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Home My WebLink About6075-zlrO~ NO. 4 TOWN OF $OUTHOLD BUll.DING DEPARTMENT Town Clerk's Office Southold, N. Y. Certific;,te Of Occupency No. Z$~1 ~ ..... Date ............. Ma)'...1.? ...... , 19. ~ THIS CERTIFIES that the building located at Roohelle. Place ........... Street Map No..Ba~t3,e~r... Block No ...........Lot No. ]p.t .2,~e...[/a.tt~t~k.. N.,~, ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated .........A~I~. - 2~.. ·., 19.. 72 pursuant to which Building Permit No. 6(F~. dated ..........~ul~. · .2~ .... , 19.. 72 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~i.vate..rose. g~,m~ t.y .dwelling .... with .dock .&. deok ...., ........... The certificate is issued to David .&. Edna. Ackerma~ ..... Qw~er.s ...... i ............ (owner, lessee or tenant ) of the aforesaid building. / Suffolk County Department of Health Approval .~'eb · .l~...~9~+.' .by. ~,. V~I& ..... UNDERWRITERS CEI~TIFICATE No..N..~3~73 ..... N.~.. 3~.. f!~.~ ............. HOUSE NUMBER . )+~.~ ......... Street . Rool~e~3,e. P~Lace ........................ ............ FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 6075 Permission is hereby granted to: ..... ~.~ ....... ~-~c:. ............ :,.,..?,.... . :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: at premises located at .....j~ ...;~....?..:.~:~.S-:...../?/~-~...~..~,.~......C~.) .......... ...................................... ~ ~ ............... .:; ............... ,,.~.,~ ...... pursuant to application dated ........................~.} ....... ~.., 19.~2.;, and approved by the Inspector '~ ~- , ' Fee $.~..~..~.... ........ FO~M NO. 6 TOWN OF SOUTHOLD Building Department Town Clerks Office Sonthold, N. Y. 11971 APPLICATION FOR CERTIFICATE 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 dispcsal--(S-9 form or equal). 3. Approval of electrical installation fram 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 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 o~ 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 3. Copy of certificate of occupancy $1.00 New Building ...... ./.. .......... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ...~...0..~..~..~.~.L....~-......~...~..A..C..~ ............ ../~..~...7~./...7~.~.~..~. ............... ..~..[...Y. ......................... Owner Or Owners Of Property /~/~VIJ~ ~'~ ~-c-O/v/I ,~ c'KE'N~vJ ~ '~/ ... , .................................... ..................... .............................. Su ivision ...................... Lo, ..... .ouse Permit No. ~..°..7..~.....7-:.. ..... Date Of Permit .~.~.~..~.~./.9..7....~.Applicant ...~....~.~..!..?. ...... /~..C...K..~...~....~...~.. ............... Health Dept. Approval ...~....~....1...;..~[.~...~ ........... Labor Dept. Approval ............ .~....:.....~... . Underwriters Approval ...~...~.~...O....~...~......~/~...~..~......plonning Board Approval .... ~..'..J~ ..................... Request For Temporary Certificate ........................................ Final Certificate ......... ~ ............... Fee Submitted $...~.... ............................. Notary Public .................................... County Construction on above described building and perr~-'~eets oil app)~obl~ codes and regulations. Sworn to before me this (stamp or seal)~ FG~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION TO ~)&v~,d,..&..i~m& ..Aeke~mal ...................... (owner or authorized agent of owner) ...... Ziea~z.n~.£~e.....Z,~eg~..~la~b~z.....Zl,Z., 11 (address of owner or author{zed agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance ...... ~ ........................... Other Applicable Laws, Ordinances or Regulations ..... ~ ........................... at premises hereinafter described in that (state character of violation) ...... .tmz..tee~..&..Z4..Ap~e&l & ...................................................................................................... (State section or paragraph of applicable law, ordinance or regulation) dock & k'hal*f YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith in or before the ......................... ~,~ ....................................... day of ............. ~. ~,~1~11,~ ........................ 19~1~... The premises to which this ORDER TO REMEDY VIOLATION refers are situated at 1~/ ~r ].at, 23t p~....L~,d,~.&..~'.tJ,~s...~l~hlll..P..l. ........... .t~ou~]%f 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. TOWN SOUT.OLD / BUILDING DEPARTMENTJ~' / ?~ TOWN C:LERK'S OFFICE ~ SOUTHOLD, N. Y, ~/~ Approved ........................................ , 19 ........ Pemit No ...... Disapproved o/c ............................................................................................ ......................... ~~.~ .~ ....................... ~..~.., D~e ...... ~,~.A.....~,.~ ............. ]~.~.~ .... INSTRUCTIONS ~:~ a. This application must be completely filled in by typewriter or in ink and ~jhmitted 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 I%~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is port 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 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 NLADE 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 nonces, 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 ~.,~.//. V ! ~ ~-~ A/ If applicant is a corporate, signature of duly authorized officer. 1. k~lion o~ I~nd on which ~r~osed work will b~ don~. M~p No.: ........................................ Municip~i~ 2. State exis~ng use and ~cupancy of premises a~ intended use a~ ~cu~ncy of pr~osed c~st~ti~: ~. ~i~itiog ~ ~ ~upo.~ ................... ~.~.~.~ ........... ~.~.,~ ............................................................. b. Intended use and ~cu~ncy ~/~ L ~ ~/~y D~ ~l~ 3. Nature of work (chock which applicable): New Building .................. Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ~ /..~). 0~.0...~... Fee ~e ~L ~. ' (to 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 ........................ ~ .......................................................................................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ Front/~ult~ 3~.' ~4R.~.O,R_- //o~$g~,~., ~-~o~' .- , 8. Dimensions of entire new construction; .................................. uur.~: ......................... uepti~ ...~...~.. .............. Height . I Z ' Number of Stories t ° '. ..................... ................ 9. Size of lot: Front ....... ~.~...~. ............. Rear .... Depth ~,~'/" /~'7 ., . 10. Date of Purchase ....................................................... ,~om~ of Former Owner ...C..~..A'...L..........~./.~'.~...~...4:./~ ........... 11. Zone or use district in which premises ore situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............................................................ 13. Name of Owner of premisesD//..~../~..~....~`./2...~..~....~.?.~K..~.~...`/~ress~.~../~.~....~.`....~..~.~.~ne No.~..~..~.-.~..~...~ Nome of Architoct ...................................................... Address ............................................ Phone No ..................... Name of Contractor ....~..J~r...U~..W..~.'~.. ......................... Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil 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 comer lot. STATE OF N~YD~ COUN~ ~ ....... ~'~ ......... tt~ ..................................................................................... being duly sworn, d~es and says t~t he is the applicant (Name of individual signing application) above named. He is the ......................................................................................................................................................... (Contractor, ag~t, corporate officer, etc.) of said ~ner or owners, and is duly authorized to pe~orm or have performed the said work and to ~ke and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and t~t.the.w~rk.will be performed in the manner set fo~h in the applicati~ filed therewith. Swam to ~re~e this ........... o, .... . ~ ~]_ .~ ~/~ / ~' . ...... ~.J ................................. :~ ......... fl - .- THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICIT%' ~ · ~ --- 85 JOHN STREET, NEW YORK, NEW YORK 10038 THIS CE~IFIES THAT only t~ e~t~ equ~mnt ~ ~eH~ ~ a~ int~u~ ~y t~ ~l~ent ~ o~ t~ a~ ~pl~a~n numar ~ t~ p~mi~s of [~vid ~ke~n~ n/s Sale ~ke ~. e/o ~y Ave. ~cCi~uck,L.l. ~ exami~d on ~ ~ ~ and found to be ln compllance wlth the requirements of th~ Board. RXTURE FIXTUR~ RANGES ~VENS DISH WASHERS EXHAUST FANS OUTLETS SWITCHES FLUORESCENT 15 22 l~ 15 DRYERS FURNACE MOTORS FUTURE APPUANCE FEEDERS TIME CLOCKS UNIT HEATERS MULTi-OUTLET DIMMERS SYSTEMS NO. OF ~ET SERVICE DISCONNECT S E R V I C NO. OF CC. COND. A.W.G. NO, OF HI-LEG A, W, G, OF HI-LEG bIO. OF NEUTRALS OF NEUTRAL OTHER APPARATUS: HoCo~s: 1-~hp. l-3~on A.C.un£C.--- W,B. Rul~nd MatCiCuck,L.I. PeE '~COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. i fi~lb £ /.: L, L%ItIp/,:¢x/ ,1