HomeMy WebLinkAboutJones, LenSUPERVISOR'S OFFICE
lb South Street
C-reenporf, N. Y.
Tel. Greenporf 7-0550
BUILDING DEPARTMENT
TOWN OF $OUTHOLD
SUFFOLK COUNTY, N. Y.
TOV~N CLERK'S OFFICE
Ma;a Street
So~thold, N. Y.
Tel. Southold $-3783
BUILDING INSPECTOR'S OFFICE
CERTIFICATE OF OCCUPANCY
"LADOR
(J/
No. 1 ~1. Date Jt~Ty Pq 1gq?
THIS CERTIFIES that the building located at E/.5 ~ueens La~e. (~/w fire d~t. ) Street,
Map No. ~e,~*.', :' ~*~,* . Block N~~*~'~'*'::'~, Lot No~
in the Town of Southold, conforms substantially fo the approved plans and specifications heretofore fi~d in +his
office with Application for BuiJdlng Permit dated ~ 10~ ;{~ch 7~ 19~, pursuant fo which
Buildine Permit No. ~ I O~ . dated ~[e.~O~ ~ ~ 19 ~, was issued, and conforms fo ail of the require-
ments of the applicab~ provisions of the law. The occupancy for which this certificate is issued is
This certificate is issued to
of the aforesaid building.
Len Jones (Owner)
(owner, lessee or tenant)
Bui,lding Inspector
(The Certificate of Occupancy will be issued only after the Building Inspector is convinced of the completion of the
construetlon in ¢ompi{ence with the Multiple Residence Law and w~th other laws, ordinances'or regulations affectlng
the premises, and in conformity wlth the approved p'lans and specifications.)
SUPBRVISOR'S OFFICE
16 South Street
Greenport, N. Y.
TeL Greenport 7-0550
BUILDING DEPARTMENT
TOWN OF $OUTHOLD
SUFFOLK COUNTY, N. Y.
TOWN CLERK'S OFFICE
Meia Street
Soutbeld, N. Y.
Tel. Southold $-37B3
BUILDING I'NSPECTOR'S OFFICE
307 Fourth Street
~reenport, N. Y.
Tel. Greenport 7-0101 J
CERTIFICATE OF OCCUPANCY
THIS CERTIFIES .+hat +he building located at ~,/'8 , ~eel~l I.~e Street,
Map No. ~Y B~ No. T~ZY ~ ~~ · M_ ~;
in +he Town of So~old, conforms substantially +o +he approved plans end specificefions heretofore fi~d in ~is
o~ce wi~ Applicati=n for Building Permit dated ~ ~ 19~, pu~uant to which
Budding Permit No.~, de~d ~ 19~, was iss~d, and conforms to all of the require-
ments of +he applicab~ provisions o~ +he law. ~e occupan~ for which this certificate is issued is
Th~s ce~ificafe is issued ~ T~ T~ ( ~ ~
.... ~ .......... ~ner, lessee or tenant)
of the af~e~id bu~ing.
Building Inspector
(The Certificate of Occupancy will be issued only at+er the Euilding Inspector is convinced of the completion of the
construction in compfiance wlth the Idultiple Residence Law end w~th other laws, ordnences or reg~Jetlons affecting
the premises, end i~ conformity with the approved p~ens and specifications.)
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 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. V.
1. Location of multiple dwelling:/]~,/,_\l,'t/'' ''
(a) Street and number ..... '~'~'/"'~'"'~'~)'"'"~)~"~
(b) Municipality ........ ...~. ~..~'......~...-
II
2. Description:
(a) type of construction .................. .~..~ ..............................................
(b) Height of building, inch. iding number of stories ..... /...~.../....~....,/..~-~..
(c) Type of heating facilities .......;.....~f~.~-:~.../~,~..
(d) Number of apartments ..........
(e) Number of living rooms .......... ~......~l~.--.'~..r.~::~..'.../~.:
...........- - - .....: ........... .....................
(f)
Number
of
kitchenettes
(g) Number of bathrooms ,. ......... q~,~/. _~ ct ~ ~'~'~~'""-"~'"~' ~'"~
(h) Number of water closet ......... ~...L~....~..~...,~...~..~..'~.....':~.....
(i) Number of occupants for which building was designed or intended to be occupied
or used .................... ..~...O... .......... . .......................................................................
3. Age of multiple dwelling:
(a) Date when constructed /~....~....~Z.. ......................
(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-
tion33~e ~Law).
STATEMEN-~ OF FILING
(Building Depart~ent~or O~her E~forcernent ~.geney)
..:~...~....~..~.... on the .......... ~....,..~....~.. ........ 19~.
(i~1'a~ o~ l~unic~pali~y)
/ / (Date of
(Signature and Designation oI Official with
whom Sta~nent of Registry was ~led}
~ No. s
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
^ffidavit: at: Final Cost: ot: Cons~rud:ion
STATE OF NEW YORK ~ ss.:
COUNTY OF ....~,~..o.:~.~ ...........................
.............................. .L..~.D........J...o..~..9..S. .............................................. , being duly sworn, deposes and says:
(applicant; or agent)
that he (slr~4~s the applicant (or agent of the applicant) named in the Application for Building
Permit dated .................. Fb~r..ch.....],~ ......... 19,5'.6. ....... relating to construction or other work to be
performed on, or in connection with, the premises located at ]~./.~. .Q..q.e.~..:q...s....L...a:.~.e ........
...... ?z~..~.~T~.~.Q:E~.t....,~^~^.; that the estimated cost stated in said application of the construction
or other work described therein was One t;hou$~zad doll. ars
Dollars ($,'1.~.0~.0~.Q0 ............ ); that the actual final cost of such construction or other work was
O~
...F...!..~.....'~...~....~..~. ....... I.~.....Lc....~.....~.ff~...~7.....g?. ....... .~.L.~ol[ars ($ ~ ~...0...O..M,,,'~O .~. ) and that the
said construction or other workwasperformed in accordan~he~provisions of law.
........................ /;'~;;' ~¢Z~Z; ;;' ;~';~;'; ..........................
Sworn to before me
Notary
Pe~t No. ~2. ....................... ~o~,~ ~,c. ~,, o, N., ~,~
~'dr ''~''''~-¥ff' .'~'xff' >'1 .~.F~.F"~F'~,., {~r"~ ......... Commission £x~ires March 30, 19~
Filed
Cost
Permit Fee Paid $..,~.~0.Q ................
Final Cost $,...i..~., .,~... .........
Additional Fee $ ....... ..'.~..:...0.,,-~...., ,~. ,,- r~L
(Cost~ for the work described in the Application for Building Permit include the cost of all o! the
construction ~nd other work done in connection therewith, exclusive of the cost of the land, ~f the
final cost is less than the estimated cost stated in the Application £or Building Permit, no portion of
the fee paid upon the filing of the application will be refunded.)
TOWN OF SOUTHOLD
APPLICATION FOR BUILDING PERMIT PURSUANT
TO MULTIPLE RESIDENCE LAW
Altered or Converted Multiple Residence Building
APPLICATION NO. / / 7 ~ C-.,..-C.~-~ //'~'~ 19 '~-~
L O CAT,ON ~/'~ ~ ~ ~ ~-'
house Number Street - DNfaflce~rom Noare~ Corner
(') Type of Occu~ency of BuiIding
to be altered or converted
(Permanent, Transient, or Private)
(2) Type of Construction ~':',"~--C~.~._.s~._---~
(Fireproof or Non-fireproof)
or Conversion
new C of O (w;ll)~.-*'~e required
Story
(include EXISTING OCCUPANCY PROPOSED OCCUPANCY
Cellar &
Basementl Persons to be
Apts. Rooms Apts. Rooms Accommodated
CorB
Second
TMrd
Fourth
Fifth
Sixth
Seventh
TOTAL
(5) State generally in what manner the Building will be al+erod or converted ~:~ ~
l
(6) Estimated Cost of Alteration or Conversion
(7) Is Application made to remove violations? If yes,: State Violation Number
(8) State what disposition will be made of waste and sewage ~'d- ~.~ ~' ~4;'
(Public sewer, private sewer, cesspool, etc.) ./C:>/~ i ~ A -T ~'
Page I
,o
STATE OF NEW YORK
COUNTY OF SUFFOLK
Len
being duly sworn, deposes and says:
Jone~
That he
(Typewrite Name)
resides at 415 third St
in the City of ~,~npr~-. in the State of ~T. V. · fhef he is making fhls
application for the approval of 8tr~ot~al
(Archltectur~l, structural, mechanical, etc.)
plans end s~cificetlons he~ew~h submitted ~nd m~de part hereof, end that to the best of his knowledge ~nd belief,
the work or construction will be carried out in compliance with such plans end specifications, end fhet it wifl conform
to ell applicable provisions o~the I~ws governing multiple residence construction.
,Owner
Sworn to before me, this /~ d~y of ~ ' , 19 ~
Notary Public or Oommissloner of Deeds ...... No. 52-~
If ~ppllc~tion is ~o be executed by someone o~her fh~n owner, acting in his behalf, ~he following additional ;nform-
ation should be supplied:
Address
(If a corporation, g~ve fu'll name_and address of at least two officers)
(SIGN HEREI .. , Applicant
Sworn to before me, this
day of , 19
Notary PubJic or Commissioner of Deeds
FOR OFFICE USE ONLY
Examined and Recommended
for opprovaJ on
Approved on
19
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 indlcafed has been done
in the manner required by law and Rules and Regulations of this Department.
Signed,
Inspecfor.
Page 2
TOWN OF $OUTHOLD
Multiple Residence Law Permit
PERMIT NO.
LOCATION
19j~8_.__APPLIOATION NO. 19 ~
Application having been made on
covering construction on a
, 19~, for a permff
multiple residence building, by or in behalf of
~ ~ (owner}
, for a dwall;ng located as above stated, and the said
application having been examined and recommended for approval on .~-...~-..~ 'l~ , 19_~, a PERMIT
is hereby issued for the performance of the
(erchitectur~I, structuraJ, mechanical, etc.)
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, this PERMIT shall expire by limitation.
--v - E~forc-ement ~)fficer
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 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. V.
I. Location of multiple dwelling:
(a) Street and number .... ~,Jg.o..r~l,tmJ~e~)....~,Ll~.e~i..l'.a~.e ...................................
(b) Municipality ...... .~.q ~'/Aq...g. ~.....~ g.~ ~ Q ~,.~, ~.....~ .~.1~'...~ ,~ J~. ..................................
2. Description:
(a) Type of construction .............~..~...8~ .....................................................................
(b) Height of building, including number of stories ...~.~.~.....-.....].....~.~.o..~.~r. .............
(c) Type of heating facilities ...........~_lq.~.e...e.....~..~..~.~.e...~. ............................................
(d) Number of apartments ...) ............. .]:.....D..o..~D.~.9.~'. ............................................
(e) Number of living rooms ...).....~....,~..~..:J:.,?..~..~...~.....~..~..~..~..O...O..~...~ .....................................
(f) Number of kitchenettes ...)....~....~.~.O..~.~..~. ..........................................................
(g) Number of bathrooms ~..~....~.....D.~..~g..~...-q~:..-..~..e..g..~...e.~.~...:~:-~...q...~.~...~'.~.. .....................
(h) Number of water closets .)...2..~h,S....-.....~...~/~l,J~....(~.~,.~.fl~.~ ....................
(i) Number of occupants for which building was designed or intended to be occupied
or used ........................ ~,0 .......... . .......................................................................
3. Age of
(a)
(b)
multiple dwelling:
Date when constructed .......................... ,~cj~.'~ ....................... ; ............................
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 ............. .../.....~......j ......... /. .......................
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-
vote 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 Law).
.................................................... Lab~...C;aml~ .........................................................
Dated at ..... .g.~..~.~.l:~.g~...~ .............. New York
............... ~..g,.~... ~.~. ......................... 195.?. ....
...... Lezt..~o~zes ....................................
(Name of O~ne~O
.... )415...3~.&..S.~.,,...Gneanpa~.t .......
(Address of Owner)
TOWN OF $OUTHOLD
Multiple Residence Law Permit
PERMIT NO. / ~ ~ 19 ~'7 APPLICATION NO. I O ~ 19 ,~ 7
LO~ATION ~ SlID ~; (llJ~N JANE ABOUT ~00
Application having been made on ~
'7
, 19L, for a permit
covering construction on a m
(new, altered, or convert'ed)
multiple residence building, by or in behalf of T,~' .T~R~
~'~ ~,..~. _-~f,-- .~ . ~ , for a dwelling Iocafad as a~ove stated, and the said
application having been exami~d and recommended for approval on ~ ~ ~ , 19 ~/, a PERMIT
is hereby issued for the performance of the .~m~ Mrs_ _~.~_.~.~
(archltectur~l, structural, mechanical, etc.)
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, this PERMIT shall expire by limitation.
FORM NO. 5
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN CLERK'S OFFICE
$OUTHOLD, N. Y.
Affidavit: of Final Cost: oJ: Const:rud:ion
STATE OF NEW YORK ~ ss.:
COUNTY OF ........... ..~... ~,o., ,1~. .......................
.................................................. ..~.e..~.~.....~.~..e..q ........................... , being duly sworn, deposes and says:
(applicant or agent)
that he (she) is the applicant (or agent of the applicant) named in the Application. for Building
Permit dated ...................... Re~'.g~...6. ........... 19..5.? ...... relating to construction or other work to be
performed on, or in connection with, the premises located at ...~./.a.~.e....C~..e..e.~g..~.e. ......................
....G.~'.e...en.~..O..r..~.!......~.:..~.: ............ ; that the estimated cost stated in said application, of the construction
or other work described therein ,~ II1~
Dollars ( $ . ~.0. .~ .0. .0. .0. ... .0. .0. ............. ); that the actual final cost of such construction or other work was
...]:.e.~.s...~9.h..ez~...J..1..o.~...0~...0.,...0~). ............................................. Dollars ($ ................................ ) and that the
said construction or other work was performed in accordance with the/applicable provisions of law.
Sworn to before me
...~..~//~ klLl.. "~ ~,,~ ~,,,v~ ~,~__j~',~,~_ o I/¢-_ / .......
tetary Public. ?,re ef New Y~
Permit No .... ..3...0..8. .................... My Commission Expires March 30, 1958
Filed Cost $...]...0.,.9.9..0. ,..0..o. ........
Permit Fee Paid $...,~?..0~ ................
Final Cost $, ..'. ........................
Additional Fee $....&~...~....~Z....
(Costs for the work described in the Application for Buildi~¢ Permit include the cost of all oI the
construction and other work done in connection therewith, exclusive of the cost of the land. If the
final cost is le~s than the estimated cost sta~ed in the Application ior Building Permit, no portion of
the fee paid upon the filing of the application will be refunded.)
TOWN OF SOUTHOLD
APPLICATION FOR BUILDING PERMIT PURSUANT
TO MULTIPLE RESIDENCE LAW '"~'Z
New Multiple Residence Building
APPL,CAT,O NO. / O
LOCATION No, number Eas~ Side ~een Lane
House Number
about 600 t South of North Roa~
Street
Height: 1 s'bO ry
Area: 2150 sa E~
(1) Type of Occupancy farm labor
(2) Type of Consh'uctior; fz'el~e
[3) Estlmeted Cost of Construction 10~000t
(4)
(Permanent or Transient}
(Fireproof or Non-fireproof)
State what disposition will be mede of waste end sewage
(Public sewer, private sewer, cesspool, etc.)
Septic tank and 250 foot tile Field
(5) Occupancy {in detail) es follows:
Story
~nclude
eljer & Persons to be
Basement) Apartments Rooms Accommodated
C;or B
First ~ bed roomm I doze t.toz'v' 29
Second
TMrd
Fourth
Fifth
Sixth
Seventh
I ~ormltory'rcom ~5 x ~O
TOTAL 2 be,irooms 9 x 9 aad*8 x 9
dining rom" 20 x 25 ; kitch~ 1: x 25 · pantry and m~p rom-
DIAGRAM.
The said land and premises are situated as follows:
~EE DIAGP~M ATTA(~H) ( LAY-0~Te ELEVATI~SJD S~AGE DISPOSAL
~ ~o w. v~ m~.,,, Pm. ~/~.~/s?)
~I'DORSEDt AP~OVED DE:PT OF BEAT. TH SUFFOLX
~/]../s ?
N
C(X~T~ N Y
The north point
of the diagram
MUST agree with
Page I
STATE OF NEW YORK
COUNTY OF SUFFOLK
LE~ JC~ES
(Typewril'e NameJ
being duly sworn, deposes and says: That he resides
in the C;~ of. GREENPORT in the State o£ N~V YORK · that he is making this
application for the epprovel of arohi~ect~ral
(Architectural~ structura~, mechanical, etc.)
plans and specifications herewith submitted and made part hereof, and that to {'he 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 applicable provisions of the laws governing multiple residence construction.
(SIGN HERE) :~' ~. ~.
Sworn to before me, t , 19
Notary Pub: ,'. t~ ~! i~w Y~
My Cc..,.~.~: ....~ res ........
If application is +o be executed by someone other than owner, acting in his behalf, ~he following additional inform-
etlon should be supplied:
Owner's Name
,Address _
{If a corporetlon~ give full name and address of af least two officers)
(SIGN HEREI
Sworn to before me, this
day of
, Applicant
, 19
Notary Public or Cornrn~ssloner of Deeds
Examined and Recommended for approval on
Approved on
FOR OFFICE USE ONLY
Superintendent.
Work commenced on '~ ~
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 DeRartment.
Page 2
APPROVED