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HomeMy WebLinkAbout5617-zF~B,M NO. & TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z.7.~.~.? ...... Date .............. ..~Y ....~. ....., 19.77. THIS CERTIFIES that the building located at .. N/.~/.. ~21n. Boad ......... Street Map No...~ ....... Block No. ~ ....... Lot No..~ .... L~.. N...Y, ......... conforms substantially to the Application for B~lding Permit heretofore ffl~ in ~s office dated ............. NOV .... 8., 19 .~1. p~suant to which Building Pemit No. ~1~.. dated ~ov 8 19 7~ was issued, ~d conforms to ~ of ~e r~ merits of the applicable provisions of the law. The occup~cy for wMch this ce~ificate ~sued is ~e~.~..~P.~g. ~..~$~1~. b~.~ ~ ~..~$~g. ~0~,. ~Q. CO~X~g. fac ~ty The certificate is issued to . .~. ~g~Q.. (owner, lessee or ten,t) of the afores~d building. S~olk County Dep~tment of Health Approv~ ~gZ~.Q~Y. ~Q. ~.~. d~g ......... UNDERWRITERS CERTIFICATE No. N3338~.1 ..... April .20...1.977 .............. HOUSE NUMBER ...... ]~.~... Street . .Earn .~.. ~el .................... Bffilding Insp~t~ TOWN O~ $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT/V{UST BE KEPT ON THE PREN~ISES UNTIL FULL COMPLE~ION OF THE WORK AUTHORIZED) N°- 5617 Z O~e .............................. .~..v.~.~.z....t~ Permission is herel~y granted to: ~..¢~e ....... ' ......... : ............................ at premises located at' ............... ~.....~..~a~..~-..~l~l~l.t/..~g...A~t~.~&~...~.l~ ........................ ............. _. ..................................... ~',~re.~ ....... ~-~.~ .............................................................................. pursuan~ to opplication dated ............................. ~ .......... ~ ........ , 19....~.I, and approved by the Building Inspector. Fee $--~rO~: ........... Building Inspector FORM NO. 6 TO~N OF $OUTHOLD , Building Department Town Clerks Office 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 Inspector with the following; for new buildings or new use' ]. 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 certif,cate of Code cornphonce 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 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 pertlnent in- formation required to prepare a certificate 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 Date ....... ..~.,a. ~...,3..~ ...~, .9.7..? .............. New Building ................ Addition ..... ~,... Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ..~/..S...~.~...~..~..n..~.~.~..a.~C~t.~.~.a.~.U;.r.~.e..~.~(~.~.~...e..~..~.~..~..~.~.....~.1..~.§ ...................................... Owner Or Owners Of Property .....B..A..,.R~....A...R~:....,.A.......B...E....P,~...I...N...,.K~_. ..................................................................... Real Property Tax Service ~: Dist. 1000F Sect.~ 125, Block 2, Lot 5 _~tax~ . .............................................................. ~oX~ ............. :~Ja3oJcXhl~ ........... ~t0uiac Zee ............. Permit No ..................... Date Of Permit .................... Applicant .................................................................. N/A N/A Hea~th Dept. Approval ............................................ L~bor Dept. ApproYa~ ................................................ Underwriters Approval .513.3.38.5.1....-:....co~tz' ........... Planning Board Approval ~./.~ ................................ attached Request For Temporary Certificate ........................................ FinaJ Certificate ...... .,.)~,.. .............................. Fee Submitted $ 5..;.9.9. ........................... Construction on above described building and permit meets al_l applicable codes and regulations. Applicant/.~~ ............... ~ ~.~.~..~'.~; ............................. Barbara A. Berdinka Sworn to before me this ~/~r. ~' ...... a:&.. day of ,.~y.,...L~3.?- .................... (stamp or Nota~ Public ................... ~.~.~.~ Coun~ ~ ~ Notary Pubhc, State c'~ New York - No 52 QuahhPd m Suf~ol~ Counl~ Term ~xplres Mdrch 3Q. THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK~ NEW YORK 10038 D.,e Apr'il 20, 1977 .~pp,,.-.,,..Xo....;,,e 907908 N 333851 THIS CERTIFIES THAT Rdo~ 500~ w/o Aldrich I~ne~ Laurel~ 1..,12. DRYERS Barbara Berdinka, n/s Main i,~ the following Io~atlon: [] Bazernent ~ 1st FI. ,,-as oxami~d on April 18, 1977 mx~u~E FIXTURES 8 [9 [3 8 FURNACE MOTORS 1 150 CB I ~ ~d ri. Outside ,s.,-tio,, ~;~:~ to, 2: Fr. 12I *t_ z SERVICE DI~CONNr.~'T : NO. OF S E R V C E xI , , 1 1/0 I 1/o __ *Special Receotacles: 1-30amp 1-50amp Motor/s: 1-1/~hp This ce.ificate must not be o~tered in a.y manner; return to the office of the Board if incorrect. Inspectors FOBM NO. $ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLDr, N. Y. ORDER TO REMEDY VIOLATION Date .... (owner or outhonxed/fifgent of owner)./ [ao~rress o owner or authorizeo agent or ownerl PLEASE TAKE NOTICE there exists a vlolahon of: Zoning Ordinance Other Applicable Laws, Ordinances or Regulations ............................................ at premises hereinafter described in that ~~,,b;.. :~.~..~ .,~_~k,~. ~.~:..:~..~..:~ tsta'}~ character of violatJ~) In v,olation of ..... ~....1~..~¢.O.,..~...~.~......~ .~.~' ................................................................... (State section or paragraph ,of apphcoble law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply w~th the law and to remedy the day of ...(~Z~..~ ....................... , 19~.~,~.'~. The pr_em.ses to .which this ORD,>TO REMEDY VIOLATION refers are s.tuated at Failure to remedy the conditions aforesaid and to comply with the applicable provisions of low may constitute an offense punishable by fine or imprisonment or both, TO~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION (owner ~ authorized o~_nt of own~gr) PLEASE TAKE NOTICE there exists o violation of: Zoning Ordinance ~J~ '0~ ...~.....~...~..__ ~ [ _~_, Other Apphcoble kaws, Ordinances or Regulations .......................................... ......... - in viola ~on o f ~4~...~Jt~/'~...'~,~.~.. ~.~, i. Z...t. ............................................................................. ~ ....... (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to~/~ ..~ ~7~' J ~c°roglY with the law, and to reme~L the cond,tio~ above mentioned fo~hwith in or before the :~.~..~~.....~.~j. .... The premises to which thi~ORDER TO REMEDY VIO~TION refers are situated at Fa,ilure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. · Building Inspector ' TOWN oF SOUTHOLD , BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E om,ned .......... ...... . p,ica.on ................ ........................................ , 19 ........ Pemit No ........................../r,e.-~";~'"- "" " Disappr°~ed a/c ................. i ................................................ 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 adjoining premises or public streets or areas, and giving o detailed description of layout ofproperty must be drown 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 Inspector will issue o 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 o 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, housing code, and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ,,4 A//~/'A {~ ! ~ ~. ~- ..O.. .................. ' If applicant is a corporate, signature of duly authorized officer. ...........-'""ii(~; ";~' i~;;ii' ~i~' '-";;i"; ~1~;111;;' ~'~ii;:'~;~'''(Name and title of corporate officer) ..... i'~ 1' Locati°n'°f'land'°n'whiCh'pr°p°sed'w°rk'Will'bedone Maa No.: .......... ~.'~.......~......~ ....... Lot No .~.)~' /.~ 7-~ Municipality 2. State existing use and occupancy of pr, Rmises and intended use and occupancy of proposed construction: b. Intended useandoccupancy ........... ..~7.....~..~.....~....~......~..~.., . y ...................... 3. Nature of work (check which applicable): New Building .................. Addition ............. Alteration .~.. ~'... Repair .................. Removal .................. Demolitior .................. _Other Work (Describe) ................................ y ..... 4. Est mated Cost ................. ~.. ....................................... Fee ...-~.... .................................................................. (to be paid on filing this application) §. If dwelling, number of dwelling units ............................ Number of dwelling units on.each floor ........ . ................... If garage, number of cars ............................................................................................................................................ ~- 6. If business, commercial or mixed occupancy, Specif~.nature and extent.of 'each t~1~ of use ..~L.....~. ................ ......... 7. Dimensions of existing structures, if any: Front ............ ...~:...~f ......... 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 ~:onstruction: Front .......... .a~.. ...................... Rear ........ .~. ................. Depth ....f..~ ........... Height Number of Stories ~ 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ...................................................... ~Nome of FoJTner Owner .............................. ~ .............. 11. Zone.or. use,dist~lct n which prem ses are s tuated ...~......,/,~ .............................................. ,.:~.. ~ .................... 12. Does proposed construction violate any zoning law, ordinance or regulationP ........ ..~...,.~. 13. Name of Owner of premises ~.~..~...~..:~...,~.......:...Address' '/~' ...~-/A O .................... Phone No~. ................... Name of Architect ...... : ............................................. Address ............................................ Phone No ..................... Nam~ 'of Contractor ....~..~.....~..~..~ ................. Address ...... ~ ........................ Phone NO. .................... PLOT DIAGP. AM Locate. cl~arty end distinctly, all buildings, whether existing or proposed, and indicate ali set-back dimehsions from'~* property lines.~ G!ve street, r and block number or description according deed, and show street names and Indicate whether interior ar comer lot. t'~STATE OF NEW.-YQRK- .-. t ~: c ~COUN~ OF .~ .......... ~ ........................ .--..'-.-~ ............................ ~ing:duly ~m, d~s and says t~ he is the applicant (Name of individual signing a~hcation)__ above named. He ,s the ....................~ .~ ................................................ ~ ................................... (~ntmetor, agar, co~ra~ officer, etc.) of said owner or owners, and is duly authorized to perform or h~e per~ed the ~id work a~ to ~ke ~d file this application; that all statements c~toin~ in this applic~i~ am t~ to the ~ of his knowledge and belief; and tha~ the work will be performed in the manner ~t fo~h in the ~pllc~i~ fil~ the~i~. Swam to ~fore me this .................... ........... ...... .......... . ELIZABETH ANN NEV~E NOTARY PUBLIC. State d~ew No. 52-81258~Suffo1~ C~ %%, · -- MONUM~7' REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: AT L ,4 Ll i~ EL TOWN OF SOU THOLD SUFFOLK CO., N.Y. SCALE: