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Home My WebLink About14148-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy THIS CERTIFIES that the building ...s.c..v ?.e.q e..d.p.o.r..c ,h ............................. Location of Property .... 52~ Green Hill Lane Greenport Ho,se ~/o: ...................... 's't/e3i ...................... County Tax Map No. 1000 Section ....3.3 ....... Block ..... .2 ......... Lot ...4..6 ............ Subdivision..E.a..s .t.e.r,n...S.h.q v..e .s ............. Filed Map No..5. 2. .3 .6...Lot No.. J.2.5. ........ conforms substantially to the Application for Building Permit heretofore filed in this office dated J.u.l.y 15 . . ,19 8.5. pursuant to which Building Permit No. 14.148Z. dated ...3.u.l.y...2.2 .................. 19.8.5., 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 ......... .... Add. ,~ .s c r.e. ar~e fl..12or~ .~,0..e,x%~.t/kr~g..d3ie. 3, ~ j-p.g ~ .......................... The certificate is issued to ... sd Ii, h I gM..L,. S.C. H13 (3~3t.g 13 ................................ (owner, I~J~ Rz~/Lr~(~ X X of the aforesaid building. Suffolk County Department of Health Approval .......................................... N?03549 UNDERWRITERS CERTIFICATE NO ................................................... Rev, 1/81 Building Inspector 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) No 14148 Z Permission is hereby granted to: .~..~..6':......~~_~ .................... ~....~...'c...~.~ ........... J..!.~..~..~ ..... ot premises located at ..................... ..~..~.....~...~...~ .............. · "~ ................................................................... 7~:~ ............................................................................ County Tax Map No. 1000 Section ...... ,.(~...,.~.,.,,,~. .... Block ...... ...(~.....,~7 ..... Lot No ........~.....~. ........... ,..'~... ~ 19.~,....., and approved by the pursuant to application dated ......... .... L..~.. ................ , ~'~ Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF $OUTHOLD 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 i~ ~ 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 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. Fees: I. Certificate of occupancy $5,00 2. Certificate of occupancy on pre-existing dwelling 3. Copy of certificate of occupancy $1.00 A.Vacant Land C.O, $5.00 $15.00 Date ...... ~ ........... / New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Proper House No. Street Ham/et Owner or Owners of Property County Tax Map No, 1000 Section ............... Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. Permit No././~l .~.~ 2. Date of Permit ~./~, J~%'~..Applicant../~f<'r.~,.. ~_~4 .~. ~>..~/~-~/ ......... 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? applicable codes and regulations. Applicant. ~"/. ~"~..~~. ......................... Rev, 10-10-78 //y/tC C.o. Zl Tf7 THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY SE, JOHN STREET, NEW YORK, NEW YORK-IOO3e -- August, 06,, 1985 347164/85 Willi~ Sc~he~ 525 G~ee~ll La~, ~ee~o~, ~ in the follotving location; ~ Basement ~ 1st Fl. ~ 2nd FI. Section Block Lot wasexaminedon ~ 29t ~985 andfoundtobeincompliancewiththerequirementsofthisBo~rd. 4 4 DRYERS FURNACE MOTORS FUTURE AFPUANCE FEEDERS TIME CLOCKS UNITHEATERS MULTI-OUTLET DIMMERS SYSTEMS NO, OF FEET SERVICE DISCONNECT S E R V I C E OTHER APPARATUS: 525 Greenliull ~ane~ Bo~ 608 ~his certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified ~L_~ ____ __co~p_~y F~QR~_?.~!?_,DI~NG~D_E~P_~AR!M~_NT. TH!~ Co~¥PF CER'~IE!C,~..TEMp~? NO~T:~£ ALTERED N ANY MANNER. FOUNDATION (1st) ---- FOUNDATION (2nd) ----- ~j m ~ 2. - ROUGtt FRAME & ~ P~UMBING .... .... ~ I~SULATION ~ER N. Y ..... STATE ENERGY , FINAL ..... ' ~ ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~°OUTHOLD, N.Y. 11971 TEL.: 765-1603 Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Rece±ved ........... 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, relationship 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 ~ Certificate of Occupancy isbell 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 iBuilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~Reguiations, 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 building for necessary inspections. ...... . . .................... (Signature of applicant, q~ ,name, if a corporation) · (Mailing address of applicant) :State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....................................................... (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 LicenseNo ......................... Electrician's License No ....................... Other Trade's License No ...................... 1:. Location of land on which proposed work will be done ................................................. ........................................................ House Number Hamlet County Tax Map No. I000 Section ...~.....~.~.. Block ....... ~ ........ Lot....~..~. ............ Subdivision .................. Filed Map No. ,~,~c/I Lot (Name) 2~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...." ~ . .~..& ..7~:&--'-- ............................. ..................... · Intended use and occupancy .................................. ~a:,~ ~,e;~ 8. ·.,. ·:.: ~: ................. 3. Natur, e of work (checklv~t~ich apblicable): New Building ..... Repmr ...... :.:... ~,...,!Remqvai .............. Demolition .............. Other Work ~ ~ ~ ~_[/~[:',._~ ~, (Desc~'~tion) 4. Estimated Cost ~ '~ .... F e .'m~?., ~ .... ~ } ' (to be prod on fihng this apphcahor) 5. I f- d~iiii~;m~b'6f' 6 f~lling ~nit s ............... Number of dw, ~lling units on each floor ................ If garage, number of cars ..... ~ ................................................................... 6. If business, commercial or mixed occupancy, specify nature ~d extent o' eac~pe of use ......... ?... .... ~ ' .~' ~P. R pth' '~ ...... 7. D~ensmns of ex~stlng structures, If any: Front ....... ear ... ~ ....... De ........... Height ............... Number of Stories ........ I ................................................ D~en~ions of same structure w~th alterations or additions: Front ..... ~ ......... Rear . .~ 9 ............ Depth ....... ~ .......... He~t ........... N ~mber of Stories ..... - 8. ~imansions oq ntire new consthction: Front ..... I~. ...... Height . /~ ~ Number of Ste~es f ..................... 9. Size of lot: Front ......... 1~ .......... Rear ....... /~...[ .... J. '[ bep[~ '~[2~['~[ "2 ..... 10. Date of Purchase .... ~. ....................... Name of Fomer }wner ............................. 11. Zone or use district in which premises are situated ................. 12. I)oes proposed construction yiptate any zoning law, ordinance or regulat~ 14. Name of Owner of premises Name of Architect ....... "~* ' '~'~ .................Address ...... Name :of Contractor .?.~.~.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or propos~ property lines. Give street and block, number or description according to dee{ interior or corner lot. STATE OF NEW YORK, COUN ..... j S.S (Name of individu~ signing contract) above named. ~ , · i (Contractor, agent, corporate of said owner or owners, and is dhly authorized to perform or have perf( application; that all statements contained in this application are true to th work will be performed in the man Sworn to before me this ~er set forth in the application filed there · ~ .... County ~/,pj?ved from premises: _Yes ll.l ...... Phone No, .e,/'.7...~:-.~' .~.~.~' .... ....... :... Phone No. . · ~..~'.~/'t/~.. Phone No. i~'.~.~, i'i~ ~, and, indicate all set-back dimensions from and show street names and indicate whether ~orn, deposes and says that he is the applicant ~cer, etc.) rmed the said work and to make and file this best of his knowledge and belief; and that the ~vith. (Signature of applicant) I