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HomeMy WebLinkAbout1429-ZFOR~I NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. CERTIFICATE OF OCCUPANCY THIS CERTIFIES that the building located at ~J~/~..J~t.,~OW~.....~ .......................... Street Map No~ll, ........... Block No ....................... Lot No. ~ ....... ...J~...$.t~.$.1~.¢~ .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .............................. ~'~......~ ................... 19.6~... pursuant to which Building Permit No ..... ~'~'..?. dated ............................. ~.lJ~tJ,~......~'......, 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 .......... ............... ~.~te..~me..~..~ m~ l~....~e lliag .............................................................................. This certificate is issued to ..~l~-tlJl:.... l~.~..J~J:Jal~d.~, ............ 0~l~l~. ................................................... (owner, lessee or tenant) of the aforesaid building. H.D. OK, Sept 27,'61, ~aJkow~ki. ..... ........................ Building mspec~ojr FORbl NO, 2 TOWN OF SOUTHOLD 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? 1429 Z Date .......................... ,,,'[';Ll~ ........ ~ ............. 1 9.6~,.. Permission is hereby granted to: A. Re 11F.-&. ~.~oas.-.tr~.....A/C....-l~.amk.. ~r.kha~.dt to l~u~L.ld ·..n~w.. one. -£.~.~...t ¥...d~a.]:t ~.n g ...................................................................................... or premises Iocoted or '-W/S'-"-MayT'tow~r"'.~o~d ........... (.)~.so~.) ................................................ .................................................. Ma.t,t~i.t, uei~ .s..... ~-~ .¥~ ........................................................................ pursuant to application dated .................................... ~T~I'~.....,~ ........... ]9.6]:., and approved by the Building Inspector Fee $"'~O'&~)O ........ FORM NO. 6 TOWN OF $OUTHOLD Building Depor~ment Town Clerks Office Southeld, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY 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 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 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: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date ..--~ ...~. '/').~.L.~..~:~ New Building ........~.......-Addit~ion ............... Old or Pre-~:~.~h,u uu,,umg .:..~. .......... Vacant Land .............. Location Of Property ........ r,,F~ ['t __ ~]...~.....~.~. ~~..~...~.....,......~.~.~..~,~...~.~/~.l......~......~..;y' Owner Or Owners Of Property ...... .....~....~. ~-..%....~.......~.~.~,~ ............................................................. Subdivision ................................................................ Lot No ............. Block No ............. House No ............. Permit No ..................... Date Of Permit .................... Applicant .................................................................. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporar~ ~Certificate ...................................... __~F hal Certificate.~7 .... ~ ............................ Fee Submitted $..~..~...xy<zC: ............. //':,? / ~ ~ Construction on above described building and pe~ ~ F~p~ble c~es and~gulations. ................ .................... c. ':' .. ..- z' Not, w v,b i .................................... Co,,ty ::' 7 GARY FLANNeR Olsen COUNSELLOI~ AT LAW P. O. BOX 38 · July 1, 1980 Re: Ales to FIuzsek File # 2831 Gentlemen: Enclosed please f.i~.d my attorney's check in the sum of ~I'. O0 f~ cover the cost of a Certificate of Occupancy. GFO/clr ~ I~~EN E~c. Building Inspectors Office Town of Southold Town Ball Southold, New York 11971 FOIJ. I~! NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. '.'5 Examined ............... :~.~.~.~.. ......19..~.../... Approved ................ ~ . 19 No ........................... .., , ....... .... Disapproved a/c .......~ ...... ~ ................................... · .. .......... APPLICATION FOR BUILDING PERMIT Dote ............................... ~'~.....~. ............ 1961 ....... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showlng location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a Uetailed desc:ription of layout of property must be drown on the diagram which is part of this location. c. The work cove~ed by this alSplicotion may not be commenced before issuance of Building Permit. d. Upon approvali of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept ion the prer~ises available for inspection throughout the progress of the work. e. No budding sh~ll be occupied or used ~n whole or in part for any purpose whatever until a Certificate of Occupancy shah have been grani~ed by the Building inspector. APPLICATION IS HEREBy MADE to the Building Deportment for the issuance of a Building Permit pursuant to the Building Zone Ordinqnce of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or a Iterations, or for removal or demolition, os herein described. The applicant agrees).to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whet.her applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................. ~nt:~ao~:~r ........................................................................................................................................... Name of owner of premises ......... Jl~..J~A~Jlr,~ ....................................................................................................... If applicant is o co~'porate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of ,l~nd on which proposed work will be done. Map No: ....... JJ~,~rt- ........................ Lot No: ....~1:~ ........... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ............... .~.~_sJ~Ll~.,'J~l~J. .......................................................................................... i1' property lines. Give street and block numbers or description according to deed, whether interior or corner lot. 3. Nature of work (check which applicable): New Building.....~ .......... Addition ................ Alteration ................. Repair ....................Removal .................... Demolition ....................Other Work (Describe) .............. 4. Estimated Cost ....... '1],,O00...00 .................................. Fee ........~0 ............................................................................. (to be paid on filing this applicatiorO .5. If dwelling, nurnbsr of dwelling units ...... .O!2~ .................. Number of dwelling units on each floor ....................... If garage, number of cars .......... OI~ ............................................................................................................... 6. If business, commercial er mixed occupancy, specify nature and extent of each t.,pe of usc ..................... 7. Dimensions of existing structures, if am: Front ............................ Rear ..................... Depth .............. Height ............................ Number of Stories .................................................................................................. Dimensions of same structure with alterations or additions: Front ............................. Rear ............... Depth .............................. Height .............................. Number of Stories ............................ 8. Dimensions of entire new construction: Front .......... i~1'. ............. Rear .......... ~' .... Depth ...... .~' ........ Height ............................ Number of Stories ~1~ .................... 9. Size of lot: Front ....... 1100 ............ Rear ...... .1[0~ ..............Depth ...... ~I.~'Q .............. 10. Date of Purchase ............... 11111.~...."1-96.1[ ................... Name of Former Owner ........ ~all.~l'/. ..................... ]1. Zone or use district in which premises are situated .......... ~.~...Z'.~IlI~f]~Z1.t,~.I~. ........................................ 12. Does proposed construction violate any zoning law, ordinance or regulation~ ...... nO ................................. 13. Name of Owner of premises. J~Jr,,~&~'.dt~ ................ Address ...~...?~.],.e...]~.~...~..jl/~l~ lx~l~.~: ................ Name of Architect ........................................................ Address ........................................... Phone i',JO ............... Name of Contractor...Jl~.o...l~,~1].1[,IK..&..~.Ol~-..,'r-3,'l~Address ......................................... Phone NO ................... PLOT DIAGRAM Locate clearly and distincth/ all buildings, whether existing or proposed, and indicate oll set-back .-Jimens~ons from and show street r, ome~ and indicate STATE OF NEW YORK. ) S S. ............................... l~O~,mm~ .I~'I ].~. ................................. being duly sworn, deposes and soys that he is the applicant (Name of individual signing application) .~/ ~ ~. ~ ~) ,.~7///~ .~c~.~-~_~ above named He is the .............. ~oz~Zr~o.toz'. ............ ~..:l~.-..~.. ............ ~...~..:....,Z./.i..'~'..t..:..~..~........~:~.....~. ...... (Contractor, ageht, corhorate officer, etc.) . /. of said owner pr owners, and is duly 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 be performed in the manner ~t~jT~O~'.l~,i~ ,the application flied therewith. Sworn to before me this ',.~,~, ~,~,~..- :?~. :. .................... ~... day 4~f ~T.I,~I~ ..........~,~,.'~j~;~ ~ '~,D (Signature of applicant) THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY ~aalt 85 JOHN STREET. NEW YORK, NEW YORK 10038 D.,. ~ 2, ].gso ,~ppii..on No. o./,i, o~o122 N 5 0 2 17 6 THIS CERTIFIES THAT only the electrical equipment as descril~d below and introduced ~y the applicd~t named on the abeme ~oplica~ion ~umber ~n the premises of in the following location; ~ Basement [] Ist FI. [] 2nd Fl. Section Block Lot was examined on ~ 25, ~80 and found go be in compliance with the requirements of this Board. FIXTURE EXTURES . RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT DRYERS E R V I C OTHER APPARATUS: This certificate must not be altered in any manner; return to the office of the Board if incorrect.~ ~nspectors may be identified COPY FOR BUILDING DEPARTMENT. THIS COPy OF CERTIFICATE MUST NOT BE ALTERED IN ANT MANNER.