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HomeMy WebLinkAbout10572-z \ , l' , ,J ,. ~ FORM NO.4' , \ ' 'I I TOWN OF SOUTHOLD 'l " t \V BUilDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. ..:?:JP.Q43......., Date....... ;r:u),y. ;2.~..,............., 19$9. THIS CERTIFIES that the bUlldmg , , , , . . . . . . . . . . . . . , . , , . . . . . . . . . " ..,............ Location ofproperty ....... n5.Q .!ii!i.~qI).. p'~j,y~. . . . ... . . . . . . . .. . , . .qW\;S\p.'~g1J.~.,. .l'f ,~.. House No. Street Hamlet County Tax Map No, 1000 SectIOn .., :1.Q4. , . . .Block ..,7.,........ .Lot . , . . . , .Q . . . . . . . . . Subdivision. . . . . . , . . , . . , . . . . . . . . . . . . . ' . . , .Filed Map , . . . . . .Lot No. ............. conforms substantially to the Application for Building B rmit here of ore filed in this office dated . .. . .F:~l?~B:I.'Y. ;2.~. . , , 19 .8.0. pursuant to which Bu o. .... :1.Q57?iG. .. . . . . .. . dated. . .. r~1:rr1,l~.ry, ?'].. . , . . . . . . . 19 !3.o. , was issu~E!, anE! ~onfurms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is . . . . . . . . . . . . . . . . , . . . 4<;l9-.i,~j,,?J;1. ,~q. :Jj:x.:!,/1'\;;i.pg .1!,S\~.~/1f},?Py' . (13:t.~I.'~g~J. .~1,1~.]'4:j.1;lg . . . . . . . . . The certificate is issued to ,....".....,. .~I,1.1;):l.r;yr.l. ~.. . . . . . . . . . . . . . . . . . . . . . ' . ( owner~ of the aforesaid building, Suffolk County Department of Health Approval UNDERWRITERS CERTIFICATE NO. . . . . . . . , . . . . . . . , . . . . . . . . . , . . . . . . . ' . . . . . . . . . . . . . . . ...... '" ... '1"<';........................ Zuilding Inspector Rev 4/79 . , l." . .i .l " 1,.d .4 ~~ ..;..."Jt Jji:. /",j, < .,;, __ ", It: 'h (L " J;" , ..,,;:,~.~~Jetljr'~~:iLd. " "'I'.."''',''j~".,,~..!4i'':I'' "1\\:iII'RI,MIII :C:"., .. ". " 'II ~tDr" (iF> .' '~T:i ri!IiIT~' . f:M "'"'i'...~~ c'~~,;1..t" - ',<;;);/"0:",,, '<; "liE" ~'+ ;l' 'j',~ ,.~..~ ,~,fi:;.~i':;;(;': ; ,', ,\I, .','" >I." it. . j;";~" ",' f; :' ,:",::11' "'..,.'"A,', '.'....,':,.., '. . , .' "" ;,.~UIra;DIN,'.fE~i[T. ~ '" *:'i11~~;;~~~i;;Z;)ti'1{~\jkJ"$f'}i:'itL;~;'j~_ !: i~:- ~{','<:' ,'''',; ;{){~~~~1;l':i::,_ . ~i '~~ .~ '. ~~:~,?:i~>~ ~ "l '-.' ~j1tif!g~i >'::~R.;J';!i%:};fi' 'H'1tt~lg'PERMt:'M'US'tja.E'{~ERt O'l\l'<1fmE..fiTte;:rS:E'1:1JNTlL FIVLL' C~.~'~.-:; >,;;; i, ';'--. ,.- > ~ t, ". .- .'_ ,:' ,.- ,.- <:~ . ',. c' t",. '{-" '_ _,~ .- ~,:.' <':i~: ,- _\:;fj;"', - _, ,,-) ~ \',' .-'- ~ .- '. '{ r :, ' -, / " ;~'''~iH.''I;;';!)%'f,.';,:; l.t~MF!~trlC)J!II0Rri41i W~R~~UT1H:'Q~I~EDf. , '~. . ;l~~~~~:r;JI:l:<ii\:~;~ 'f '.' 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"t 'd C E f.? d .2.. 1 J) 0 d pU':\l,~ana app Ica Ion ~a~, ....,......................It........................,...., 'I:......., an approved by the ',BlJiI~ing In$pe(:tor. I , ' .gft , !tee .$.../.11................ d;.,~ k( /J(/c/~ ~ .. / JS/ ~ IP60 - ID'I- -;--': Co ~o/'./ ~~/f.-/ ... .................. .....B~iidi.;;g..'I~-;;;~~t~~ .... ................ ..... ~,i,>~ . '-~- '~u: ~ ; ',< ., >t' ~:1 _! ,. ' ~, FORM NO.4 TOWN OF SOUTHOI,.D BUILDING DEPARTMENT Office of the Building Inspector Town Hall South old, N.Y. Certificate Of Occupancy No. Z.HG'78, . . .. . . . .. Date. . . . . . . Jul.y. .1(1. . . . . . . . . . . . . . . . ., 198:? . THIS CERTIFIES that the bullding . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LocationofProperty .115.0......,......,.... J1,,$911. .!)~;I.;v.e........... .C.q~>=.h.q:i1f!'!..... House No. Street Hamlet County Tax Map No. 1000 Section ..104...... .Block .. .07. . . . . . . . . .Lot . .QQ\s. . . . . . . . . . . . Subdivision, . .X . . . . . . . . . . . . . . ' , . . . . . . . . . . .Filed Map No. .X..... .Lot No. . 'f:. . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . fJ!l.b.r'l.lIH'.y: .22. . .. . ..,19 .aOpursuant to which Building Permit No. .' .~'j\),S.'li.'1\ ... .... dated. . . f.e.bruar.y. 2.7, .. . . .. . , . .. 19 .8.~, 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 . . . . . . . . . . . .an . ~d.d.ltiDn . to. .an . ()x.tCj t;LPJ.': .Q.c.c.e.',!!9r.y. . Ii' ~P,~~6~. .~\.!~;t.,d,~t)J;.... . . . . . . . . . . . . The certificate is issued to ....,. .r<;aj;)1.~y'1). ri._. .\1!O~.~~. " . .. .. . ... .. .... ... . " .,. . ..... (owner, ISfise"Qf-tfNlaRt~ of the aforesaid building. Suffolk County Department of Health Approval ..... .n./. ~. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . , . . . .n./.~. . . . . . . . . . . . . . . . . . . . .. . . . . . . . . ., . .C..~.~<.l6.~:...... Building Inspector Rev. 1/81 I , ' ,.t 'elL . ~ ""' i ;. . FORM NO.6 TOWN OF SOUTHOLD Building Department Town Hall Southald, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This applicatian must be filled in typewriter OR ink. and submitted in duplicate to the Building Inspec- tor with the following; for new bu ildings or new use: 1. Final survey of property with accurate lacatian of all buildings, property lines, streets, and unusual natu ral or topograph ic featu res. 2. Final approval of Health Dept. af water supply and sewerage dispasal-(S-9 form or equal). 3. Approval af electrical installation from Board of F ire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Re,sid~nces and similar buildings and installa. tians, a certificate of Code campliance fram the Architect ar Engineer respansible for the building. 5. Submit Planning Board appraval of campleted 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 peoperty showing all property lines, streets, buildings and unusual natural or topograph ic featu res. 2. Sworn statement of owner ar previous owner as ta use, occupancy and condition of buildings. 3. Date of any housing cade ar safety inspectian of buildings'ar premises, or other pertinent informa- tian required to prepare a certificate. C. Fees: 1. Certificate af occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling ar land use $5.00 3. Copy af certificate of occupancy $1.00 ::...-c-c4 - - ~ H H H,/lI.8'.': H.H N_B~.........~;;i"'~......... V~."''''"'' H....H..... ~_/[o~ nOT~~.~..~~......ta~..~;3t House No. -h:, ~ Ham e ' Owner or Owners of Property . .-If;1-rIt.rY.YN. '~'" j.,. . .~... ;"".. . . . . . . . .. . .. . .. . .. . . . . County Tax Map No. 1000 Section ............... Block............... Lot.li9:.o.J!1.~H Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Filed MapNo. . . . . . . . . . .Lot No. ............. Perm it Na. ((J..ff1?-:. Date afperm it o/~. r/1.'t.? ,App licant ::~ t.#.tfy.1':'.I'J.:. (r-~ ./~.. Health Dept. Approval ... . . . . . . . . . . . . . . . . . . . . . Labor Dept. Approval ........................ Underwriters Appraval . . . . , . . . . . . . . . . . . . . . . . . .Planning Board Approval. .. .. .. . .. .'-,. .. . . .. . . . Request for Temparary Certificate. . . . . . . . . . . . . . . . . . . . .Final Certificate.. . . . . . . . . . . .. . . . . . . . . . .$~ Fee Submitted $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Canstruction on above described bU~'ding ~it meets all applEble c~s and regulations. Applicant.. ~~.l1I./~............... Re\l.10~10.78 C.O.::;: 11078 ~. '(t ~o ',;L /3../ >lL3 <f-.<{. { 7/tlf/t2 @J I j; , -~ i" >_ i " ,--~ .~ Jl _".n ._,t,_,. ;! ~...:-__'::':::_:'!:"-::;;.;;:;:;_.:;;", ~'",'" ",,-,,'_,~O''''''~''''~,"'' _,+' ,."",;'"_'_~~W-.o;" ,w "'_'~""" ., ^ _.._ _,'_'~"_'~ ~~ ., "~<'''""._ ,,,.,, ''"'~~'''''''''''''_.'",,".''''~''='~''''',<H''_'__'_''~.'_~'_''o,,__........M '_'~_'_ "<'''. _ n' _ '" ':":"'F '" .) u I L "'D I /'oJ G- 'P E (2. (V') IT .:tt , - -":,-,,-- ~ - .-' _!-. --.- - - --- - ~:;--=..- , - ., -- - - - -- - I~ CIEl,.. D 11"-1 'S P EC" 9 ,\.1 Ji Pl> r;. I C 0 1~/\.iV. c: 1\.1 T:5 'I .- - - ;-..\ ~ i '/oJ I $1 11 I ,j 1 FDwL/uArI CJ IV ~~ . . .11 ! /1/ ~ C <~I/-1<7) 0").,,J/ . I i / ~ ! :t I!o, I ~ 1\ IcQ " Z~: I , "" I '-." I 2 I I: - :j><........ \2.0 t..J c:; H Ii \:I, Ff?Alv\~ " ~~ , /J" Z-~_' /,///f!.J -"'_ 'e:; ?L u /VI t3 I N C; i ~. A~ II; C> , / 'V ~~ I ! 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FORM NO.1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 . Examined. . . . , . , . . .df':2,- 7., 19 .f'V 1057:2 Application No. . . . . . . . . . . . . . . . . . Approved...."... .':;;..7..,19 P-Operrmt No.., /~.~?;2 Z- Disapproved a/c ,.,.,. . . . . , , .................... . .... ,_................. , . ...... .....ijC.... ~ ~ / ') / .. .. .... ;{(tJ:1 (i( .. /. /.., c;z, :1 .. (Building Inspector) APPLICATION rtJR BUILDING PERMIT '7 Date .~~.-?:2.:, . ., 19ft? INSTRUCTIONS a. ThIS applIcation must be completely fi1led 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 givmg 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 Pennit. d. Upon approval of this applicatIon, the Building Inspector wi1lIssue a Building Pennit to the applicant. Such pennit 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 Pennit pursuant to the Building Zone Ordmance 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 herem 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 buildmgs for necessary inspections. ~ ....v::.~41",.~.7h.'. ..~~~-.e..... . {Signature of ap !Cant, _,.if. "'~,~, , . , . . . . . . . . . . . . . . . . . , . . , . . . . , . . , . . . . . . . . . . . .. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . , . . , . , , .OWI'{~ If. , , . . . , . , . . . . . . . . . . . . . . . , . , , . . . . . . . . . . . . . . . . . . . . , , ' . . . ' . . . . . . . . . . . Name of owner of premises . /i:;::;.Tlf.tf'.(~Y. (!J~( F:.'9-: (-f. . , . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . (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 wi1l be done. ..............,............,...,................. ~~nf. r.;;,.;L? ~ ,P,~~. (I1/{~<,>,--r.,:.pf\.I.(E',..,..".... .Co~~,,: ~~......, . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . It 'I 7 0.) . , ' . , . , . . . . . . . " Block ...........,...... Lot..........,........ tf/ Subdivision. , .................... . " , . . . , . . . Filed Map No. . . .' >;-c . . . . . .. Lot . . . . , . . . . ' , . . . . (Name) 2. State eXisting use and occupancy of premjses and intended use and occupancy of proposed construction: a. Existmguse and occupancy. ,PI?} 4r<i?.ffi'(>1~..............................,.............. b. Intended use and occupancy " f' .. ..,.........,..............,........................ ....... ....., -j , ,. , . . ~ ,~~. ,,' J;._.A. ......:. ,,~<~ 1&- ~< . 3. Nature of work (cl).eck which applicable): New BUildinw1.t?P.(?7f'...y<&lditi~.. ., ... . .. Alteratian .......... Repair .............. Remqval . . . . . , . . . . . . .. Demolition .............. Other Work. . . . . . . . . . . . . . . 00 ;, tJ>-- (Deseription) 4. Estimated Cost ~c!(J.t.?..~'/!'f7lf:q)r.{.(':I.~T"":{.-/)...... Fee....! fJ............................... ,i ' (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits . _ t!? 'Y. ~. . . . .. Number of dwelling units on each floor. . ';'. . . . . .~ . . . . . . If garage, number of cars Gl..-:-.:I.'I:p'(;I./l'/r..fY?oI!t.<?"((..~tf. .4'ff~. -:o/..~. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . .-. . . . . . . . :. . . . . . . . . 7. Dimensions-1existingstructur~s,ifany: Front.. ,:;1.;;2. ~'....... Rear . .~"?';;::.":...... Depth .:??~.~........ H~ight . .1. ..I.. ........ NU11jber ofSt?ries .Q<<.~. . . . . . .. . . . #:p"..... . .. . . . . . . . . . . '4JS"/ . .. . . . . .. DnnenSlOns of s~e structure with alterations ~ons: Front ... ............. Rear . . . . . . . . . . . . . .". . . . Depth.. .~?'(............ .i.. Height... .... /"I.~I)IP' .'1.~. Number of Stories . tf{('?,... -:1.'..,........ 8. Dimensions of ~tire new constmction: Front. . . . ./. ~ ~. . . . .. Rear . . . I.~ :-. . . . . . . . Depth r:!. ........... Height ............... Nu~er of Stories. . . .~1(t::-.... . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front 'j" ~';'6,"""""'" Rear... ..:?~::?........... ':~Pth~<P.~. 1:1.'.......... 10. Date of Purchase .. t?/.9. ..;p:.............. .~an4e of Former 9wner q(.. ~~./,\(.~ ............. I J. Zone or use district in which pr~mises are situated.. ~$'.I.o.e/Y':TI. <i'.~ .. . . .. . . .. . . .. . .. . .. . .. . .. . . 12. Does proposed constru~n violate any zoning law, ordinance or regulation: ...!!!.... tf; 'F:'it..~. . . . . . . . . . . . 13. Wi1110t be regraded ....~ '/f;;." . . . . . . . . ;;til. . . . . . Will e~ss fil1 be removed from prgmis~s: . Yes ~ 14. Name of Owner of premises. i1.(II-.tfy()( /'1.,! .'\-I."'rAddress . .~T<i#.".~.<! ~. . . . . Phone No. 7:~"'I,..,.~~. .. ' Name \,f Architect ". .~1'v.f"'-' . . . . . . . . . . . . . . Address. . . . . . . . . . . . . . . . . . . Phone No. .. 'Il' . 'y.::;' . . . Name?fContractor.. ~ w~if?.,......." .Address.r.1.~.At!",Y'oC?...... .PhoneNot4.~. ~"? .~. PLOT DIAGRAM Locate clearly and distinctly alii buildings, whether existing or praposed, and, indicate all set-back dimensions from property lines. Give street and block number or descriPt~ according to deed, and show street names and indicate whether interior or corner lot. " , . (j:t\:J t ~(y' \ I /{, r---'--'~'-- -,-- -- '.- \ ~~ ) ~i ~~ M -----~-,~-, ---. ~_ .~._._ _. _e., ~.. >_.___ _, JJI", W:.\ ~ OLD " J~ ~ .5.a..~ 7, t> to/ 11JlPt1.,~t/ \. ~ ~ ..---- '(jj'..---.:;.;" ''''oO'_" .,.. ...,.. ~ ~ - , ."..:t. ~ ,,;1, J.. /6/ .~ -, ':'::t -- L--'" J''\,. ! ,~-~/ I !.1 of"t< ' , I J ~ ~ NjIY{ \ ( dq '3 STATE OFNEW YORK, .LK' S S C~Y OF .-!:<! f.'"~ . . . ..~ . . .; ,('?--T4('otf' t:~ . .#.. . !f~(t!f............... being duly sworn, deposes and says thaf'he is the applicant (Name of individual sigIJing contract) above named. ,,, I SHe is the. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . , . . . . . . , : (Contractor, agent, corporate offieer, etc.) , -e+ said oWl'er or owners, and is dujy 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 bf\ performed in the mann~r set forth in the application filed therewith. Swom to before me this , .......... .o?~.":":~..... .day of. r9f.4.~e-:-1~r....., 19r.q I Not",P~~d .<<!~co~ty~ .....~.IF~ C2-c ..... .......... I 'NOTl;.R' rlJ:JlIC, $/'.1,; d NawYoT (Signature of applicant) :1')", 52. ~r, j 0 I ',2, <,~":.:',!H",') h $,\~fd~ CI \Joly ~ Commi~l>jo11 !:.:Xrr,IOi M<1rcn 301 19 ~{f) Q : \ '-1 ~o I cr : 0)> . f./)'":t::J-r. ro 0 : C:-.j Z: ~ D in' u> -. ~ : z ,T1 ~o : 0.., 0 u> :-1 ~a : 3 ~Q 0: .-+ :J : -< 0 . ~ ...... ::r o. '11 -< : ~co'2..o (\) 3 : 0 . 0 -. _' Z Z~~~ ~ ~ g"~ 8 ~ ~ p-z~. 'Tlrn:'i; _0 , ~.,.. _1 ~ '" . 0 "" . ............ -i ...... ..... -'"i"'-'.., . 3",. ro 0", '" r.t' 0 0 : .: ". '011"" n.... 1 ~ :J 0 : CO ~ . -< - ~ - \-.~ - ". CO -'" 1. Q rp 0 '"'" ' ~ 3 ~'o ! ., ii." >-.._ ~ ~~~q~: ~ (\)g-o~ ~ _.~ f.1\7' -.,. :;: ~"'" ': :}... 5 : :J :" 9' J<:?,,"s; : ~ in"g "'-V1 : 9,;,. ~ ;;"'~z: :::,-_: :S'::iI' ~ s.~ z :: 0 u> a : 0.;.: woo......RJ:. """"':j . c:~: 0"-", :: 300.: 00. . "'~ .: (\)... : - : _n~ ~ :: 0.(\)_. . 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