HomeMy WebLinkAbout617-zNO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
CERTIFICATE OF OC:CUPANC~Y
No. Z 658 Dote June
THIS CERTIFIES that the. buildin.g located at
Map No ......................... Block No ......................... Lot No ...................................................................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
............... ~.~...~.g ...................... , 19~.~..., pursuant to which Building Permit No....~..~.~ ...........
dated ................. ~..~.~ ................. 19..'~.~., wc~ issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupa, ncy for which this certificate is issued is ................
I~s ceff~fico~e ~s ~ss e~ ~oCharles ~ ~vel~ Wt~ers~o~ o~er
(o~m~,r, ~essee o~ ~enou~)
of the aforesaid building.
Buildin~ '"t ............
FOI~M NO. 2.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N.° 617 z
Dote ...................... ] 9 ........
Permission is hereby granted to:
........................ ~i~ ;'"'~;¥'~ ...........................
to .....~,ove .................................................................................................................................. an ex[s~J.~ eot,~age ~o t~ ~o~at~on
at premises located ot~..~[~....~:~[..~..,..(~[..[~.~] ...................................................
................................................... ~b~;'"'}¥;~', ................................................................................
pursuant to application dated ............... ~....~ ............................... 19 ........ , and approved by the
~9
Buffding Inspector
No. 5
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
ORDER TO REMEDY VIOLATION
Date ................. ~.nch... 26 ...................... 19~9 ....
(owner or authorized agent of owner)
........ ..............
(address of owner or authorized agent of owner)
PLEASE TAKE NOTICE there exists a violation of:
Zoning Ordinance Artiole VT'Ir ..eec~s:ton..'/0~.: ................
Other Applicable Laws, Ordinances or Regulations .........................................
at p;emises hereinafter described in that .......
(state character of violation)
without a building permit.
............................................................. P.~,per..'t,y... lo~a~e~.. N/~. Ho.r.~o.a...b~et...-...t~e~..~y...~ ,.
~oand,.. ~..By. ~ .8~r$~s,.. ~outh..by..R'_,~ff...way.,..~e~t~..b~. ~y&~t ,.. ~t. ~outhold s..N.~. ............
¥ o at on ..............
(state section or paragraph of applicable law, ordinance or regulation)
YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the Iow and to remedy the
conditions above mentioned forthwith in or before the ......... ~S.~r,~ ...... (...6). ..................................
day of ........................... ..A..'p~..~.~. .............. 19...5'..9. ......
The premises to which this ORDER TO REM EDY VIOLATION refers are situated at. N/E side
HO...r...$~..~....l~....t,~..,.......8~,..u..t..h..o..]:~ .................................... County of Suffolk, New York.
Failure to remedy the conditions aforesaid and to comply with the applicable provisions of Iow
may constitute an offense punishable by fine or imprisonment or both.
Building Inspector
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTNOLD, N. Y.
· 'Th
Examined ........................................ 19 ........
Approved ........................................ 19 ........ Permit No
.... ....................................................
(BuHdi~ Inspector)
yr ,
Application No .............................
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted 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 Iocatlon.
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 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 all applicable laws, ordinances and regulations.
(Signature of applicant, or name, if o 6orpo~ration)
(Address of applicant)
State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of prem s ......... .~ ............................................... -7'"'""': .......... :' .................. ~ ......................................
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
1. Location of land on which proposed work will be done. Map No: ............................................Lot No: ........ '~.:~.....T...
Street and Number ..~...~ ...... /.f.~.~ ........................................................................................................
Municipality
2.State existing use and occupancy of p~emises and intended use and occupancy of proposed construction:
o, Ex~Stin~ ~se and occupancy ................... ~ ........................................................................................................
....... ..............................................................
3. Nature of work (check which applicable): New Building .................... Addition ....................Alteration ..,~.:. ............
Repair ............ ..~.....Remova, .................... Demolition ....................Other Work (Describe)l~..p./..~..D...I..~G.
4. Estm~ted Cost ~ ~. Fee !~
(to be paid on filing this application)
5. If dwelling, number of dwelling units ....... ~ .......... Number of dwelling units on e~ch floor ............................
If garage, number of cars ............................................................................................................................................
6. If business, commercial or mixed occupancy specify nature and extent of each type of use .............................
. . . ~ ~ ~
7. D mens OhS of ex st ng structures, f 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 ............................
Height ............................ Number of Stories ............................
9. Size of lot: Front ..Z,~.~ ............. Rear ...... {..Z...~. .......... Depth ~ ~ ~ ~
~0. D~, of ~,,chos~ ........ !..~..~..~ ............................... ~ of ~o~e, Ow~.~ ....................................
11. Z~ne or use district in which premises ore sltu~ted .............. t..* .............................................................................
]2. Does proposed conslruction v~olote on~ zoMn~ Iow~ ordinonce or re~u~tion? ....................................................
]3~ Nome of Owner o{ premises x ........ Address ............................................ Phone ~O .....................
Nome of Archffect ........................................................ Address ............................................ Phone MO .....................
Nome o{ Controctor .................................................... AdBross ............................................ Phone MO .....................
PLOT DIAGRAM
Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions from
property lines. Give street and block number~ or description according to deed, and shaw street names and indicate
whether interior or corner lot. L,
STATE OF NEW~Ogg,~Jr )~ S
. .
(Name of individual signing application)
above named. He ~s .,,e ..........................................................................................................................................................
(Contractor, agent, corporate o~ficer, etc.)
of said owner or owners, and is duly authorized to perform or ~ave performed t~e said work and to make qnd file
this qpplication; t~ot all statements contained in this application are true to the best of his knowledge ~nd belief;
and fho~ t~e work ~ilJ be performed in the m~nner s~nforth in t~e application filed t~erewith,
Sworn to before me this