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Home My WebLink About40-zFORI~I NO. 4 TOWN OF SOUTHOLD BUILD~NG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. CERTIFICATE OF OCCUPANCY ........... Date ................... ............ 19.5~.... THIS CERTIFIES that the building located at ..pr.~.~/.&ti~..~,o~l,d...o.~.~...~e~gen...A%,e~Street Map No ..........~ .............. Block No ......~}Q[~X .................. , ~t*t~...~a.tt¢[.~.~......~;~', conforms substantially to the Application for Building Permit heretofore filed in this office dated .................... ~],~r. ...... .~ ................. 1~'~......, pursuant to which Building Permit No ..~..~O ................ , dated ...................... ~g%]~.....~. ................. 19.5~?..., 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 ............ ................................ PRI~ATE..D. WELLZ. N~ ........................................................................................ This certificate is issued to ..... l~{~)r3A1.....]3a,kel? .....~ ........... (...{)~/).e.z'.) ............................................. ~owner, {essee or tenant) of the aforesaid building. Building Inspector FORM NO. 6 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- tor 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 installa- tions, 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 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 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5,00 Date ...~a.~Z. 5. c. ~9. 8. % ............ New Building ............. Old or Pre-existing Building .... ~. ....... Vacant Land ............. Location of Property ..................................................... ~4;t;.$t;v. qi¢ ..... House No. Street Ham/et former 1 owned by Owner or Owners of Property !S.t..e.~.he.q ,~.. '..~..c.C.°.~Z ! · .[~..C.%.~.~. ~....B.A.ed..~..a~.~..~,A.U.~.Z.~.~..~:..~.A.~..~.* .... County Tax Map No. 1000 Section . .Z.O. 5. .......... Block . .Z. ............ Lot..4 ............. Subdivision ................................. 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 ....................... Fee Submitted $., Jr'.qq Construction on above described building and p.er_~me~"¢alJ.~'pli~Ci~e cj:~e~n.d.~u,aLio.~. believe Mr. Baker bought the property in October of 1956 and buil~ ~1 ~ the house in 1957. FOI~M ~o. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, ORDER TO REMEDY VIOLATION Date ....................................~~ .......... ...... - (address of owner or authorize~ ~gent of owner) PLEASE TAKE NOTICE there exists o violation of: ~,~ ,., ~¢~ Zoning Ordinance ~ ..f ........... Other Applicable Laws, Ordinances or Regulations ..................... ;,~,. ................ ', at premises hereinafter described m that ...................... .~. ................ (state chorrlcter of violation) (state section or paragraph of appUcable Iow, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply wifh the Iow and to remedy the conditions above mentioned forthwith in or before the .......... ~:.....j.~....~. ...................... day of ........ .~..~ ..................... 19.~...?.. ,~ The r~ej~,is~ to which this ORDER TO REM EDY VIOLATION refers are situated at ................................... ..~ ............................. County of Suffolk, New York. Failure to rernedy the conditions aforesaid a nd to comply with the applicable provisions of may constitute an offense punishable by fine or imprisonment O~ both FOEI~I NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned.... .... ........... lq.....)... ~ ,~ I " z~ Approved ........................................ ] 9..~.~...Perm~t ................................. D isopp roved a/c ............. -~.~'~': ...... ~ ..... ' '"" '"'~'~"~'::"Z:: .... ................. ........... .l: ....... ......... (Building Inspector) APPLICATION FOR BLIILDING PERMIT Date....:~. ..................................... 19 ............ INSTRUCTIONS o. This applicotion must be completely filled in by typewriter or in ink ond submitted in duplicote 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 o 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 P~rmit 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 port for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuonce of a Building Permit pursuont 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, ordinances and regulations. ...... .............................................. (Signature of applicant, or name, if o corporation) .................. ............ ..... State whether applicant is owner, lessee, agent, architect, engineer, gener~or,~el~ctricon, plumber or builder. ................. .~.-.' _¢..~.~..*.:t :?..! ...... ..c..~?~....?.~: ................................................................................ Name of owner of premises .......... /.~..,,¢~.,..! ...................... ..~..~..f.~.~....i ................................................................................. applicant is a corporate, signature of duly authorized officer. (Name ond~]title of corporate officer) Location of land on which proposed work will be done. Map No ................................... Block .................................. Street and Number/~....~,(:L..~..,/~ ............ ~....~,~.Y.. ....... .~. .......... (~ ..................................... ~.J..~. ......................... State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Existing use and occupancy ............ ~../..,,/.l..,.:.,../}_,.(~,',..i .......... !.:..?..,...~,:.,',~. ............................................................... b. Intended use and occupancy 3. Nature of work (check which applicable): New Buildihg ...... ~'~ ....... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................. .~C)ther Work (Describe) .................... 4. Estimated Cost ....... ./.~.~. ............................................. ee ..~.. ..................................................................................... (to be paid on filing this application) FEES: If dwelling, number of dwelling units ..................... Number of dwelling units on eoch floor ........................... If goroge, number of cots ........................................................................................................................................ 6. If business, commerical or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: 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 constructian: Front........°r~...G. ................ Reor ....... : ................... Depth :~ cr Height ....... ..~...z..~...~ ........ Number of Stories .........../ ................. 9. Size of lot: Front ....~.?r..~..%~..'.~.. ...... Rear ...... ..~..,~..~..:.,./...o. ..... Depth ..../../...~...?.....~. ....... 10. Zone or use district in which premises are situated ............ .~'..i~..J..~ ..................................................... 11.. Does proposed constructio~ violate any zoning law, ordinance or regulation? ......... ...~......~.. ............................... 12. Name of Owner of nrm'~i¢~¢~/~4'~j//j /~/'~'/~/J/'/~'/,4~kad,~,,'~e~ ,~ ~/~,,r_ li'/4;rI> ¢,,,~ Ph,~,~,, ' ' : . ........................................................................................................... , NO. ~ :' Nbme of Arch.tect..~.: ....... ~ .............. t ..................... Address Z~..'.~ ................. .~ ............ ~...l~one' C'- 'jy~,,¢.~ .;r~,~ ' ' ~ '/~/~ ~/~ ~,~r 'r~ NO. 4;~..4...~..~..~..~,../"' ~ . Name of Contractor ................................................... :Address ......................... ................... Phone NO. , , PLOT DIAGRAM Locate clearly 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. STATE OFJNEV0 YOR?;. ,/) ) COUNTY,/OF ~..3 S S.. ............................................................................................. :..being duly sworn, deposes and says that he is the"appllcaht (Name of individual signing applfcation) above named. He is the ................. .~.%..~.......~....:...~.'.~ ............................................................................ ~...'..'.~' (Contr~or,~n~agent, corporate 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 ......... ~ ........... day of ....~ .................. 19.~..'~.~... Notary Pub I ic~.. g.~..~J.-~/,-*,,.,~.... · .County ngature FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined......f:~/..¥......zt ................... 19 ........ Approved ............. "/ ........ ~'~ ........ '..~. ....... 19..;;....Permit No..?~....~...../.~.'. ............ ..................... ../...: ............... ~'. ........ <::% ............ ::h .... ' ....... ..................... i'~"u'~'~',~'~';,';'"i;'~;;~';;';i ........... }; ................. Dete ............ ............. .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in dupricate to the Building Inspector. b. Plot plan showing location of lot and of buildir~gs on premises~ relationship to adjoining premises or pubiic streets or areas, and giving o 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. Up,on 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 issuance 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 oil applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) ....... (AddreSs of app)/icant) State whether applicon~t..is owner, le~r~e, agent, architect, engineer, general contractor, electrican, plumber or builder. ................................. ........ ................................................................................................. Name of owner of premises .......................... ". .................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name an~tle of ~[rporate officer) 1. Location of land on which proposed work will be done. Map No ............... :~;. .......... Block ...... .~..~.: ...................... Street and Number Y f~ f*~ ! 0 ,'t/ lz £: 2. State existing use and occupancy of premieses end intended use and occupancy of proposed construction: o. Existing use and occupancy, ..~....~.. ~,~/'~ it/ / ~'- A' I ~.~ ..D...~.,~,. '-~. ~ ~.~ b. Intended use and occupancy ..................... .~. .... ! ............................................................................ 3. Nature of work (check which applicable): New Building ...... ..~'... ........ Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .....~ .............. Other Work (Describe) .................... (to be paid on filing this application) FEES: If dwellin§, number of dwelling units ...... / .................. Number of dwelling units on each floor ............. ; ............... If garage, number of cars ........................................................................................................................................ 6. If business, commericol or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: 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 ........ .~...(? ............. Rear ........ .~.....~. ............ Depth .i.~....? ................... Height ...... ~_...~...i...,~.. ....... Number of Stories ..~....'.....~ ....... ..~..... ~'1' ~- ~'' /''/~ Depth 9. Size of lot: Front ~ ~ ~- ~ ~ Rear ........................................................ 10. Zone or use district in which premises are situated ............ ....... ~ ................................................ 11. Does proposed constructian violate any zoning law, ordinance or regulation? ......... ...~.....~.. .................... : ........... 12. Name of Owner of prerr, ises./~.¢..L..~....~..../~.~/.(~.~(.L....Address /.~..~/J.~g'~.~......~f/.~i~..Phone NO ......... ~'~ ........... Arch itect... (~.-~.:.. ~3:...).~-~'~.~ ,.. ,... , .,...~.,........... .......... Address '~'~ .~' Name of Name of Contractor ......... ~..: ....................................... Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ali 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. STATE OF COUNT, S S.. ................................................................................................ being duly sworn, deposes and says that he is the' appllcdnt (Name of individual sianing application) above named. He is the ......... ..-~,~...,,.~. ............. -....~ ............................................................................................. (CoPi~ractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove 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 ........ ~. ............ day of ~ ...................... 19...~...~... (Singature of