HomeMy WebLinkAboutZ-12414 FORM N0.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
U P D A T E D
Certificate Of Occupancy
No....Z12414 April 5 84
Date .................................19...
THIS CERTIFIES that the building --dwelling,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Location of Property ..245. Bay, Road, ,1465, ,Sandy .Beach Road Greenport
House No. Street Hamlet
County Tax Map No. 1000 Section ...043......Block ...44..........Lot .:...042 , , , , , , , ,
Subdivision X .........................Filed Map No. ..X .....Lot No. X .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
,September. 8, , , , , 19 5$ pursuant to which Building Permit No. 432 . Z.. , , , .
dated September 19 58. ,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.updated C.O. for private one-family dwelling.
The certificate is issued to ....A~7TOAJ, yd,., I~,U,R~~,~,,Z , HIS ,WIFE , JU,LIA.......... .
(owner, lesseeerterrent}
of the aforesaid building.
Suffolk County Department of Health Approval no ,record
UNDERWRITERS CERTIFICATE NO no ,record
Building Inspector
Rev. 1/ai
' FORM NO. B
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, 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 Inspec-
torwith 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, acertificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
8. 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
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 $5.00 //r
2. Certificate of occupancy on pre-existing dwelling / land use s!S/$5.00
3. Copy of certificate of occupancy $1.00 /
Date ,February 3, 1984
New Building .............Old or Pre-existing Buildi XX Vacant Land
~ay Road""'
Beach Road Green ort
Location of Property P . .
House No. Street Ham/et
Owner or Ownersof Property , , , , Anton CV. and Julia Ficurilli
County Tax Map No. 1000 Section , , , 043 ,Block ~.4 Lot . , , , 042
Subdivision .................................Filed Map No. ..........Lot No. .
Permit No. Date of Permit ..........Applicant .
Health Dept. Approval . ..Labor Dept. Approval .
Underwriters Approval .........................Planning Board Approval , .
Request for Temporary Certificate .....................Final Certificate , , , , XX
Fee Submitted $ . , 15.00
Construction on above described building andC ~~iirmit meets all le codes a ulations.
Applicant ...C~I"!..~.
, . .L
Irving L. Price, Jr.~ ~Att~ ~ ey%~lgent 'f6Y"
a«.~o-toes Anton W, and Julia Ficurilli
_
Premises at Beach Road and Bay Road
Greenport, New York
STATE OF NEW YORK) ss.:
COUNTY OF SUFFOLK)
I, JULIA FICURILLI, residing at 215 Fourth Avenue,
Greenport, New York, being duly sworn, deposes and says:
That I am one of the present owners of the premises located
at Beach Road and Bay Road, Greenport, New York, and designated on the
Suffolk County Tax Map as District 1000, Section 043, Block 04, Lot
042, and am familiar with the condition of same;
That the structure situated thereon has been designed,
arranged and physically occupied as a single family dwelling;
That at this time the premises is/is not occupied; '
That the condition of the existing structure on the premises
is good;
That I make this affidavit in the knowledge that the Build-
ing Department of the Town of Southold will rely on the accuracy there
of in issuing a certificate of occupancy for pre-existing use.
ulia Fi uril i
Sworn to before me this
zd
day of , 1984.
Notary Publi
uui/IS M, CANNON
NOIgLLY PUBLIC, State of N.Y
Sulf fo. No. 470159q
term Expires March 3Q 1901
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CERT/F/ED TO
MAP OF THE T/TLE GUARANTEE CO.
DESCR/BED PROPERTY ROBERT P. SHUHY
ANN MAR/E SNUNY
EAST O~' THE V/LLA6E OF
6REENA~4T
TOWN OF SOUTf~LO y<P`%W,
of yo,~, dOf10CI~ OSSOCI~IteS
SUFFOLA' CO.,Mr '~o~o ~A
"9~~\~ 313 west main street
* Q ~ riverhead ,new York 11901
(516) 369-1717
AREA ~ d;6e? ~ • '~~yy+~,"~' 48269 ~t~JO~ JAN.16, 1884 Joe Pb. 84-418
0./S3~ ACRES ~ SAND SuQ 1000-043-04-42 Sca le I •20