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Home My WebLink AboutBroad View Guest HouseSUPERVISOR'S OFFICE 16 South Street Greenpor+, FI. Y. TeL Greenport 7-0~S0 BUILDING DEPARTMENT TOWN OF $OUTHOLD SUFFOLK COUNTY, N. Y. TOWN CLERK'S OFFICE Mal. Street Southold, N. Y. TeL 5o~thold 5-3783 BU[LDIN& ~NSPECTOR'S OFFICE Sou%ho1&, ~,Y,' CERTIFICATE OF OCCUPANCY "BROAD VIEW GUEST HOUSE" THIS CERTIFIES that the building located at _~./~ _-!~__- P_~,-,.~_I_~ n_.7 R.~_~,,._..,~ Street, h/lap No. ~.el,&,lS , Block No. e~l~l,e.~ , Lltll~. Ma++.q_+..*~,?~; N..Ye in the Town of Southold, conforms substantially ~I~I~~~I~i~;~Aa'~'_~_L~_-~iA.--~,~--w-~i~g'J_w~w~R~ menfs ~ the appl;ceb~ pr~islons of the law. ~e occupan~ ~or ~ich this ~Hificate is ;ss~d is This certificate is issued fo ' {ow~,, ess · or renan of the aforesaid building. Xseued after oorreotion of Violation not, toe ~ tO1 Inspector (l~e Ce~ficete of Occupancy will be issued only after the Building Inspector is convlnced of the completion of the construeflon In compliance wlth the Multiple Residence Law and with other laws, ordinances .or regulations affecting the premises, and in conformity with the approved plans end specifications, SUPERVISOR'S OFFICE 16 South Street G~eenport, N. Y. Tel. Greenport BUILDING DEPARTMENT TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. TOV~N CLERK'S OFFICE Main Street Seuflmld, N. Y, Tel. Southoid $-3783 CERTIFICATE OF OCCUPANCY No. ~1 l?& Date ~W. ~ 19._~_ THIS CERTIFIES that the building located a+ ale u .... 4.. ~._ u'~,,~ Street, MapNo. ~ ,B~kNo. m ,Lot No, in the Town of Sou~old, conforms subsfantial~ fo the approved plans and specifications heretofore fi~d in ~is o~ce wi~ Application for Building Permit dated ~m~t 1~ 19~ pursuant fo which Building Permit No.~, dated ~ 19 ~, was issued, and conforms fo all of the require- ments of the applicab~ provisions of the law. ~e occupan~ for which this ~dificate is issued is This ce~ificate is ~ssued ~ ~ ~ g.~.~ ~ h~v~eve (owner, lessee or Senant) of the afore~id bu~ld~n9. Bu~lding Inspector (The Certificate of Occupancy will be issued only after the Building Inspector is convinced of the completion of the construction in compliance with the Multiple Residence Law and with other laws, ordlnances.or regulations affecting the premises, and in conformity with the approved plans and specifications.) FORM NO. 5 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Affidavit of Final Cost of Construction STATE OF NEW YORK COUNTY OF S~L~folk I ss.: BROAD VIEW GUEST HOUSE '"'~""?' ...... "i being duly sworn, deposes and soys: that he (she) is the applicant (or agent of the applicant) named in the Application, for Building Permit dated ........................ ~$b..-..~...3 ....... 19.~)~, ...... relating to construction or other work to be performed on, or in connection with, the premises located at ...~/,~..~.el~.Q:~,~,~...~jt~...~.],.V.l~.e.~... ...~t.jr.~'l.l...~,Y.~ .............. ; that the estimated cost stated in said application, of the construction or other work described therein was ~9/O Thousand Dollars ($...~..~..0...0..0..: ................ ); that the actual final cost of such construction or other work was ................... ~ ................................................................... Dollars ($ ................................ ) end that the said construction or other work was performed in ac,Qgrdance with the applicable provisions of law. .......... Sworn to before me \ th~s.....~...day of...:}.~~~ ..... ~..~...~ I'gotar y PuBlic Permit No. I~I 1~..1..~.,,~ .................... Filed Cost $. 2.,.~.Q{~ ............... Permit Fee Poid $.~.,.0~. ................. Final Cost $,.....~..~ ........... Additional Fee $.~...~...' ................... (Cost~ for the work described in the Application for Building Permit include the cost oi all ~f the construction and other work done in connection therewith, exclusive o;/ the cost of the la~d. If the final cost is less than the estimated cost stated h~ the Application for Building Permit, no portion of the fee paid upon the filing of the application will be refunded.) Origina for Municipal Building Department STATEMENT OF REGISTRY To be filed in duplicate with the municipal building department or local enforcement agency by every owner of a multiple dwelling, as defined in subdivision 33 of section 4 of the Multiple Residence Law. Within 30 days after the filing of this statement, the municipal building department or en- forcement agency is required by section 300, Multiple Residence Law, to file a duplicate copy hereof with the State Building Code Commission, 1740 Broadway, New York 19, N. Y. 1. locationof multiple dwelling: j~ (a) Street and number ..... [..~..C.cK~.~..~....J.'m~-,~...'..,~.....~.C) cb, ........ ....... ........ 2. Description: (a) Type of construction ....~.~..~.~.~.~...~..:.~~..~ (b) Heioht of buildino, includin~ number (C) Type of heating facilities ...... ~.~.Ct....~...~~J....~~ (d) Number of apartments ........... .~ ................... ~ ....................................... J ........ (e) Number of living rooms ............ ~ ....................................................................... (f) Number of kitchenettes ........... .~ ........................................................................ (g) Number of bathrooms ........... .~. ........................................................................ (h) Number of water closets ...................................................................................... (i) Number of occupants for which building was de~ned or intended to be occupied or used ...................... ~...~..~.., ..~ .~.~. i.. ~ ....................................... 3. Age of (a) (b) multiple dwelling: . .~.~- Date when constructed ......... k~.~..~.......'~....~.~.. Dates of substantial additions, alterations or modifications of dwelling, with brief description thereof .................................................................................... (c) If now under construction, state when construction commenced and anticipated date of completion ............................................................................................ 4. Use: Describe the principal use made, or, in the case of buildings under construction, to be made, of the multiple dwelling (such as apartment house, hotel, apartment hotel, lodging house, boarding house, school, convalescent, old age or nursing home, pri- vate dwelling two or more stories in height with five or more boarders, roomers or Jodgers, or other classification of multiple dwelling including those specified in sec- tion 33, Multiple Residence Law). ........... ........ ...... f.~,..~ 0~,) .' __ ~ _ ~'-----~ ~ (~ ,STATE/v~NT OF FILING (Building Depar~n~en~ o~ OLder E~forcement Agency) ...... .~...~.~...~~ the ........ .~...~.~..~.....~.....C:/. ....... ,9~..7 (Name of~u~'c'pa 'ty) /~/_ (Date Of ~iling) Original for Municipal Building Department I~ STATEMENT OF REGISTRY To be filed in duplicate with the municipal building deportment or local enforcement agency by every owner of a multiple dwelling, as defined in subdivision 33 of section 4 of the Multiple Residence Law. Within 30 days after the filing of this statement, the municip~31 building department or en- forcement agency is required by section 300, Multiple Residence Law, to file a duplicate copy hereof with the State Building Code Commission, 1740 Broadway, New York !9, N. Y. (a) Street and number (b) Mun c pal ty ................... ~~ ...... ~.~~.~....~.~. Description: . f ..... O ~ L (b) Height o bul d~ng, incladlng ~umbe~ of stories ...~..~.~...~ ....... Type of heat ng fac t es ~ ~O (c) ......... ~..... ........................ (d) Number of apartments ~..~.a.~...~.~.~.~...~..g.m~ (e) Number of living rooms .............~ ........................................................................ (f) Number of kitchenettes ........... ~ ........................................................................... (g) Number of bathrooms .......... ~ ......................................................................... (h) Number of water closets ....... ~ .......................................................................... (i) Number of occupants for which building was designed or intended to be occupied 3. Age of multiple dwelling: (a) Date when constructed ............. ~f.~.~ .............................................................. (b) Dates of substantial additions, alterations or modifications of dwelling, with brief description thereof .................................................................................... (c) If now under construction, state when construction commenced and anticipated date of completion ............................................................................................ 4. Use: Describe the principal use made, or, in the case of buildings under construction, to be made, of the multiple dwelling (such as apartment house, hotel, apartment hotel, lodging house, boarding house, school, convalescent, old age or nursing home, pri- vate dwelling two or more stories in height with five or more boarders, roomers or lodgers, or other classification of multiple dwelling including those specified in sec- tion 33, Multiple Residence L~,~ ............ , . TOWN OF $OUTHOLD APPLICATION FOR BUILDING PERMIT PURSUANT TO MULTIPLE RESIDENCE LAW Altered or Converted Multiple Residence Building APPLICATION NO. /~' ~-~- / LOCATION f~--~/~'t~-~ ~,4-y House Number Street Distance ~rom Nearesf~:orner Height: Area (i) Type of Occupancy of Building to be altered or converted (Permanent, Transient, or PHvate) (2) Type of Construction (Fireproof or Non-flreproof) (3) Use and Occupancy after Alteration or Conversion (4) A new C of O (will) (will not) be required ~ !/~- ~ Story (include EXISTING OCCUPANCY PROPOSED OCCUPANCY Cellar & Basement) Persons to be Apts. Rooms Apts. Rooms Accommodated CorB Second ,/ Th;rd Fourth Fifth Sixth Seventh TOTAL C7/ ~ ./,/_:, (5) State generally in what manner the Building will be altered or converted (6) Estimated Cost of Alteration or Conversion (7) Is Appllcat;on made to remove violations? If yes,: State Violation Number (8) State what disposition will be made of waste and sewage ~,~ ~ c~ ~ p ~ L~ J---, (Public sewer, private sewer, cesspool, etc.) Page I STATE OF NEW YORK COUNTY OF SUFFOLK (Typewrite Name) being duly sworn, deposes and says: That he resides at in the City of. in the State of · that he is making this application for the approval of (Architectural, structural, mechanical, etc.) plans and specifications herew~h submitted and made part hereof, and that to the best of his knowledge and belief, the work or construction will be carried out in compliance with such plans and specifications, and that it will conform to all epplicable provisions of the laws governing multiple residence construction. (SIGN HEP`E) , Owner Sworn to before me, this day of , 19 Notary Public or Commissioner of Deeds if application is to be executed by someone other than owner, acting in his behalf, the following additional inform- ation should be supplied: Owner's Name .Address (If a corporation, give full name end address of at least two officers) (SIGN HEP, EI , Applicant Sworn to before me, this ~ey of , 19 Notary Publlc or Comm~ssloner of Deeds FOR OFFICE USE ONLY Examined and Recommended for approval on 19 Approved on 19 Superintendent. Work commenced on. 19 Date Completed 19 I HEREBY CERTIFY that the above report is true in every respect and that the work indicated has been done in the manner required by law and Rules and Regulations of this Department. Signed Inspector. Page 2 TOWN OF $OUTHOLD Multiple Residence Law Permit PERMIT NO. i~i ~.e~u:jz..3' ],~9 62, APPLICATION NO.~ 19 (.,,2, LOCATION ~'~ P~:onic Bray Blwd~ ~cu-ul Application having been made coverJng construction on a , 19/- , for a permit multiple residence building, by or in behalf of , for a dwelling located as above stated, and the said application having been examined and recommended for approval on ~,~.%K.T,~- ~ , 19 ~,~, a PERMIT is hereby issued for the performance of the mL~-~,r~-m.~. (architectural, str~cturat, mechanical, etc.) work described in the above numbered applice+ion and any accompanying plans and specifications. If no work is performed within one year from the time of its issuance, this PERMIT shall expire by limitation. Approved ~'e~ tz~Z',lr i~ 19 6~- Enforcement Officer FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam ned .......................................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su6mitted in duplicate to the Building Inspector. 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 location. 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 issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of 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 issuanc,e of a Building Permit pursuant to the Building Zone Ordinance 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 herein described. The applicant agrees to comply with all applicable laws, or~J,h.~qces and regulations. (S~gnature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................. ...................................................................................................................................................... Name of owner of premises...~:.%;~:..~, ................................................................................... If applicant is a corporate, signature of duly authorized officer. / (Name and title of corporate officer) Locatonof and on wh ch proposed work w bedone MopNc~.~; ~,~.,.' '~J.~)~LotNo' Street and Numb .............. . ..I .... ./. ......... ..................... .......................................................... Municipality 2. State existing use and occupancy of premises and in,tended use and occupancy of proposed construction: o. Existing use ond occupancy ....... ...................................................................................... b. ntended use and occupancy ~ ....................................... 3. Nature of work (check which applicable): New Building .................... Addition ..... /~ .......... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ...... ..~....~.~..~..Q.,.....~... ...................... Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... .~. ............. Number of dwelling units on each floor ........ ~ ................ If garage, number of cars ............................................................................................................................................ 6. If business, commercial er mixed occupancy, specify nature and extent of each type of use..~_,~ ............. .9- / ~ / 7. Dimensions of existing structures, if any: Front ......... .c~......: ......... Rear ........ ~.~/(. ............ Depth ....~.D..~ .............. ! Height ........ /....~.. ............. Number of Stories ..... /. ..................................................................................................... Dimensions of same structure with alterations or additions: Front ....... ..~'..~'.~ ............... Rear ...... Depth ......-~...c.'?..x. ............... Height ....~'.. ...................... Number of Stories ................................ 8. Dimensions of entire new construction: Front .......... ..~'..~.' ............ Rear ...... ~.....'~../. .......... Depth ...~...(~.../. .............. Height .....:.~....~':..~i ............ Number of Stories ....... ?.'~. ............... 9. Size of lot: Front ..... ~..-O...~ ............. Rear ...../...~.. ............... Depth ........................ 10. Date of Purchase ...... ..~....~..~..~ .......... /...~..)..'~ ....... Name of Former Owner .~./~..,~.~.)ff.......J~'..~:..~...~../.-,¢~ ............ 11. Zone or use district in which premises are situated ................................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? 13. Name of Owner of premises.,,~-~.~.~ ...... Address .~,~--,,~zb .~..7~J~-~.. ........ Phone NO/J/],6.~..~..~...~ Name of Architect ........................................................ ~' Address .................. '"" ..................... Phone NO ..................... Name of Contractor....~.~.~'..~/~~Address ~.~.~....'~.../. ....... Phone NO.~.,'~.?..:..O..O..~.,~ PLOT DIAGRAM Locate dearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. ,~C~'~/~ STATE OF NEW YORK, ) S S. COUNTY OF ............................ ) ................................................................................................ being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ............................................................................................................................................................. (Contractor, agent, corlborate officer, etc.) of said owner or 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 set forth in the application filed therewith. Sworn to before me this ~ ~'t~o~-~:' ~-v~ No. 5~-~5~ . ........... .~ ....... day ~of .~,~ ..................... 19~ ..... ' ~gnature of apphcont) ~ TOWN OF $OUTHOLD APPLICATION FOR BUILDING PERMIT PURSUANT TO MULTIPLE RESIDENCE LAW Altered or Converted Multiple Residence Building APPLICATION NO. "tJJ~l ""~ LOCATION P~" C. ~ t~ I C House Number Height: ,/~ J"~' · ! Street Area Distance from Nearest Corner (I) Type of Occul~ancy of Building ' to be altered or converted /"'f ( ~'Permanent, Transient, or Private) {2) Type of Construction ~)~ on-fireproofI (3) Use end Oceupency after Alteratlon~ ~c_ . . ~ or Conversion. (4) A new C of O (will)..~lJll~ be required Story (include EXISTING OCCUPANCY PROPOSED OCCUPANCY Cellar & BasemenfJ Persons +o be Apts. Rooms Apts. Rooms Accommodated CorB Second Third Fourth Fifth S|~fh Seventh TOTAL (5) State generally in what manner the Building will be altered or converted 16) Estimated Cos+ of Alte.ation or Conversion (7) Is Application made to remove violations? If yes,: State Violation Number .~ (8) State what disposition will be made of waste and · (Public sewer, private sewer, cesspool, etc.) ~ Page I STATE OF NEW YORK COUNTY OF SUFFOLK being duly sworn, deposes and says: That he (Typewrite Name) resides at in ('he Clfy of ~ A U ~_ ~ ~ in {'he S('ate of ~ ("/ · ('ha+ he is making this application (or the approval o~ ~ ~' ~ U ~ ~ ~ U h (Archifecfural, structure), aachen)cai, eft.) plans and specificaHons herew)h submif+ed an~ made par+ hereo~, and +haf ~o +he best o( his knowledge an~elle(, the wor~ or cons+rucHon will be carried out in comp~iance w)fh such plans and specifications, and fhaf if wlll con(ora +o ail applicable provis)ons o( the laws governlng mulf~le residence consfruc+ion, (SIGN HERE) ' , Owner Sworn fo before me, this / ~/'~ day of ~ ~ ~ ~ ' ,19, ~ , Ho. 52~7~ ~ . ~ ~mm~ss~on Expires March ~, 1~ I{ appl[caflon is fo be executed by someone of her than owner, acHng in his behalf, fha ~ollowlng additional ~n{orm- etlon should be supplied: , .Address ~ (If a corporaHon, g~ve full name end address of a~' leas{' two officers) (SIGN HERE) Sworn to before me, this day of , Applicant , 19 Notary Public or Commissioner of Deeds FOR OFFICE USE ONLY Examined end Recommended '~or approval on Approved on 19 19 Examiner. Superlnfenden{'. Work commenced on 19 Date Completed 19 I HEREBY CERTIFY that the above report is true in every respect and that the work indicated has been done in the manner required by law and Rules and Regulations of this Department. Signed, Page 2 t t .... -It TOWN OF $OUTHOLD APPLICATION FOR BUILDING PERMIT PURSUANT TO MULTIPLE RESIDENCE LAW Altered or Converted Multiple Residence Building APPLICATION NO. / ~ ~ ~ H 19 House Number Street Distance from Nearest Corner Helghf: ~ ~ Area / ~' c~0 ~ F T to be altered or converted (Permanent, Transient, or Private) (2) Type of Construction /~'.'"~C.,--~- //~O"~(F;reproof or ~'~ 'N~ (3) Use and Occupancy after Alteration or Conversion (4) A new C of O (will) (will not) be required Story (include EXISTING OCCUPANCY PROPOSED OCCUPANCY Cellar & Basement) Persons fo be Apts. Rooms Apts. Rooms Accommodated Cor B Second Third Fourth ~fth Sixth Seventh TOTAL State generally in what manner the Building will be altered or converted _ ~:~/~ ~ (6) Estimated Cost of Alteration or Conversion ~5-o ~ (7) Is Application made to remove violations? If yes,: State Violation Number /~/'0 (8) State what disposition will be made of waste and .wage t/~'~-~ ~ ~o"~----~ , (Public sewer, private sewer, cesspool, etc.) Page I TOWN OF SOUTHOLD Multiple Residence Law Permit PERMIT NO. 11~ .T~ 4 19LAPPLICATION NO. LOCATION .~ ~m{n t~ RI~I.. ~.~. Application having been made on covering construction on a Air.m,1 , 19.~, for a permit [new, altered, or converted) multiple residence building, by or in behalf of ~-__~ owner) , for a dwelling located as above stated, and the said application having been examined and recommended for approval on _~-_~---%w~' ~. is hereby issued for the performance of the Rt.~q.atewnl ~le (architectural, structural, mechanical, etc.) . 19.~1~, a PERMIT work described in the above numbered application and any accompanying plans and specifications. If no work is performed within one year from the time of its issuance, fhls PERMIT shall expire by limitation. Approved " E~f~r~¢em~nt Office~. / Original for Municipal Building Department STATEMENT OF REGISTRY To be filed in duplicate with the municipal building department or local enforcement agency by every owner of a multiple dwelling, as defined in subdivision 33 of sect/on 4 of the Multiple Residence Law. Within 30 days after the filing of this statement, the municipal building department or enforcement agency is required by section 300, Multiple Residence Law, to file a duplicate copy hereof with the State Build- ing Code Commission, 1740 Broadway, New York 19, New York. h Location of multiple dwellbg: ~r~ (a) Street and number ~'~ ' ~'~ ~1 ~ 4. (b) Municipality ~/I ~'~ ~j~_~__~ .-~. ~'~. ~! 2. Description: (a) Type of construction _ ~.~-~-~.-. S {b) Height of building, including number of stories __~-~_c~ . ~ .~. ~T' (c) Type of heating facilities (d) Number of apartments {e) Number of ]ivlng rooms (f) Number of kitcheneHes (g) Number of bathrooms (h) Number of water closets (1) Number of occupants for which building was designed or intended to be occupied or used 3. Age of multiple dwelling: (a) Date when constructed ~ ~ :~ · (b) Daf es of substantial additions, alterations or modifications of dwelling, with brief descrip- tionthereof ~J~ (_'~-"u.,-~ ~-e..A',-..~,,~-.,m.--. oJ.~.~ I If now under construction, state when construction commenced and anticipated date of completion Use: Describe the principal use made, or, ~n the case of buildings under construction, to be made, ?the multiple dwelfing (such as apartment house, hotel, apartment hote~: Iodglng house; board- mg h.ouse, school, convalescent, old age or nursing home, private dwelhng two .or more stories in hmght with five or more boarders, roomers or lodgers, or other classification of multiple dwelling bcluding those specified in section 4, subdivlsbn 33, Multiple Residence Law): Dated a+ ~/~~c~ , New York (Name of Owner) (Address of Owner) . . , STATEIv~ENT OF FILING (Name of ~unlcipali~) (// /Date ~ Fil:.~) ~ig~ature and Design[tion of O~icior Statement of Regkfry was ~led} I t I BATH 30:-0" fWINDOW SIZE5 Z 1%0"× 51 'u I ~o"x4o" ~BgOADVIEW APAg¥~