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Home My WebLink About5338-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy Z103T3 Febvnaey 2, 81 Date ................................. 19... THIS CERTIFIES that the building ................................................ 240 Headow Lane, Cutchofue, Location of Property ~a~ ~;o[ ........................................................ 116 Street 02 024 /'/am/et County Tax Map No. ]000 Section ............ Block ............... Lot ................. Subdivision ............................... Fried Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore ~ed in this office dated June 8, 71 5338 Z ..................... ,19... pursuant to which Building Permit No ...................... dated ...... JIIa~l. 04 .............. 19. ? .1, was issued, and conforms to all of the requirements of the applicable provisiom of the law. The occupancy for which this certificate is issued is ......... Addition to Private One-Family .D?.o. lltnfl The certificate is issued to .... Ernest #. and Janet L°. Case (ov,,ner, I~ or tenant) of the aforesaid buiidinS. Suffolk County Department of Health Approval .......................................... Loond~nE UNDBRWRITBRS C£RTIFICATB NO .................................................. Rw. 1/81 TOWN OF $OUTHOLD 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? 5338 Z pursuan¢ to application dated .............................. ~.~t~,~ ............ J~....., Building Inspector. Permission is hereby granted to: ........... ~r~e,~.~ ...~ ~...~.~ ................ : .................. ..................... ~.u~t ~,~ .................. ~, ................. to .... ~-~td...e~ ....~,.~i~.. ~...~ ~.~.~.~ ..~e~ ~ .............. : ........................................ at premises located ot ............. )]./f~.....~e.¢Z,-m~-'~ ............. 'i .......................................................... ...................................................... .q..tt.?,..~.~.v..~ ........... .~.:~.,....,.. .......................................................... 19.....~.~ and approved by the FORM NO, 6 TOWN OF SOUTHOLD Building Depa,t,:~ant 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 disposet-(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- lions, 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 building~ 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- lion 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 New Building ........... Old or Pre-existing Building ....... ..... Vacant Land ............. Location of Property .. House No. Street Owner or Owners of Property ~'~~.~..~..~~. ,. ~ ............. CounW Tax Map No. 1000 Section . ./..~. ~ ........ Block .. ~.~ ....... Lot... ~:~.~-..~. .... Subdivision ................................. Filed Map No ........... Lot No .............. Perm,t No~.33X~. Date of Permiq~/~./..Applicant .~..~...~.... Health Dept Approval -"'-- Labor Dept Approval . . Underwriters Approval Planning Board Approval ............. Request for Temporary Certificate ..................... Final Certificate ...... . .~..... ......... Fee Submitted $ . . .~. ~.. ~.. ................... / Construction on above described building an~.~rmit meets all applicable codes and regulations. Applicant . ~~.:.~'/~' ........... \~.~.. > ~t. ~ TOWN OF $OUTHOLD BUILDING DEPARTME~IT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. (owner or authorized agent of owner) (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance ART. XIV Other Applicable Laws, Ordinances'or Regulations ....... ; .................................... - Buildin P at premises hereinafter described in that ........ ~...~...z~.~.~ ~..~.~ (state character of violation) dated 1 has ex ired. ................ ........ . You a e new permit ~ in violation of Sec. 100-1~1H ' ' (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 ...~.~7~,,~ ............ i ....................... ..... .............. The premises to which this ORDER TO REMEDY VIOLATION refers are situated at · ~.~--.-.~-e--g.~.~3'h.~-~-R~.-,-...~.~-~.~g.g.g.e..~.;'.; ........... County of Suffolk, New York. Failure 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~.x~C FOF, M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE Ex, mined ........ __ ~ Application No ............................. ~proved 19..2./Pemit No..~...}...(..~..~~-~ ...................... (Buidin. Inspector) / ~ 9-v'v ~ APPLICATION FOR BUILDING~MP~['~ INSTRUCTIONS a. This application must be completely filled in by ~pewriter or in ink and submi~ed in duplicate to 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 detail~ description of layout ofproper~ must be drawn on the diagram which is ~ of this application. c. The work covered by this application may not be comme~ed before issuance of Building Permit. d. Upon approval of this application, t~e Building Inspector will issue a Building Permit to the applicanL Such permit shall be kept on the premises available for inspection throughout the pr~ress of the work. e. No building shall be ~cupied or used in whole or in pa~ for any pu~ose whatever until a Ce~ificate of ~cupancy shall hav~ 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, ordi nances3_.building code, housing code, and regulations. (Signature of applicant, or name, if a corporation) .............................. '('~,~J~tess at appli'"'"'"/';'---:: [~fi~i ................ ) .............. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~9 ,o,,,'6~. '~ ";:q '~5' : ........................ ....... ....... ........ ................... ................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done. Map No.: ....................... ;~ .............. Lot No ......................... Street and Number ...~....~..G.....~.~..,'~.~..~..~.....~.~.../~....~. ............................. ~.?..~...c....//..~..~'...~....~'. ......................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ..~.....~. / b. Intended use and occupancy ....... K.~...~./.~...~...,~...0.....~'.. ....................................................................................... ' ~ '~ 8uiiding .................. Addition Al o .................. 3. Nature of work (check which applicable): New .................. Repair .................. Re_~Enoval .................. Demolitio~ .................. Olher Work (Describe) ........................................ 4. Estimated Cost ........ ..~..../...~.....~...~.. ................................. Fee .... ..~...'~.:.f.~ ......... (t~ be paid on filing this application) 5. 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, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ........ .~..~...~. ........... Rear ...... ~.. ....................... Depth ...~.....~...~ ........ Height ....... /..~...~ ......... Numbe~ 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 ..../.....'~....~.....~..~... Rear ....... ./....o'~....~......'~....7~:. ........ Depth .......~.....~....~....~.'.......~... 10. Date of Purchase ........ ~. ....... /~..~.. ............. Nome of Former Owner ..... ~..__~.~..,~..~..~.~....~.~....~....~..5'...~'.. .......... 11. Zone or use district in which premises are situated ............................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ....... .~....~.: ............................................ 13. Name of Owner of premises .~...~_~...~.£..~.....~.:. ~.~...~..~.~.. Address .~..~.~..~..~...~...~..~.,, ~6~C#fPh~n Name of Architect ....~'~'z~Z~....~..; .................................. Address ............................................ Phone No ..................... Name of Contractor ...~./,~Z~...~.. ................................... Address ............................................ Phone No ..................... PLOT DIAGPuau~A Locate clearly and distinctly all 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 show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF ..... S,U f~o.1J~ .......... ........... :,,~3;~ftI~,~;,,E,,..~%~,{~ ....... ; ......................................... being duly sworn, deposes and says thor he is the applicant (Name of individual signing application) above named. He is the .................................. o',~te3: ............................. (Contractor, 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 thor the work will be performed in the manner set forth in the applicaticx~ filed therewith. Swomtobeforemethis/.~ ~.~, ~ ~..*~ 197.1...... ~. ~ ~ ...... .~t ~l'1 .......... doy Of ....... ~.I1~.8...i ........... Notary Public,~.~A~~ ...... ............................. County of Suffolk (Signature o¥'~ppii~,~'i ................ NOTARY PUBLiC/State of New No. 52-8 z~.58~,~W~c, CouEt~ Term ~;,,$~,.~ {~