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Home My WebLink About6005-zFO~ NO. & TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificnte Of Occupnncy No..ZSC~.0 ..... Date ...l~a~.Ch.. ~0 .............. , 19..~. THIS CERTIFIES that the building located at .Sg~0. ]~Ln~te~ .B].¥.d..... Street Map No....9'17 ...... Block No ........... Lot No .................................. conforms substantially to the Application for Building Permit heretofore filed in this office dated .. 'o'U].y-'-1 ~1 .......... , 19. ?~ pursuant to which Building Permit No.. dated .. ,,TtlJ. y...1.'l ........... , 19~'~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ..... P/t'~VATE. '0h'E--FAIq~Y .D%r~ ................................... The certificate is issued to ...~..~.n...e~.d...~?..~...FV.$..e~...T.~ .c.1/~l....~..B.e~ .(forelel~ly Vail (ownerr~e~:~z~' ' ' ' of the aforesaid building. Suffolk County Department of Health Approval ...... N?~R .......................... UNDERWRITERS CERTIFICATE No ............... N~?6.~ ..................... HOUSE NUMBER .. ~ ....... Street ...... ~.e...h~ka..' .B.i..v.d., .................. ............................................ .s.o..u.t..~.~..~. ~.~...~.o.r.k .............. Building Inspector · 0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION~)P THE WORK AUTHORIZED) N°. 6005 Z Date .......................... Z. '/'7 ...... . ,gZ.....~-- Permission is hereby granted to: ............. ~.:i.*.'..~'::. ....... z~ ........ ~..~..~.~...~.~.7 to ...~..D..~........T./~ ........ ~.~. ~-..~...L/..~..~. ................................................................................... atpremiseslocatedat ............... ~. " /' .~L. I,(.Z'. l /. /J /..~. ,'~ ,~...L ~.. ./.~ ...................................................................................... ~.4Ll~....7..~ /l..(/..L..l~ ........................................ pursuant to application dated ............................... /../.......~..(/.~.~..., 19~..~,,~, and approved by the Building Inspector. Building Inspector FORM TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Dote ...... ~.~..~/..~.~.~.....~.~i/~ ~ ...... , (owner or outhorized ~'~o'f owner) / (eddress of owner or euthorized ~gent of owner) ~ PLEASE TAKE NOTICE there exists ~ violation of: Zoning Ordinance .... ~.~6~ ...................... Other Applicable Laws, Ordinances'or__~ ~ ~ .~Reguloti0~x~ ....... ~'"~"iJ ...................... . ..... · ot premises hereinafter described in thot ~W~.. ~..~..~..~~..Z~....~.~.~.~..~...'~.~:....'Z. //~ j ~ (state character of violation~ ~ secl~n p g p p ' ' g ' YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the la~ and to remedy the ~ ~ ~ ~ ~ ~ ~ ~ .................. ~,,,,~ ................................... ..................... , y~e premises to which this O~pER TO~EMEDY VIOLATION refers are situated at /~'~'~-'= ~~ ~. ~.., co.~,y o, ~.f~o,~. ~ew ~or~. 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. // / FO~M NO. 6 TOWN OF SOUTHOLD Bu;lding 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 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 disposals(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 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. Swam 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 Dote March 29, 1978 New Addition ........ ~. ......... Old or Pre-existing Bulldln~ ~ ........................... Vacant Land ............................ Location Of Property Minnehaha Boulevard, Southold, New York Owner Or Owners Of Propedy Martin and Emma Frieda Tschiember (formerly Van Taggart) Subdivision .....~-a..u.c~b..~.~...~.~..%~.~:.~ ............... i ............... Lot No ............. Block No ............. House No ............. Permit No...~.0.9.5.~ ........ Date Of Permit ..7/.~..~/.7.%....Applicant ...~:~..n...~.~.~[~ ......................................... Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .... ~. .3. 7. .6. .5. .4. .5. ............................ Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate .......X ................................. Fee Submitted $ 5.00 Construction on above described building and.13er, mit meets atl ~gpplicable codes gnd regulations. Apphcant . Wick~m, Wickham & ~essler~ P.C. Sworn to before me thls by Abigail A. Wickham (stamp or seal)~/~,/ DOROTHY HENDERSON NOTARY PUBLIC, S~e o~ New York ~) Comm;ssion Exp~re~ Marc!~ 30, ~' ~0~t\ BUILDING DEPARTMENT TOWN ~CLERK'S OF~CE ~TH~D, N. Y. .............. ~ ~? ..... 19 ........ ~ed ................ ~.~).......y:..~/, ]~..~i~ ~o ..................................... ~ppr~ed ,. · . .............. ~d.~ .. :.: ~..'~.~, ...... APPLI~TION FOR BUILmNG PE~IT~ ...... ................... a. This appl~fio~ mus~ ~ comple~el~ fille~ i~ by ~wHter or i~ i~ ~d su~m ~ed ~ ~ripli~te to zhe ~uilding Iflspe~or, wit~ b. Plo~ pl~ ~oWing Iocat~o~ o~ lot ~d o~ buildings on p~misfl, relationship ~o adjoi~ giving ~ ~iled ~ripfion of la~o~ of pro~r~ mus~ ~ drewfl on d~am ~ch is ~ of this appli~fion. ~. T~ ~ ~red ~ ~his appli~fio~ may flo~ ~ commefl~d ~f~e issua~ of Building Permit. d. ~ ~vai of this application, ~he BuildZ~g Inspector will issue a Buildifl~ ~ermi~ lhe ~mim avaJ~e .f~ ifls~ion ~hrou~ho~ the work. e~ ~o ~i~t~ ~R~ o~P~ad or ~d iff whole or ~ pa~ ~or 8~y'p~ Whatever ~fil Gran~ ~ the Buildi~ I,s~ctor. A. PPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Buildii~ Zo~ .O~l.n. ance of .th.e Town of So. uthold, Suffolk County, New York and other applicable Laws, Ordinances or Regulations for the~Onstruc~ on ou~.?~ngs, .a~dl.?.,ons or alterations, or for removal or demolition, as herein described. The applicant agrees to Comply with all applicable oramance~, ou,d~rlg code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Address of applicant) State whether applicant is owner, lessee, agent, archltaCt, engineer, general contractor, electrician, plumber or builder. ........... Name of owner of premises.~,a~,..... · .~t4. . ...,..~4~.=.~ ~ lC:.~....... .......... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will he done. Map No.: ,.....~.,/.~... ..... Lot No, . . ..~; ................. : ..... at,et and Numar .~--,~.;,-e,....~,...LL,...~X~& ........ ~--~'--l~=...:'~,i.., .............................................. MunicipaliW 2. S~ exi~ing um and o~u~ncy of premims and in~nd~ u~ and ~cupancy of pmpo~ con,ruction: 8. b. Existing use and occupancy ....~,~L~.~.~..~ .............. ~...i.....~.a, ...... ,..~.~ .............................................. Intended use and occupancy .~.~.~.:~..~.~.~....~ J ......... ~.-.....~ - >~ ~ · . ~ ., ~ ~.~ ., .....~.~.~.~. ............................................. ~ ,3..4Nature of WOrk (che~k which applicable): New Building ....................... Addition .... .l~air ......................... Removal ......................... Demolition ........................ Other Work .................................... ~. - (Description) 4. Estimated Cost ............................................... Fee ~. ' (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 .................................. · .......................................................................................................... 6. if business, commercial er mixed occupancy, specify nature and extent of each type of usa ..................................... 7. Dimensions of existing structures, if any: Front .~.~':....~..~.,~.. Rear ~'Z'..:~../~. ....... Depth ~,~'..~.,.7....-/....)..~.. ........... Height ...J.~..:. .............................................. Number of Stories .................. 1 ......................................................... Dimensions of same structure with alterations or additions: Front ..... ~ ................. Rear ....... .z~.~.. ......................... '" Depth ..............;~..~, ....................... Height ............ 2.~.. ..................... Number of Stories ,,..~. ................................. y Dimensions of entire new construction: Front ......................... Rear ............................ Depth ................................. Height......... ...................... ......... . ........ Number of Stories ......................................................................................... 9,; Size of lot: Front ....... ~..~.. ......... ' ........... Rear .....~..(~ ............................ Depth ...~...~.,~=~ ................................ Height ................................. i~ ............ Number of Stories ........ : ............................................................................. 10. Date of Purchase ...... I...~.~..~ ........ , ........ Name of Former Owner ........ ~ ......................................... 11. Zone or use district in which premises are situated ..................... ~. .......................................................................... 12. Does proposed construction violate any zoning law, ordi~anca or regulation: ..(~ ............................. ;7 .......... 13. Will lot be regraded ................................ Will excess fill be removed from premisas: [ ] Yes [1'No 14. Name of Owner of premises ..~,.v~ ....... ~/~....~c~.~,.~.t:.....:ln~.;..~.,.~,,.-'l./Z-'~=,-~¢l..--~l~j..v.~......~A.~%~ ~ (Address) (Phone No.) ' Name of Architect ..................................................................... (Address) (Phone No.) Name of Contractor ................................................................................................................................................... (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposad, and indicate all sat-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. : STATE OF NE ) OF. (Na~ of i~vid~ He iS the ..--0.~-~. ............................................................................................................................................................................... { Con~ctor, ~nt, coyote ofccp, etc.} of said owner or owners, and is duly auth~ ~m or have ~rfor~d the ~id work and to make and file this appli~tion; ~ all ~t fo~h in tbe ap~i~t~n filed t~-~49a3 suffol~