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Home My WebLink AboutHoulis, Helen & NickSUPERVISOR'S OFFICE I& South Street C~reenport, N. Y. Tel. C~reenport 7-0550 BUILDIN~ DEPARTMENT TOWN OF $OUTHOLD SUFFOLK COUNTY, N. Y. TOWN CLERK'S OFFICE Main Street So. tho]d, N. Y. Tel. Southold $-3783 BUILDINC= I'NSPECTOR'S OFFICE SOuthold, N.Y. CERTIFICATE OF OCCUPANCY No. 125 Date A'~_:ii~t :,~, 19 r~7 This certificate is issued to of the aforesaid building. THIS CERTIFIES that the building Ioceted at ~,/~ . Rny ~w~: Street, Map No. **# , Block No. in the Town of Southold, confo~s substantially fo the approved plans end specifications heretofore ~d in fhis o~ce with Appli~fion for Building Permit dated ~Ge ~7 I~ , pursuant fo which Building Permit No. IOT , dated ~ 19~ , was issued, and conforms to ell of the require- ments of the applicab~ provisions of the law. The occupancy for which this ce~ificafe is issued is Iowner, lessee Bui,lding Inspector (The Certificate of Occupancy will be issued only after the Building Inspector is convinced of the completion ~f the construction in compliance wJth the Multiple Residence Law and with other Jaws, ordnances ,or recJu}afions affecting the premises, and ~n conformity w~th the approved plans and specifications.) TOWN OF $OUTHOLD Multiple Residence Law Permit Application having been mede on --,- .... r ]1. , 193j&.._. k.. · permit covering construct|on on · ~ - ---- e'lfered, or con,m.te~ ' ~'(new, 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 _~_.'*__-~___~_ ]_1, 19_~, a PERMIT is hereby issued for the performance of the (architectural, structural, mechanical, etc.) work described in the above numbornd application and any accompanying plans and specifications. If no work is performed wffhin one year from the time of its issuance, this PERMIT shall expire by limitation. Approved Enforcement Officer If th.ti bu.tld'ln; XI .~ed for el~ othe~ ].lrpole th.n In .ee.~r/ buildin~ flor the u.e of tenmmtl of the property, ml~ exeept~m f~om the, Bo&rd Of Al)pea3.lt or · ehan~e of sone v'lll be noeessal*yo Buildip~ Inspeetol-o TOWN OF SOUTHOLD APPLICATION FOR BUILDING PERMIT PURSUANT TO MULTIPLE RESIDENCE LAW New Multiple Residence Building APPLICATION NO. /~:'~ ~ (I) Type of Occupancy ~ "'~ ~ (Permanent or Transient} (2) Type of Construction (Fireproof or Non-fireproof) J3) Estimated Cost of Construction ~ ~ ~ (4) State w~at disposifion will be made of waste and sewage JPublic sewer, private sewer, cesspool, etc.) (5) Occupancy (in detail) as follows: Story ~nclude ellar & Persons fo be Besemenf) Apartments Rooms Accommodated Cor B SeCond Third Foudh S;~h Seventh TOT, DIAGRAM. The said land and premises are s;tuefed as follows: Pa, le I The norfh point of rite diagram MUST agree wifh STATE OF NEW YORK COUNTY OF SUFFOLK ~-'"~-~'-'~'~ ~-~/~' ~ 0.-~ -- /~ l~/~/J ~ ~ (Typewr;fe Name) end ,,y,: That he resides a* ~ ~ ~. being duly deposes sworn, / ~c=+~on ~o~ t"~ ~,ov~ o~ ~~~~ (Arch;tectural, structural, mechanlcaL etc.) plans and specr~cafions herew~h submitted and made part hereof, and that fo the best o~ his knowledge and belle~, the work or construction will be carried out ;n compliance with such plans and speci~cafions, and that if will conform fo all applicable provisions of the laws governln~ multiple residence construction. {SIGN HERE) ~ . Owner Sworn fo before me, +his day of , 19 Notary Publrc 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 sup£11ed: Owner's Neme Addres 7 Jif a corporaHon, g~ve full name and address of 6t least two officers) Sworn to before me, this / ~' day of Notary Publlc or ~ommlssioner of Deeds , Applicant FOR OFFICE USE ONLY Examined end Recommended for approval on 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 ~e manner required by law and Rules and Regulations of this Department. Signed Inspector. Page 2 TOWN OF $OUTHOLD APPLICATION FOR BUILDING PERMIT PURSUANT TO MULTIPLE RESIDENCE LAW Altered or Converted Multiple Residence Building APPLICATION NO. / ~) '"7 LOCATION olde Number Height: ~-.'/,~'~ St Distance from Neeres+ Corner Area (I) Type of Occul~ancy of Bul, ing (~D./.~,v~___._~, (~.~~) ' fo be-altered or converted (Permanent, Transient, or Private) (2) Type of Construction ~~ - (Fireproof or Non-fireproof) (3} Use and Occupancy after Alteration or Conversion ' ~ (~~ (4) A new C of O (will) ~ be required "~.~3 ~, (~, ~ ~ ~ Story {indude EXISTING OCCUPANCY PROPOSED OCCUPANCY Cellar & Besemen+} Persons +o be Apts. Rooms Apts. Rooms Accommodated Cor B Sixth Seventh TOTAL / (5) State c~enerally in what ~anner the .Building will be altered or converted {6] Estimated Cost of Alteration or Conversion (7) Is Application made to remove violations? {8) State what disposition will be made of waste and sewage {Public sewer, private sawer, cesspool, etc.) If yes,: State Violation Number Page I STATE OF NEW YORK COUNTY OF SUFFOLK /'"'J E/...,t~,/l,'/ /JO O/--. ' "~ (Typewrlfe Name) being duly sworn, deposes and says: That he resides at ~'~' ! ;ntheC;fy'of~~J~ in fheStafeof C~ ~-~'ff-~P'J/c :that he is making this app'ioatlon ortheapprova, of (Archltecfurel, structural, mechanical, plans and specifications herew?rh submitted end mede pert hereof, and that to the best of his knowledge and belief, the work or construction will be carried out Jn compliance w~th such plans and specifications, and thet it will conform to all applicable provisions of the laws governing multiple residence construction. JSIGN HERE)~ Sworn to before me, this ~ ~ day of LEY , Owner , ,.5"7 Notary Public or Commissioner of Deeds -~¥ ruui~. ~ta~e of New York ~a ~:::=~ ~h 30 19.~ -/ If application is to be executed by someone other than owner, acting in his beh~f, the folowlng additional inform- ation should be supplied: Owner's Name .Address ~ (If · corporation, g~ve f~ll name and address of at least two officers) (SIGN HEREJ Sworn to before me, this day of , Applican~ , 19 Notary Public or Commissioner of Deeds FOR OFFICE USE ONLY Examined and Recommended for approval on Approved on Superintendent. Work commenced onf~-'~~ /l~ 19~'/'~ate Completed 19__ I HEREBY CERTIFY that the above report' is true in every respect and ~'he~r the work indicated has been done in the manner required by law and Rules and Regulations of this Depertmenf. Signed, Inspector. Page 2 ,. ¢ Original for Municipal Building Department STATEMENT OF RE61STRY To be filed ~p duplicate with the municipal building department or local enforcement agency by every owner of a ~ultiple dwelling, as defined in subdivision 33 of section 4 of the Multiple Residence Law. Within 30 dc~ys 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. I. Location of multiple dwelling: (a) Street and number 0 (b) Municipality ,'/~ (a) Type of constructlon (b} Height of bu~]d~ng, including number of ~orles (d) Number of apaOments ~ (e) Number of living rooms (f} Number of kltcheneffes (g) Number of bathrooms (h) Number of water close~~ (1) Number of occupants for which buildlng was designed or intended 3. Age of m ultZple dwelling: . ~...~jp ¢ ~.,/~ .~"~"~ (a) Dote when constructed , . -T', ~. . (b) Dates of substantial additi~s, alterations or modi~cat;ons of dwelling, wffh brbf descrlp- / / !~ / ' ' ~.~.~ .~-', ~/~./" (c) If n~under construdlon, ~ate when construction commenced and anticipated date of completion Describe the principal use made, or, ;n the case of buildings under construction, +o be made, of the multiple dwelJing (such as apartment house, hotel, apartment hotel, Iodcjing house, board- !ng h.ouse ~.c. hool convc~lescent, old age or nurslng home, private dwelfing two or more stories m height w~th five or more boarders, roomers or odgers, or other c ass~ficafion of mu tip e dwelJing including those specified in seotlon ~, subdivision 33, Multiple Residence Law): Dated a~-~''~'/ , New York , 195 ,.-~' · / STATEMENT OF FILIN~ F,,ed w,th the ' of the (Name of MunldpaJity) (Signature and Deslgnatbn of Offidaf Statement of ~egis~ry was Rled)