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Home My WebLink About10709-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N.Y. Certificate Of Occupancy No .... ~92(? ........ Date ..... June 9 198.9. THIS CERTIFIES that the bmlding ................................................ ~ t Greenoort Hamlet Location of Property 58525 Court y Rd 27 House No. Street County Tax Map No. 1000 Section ....h.h. ...... Block ..... ?. ........ Lot..!7 ............. Subdivision ............................. Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated . .J.u~...e...6 .......... , 19 .8.0. pursuant to which Building Permit No ..... 1.QT..09.Z. .......... dated Jurle 9 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 ......... One Fsmily Dwelling (with larger deck) The certificate is issued to Onnik ~rslanyan .......................... (owner,~L ~ ' t) of the aforesaid building. Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO .................................................. .......... ..... Building Inspector Rev 4/79 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, 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 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 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 buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing a~l 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 informa- tion required to prepare a certificate. Fees: 1. 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 Dete· New Building ./¢-~.~..<~.~,~. Old or Pre-existing Building ............ Vacant Land ............. Location of Property ..... ~.~..~.~.o~:~'/.~, ~.~. ............... ~.~,~. ~:~ ...... House No. ~ ~ ~--~ .~-- Street Ham/et Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section .... ~ .~ ..... Block ...... 2 ...... Lot ..... /. ~. ...... Subdivision ................................. Filed Map No ........... Lot No .............. ~ ? ¢0 '~ t~.~-,. ~...Applicant .... ¢.~f.~ ~ .... :~'~ ¢..Y. ~(~ Permit No./ .......... ~ate of Perm/ 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 pep;nit meets all applicable codes and regulations. Applicant...,~/'~;c:~,...~ .: . .~,~ ~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ..... t ~¥/ .......,., 19 ;_.. Approved...; .~'.L.~':..-....~., 19 ? {'~ermit No.. ~ ~. '~7~ Disapproved J~( ...... ~_.~} ....... ;: .... ..... (Building Inspector) ~PPBIC~TIO~ FO~ BUI[DlffiG P~IT INSTRUCTIONS Application No.../.O...:.~../~. ..... 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 a detailed description of layout of property must be drown on the dia~am 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 issue a Building Permit to the applicant. Such permit shall be kept on the promises 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 regulations, and to admit authorized inspectors on premises and in buildings for necessaw inspections. (Sig~icant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises 0/l/r/{///<:: /t~/{~S' /__ ~. ~/'~.~ A// (as on the tax roll or latest deed) If applicant is a corporation, 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 will be done...2 .~..../.~.~...~. :/..~./ .... .~. ~..~.'. ............. ....... ......... ....................... f:. :.Y.U?. House Number ~O ,Street Hamlet ..... ..... ............ ...... ......... County Tax Map No. 1000 Section / S~bdivision ............................... , ..... Filed Map So ............... Lot .... ' ........... (Name) 2. State existing ~s~ and occupancy of premises and intended use and occupancy of proposed construction: a. Exisbng use and occupancy .......... ~'....~N.~... Yh~ I I,~ ~LL-[ ~{ ~ b. Intended use and occupancy ~ m ~ ~ (~H . ~E ~ ~ ~ 3. Nature of work (check which applicable): New Building .......... Addition . ..~ ....... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... 00 /../_ (Des°rip.on) 4. Estimated Cost ...................................... Fee ................................... (to be paid on filing this application) If dwelling, number of dwelling Cnits ...... f ........ Number of dwelling units on each floor ................ 5. 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 structure:s,, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure w!th alterations or additions: Front ................. Rear .................. ' Height Number of Stories Depth ................................................................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... Height ...; ........... Nun3ber of Stones ........................................................ : Depth .,..,, ............. 9. Size of lot: Front ........... ~ ........... ear ............... . .......... 10. [)ate of Purchase ................ Name of Former Owner ... ~.67.~..CT .,~..t,.( .O. ......... 1 1. Zone or use district in which premises are situated ........... 7-~..~.~. t..D.. ~ .~.."~f.A..t ....................... 12. 'Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ......... . ................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . .o.~..~%~.. 4~..~.~., .~Address .. Phone No... ~. ~.~7.~/. ~:~'. Name of Architect .......................... Address ................... Phone No ................ Name of Contractor ......................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property .tines:~Gi,v,e street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. -/ STATE OF NEW tY~01qK,,~ ~ '~ i ~ ~ ' COUNTY ~F~.i ~'~. ~ ., O'/~'/P'J'~ ..... _/~.. i~..~/]: rA/c~/~2~/~.ah ..... being duly sworn, deposes; ~d says that he is the applicant (Name of individual sigping cont a above named. He is the ..................... i...~i~. ~ A/I~ ~. ...................................................... ~ (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 coniained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manher set forth in the application filed therewith. Sworn to before me this ............. ~..~ ..... day ;f ........... . .~.U,d~ ~.., 19~..~. Notary_l~u,blic, .......... .'~. ~J.~. County ~' '(£LIZ/~BETH ANN NEVILLE ... ,,~,~ NOTARY PUBLiC,State of New York No. §2.8125850, Suffolk Cou. iit~ ~ leaa Expires March 30, FEE' NOTli 765-1 FOR 2. ROU 3 INSU 4 FINA _ BE ALL THE · STA-~ CODES J~J~SIGN AS NOTED BY: BUILDING DEPARTMENT AT 9 AM TO 4 PM FOR THE NG NSPECT ONS kTION - TWO REQUIRED URED CONCRETE - FRAMING & PLUMBING CONSTRUCTION MUST RTE FOR C O SHALL MEET FMENTS OF THE ~. Y, ICTION & ENerGY RESPONSIBLE FOR FRRORS