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Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 CA 4W
Southold,NY 11971-0959 O • �O
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
NOTICE Pursuant to Chapter 100 Southold Town Code
DATE: June 28, 2012
TO: Kyle Hoffman & Carol Hoffman
272 Livermore Avenue
Staten Island, NY 10314
A. The last Assessment rolls of the Town of Southold shows you are the owner of
the following described premises;
Located at 270 Illinois Avenue, Mattituck, NY; District 1000, Section 113, Block
11, Lot 18.1
B. The premise indicated above and the structures located on the property are
unsafe and dangerous and as such constitutes a hazard to safety by reason of
the following;
The main dwelling is abandoned and open at various points.
The property has not been adequately maintained as per the town's property
maintenance code.
The building and property are deemed to be unsafe due to inadequate
maintenance, neglect, dilapidation and abandonment.
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Town Hall Annexl l e' 65
�65i-1802
54375 Main RoadFax(631)765-9502
P.O.Box 1179 G Q Pv�,
Southold,NY 11971-0959
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BUILDING DEPARTMENT
TOWN OF SOUTHOLD
NOTICE Pursuant to Chapter 100 Southold Town Code _
DATE: June 28, 2012
TO: Kyle Hoffman & Carol Hoffman
272 Livermore Avenue
Staten Island, NY 10314
A. The last Assessment rolls of the Town of Southold shows you are the owner of
the following described premises;
Located at 270 Illinois Avenue, Mattituck, NY; District 1000, Section 113, Block
11, Lot 18.1
B. The premise indicated above and the structures located on the property are
unsafe and dangerous and as such constitutes a hazard to safety by reason of
the following;
The main dwelling is abandoned and open at various points.
The property has not been adequately maintained as per the town's property
maintenance code.
The building and property are deemed to be unsafe due to inadequate
maintenance, neglect, dilapidation and abandonment.
C. You are hereby ordered to make the building and premises safe and secure, or
demolish the building and remove all debris.
D. The above work shall commence within ten (10) days from the date of this notice
and shall be completed within thirty (30) days thereafter.
E. In the event you fail to comply with the above, a hearing will be held before the
Southold Town Board concerning same at 9:00 A.M. on Tuesday, July 31, 2012
at Southold Town Hall, 53095 Main Road, Southold 11971
F. In the event that the Southold Town Board after the hearing herein shall
determine that the building or structure is unsafe or dangerous to the public, the
Town Board may order the building or structure to be repaired and secured or
demolished and removed.
G. In the event that the building, structures and premises shall be determined by the
Town to be unsafe or dangerous and in the event of the neglect or refusal of the
owner to repair or remove same within the time provided, the Town may remove
such building or structure by whatever means it deems appropriate and assess
all costs and expenses incurred by the Town in connection with the proceedings
to remove and secure, including the cost of actually removing said building or
structure, against the land on which said building or structure is located.
Damon Peter allis
Zoning Inspector
C. You are hereby ordered to make the building and premises safe and secure„or
demolish the building and remove all debris.
D. The above work shall commence within ten (10) days from the date of this notice
and shall be completed within thirty(30) days thereafter.
E. In the event you fail to comply with the above, a hearing will be held before the
Southold Town Board concerning same at 9:00 A.M. on Tuesday, July 31, 2012
at Southold Town Hall, 53095 Main Road, Southold 11971
F. In the event that the Southold Town Board after the hearing herein shall
determine that the building or structure is unsafe or dangerous to the public, the
Town Board may order the building or structure to be repaired and secured or
demolished and removed.
G. In the event that the building, structures and premises shall be determined by the
Town to be unsafe or dangerous and in the event of the neglect or refusal of the
owner to repair or remove same within the time provided, the Town may remove
such building or structure by whatever means it deems appropriate and assess
all costs and expenses incurred by the Town in connection with the proceedings
to remove and secure, including the cost of actually removing said building or
structure, against the land on which said building or structure is located.
Damon Peter allis
Zoning Inspector
LEGAL NOTICE
NOTICE OF PUBLIC HEARING
NOTICE IS HEREBY GIVEN,there has been presented to the Town Board of the
Town of Southold, Suffolk County,New York, on the 17'h day of January, 2012, a Local
Law entitled "A Local Law in relation to Amendments to Chapter 100, Buildings,
Unsafe, in connection with Unsafe Buildings,Premises and Property Maintenance
Law of the Town of Southold" and
NOTICE IS HEREBY FURTHER GIVEN that the Town Board of the Town of
Southold will hold a public hearing on the aforesaid Local Law at Southold Town Hall,
53095 Main Road, Southold,New York, on the 141h day of February, 2012 at 7:34 p.m.
at which time all interested persons will be given an opportunity to be heard.
The proposed Local Law entitled, "A Local Law in relation to Amendments to
Chapter 100,Buildings,Unsafe, in connection with Unsafe Buildings, Premises and
Property Maintenance Law of the Town of Southold" reads as follows:
LOCAL LAW NO. 2012
A Local Law entitled, "A Local Law in relation to Amendments to Chapter 100,
Buildings, Unsafe, in connection with Unsafe Buildings, Premises and Property
Maintenance Law of the Town of Southold".
BE IT ENACTED by the Town Board of the Town of Southold as follows:
I. Chapter 100 of the Code of the Town of Southold is hereby amended as follows:
§100-1. Title.
This chapter shall be known as the "Unsafe Buildings, Premises and C011apsed S+..,,,.* res
Property Maintenance Law of the Town of Southold."
§100-2. Purpose.
The purpose of this chapter is to promote they„blie health saf y and general welfare o
the esidents of the-ro a% e f South conservation of propertyand property values, to
eliminate safety and health hazards and to address unsightly conditions, environmental
public nuisance(s) and dangerous obstructions to emergency vehicle access. and
eensen,afien of pr-epeAy and pr-epei4y values and to eliminate safety and health haz
§100-3. . Definitions.
Unless otherwise expressly stated, the following terms shall for the purpose of this
Chapter, have the meanings as herein defined. Any word or term not noted below shall
be used with a meaning as defined in Webster's Third New International Dictionary of
}
the English Language unabridged or latest edition).
EXTERIOR PROPERTY—The men—pace on the premises and on adjoining property
under the control of owners or operators of such premises.
GARBAGE—Putrescible animal and vegetable wastes resulting from the handling,
preparation cooking and consumption of food.
JUNKED VEHICLE—Any vehicle including a trailer, which is without a currently valid
license plate or plates and is in such a rusted wrecked discarded, dismantled, partly
dismantled inoperative or abandoned condition as to be no longer intended or in
condition for legal use on the public highways.
LAND—The term "land" and "property" shall have the same meaning as "premises" as
defined herein.
LITTER—Garbage refuse and rubbish and all other waste material which, if thrown or
deposited upon the ground tends to create a danger to public health safety and welfare or
tends to create blight.
OCCUPANT—Any individual or person occupying a premises or building, or having
possession of a premises or building.
OWNER—Any person agent aerator, firm or corporation having a legal or equitable
interest in the property; or recorded in the official records of the state, county or
municipality as holding title or deed to the property; or otherwise having control of the
property, including the guardian of the estate of an s�person, and the executor or
administrator of the estate of such person if ordered to take possession of real property by
a court.
PERSON—An individual, association, firm, syndicate, company, trust, corporation,
department, bureau or agency or any other entity recognized law as the subject of
rights and duties.
PREMISES—A lot plot or parcel of land, easement or public way, including any
structures thereon.
RUBBISH—NoLiputrescible solid wastes consisting of both combustible and
noncombustible wastes such as, but not limited to, paper wrappings, cardboard, tin cans,
wood, glass, bedding, and crockery.
§100-3 4. Unsafe buildings and ohibited. Standards.
4
A. Property Maintenance.
1. Surface and subsurface water shall be adequately drained to protect
buildings and structures, to prevent damage to adjacent property and to
prevent the development of stagnant ponds. Swimming pools, spas, hot
tubs and other similar structures erected for recreational use shall be
maintained so as to avoid the stagnation of the water therein.
2. Landscaping shall be adequately maintained so that lawns,hedges, bushes,
weeds and trees do not become overgrown and unsightly so as to
constitute an unsafe condition or blight. At no time shall landscaping,
hedges bushes weeds or trees create an impediment to emergency and/or
fire rescue vehicle access.
3. Garbage crates rubbish, refuse or debris shall be kept inside building or
buildings on the premises, or in an acceptable enclosed container, and
shall be regularly collected and removed from the premises.
4. Open wells cesspools or cisterns shall be securely closed or barricaded to
prevent access by the public.
5. Junked or unregistered vehicles may not be located or stored in open view,
but shall be stored in a suitable location inside a building or behind a fence
outside of public view.
6. Exterior facades shall at all times be kept free of graffiti or other
defacement.
A-.B. Unsafe buildings. All buildings or structures which are structurally unsafe,
dangerous, unsanitary or not provided with adequate egress or which in relation to
existing use constitute a hazard to safety or health by reason of inadequate
maintenance, dilapidation, obsolescence or abandonment are, severally, for the
purpose of this chapter, unsafe buildings. All such buildings and structures are
hereby declared to be illegal and are prohibited and shall be abated by repair and
rehabilitation or by demolition and removal in accordance with the procedures of
this chapter.
B-.C. Unsafe premises. All premises which are unsafe or dangerous, which suffer from
inadequate maintenance or neglect or which do not permit or provide for adequate
access by emergency and/or fire rescue vehicles are, for the purpose of this
chapter, unsafe premises. All such premises are hereby declared to be illegal, are
prohibited and shall be abated by repair and rehabilitation in accordance with the
procedures of this chapter.
§100-4-5. Inspection and report.
r
r
A. Unsafe building. When, in the opinion of the Building Inspector, any structure
located in the Town shall be deemed to be unsafe or dangerous to the public, he
shall make a formal inspection thereof and thereafter prepare a written report
thereof and file the same in his office.
B. Unsafe premises. When, either on the Building Inspector's own volition or after
receiving a written recommendation from the Commissioners of any Fire
Department or Fire District or from the Village of Greenport Fire Wardens or
Village Trustees located in the Town that any premises is unsafe in that it does
not permit or provide for adequate access by emergency and/or fire rescue
vehicles as required by §280-109(C), in which recommendation the Building
Inspector concurs,the Building Inspector shall make a formal inspection thereof
and thereafter prepare a written report thereof and file the same in his office.
§100-6 6. Service of notice.
A. When it shall be determined by the Building Inspector that a building, premises or
structure is dangerous or unsafe to the public, or is in violation of any one or more
of the provisions under §100-4(A), he shall promptly serve or cause to be served a
notice on the owner or other persons having an interest in such premises, building
or structure as hereinafter provided.
B. The aforementioned notice shall be served on the owner of the building, structure
or premises or some one of the owner's executors, legal representatives, agents,
lessees or other person having a vested or contingent interest in the same, as
shown by the last completed assessment roll of the Town, either personally or by
registered mail, addressed to the person intended to be served at the last known
place of business. If the notice is served by registered mail, the Building
Inspector shall cause a copy of such notice to be posted on the premises.
§100-6 7. Contents of notice.
The notice referred to in §100-5 6 hereof shall contain the following:
A. A description of the premises.
B. A statement of the particulars in which the premises, building or structure is
unsafe or dangerous or is in violation of any one or more of the provisions under
100-4(A).
C. An order requiring the premises, building or structure to be made safe and secure
or removed, or if there is a violation of§100-4A, an order to remedy.
D. A statement that the securing or removal of the building or structure or the
rehabilitation of the premises shall commence within 10 days from the date of the
service of the notice and shall be completed within 30 days thereafter. If a
violation of any one or more of the provisions under §100-4 A are cited, a
statement that remediation of the violation must be completed within 10 days
from the date of service of the notice. The Building Inspector may extend the
time of compliance specified in the notice, where there is evidence of intent to
comply within the time specified and conditions exist which prevent immediate
compliance. In granting any such extension of time, the Building Inspector may
impose such conditions as he may deem appropriate.
E. A statement that, in the event of the neglect or refusal of the person served with
notice to comply with the same, a hearing will be held before the Southold Town
Board, notice of which and the time and place thereof to be specified in the notice
to the owner referred to in §1004 6 hereof. No hearing is required if the only
violation alleged is pursuant to-§100-4(A).
F. A statement that, in the event that the Town Board, after the hearing specified in
§100-6 7(E)hereof, shall determine that the premises, building or structure is
unsafe or dangerous to the public, the Town Board may order the building or
structure to be repaired, made safe and/or secured or taken down and removed. In
the case of an unsafe premises, the Town Board may order the premises
rehabilitated and made safe.
G. A statement,that, in the event that the premises, building or structure shall be
determined by the Town to be unsafe or dangerous and in the event of the neglect
or refusal of the owner to make safe, repair or remove the same within the time
provided, the Town may remove such building or structure or make safe the
premises by whatever means it deems appropriate and assess all costs and
expenses incurred by the Town in connection with the proceedings to remove or
secure, including the cost of actually removing said building or structure, against
the land on which said buildings or structures are located.
§100-7 8. Filing a copy of notice.
A copy of the notice referred to in §100-6 7 hereof may be filed with the County Clerk of
the county within which such premises, building or structure is located, which notice
shall be filed by such Clerk in the same manner as a notice of pendency pursuant to
Article 65 of the Civil Practice Law and Rules and shall have the same effect as a notice
of pendency as therein provided, except as otherwise hereinafter provided in this section.
A notice so filed shall be effective for a period of one year from the date of filing;
provided, however, that it may be vacated upon the order of a Judge or Justice of a court
of record or upon the consent of the Town Attorney. The clerk of the county where such
notice is filed shall mark such notice and any record or docket thereof as canceled of
record, upon the presentation and filing of such consent or of a certified copy of such
order.
§100-8 9. Emergency measures to vacate.
If the Building Inspector determines in his inspection of any premises, building or
structure that there is actual and immediate danger of failure or collapse so as to endanger
life, he shall promptly require the premises, building, structure or portion thereof to be
vacated forthwith and not to be reoccupied until the specified repairs are completed,
inspected and approved by the Building Inspector. For this purpose, he may enter such
premises, building or structure, or land on which it stands or adjoining land or structures
with such assistance and at such cost as may be necessary. He may also order adjacent
structures to be vacated and protect the public by appropriate barricades or such other
means as may be necessary and for this purpose may close a private or public right-of-
way. The Building Inspector shall cause to be posted at each entrance to such premises,
building or structure a notice stating, "This building (or premises, if applicable) is unsafe
and its use or occupancy has been prohibited by the Building Inspector." Such notice
shall remain posted until the required rehabilitation, repairs are made or demolition is
completed. It shall be unlawful for any person, firm or corporation or their agents or other
persons to remove such notice without written permission of the Building Inspector or for
any person to enter the building except for the purpose of making the required repairs or
the demolition thereof.
§100-9-10. Costs and expenses.
All costs and expenses incurred by the Town of Southold in connection with any
proceeding or any work done to remove the danger or in connection with the demolition
and removal of any such building or structure, or any work done to abate any violation of
provisions under §100-4(A) of this chapter shall be assessed against the land on which
such building or structure is located, and a statement of such expenses shall be presented
to the owner of the property, or if the owner cannot be ascertained or located, then such
statement shall be posted in a conspicuous place on the premises. Such assessment shall
be and constitute a lien upon such land. If the owner shall fail to pay such expenses
within 10 days after the statement is presented or posted, a legal action may be brought to
collect such assessment or to foreclose such lien. As an alternative to the maintenance of
any such action, the Building Inspector may file a certificate of the actual expenses
incurred as aforesaid, together with a statement identifying the property in connection
with which the expenses were incurred and the owner thereof, with the assessors who
shall, in the preparation of the next assessment roll, assess such amount upon such
property. Such amount shall be included in the levy against such property, shall
constitute a lien and shall be collected and enforced in the same manner, by the same
proceedings, at the same time and under the same penalties as is provided by law for the
collection and enforcement of real property taxes in the Town of Southold.
§100- 011. Penalties for offenses.
A. Any person who violates a provision under §100-4(A) of this chapter shall be
guilty of a violation punishable by a fine not to exceed $2,500.
X.D. Any person who neglects, refuses or fails to comply with any order or notice
issued hereunder shall be guilty of a violation punishable by a fine not to exceed
$5,000 or by imprisonment for a term not to exceed 15 days, or both such fine and
imprisonment. Each week's continued violation shall constitute a separate and
additional offense.
H-.C. In addition to the criminal violation,the Town Attorney is authorized to pursue
any and all actions in law or equity, including but not limited to actions for
compensatory damages, civil penalties, or injunctive relief.
ED. Strict liability. Personal knowledge of the existence of a violation under this
chapter is not required, no mens rea(intent) is required, and any violation charged
herein shall be one of strict liability.
§100-14 12. Severability.
The invalidity of any seefien, subseetieR or-provision of this ehapter-shall not ifivalida
any other sectio subsection opr-evision thereof_
If any clause, sentence,paragraph, section, or part of this Local Law shall be adjudged by
any court of competent jurisdiction to be invalid,the judgment shall not affect the
validity of this law as a whole or any part thereof other than the part so decided to be
unconstitutional or invalid.
§1004213. When effective.
This chapter shall take effect immediately upon filing with the Secretary of State as
provided by law.
Dated: Janaury 17, 2012 BY ORDER OF THE TOWN
BOARD
OF THE TOWN OF SOUTHOLD
Elizabeth Neville
Town Clerk
Please publish on February 2,2012 and forward one affidavit of publication to Elizabeth
A.Neville, Town Clerk, P O Box 1179, Southold NY 11971
Copies to:
Suffolk Times Town Board Town Attorney
Buildiing Dept Web Site Town Clerk Bulletin Board
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BUILDING DEPT SEARCH
*IN ORDER TO SEARCH BUILDING PERMIT FILES YOUMUST
APPLY FORA SUBSCRIPTION TO BE ABLE TO VIEW THEM. SEE
THE TOWN CLERKS OFFICE FOR ANAPPLICATION. OR YOU
CAN SUBMIT A FOIL REQUEST TO HA VE COPIES PRINTED FOR
YOU*
Press Search(the magnifying glass at the top of the screen)Click on Customize
Search
Select field from the drop down menu
Select the Building Dept template
Close out any other search boxes.
BP SEARCHES—type the Building Permit number into that field on the Building
Permit Template and press search.
BP SEARCHES WITHOUT BP NUMBER-
When searching for BP's and you do not have a BP#use the "Building Permits"
Template and enter the Tax Map#
To search using Tag Map numbers:
Type in the tax map number you are looking for using the 1000 then—then
the section followed by a dot and a dash (.-) then the block— lot
Example:
1000-100.4-1
All files in Laser that have tax map numbers are labeled this way.
If the search comes up with nothing then try putting an asterisk (*) after the
TM#.
If that does not work then eliminate the lot and just put an asterisk in its spot.
1000-100.-1-*
1000-100.-1-I*
The only exception to this is if the section has a dot in it then you can
eliminate the dot dash (.-)
EXAMPLE: 1000-38.1-1-2
PRE C/O SEARCH
Use the Pre C/O Template. Type in the owners last name surrounded by asterisks * (ex
* Smith*)Hit search.
You can also type in the Tax Map #(Follow directions in BP search for typing Tax Map
#correctly)
***USE THE FOLLOWING SEARCH WHEN YOU CANNOT FIND ABP OR
PRE C/O**
BOOK SEARCH
There are two books you need to search in
If you cannot find your BP or a Pre, close out all the search boxes and Go to SEARCH,
click CUSTOMIZE SEARCH.
In the drop down menu select TEXT. Go back into the drop down menu again and
Select WITHIN FOLDER. Go to the WITHIN FOLDER box and press the button with
The 3 dots on it to open up the folders list and then select which folder you want to
Search and press OK. Type a word into the phrase box and press search.
Search for a word or phrase in a document:
Go to the search screen, click on Customize Search, check off Text and Within folder,
then click on the small gray box with three dots on it next to Within folder to scroll
through Laser and select the folder you want to run the search in such as minutes, you can
search all the minutes or select a particular year. If you have a specific meeting or file to
search then deselect Within Folder and select Document/Folder name and enter the
name of the document there, exactly as it is typed into Laser.
Type the word or phrase you are looking for in the Basic Text Phrase box, click search.
The Search results will give you the specific pages the word or phrase appears on within
the document.
FOBN NO. S
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. .4044k5. . Date . . . . . . . . . . . . .Ifey. . .6. . . . . . . .. 19. 15
THIS CERTIFIES that the building located at . .Illinois. Ave. . . . . . . . . . . . Street
Map No. T01.3.YWQ04. Block No. . . . . . . . . . .Lot No. . .ptso�24y25,4Q &•1t 1. . . •Mattituck N
hconforms substantially to the
code
aaeit.be•fors. .4pr11 .23. . ., 19. 57! pursuant to which �•ZC �cy
dated . . . . . . . . . . .May. . . .6. . . ., 19. 75, was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is .P'hate -one. T-amily•dwe.11Ing• with- -gara-ge ecey.• •ble.-C • • • • • • • .
The certificate is issued to .Goo... •Woodhull •&•'4Ji,fe• • • 46tner& -to• Miohael •Simone & wi.
(owner, lessee or tenant) new owners
of the aforesaid building.
Suffolk County Department of Health Approval prey-, .existing . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE No. . .pre-,ex1zti.n& . . . . . . . . . . . . . . . . . . . . . . . . . . .
HOUSE NUMBER . . . .2-7Q . . . . . . Street . . lllinnis. .�.ve. . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . �f. �. . . . . . .
Building Inspector
i
L
HOUSING CODE INSPECTION
May 5, 1975
,270 Illinois Ave. R-1
Mattituck, N. Y.
Sub. Div. - Tollewood, #175
Lots: N- 1/3 #24 - N- 1/30 #25
S- 1/2 #40 - and #41
Tax Roll: George T. Woodhull & Wf
Occupied
Upon receipt of an application for a Pre-Existing Certificate
of Occupancy, I made an inspection of this one story framed
dwelling. I was admitted to building by Dick Woodhull and
began this inspection at approximately 1:10 P.M.
The building consists of two bedrooms, living room,
kitchen, bathroom, enclosed rear porch and an enclosed
front porch. Heat is supplied to all rooms except front
porch from an oil fired forced warm air furnace located
in partial full cellar; balance of foundation is crawl space.
The following violations of The.-Housing Code, Chapter 52 ,
Town of Southold, were found.
Front porch entry, no means of controlling light
in room on entry, Article V, Section 52-56 B-2.
Water ump - electric hook-up to motor -
BX conductor with lamp cord two prong plug,
plugged into outlet, no ground connection.
Article V, Section 52-56 - A-1-3-5.
Accessory buildings consist of a utility building and a two
car garage with work shop, a full bathroom, is in work shop
section accessible from garage.
Buildings and grounds are in good condition. Inspection
completed at approximately 1:35 P.M.
Re ectfull submitted,
�d rHinerm nn�`������.
EH:mm Building Inspector
TOWN Or SOUTHCLD
Building Deportmeot
Town Clerks Office
Southold, N. Y. 11971
APPLICATION FOR CERTIFICATZ OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building
Inspector 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
Installations, a certificate of Code compliance from the Architect or Engineer responsible for
the building.
5. Submit Planning Board approval of-completed site pian 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 property 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 in-
formation required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00 May 1, 1975- '
Dote ........... ................................
New Building .................... Old or Pre-existing Building X ....... Vacant Land
. ............. ...... ............................
Location Of Property .E/SNia£linois t £iick;Al�?"e"w' or rivate..road).....of...,Westphalia Avenue.
............ . ................................
Owner Or Owners Of Property ,GEORGE T. WOODHULL and RUTHANNE WOODHULL, his wife
{To be Michael J. �Simone & .Wi eT................I..............
...........
Subdivision ...........»...................................................Lot No. ............ Block No. .......:.... House No.............
PermitNo. .................... Date Of Permit....................Applicant ..................................................................
HealthDept. Approval ............................................Labor Dept. Approval .....................:........
UnderwritersApproval ..............................................Planning Board Approval ..............................A........:
Request For Temporary Certificate ....:....................................Final Certificate ...............X.......................,
Fee Submitted $...L.00.&...................... ,
Construction on above described building and m I pi' le codes and regulations.
Applicant .... .. ......... ........ ... ................................................
Wickham & Lark, P.C. , ttys. for George T.
Sworn to before me this Woodhull & Wife
.....Zst... day of .........MaXr......19.75:......... (stampar seal)
Notary Public ......... Suffolk County
A.R-- NOTE: Key -- Owner on premise:
MARY LOUDQRCSKI
Closing -- 5/8/75.
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NOTARY PUBLIC, atitte o/N+w Yaq
No. 52-1008ti5a Suffolk U,yuaiy
Cemmlasloe Expires March 30. 19117
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