)/Tt/57/ State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. . ...~.'~.~. ~Sg.~-:c- .... .C .~>.~.~..T.9~.9~._e~q>. ~ ...................................................... Name of owner of premises ...ff.~. ~././~ ..... ~. ~..~.~. ~.~-75. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (N~t.me and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ......................... Other Trade's License No ...................... 1. Loca¢on of land on which proposed work will be d, one ............. ........ : ............................. ......... &.. x4..<-.,?... ..... ,4 ............. House Nmnber Street Hamlet County Tax Map No. 1000 Section ...... cg...:3.'2.) ...... Block ..... ~. ........... Lot ..... /.?:4. .......... Subdivision..~..'~)..~--.~.~.. ~::C. ZJ~. ~d,..~,.. Filed Map No. x..47-..~..3/ ..... Lot...~/...~. ~. ..... (Name) 2. State existing use and occupancy of premises and intended use and ~ccupancy of proposed construction: a. Existing use and occupancy ...... .~..~. Z~Ic~..- ..... t ....... ......... ''' :" ....................... I b. Intended use and occupancy ..... ~)..'TEL4-...g~.O~?cW.r&. 2 . !} ~ 7 . . . . ..! ........................... ~/d 3. Nature of work (check which a~plicable ........ Repair .............. Remgval .... ."~.....~--~.. Demolition 4. Estimated Cost ..... ~. . >.Q ....................... Fee 10. 11. 12. 13. 14. Addition .......... Alteration .......... ............ Other Work ............... (Description) i (to be paid on filing this application) If dwelling, number of dwellingiunits ............... Number of dwelling units on each floor ................ If garage, number of cars ........................ ' ................................................ If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... tteight ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... ;.. Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front . .~.~..?..3 ~ Rear ............... Depth ............... Height ............... Number of Stories ........................................................ Size of lot: Front .......... i ........... Rear ....... ............... Depth ...................... Date of Purchase .......... i .................. Name of Former Owner ............................. Zone or use district in which premises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ............................... Will lot be regraded .....~. ~'fl. ................. Will excess fill be removed from premises: Yes Name of Architect ......... I ................. Address ... ¢~.¢1A~,/~ o2a~. .... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing 'or proposed, and, indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. I STATE OF NEWt~RK,..~ .~.~ i,,,, COUNt_ (Name of individual sig~ing contract) above named. ~ · .- ...... being duly sworn, deposes and says that he is the applicant tte is the .................. (Co~d"A'4~TT~4kX' 'r ~;~r ~ agen'-'-t', .............................................. corporate officer, etc.) of said owner or owners, and is duiy 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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ' N~ Public .............. SUFFOLK CO, HEALTH DEPT. APPROVal STATEMENT OF INTENT '" SYSTEMS FOR THIS R~tDENCE WELL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. ~ HEALTH SERVI~S. CONSTRUCTION ONLY <~, - ~' ;' STATEMENT OF INTENT j "-' ') N,(~c)°O2'IO"E. 2~t,'-/8 ' THE WATER SUPPLY AND ~WAGE DIS~SAL -- ' ' ~ '~r~ SYSTEMS FOR THIS RESIDENCE WILL ,/ CONFORM TO THE STANDARDS OF THE ~ SUFFOL~ DEPT. OF~E~T~ SERVICES. .... APPLICANT , O~ ~. 'v~' -- -t ~ / / SUFFOLK COUNTY DEPT. OF HEALTH ~ ~ y / ~,~- ~, ~ ,~ .... SU~F~KCO. TAX ~i '~¢~ , . , ~ ,, , -,,,,, ..... ~AP uP P~OPEF4'F"V N EAX~ THE NEW YORK BOARD OF FIRE UNDERWRITERS EIUREAU OF EL. ECTRIC;ITY ~--- O~1,' 8,5 JOHN STREET, NEW YORK, NE~W'~ORK: 10038 ~ ~, ~ ~,,~.,,o.~.~.,s,~ ~/~ N 676362 THIS CERTIFIES THAT in the/ollowJng location; ~ Basement ~ 'st FI. :~ 2,,d FI. Section Block Lot Jan~:~ 21 1985 40 DRYERS SYSTEMS NO. OF FEET OTHER APPARATUS~ E R V C OF HI-LEG AW.G, OF NEUTRAL 2/O Litebrlte Ele~'.trical C~utrso In¢~. P 0 Nox 414 I~ka Grove~ N Y 117'35 Lle~ 2216 11 This cerhflcate must not be altered m any manner, return to the office of the Board ,f~inc~rrec,. Inspectqr, may be ,dent,f,ed by thmr credentials. Cq?~ FOR aU LD NG DEPARTM]ENT TH ~ COPY OF CER~T F CA"~E~OT BE ~LTEREP'IN ANY MANNE~ - ,I ~ FF~TI kl& P~TAI b II, II, CT ~:¢HHPA'fl ¢I~ FL.AH I~ v'HiMN~'Y ~I~FLAdE // ~ LIltINg5 AND ANY E~dI~P4~ ~4P ~ INFIL-]'I~AfI~/N F~I'AIL ¸:i I'~ D~TE?/~I~ {~ B.P. '~ FEE! I ~-~, o~~''' BY: NOTI~ BU:LOING DEp~RTM~NT Al 765.1802 ~ ~M TO 4 PM FOR THE ~OLLOWING INSPECTIONS: I, FOUNDATION ~O REQU RED FOR pO~ED cONCRETE 2. RO~H - ~AMING & pLUM~ING 3. INSULAT~N 4, FINAL - CON'STRUCTION MUS~ BE CQMpLETE FOR C.O. ALL CON~RU~ION SHALL ME~ THE REOilIREMENTS O~ THE N,Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBL~ FOR DESIGN OR CONSTRU~ION ERRORS. ~PMi~NT ~ OCCUPANCY OR : US£ IS UNL/~FUI '~vl/ITHi~T" CE~~I!~ ~, OF OCCUPANCY