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Home My WebLink About3187-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z13208 Date Feb. 8 ., 198..5. THIS CERTIFIES that the building ....... .N.e.w...D.w.e. 1..1 .i.n.q .......................... ;.~5o0' .M?..r.l..~ .n ~tr~t' Southold Location of Property [-I[~s ............................................ Ham/et County Tax Map No. 1000 Section . . .0..5 .6 ...... Block .... 0..7 ......... Lot ...0..2.1 ........... Subdivision Southold Shores .Filed Map No..3.8..5.3...Lot No. · · .3. ......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .... .A.u.q: ..... 8. ...... ,19 .6.6. pursuant to which Building Permit No .... .3).8. 7. .Z ............ dated ...... .A.u.g :...1..1 ............ 19 .6.6., 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 ......... New Private One Family Dwelling HOWARD F. & JANET A. MALONE The certificate is issued to ..................... id~,;e'r,'t[~,s~'~/~n'O' ..................... of the aforesaid building. Suffolk County Department of Health Approval ........... N.. [.A....P.r.e.-zr.e. gp.r.d. ............. UNDERWRITERS CERTIFICATE NO. N 55118 0 Building Inspector Rev. 1/81 F01~I~I NO. 2 TOWN 0~ $OUTHOLD TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PEP~MIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 3187 z Permission is hereby granted to: ............... 2 ~.....2~lx:~.A.~.~ ................................. Date ......... AUB~S% 11.~ lg66 pursuant to application dated ............................. ..A...~.~,~..~. ....... ~.... .... 19.~.~..., and approved by the Building Inspector Fee $ .,~Q · .O.Q ........... Building Inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall ,~.'~)uthold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitte~[~!ic;tc 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 featu res. 2. Final approval of Health Dept. of water supply and sewerage disposa~--{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 propertv 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. Fees: 1. Certificate of occupancy $5.00 / 2. Certificate of occupancy on pre-existing dwelling/ land 3. Copy of certificate of occupancy $1.00 use --Pre-Existing C.O. $15.00 Vacant land C.O. $ 5.00 Date. , ,/~,~ New Building ............. Old or Pre-existing Building ............ Vacant Land ............. LocationofProperty ~.~0 ~L~UI~ I~/~'~_,~)l,J ~J~ ~ ~o~/h~ ~,~ Hou~ No. Street Hamlet County Tax Map No. 1000 Section . .0.~ ....... Block ...O~ ......... Lot...O.~ ........ Subdivision >~,ff ?~fc~ ........... Filed Map No. . .Lot No, .~ ........... Permit No.~./~ ~ .~. Date of Permit ~ ~ ¢,~..Applicant/~ ~(~, ~. ~ ~, ~,~,~ ....... ~ ~ App Health Dept. Approval ........................ Labor Dept, royal ........................ ~(E~ gB dApp Unde~ritersApproval., ,..,.,...,,,..,,.,,,.Plannin oar roval ...................... Request for Temporary Certificate .... T ................ n ate Fee Submitted $. ~,~, .~ .................... Construction on above described building and permit meets all ap_.~licable codes and regulations. Rev. 10-10-78 TOWN OF SOUTHOLD ,BULL DIN G DEPART MEN T~/ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date .. ~ f~h rllar.lz..17.., .......................... 19].7.... TO lto. w~a D,..~.,... FJ, a 1.qa.e. .................................... (owner or authorized agent of owner) (address of owner or authorized agent of owner) 11762 PLEASE TAKE NOTICE there exists a violation of: Chapter 100 Zoning Ordinance . .A...~..~....~ ~..Z.....&....~...Z.~. ........... Other Applicable Laws, Ordinances or Regulations ............................................ at premises hereinafter described in that ~.azsed gong. rote ]g. atzo has been, construct d (state character of violation) ...... w~zth~s~uf~z~ent~s~t~ha~k~t~s~z~.yar~1~o~b~uz~d~%g~pe~m~.~d~ P~m, ove ~atio to comply to set bagk ~..~quirements and ag~.~l.~ for uermit.~ in violation of ..~e~tlor~s..lOO..-.3~b..a~..1.~g..-.161 ..................................................................... (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the ....~.en.t.y..,~ic3b;~.....4.2.8) ........................ day of ..... ~.e,~z~r.~, ............................. , 19....2.7. The premises to which this ORDER TO REMEDY VIOLATION refers are situated at ...... ~.~g,.~...~9,r,],i~..P.~,...gr.~9~PP.:~.~. .............. County of Suffolk, New York. Southold Shores, lot %3 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 FO~M ~0. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, No Y. Approved '~ 19 ........ Permit No. Application No. -"~'/~(' ~ ........ (Building Inspectoc APPLICATION FOR BUILDING PERMIT 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 ~djoining 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 application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Ipspector 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 ~ 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, building code and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, eh.al'neet, general contractor, electrician, plumber or builder. ...... ' ...................... ~¢~,.,~Ap~l~-c~ ...................................' ............................... ~ .............................. Name of owner of premises ..... J. tO~tr~A~...t],,...~'~ft3,Otl~ ........................................................................................................ If applicant is a corporate, signature of duly authorized officer. .... ~ ~,~.. Z~.~ ..,~p~ ;.1~ ........................................................... (Name and title of corporate office~) Loc~tion o~ bnd on which proposed work w~ll be done. M~p No.: ...~.~ ........................... Lot No.: ........................ Street and Number .... ...................... Municipality 2.. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... ~...~ .............................................................................................. b. Intended use and occupancy ....~*..~J.l~...~...g.~:~.~D~7~]ff~..]~9~.~...~D~'. .... 4. 5. 6. Nat Ire of work (check which applicable): New Building .... .~t' ........... Addition .................. Alteration Rep ir .................. Removal .................. Demolition .................. Other Work (Describe) Esti ~ated Cost ...~.QO~ ........ ~ .................. Fee '"~J.O~O.' J [.to be paid on filing this application) Jf d~velling, number of dwelling units ..J[:~. .................. Number of dwelling units on each floor ...,JJJ~O ............ If gbrage, number of cars ..... If l~usiness, commercial or mixed occupancy, specify nature and extent of each type of use Dimensions of existing structures, if any: Front ............//i/,,~j/,,,z~,-,t~ .............. Rear ..... ~ .................... Depth Height ........................ Number of Stories ......... ...//..J....../..~.~..../J..../.~-... ............................. Dir~ensionsi' of same structure with alterations o/d it~nsL.~o]X~"' 1' ' ' ' ~//~'"~(,~.....% ........................... Rear Dep[th ................................ Height .................. ( ........ Number of Stories ................................. Din~ensions of entire new construction: Front .,~,0.t. ........................... Rear .......~.~ ................ Depth ..:.. :: .~.,.~'~.~. Hei~lht ..... .]-.~?. ........ Number of Stories ..... .O~. ....... I O* Siz~J of lot: Front ...~'g. ..................... Rear ...lg~ ........................ Depth ...~0.0..I, ................... Dark of Purchase ...~,.~-,,~.~'...'J~r...~Z.*.~.~.(,L~. ................. Name of Former Owner J:J~].~..~..~.~tl~ ..... ZorJe or use district in which premises are situated ...... ~....]~.~ Doe~ proposed construction violate any zoning law, ordinance or regulation? ...... I , ]{OWlJ~d F, ~lone A"res 3~ ~h~?.d. Ave. Ph ~e1~I 1 Na~nel of Owner or premises ........................................ aa s ~J~laJ~J~(J~A~ Na~qe of Architect ....... ..~.(~1~ ..................................... Address ............................................ Phone No. Naive of Contractor ...... ~ ..................................... Address ............................................ Phone No. 11. 12. 13. Locot property whether in PLOT DIAGRAM clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr neB. Give street and block number or description according to deed, and show street names and indic STATE OI NE%~ YORI~/,./' '~ ,-. ,- ' COUNTY OF .;'~,,.~ .~.//.(t;~....%.~ ....... ...... ~/.~..~.~'.z......C.....,l.7....~....' ................................. b.e.ng duly sworn, deposes and says that he is the applic (Nome of individual signing application) ~'~ above nal~ed. He is the ...................... (Contractor, agent, corporate officer, etc.) I of said owner or owners, and is duly authorized to perform or have performed the said work and to make and this application; that all statements contained in this application are true to the best of his knowledge and belief; that the w~ork will be performed in the manner set forth in the application flied therewith. Swam to ~efore me this ............. ~ ........ day of 19~... Notary (Signature of applicant) Cl Expires M~r ~/~ 7'