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Home My WebLink About15885-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No...Z.I.5.6.4..2 ......... Date ..... .).,Er. il 14, 1987 THIS CERTIFIES that the building ..... A.d..d }.t.l.o..n .................................. Location of Pzoperty . 1200 Gillette Drive East Marion County Tax Map No. 1000 Section . . .0. 3. .8 ...... Block .... 0. 2. ......... Lot .... 0. ! .3 .......... Subdivision.. ?l.a.r...[.o.n, .~...a.n.o.r, .............. Filed Map No..2.0.3.8....Lot No. 2. J ........... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... ,F.e.b.....2.,.. ! ~ .8.7 .... pursuant to which Building Permit No.. 1. ~ ~ .8.5.~ ............. dated A.p.r..i .1.. 1. Q,..1.9.8..7 ............ 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 ......... .... p.a.c,l.c..a.d.d. ~..t .~.o.n...t p..a.n...e?.~ s..t.i.n.g.. ?p.e...f .a.m.i. ! y..d.w.e..1.1.i.n.g.: ................. The certificate is issued toJOSEPH A. CHEREPOWICH AMD WIFE. ..................... ?o¥,,'o'r, ................... of the aforesaid building. Suffolk County Department of Health Approval ....... .N./.A. ............................... UNDERWRITERS CERTIFICATE NO ............... N/A ' PLUMBERS CERTIFICATION DATED: N/A Rev. 1/81 FO~ NO. ~ TOWN OF $OUT~OL~ BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 15885' Z Date ..... ~.w~r~.=..=... ....................... , Permission is hereby granted to: .~..r........~...~...s.:~..:....I.t..~.~ .... I'0 '~'~""~":¥~'~-~'"'< ........ '~ ......... i~:~'~ ....... at premises located at .Z'.~...~......~...A~..~../..~.~ .................................... County Tax Map No. 1000 Section ...~....~....~. ......... Block ...... ~ ............ Lot No. pursuant to application dated ...~..~...~ ................. , 19..~...~.., and approved by the Building Inspector. Fee $.~m~.~...:..~.. ~~.~ ................ Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ ~ 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 natu roi 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. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" lend 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, 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. C. Fees: 1. Certificate of occupancy $25.00 -- BUSTNESS $50.00 2, Certificate of occupancy on pre~existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.'00. over 5 years $]0.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50,00 Date ..F..e.b.r.u.a..r.y. 2,. 1.98.7 , , ,addition New C on s t r u c t i on (~ecK/oid or Pre-existing Building ....... Vacant Land Gillette Driv~ East Marion Location of Property ................................................................... House No, Street Hamlet Owner or Owners of Property Joseph A. Cherepowich and wife 038 02 013 County Tax Map No. 1000 Section ............... Block ............... Lot ................ Subdivision. Marion Manor 2038 ................................ Filed Map No ........... Lot No. 21 Permit No ...... , ..... Date of Permit ....... Applicant Jose h A. Cherepowich Health Dept. Approval ...' ..................... Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate .... X. .................. Fee Submitted $ 25.,00 Construction on above ~e~cribed building/a~permit mee~ bio codes and regulations. .................... °~ ~/ u~ ~L~D1T 2O ERS'/' MAP. IO~ TOX, Vhl OF SDLJT'kIOLD, ~'t.v, HAP OF' PI~OPE~TY 5U~\, E YE::D FOP. ' C '::'" t b. Ch .xE ,lCf-:l [] ' MortuJ"!~Ep~i' ATI'ORNEY AT LAW 828 FRONT STREET, P.O. BOX E GREENPORT, N.Y. 11944 P~ONE (516) 477-1016 February 2, 1987 Building Department Town of Southold Southold, NY 11971 Re: Cherepowich, Joseph A. Gillette Drive, East Marion, NY Gentlemen: With reference to the above captioned matter, enclosed herewith please find application for Building Permit, in duplicate, together with a check in the amount of $50.00 to cover the fee. Also enclosed find application pancy in duplicate together with check $25.O0. for certificate of occu- for fee in the amount of If you have any questions please do not hesitate to contact me. Very truly yours, William H. Price, Jr. WHP/lg Enclosures 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING [~]~INAL DATE %64 5~ I0 E, .L, QT 22 ..,,g~. ~ 1 IO"V¢, tO0, O0 ~LOT 20 u...........l...~,[~m,,,u,,,,,,,, from . . . . BUILDINO INSPECTOR'S OFFICE TOWN HALL, SOUTHOLD, ~N~. y. 11971 765-1802 February 5, 1987 PLEASE HAVE APPLICATION NOTARIZED. THANK YOU. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .~../..O..., 193..~. .Q~.. 1..O.., 19~ .'1. Permit No./. .~.~?~.~..~. Approved ,Disapproved· a/c ..................................... Received .......... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date...~.e.b..r.u.a.r.y..2 .... ,198.7.. INSTRUCTIONS 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, ~lationship to adjoining premises or public streets or areas, and giving a detailed description of layout of prop.erty_ - ~"~ )~ '~_~'~, ,,e~,-mustl~ [~l/awn.on the diagram which is part of this appli- cation. ,,, '" d, Upon approval of this application, the Building J~l~r'l¥~sl ~l~l~a'~B~'~.j~nit to the applicant. Such permit shall be kept on the premises available for inspectiog,t~J[~)h6ut ~ e. No building shall be occupied or used in~ko~OoYir~/tl~lr'ant ~.f~.l~e'~hatever until a Certificate of Occupancy shall have been granted by the Building Inspector.~.~ ~ ~, Building Zone Ordinance of the Town of Southold~l~Offn~t~:~ )~/Ybrk, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additio~. ~r'~alt~g~,, tot for removal or)~en~elition, as herein described. The applicant agrees to 'comply with all applicable law~~, 9.rd,~na' .n,..'¢~, building cod~, hot)aSrjg,4ode, and regulations, and to admit authorized inspectom on premises and in building fo~ //(Sigrfature of applibant, of name, if a corporation) ~ JOSEPH A. CHEREPOWICH .... 9.~33.qt..t,e..D,r. ~.v.e,,., .~.a.s,t., .~.a.r.~.o..n~, .~¥ ..... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... owner ......... b....c..hp.r, qpg.w.~.q ~ ............................................. :. Name of owner of premises Jos.e. Eh (as on the tax roll or late~ deed) 4/~,~-~ ~, p q? I .~ ~ ;~ ~ ~ ' If applicant is a corporation, signature of duly authorized officer. NOT!FY ~iJtLD~N~ OEPART'MV~T AT ROUG~ ~a,~,/~4G ~ F~.UMBING ~. FINer, r2Oe~T~gcT~o~ ~UST Other Trade's License No ....... ',: ~ Y 1, Locatioa of land on which proposed work will be done, '" .. East ~ar~p~ ~ ~illette Drive, ...... House Number Street Hamlet County Tax Map No 1000 Section 38 02 Lot .0.~3. .............. Block .............. Subdivision .. ~ar£on Manor p N 2038 Lot 2.1. ................................. Filed Ma o ................ (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Existing use and occupancy 9.n.%-.f.a..m.i.l.X T~.s J, ql~p.c.e~ - - z: ~--:: ' one-family resi. dence b. Intended use and occupancy ........... , ............ /~f~¥v~ ~,*~..-):,~ .r.a~,%~ ..................... 3. Nature of work (check which applicable): New Building .......... Addition . .d?. ?.k .... Alteration .......... : Repair RemoVal .............. Demolition .............. Other Work ............... , , (Description) ' $50 00 4 Estimated Cost ~.l,O. qg,.O0 Fee . '... · ............. i (to be paid on filing this application) · ' ~ on each floor $. If dwelling, number of dwelling units ............... Number of dwelling units ., .............. If garage, number of cars ................... . .................................................... 6. If business commercial or mixedloccupancy, specify nature and extent of each type of use .................. 7. Dimension~ of existing structures, if any Front..7.2. ........... Rear ...7. .2 ......... Depth . .2.7 .......... Height 16 Number of Stories 1 Dimensions of same structure with alterations or additions: Front 72 Rear . 72 Depth 4.3. i Height . 16.. Number of Stofies 8. Dimensions of entire new construction: Front .....1. 6...., ..... Rear .... 1..6 ......... Depth .... ,t.6. ....... ~H. cight ............ Num er of Stories 1 ..... i6b ............ :~ ~)'0 Size of lot: Front 1 0 0 i ... ]Rear. .................... Depth .... .......... Date of Purchase . .1.2./..1.5./.6. 9. [ ................. Name of FOrmer Owner . .h.n..d.r.e.w.. le~lqo, q ............ .. Zone or use district in which premises are situated ................................................ .. Does proposed construction violfite any zoning law, ordinance or regulation: No Will lot be regraded .... N.q.. i: .................. Will excess fill be removed from premises: Yes NO Name of Owner of premises .J.q~.ep.h..3~...C.h.e.~.e~..w.~.C~ddress .G~.~.~..e.t~.e.. p.r.~.v.e... Phone No. 4. 7. .7 .--.1.6. 8..0..(.w. 9 .~k) Name of Architect ..... .. Address Phone No Name of Contractor ......................... Address ................... Phone No ................ 10. 11. 12. 13. 14. Locate clearly and distinctl~L ~l' property lines. Give street and blo~k~ interior or corner lot. // , -, DIAGRAM ' ~butldings~ ~wkether e~stmg or proposed, and. ~n&cate all set-hack dunens~ons from ~d~ber O~;d'escripfio'fi.a~eording to deed, and show street names and indicate whethdr See attached survey STATE OF ,NEW YORK, [S.S C'tqH~rrV c~ SUFFOLK ' 079.s.e.p.h' .A. Cherepowidh being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the 9.w.n.e.r ' i (Contractor, agent, corporate officer, etc.) ofx~rk~v~r, ol-xorx~me~¢ and is duly authorized to perform or have performed the said work and to make and file this application; that all statements con(ained 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 2nd ~,,. ~ February ~o87 ......................... .................... ' ..... : / ~ f ' Notar~ Public, State of NewYo~k /~'./.(. · '1#.~' '~-,/' ¥~."'~.. "~'-'~.'.~ ' '~ ............. , - No. 48211818, Suffolk County /~4~ose~h A. Cherepowi~h (Signature of applicant) : mrm Expires September 30; 1088 ~" -,