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Home My WebLink About10268-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate O[ Occupancy No. Z10t~83 Date May 7, .,19..8.1 THIS CERTIFIES that the building ................................................ Location of Property .... .1.3.6.9.5. .M.a..i.n..R.o..a.d., ......... .M.a.~.~.i..~.u.c.k. ,..N...Y... ............. House No. Street Ham/et County Tax Map No. 1000 Section ..... .~.~ 0....Block ..... .0.3. .......Lot .., 0..3.2 ........... Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·...M.a.y...8 ............ , 19 7.9. pursuant to which Building Permit No.. l 02.6.8. g ............ dated ..... .J.u.~ 9..1.5 .............. 19 7°0. , 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.n.~ .vp.u.n.~...S.~.~.m..m.~p.g..P9.o.!. ~;t.t.h..~p.c.l,O~.u.v.~, .............................. The certificate is issued to . . .ql~..O.~g~l.ROl~ ......................................... (owner. Je,%~ ~r.t~n~,n~ . . of the aforesaid building. Suffolk County Department of Health Approval .... ~/R .............................. UNDERWRITERS CERTIFICATE NO...N.4.4.Q 0 .4.6 ........................................ * Board of Appeals Approved #2551 6-14-79 / / Building Inspector Rev. 1/81 FORM NO. 2 TOWN OF $OUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. BUiLDiNG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10268 Z Date ..... .~......./....'~...~... ............ , 19.Z.~. Permission is hereby granted to: .............~. :.~____,~.. . '(.~ ~. ;. . ~ ~' ~.A'Y.f , ...... .................. ../..~......,~..~ ..................... ~~,..hz.~.~,, . ................. ................................................. ~: ............................ ~~.~... ...... .).; ..... ,t premises located at .l(.~...C?..~........'~L/~f~...Z~.~'J.r...~[..~::"~f~ pursuant ,o application dated ............ Z~/~...~ ............ :...., ]9.r~..Z~J, and approved by the Building Inspector.. Pea *.../~.....--.. ....... / q3uilding Inspector TOWN OF $OUTHO~D Building ,Department Town Clerks Office Southold, N. Y. 11971 APpI-ICATION FOP, CERTIFIGATE OF OCCUPAHCY 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 disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences Ond 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 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: I. Certificate of occupancy $,5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date ......3...u..~,. ,e. ,.,...3..0.,...7..?. ................ New Building .................... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ...... ~C.~.~..~:~.~..~.~c..k.~h..a...m.~'~A~¥.e.~:~.a~.n.~.d~.~.~a.~°~?~5~ ..................... Owner Or Owners Of Property ...... .G.~D,~...G.~LtXII~.O.D..e. ................................................................................. Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No ..................... Date Of Permit .................... Applicant .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval ........ .A.gl;a~h~d .................. Planning Board Approval ..... .';.T..'~Z'..T.Z'..T.~..T. ZZ'..Z ...... Request For Temporary Certificate ........................................ Final Certificate ...~'.¢;~.~.~..~.~......~.~s ................ Fee Submitted $ ............ ~5 .................... Construction on above described building and permit meets all applicable codes and regulations. Applicant .....G et~ e...G.~, a ~.n e.t~ e ..................................................................... Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or seal) THE NEW YORK BOARD OF FIRE UNDERWRITERS ~T' BUREAU OF ELECTRICITY v~/// /~,~- Co ~'-'~ Ju].y ~s 1979 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~/~ f~- --- THIS CE~IFIES THAT ~ ~ --- ~ly t~ e~ ~u~me~t ~ ~ ~ ~ int~ by t~ ~l~nt ~ on t~ ~ ~pi~t~ numar in t~ p~m~s of Oene alaonne,Route 25,Co~ne~ of ~lc~am in the following location; ~ B~....t ~ ~st rt. ~ ~.d FI. ours 1 de s~tio. B~ ~t ~., .,..i..d o. June 28, 1979 .~ fo..d to be in compliance with the requ~re.e, tz of this B.rd. FIXTURE LECEPTA LE I FIXTURES I RANGES OUTLETS I-] C S SWITCHES I!~CANO~SCENT FtUORESCENT! ~ !~T'FURNACE1M RS ]' ! K.W. NO. OF SERVICE D~SCONNECT ~UIP 1~'2W l.ff3W 3,~3W 3~4W SNO. O~E~C~CO~D, R HI-LEG UNIT HEATERS MULTI-OUTLET SYSTEMS ' · * MO. O~ FEET C (Swimming PooI) This certificate covers compliance at 1~e crate Of inspection only. Because of unusual envt~onmenta It 18 advisable to have frequent teat and/or ~epalrs made by a qualified person. EXHAUST FANS AMT. H, P. DIMMERS glenn R. Bradley lio~ton AYe. Mattituck,N.Y. 11952 L1c.1227 This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY,FOR BUILDING DBEARTMENT, THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TOWN OF SOUTHOLD OFFICB OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 November 12, 1980 Eugene Giannone Main Road Mattituck, New York Dear Sir: ~ This is to notify you that Building Permit No. . 10268Z issued ___~June 15, 1979 to construct I/G pool will expire on DeCember 1~190o ....... If more time is required to complete the Job aud obtain a Certificate of Occupancy, you may apply, FY letter, for a six (6) month extension. '' ' If the work is not completed and the not issued after the six (6) month extension period, than required to apply for a new building permit. Very truly y. ours, GEORGE H. FISHER Sr. Building Inspector Certificate of Occupancy you are TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. APPLICATION FOR BUILDING I~ERMIT Application No./.~.~.~..~.: ............ INSTR. UCTIONS a. This application must be completely filled in by typewriter o~ in ii~k and submitted in triplicate to the Building~ Inspector, with 3 sets of plans, accurate plat plan to seals. Fee according ~o Schedule.' b. Plot plan showing location, of lot and of buildings on premises, relotiO~nship tO adjoining premises or public streets o~ areas, and givir~ a detailed description of layout ofproperty must be drown 6n the diagram which is part of this application. c The work covered by this application may not be commenced befor~ issuance of Building Permit. ~-~ will issue ~ Building Permit to the applicant. Such permit C~ d. Upon this the Building Inspector shall be kept on the premises available for inspection throughout the worE.I[., e. No building shat[ 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, ^PPLICA~ION IS HEREBY ~^DE to the Building Department for t~e issuance of o Building Permit pursuant to the ~__~ Building Zone Ordinance of the Town of Southoid, Suffolk County, New york, and dther applicable Laws, Ordinances or Ragu at ons~ for the construction of buildings, additions or alterations, o.r for removal or demolition, as herein described. ~P The applicant agrees to comply with ali applicable taws, ordinances, building code, h6usinct code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary~ctions. ~ (Signature~f/applic~/x/or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generd[ ~ntract6r, electrician, plumber or builder.? Nome of owner of premises ...... Golle..~.~.ll.~ltlolae ...................... ~ ............................................ ~ .......................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ........... ........ Plumbers License No ................................................. ~/ Electrician's License No ...... (}'~etl."D'~cl'].-y ............ Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map. No.: .1~0~6 .......... ~ ................ Lot No ......................... Street and Number ..................~.'~...~.~.~.'Ge.~....}JI,~..~l~,t~..t~l'l~.~}q.~'g~tl~,.A~ ............................................. Municipality 2. State existing use and occupancy of p~mises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ............... Repair .................. Removal .................. Demolitior~ .................... Other Work ~.///~,~.:....~ (Description) 4. Estimated Cost ................ ,~4~.~., .............................. Fee ...~../..~..~: .................................................................. ... (to be paid on filing this application) 5. IF dwelling, number of dwelling units ............................ Numbcr of dwelling units on each floor ............................ If garage, number of cars ............ .I .............................................................................................................................. 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 ....~0 ........... Height ........................ Number of Stories ...........2 .................................................................................................... Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height ......... ; .......... Number of Stories ..................................................................................................................... 9. Size of lot: Front ............ 78' ....................................... Rear ..... '7'6 ................................ Depth ..... t?'8 .................... 10. Date of Purchase ............~ ........................................ Nome of Former Owner .... ~eee~ne'~ ................................ 11. Zone or use district in which premises are situated ..................................................................................................... ]2. Does proposed construction violate any zoning law, ordinance or regulation: ....... y,~.B .......................................... i3. Will lot be regraded . ........ 1~..O. .............. Will excess fill be removed from premises: (X) Yes ( ) No 14. Name of Owner of premises~, e~t.~..~ll~.~o~.~ ......... Address ~t:~:~.~ll:k .......... Phone No. Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ....... ¢¥e.~.~ ........................................... Address ................................ Phone No ....................... PLOT DIAGRAM b~cate 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. ........ ~.~~.~,,,~< .............................. being duly sworn, deposes and says that he is the applicant ~ (Name of i~i iv dual~igning contract) above named. He is the ~. ..... · (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly aufhorized to perform or' have performed the said work and to make and file this application; that oil statements contrained in this ~pplicetion are true to the best of his knowledge and belief; and tha~ the work will be performec~-F~the manner set forth in the application filed therewith. Sworn to ~b~t~m. e this / I day of ....... 'ZZi Z.ZZ ...... i ca.n ...................................... ~ ' ~' ~nature of app icant) ~ BABETTE C. CONEOY / ~O,T, ARY PUBLIC, State oi Now Yot~ / Suitolk County No. ~2-5~9280D /-, / Of