Loading...
HomeMy WebLinkAbout5758-zFORM NO, & TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupnncy THIS CERTIFIES that the building located at .... 6~. D~ .............. Street Map Nol~ld~. l~Or~lock No....ii ....... Lot No. P.~. confoms substantially to the Application for Building Permit heretofore filed in this office dated ............ 14a~.. 20., 19.72 pursuant to which Building Permit No. dated .......... Mar...23 ..... , 19.52, was issued, and confoms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private..olxe. facile..dwelling, with. a4diti~ ....................... The certificate is issued to .. I,o~tae..~.,. l~ebel ..... 01~ez ........................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N. ,R.* ................................ UNDERWRITERS CERTIFICATE No..]l~0 ..... ~...2~...~97~. .............. HOUSE NUMBER ..... ~0 ..... Street....0troY~..I~*~.v~ ........ ~t~o14 ....... FO~ NO. ~ TOWN OF $OUTNOLD BUILDING DEPARTMENT TOWN C:LERK'$ OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 5758 Z Permission is hereby granted to: .......... Lm~e..~....~.e~l~- ............................... ............. 6~...l~..~.~e.t,....~......~ ......... ............... l~;~t.....i..:~.....t :1;;~0 ........... to ....~"~..~..~...~..e..s.~.s.~....~:..~.~....~?:~.~.s...~A..~....e.~.*..~.~...~.~.~...~.. .................. at premises located at ....... ~O~,~..p~...~i.~l~j..4.~..~6....~l~..t~l~,li..~l~l~..~ ..... ............................... ~l~.4e~ .............. ~e~t~e3~ ......... ~..~.. ................................................. pursuanrc to application dated .......................... .l~,~C~....~.O ........... , 19....~.~, and approved by the Building Inspector. FORM NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Southokl, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY hu~ructions A. This application must be filled in typewriter OR ink, and submltted~n~n DupI~I~TE t~the Building Inspector with the following; for new buildings or new use: . ~ ~ 1. Final survey of property with accurate location of oll buildings,~rrf~ 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 fram Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance fram 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: I. 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 , c iP'lg New B~ilding ................ Addition ...X. ........ Old or Pre-existing Building ................ Vacant Land .............. Location Of , ~w-Y~... ..................................................................................................................... Owner Or Owners Of Property Z~..~.../.,~.. ~/.?...~...~.E~t~ .~.. ........ ', ., . · ............................. ................... ~ubdivision I~¢.~.~...AL~.i~!...'~ ........................ z.....: ....... Lot No. ............ I~x:k No. ~(Z~.~..~ House. No.~.~..~/ Permit No~ ..u~'"'..4~lr...."~,.. Date Of Permit~"~../..~...~,icant ~ .....~...%.~ ................. ' Health Dept. Approval ............................................ Labor Dept. Approval ................................................ · Underwriters Approval ..... : ........................................ Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fined Certificate .......................................... Fee Submitted $ .................................... Construction on above described build.Jng~~/,~a?~lic,~ ~ ;c~ e~ ar~u~i~ns. · APPl ica n~'Z'~"'~"'":~v"3v"¢'/' ~ '"' ~ "~z r" "A '~'~'72'~ ............ I~ualified in Westches=er C~uflty ~,ammissi0n Expires March 30, 1977 THE NEW YORK BOARO Of FIRE UNDERWRITERS  BUREAU OF ELECTRICITY 85 JOHN STREET, NE%' YORK, NEW YORK 10038: ,oa,~ l~y 24, 1977 ~ppli~.~lonXo. on/ile SSS997 N 338840 THIS CERTIFIES THAT only the electrical equipment ~ described bel~ and int~dueed by tile applicant named on the above application number in t[te premises of Harold ~ Louise Reebel, 280 Grove Dcive, Reydow Sho~es, souEhold, L.I. in the followlng locatlon; ~ Basement ~ 1st FI. ~ 2nd ?'l'. ,Section Block Lot w.sox, mlnedon ~y 19, 1977 andfo,,ndtobelncompliancewlththerequlrementsqthlsBoard. FIXTURE FIXTURES ~ ~ANGES 'COOKING PECKS~ OVENS rDISH WASHERS I OUTLET ~ECEPTACLES SWITCHES ~ ~E~cu.~ - -- ~ -- --"'~"~ DRYERS FURNAC~ ~OTOES FUTURE APPLIANCE FEEDERS S['EClAL REC'PT~ TI~E CLOCKS 8E~L UN T HEATERS MULTI OUTLET EXHAUST FANS · I S E R V I C E Panelboard/s: 1-12ckt 100amp Harold Reebel 67 Manhasset Woods Rd. Manhasset, L.i. 11030 STATE OF NEI¥ YORK : COUNTY OF___~.I-JE.P..o-.L..K. .................................................... _ _ .J_U..S..T_I..C..E. ....... COURT ........ .T_ .O_..W~!.. ........ OF .... _S__ _Q~ ~ .t! Q_Ij> .......................................... 7ol!r t r.ptr of II!r ~lalr nf ~rm ~ork ; 3nfurmaliml Louise V. Reebel .. [ ...................................................... 5;?;;,%'J~i ..... 7-' '! Howard Ter.r~f~ Buildinq In_s~ector '._..~ .... residing Jocke Creek Drive, Southoldt New York by this information makr written accusation as follows: That Louise V. Reebel ............ on the 19th day of.._J__a_.n..u_a_.r_Z. 19__7..7_ ........ at (Location) in the ...... . _12I. _a_ .m_ .1.e_ _t.. ..................... of ....... .S..o..u_ .t_ _h.o_ _1. _~ .................................................... Count)' of.___S..u..f_f_.q~_k_ .............................................................................. ,New York, di commit the offense ~f~-°..~..°-u-p.~..i.~n.~-..a..d..dj:3-~:.°.~n-~.°-n.~?..x-i-~.~.~~-59-~.E~3.~.9A .... the required Certificate of Occupancy. _ ....... a (~i~rne~'"or) (violation) in violation of Section _.Ar.t....XIv+._Re=,_.__l.D..0.r_L{.4__A-_~J.-)of'ff Chapter 100 of the Code of the Town of Southold _.-_.-..-._-.-__-_.-..-_.-..-__2_~k~w-~q~,-~a~e-~-N~-¥~g, in that (s)he did, at the aforesaid time and place Count One: occupy addition built onto existing dwelling located on the above mentioned premises without applying for or securing a Certificate of Occupancy. Thefactsupon whichthisinformationisbased are asfollows: Louise Reebel obtained Building Permit #5758Z on March 23, 1972, and constructed an addition onto an existing dwelling. After due notice by mail, she has failed to apply for or obtain a Certificate of Occupancy. IYherefore, Complainant prays that ....... ~.o. _u_ .j:. ~ _e__. _V__.__. .R. .e_e_.b..e_ .l_ ....................................... be dealt with pursuant to law. **Subscribed and Sworn to before me on / Complainant ,/ Howard Terry, Building Inspector Name Town Justice Title or Office eset forth statutory language constituting the offense **use only one The foregoing factual allegations are based upon personal knowledge of the complainant (and upon informat and belief, the sources of complainants infozmation and belief being, Wherefore, Complainant prays that_ ....................................................................... ;--- be dealt with pursuant to law. **Subscribed and Sworn to before me on ........................................................ , 19 ....... Compl~nant Name Title or Office *set fo~h statutory language constituting the offense **use only one **Verification By Subscription and Notice Pursuant to CPL Section 100.30, subd. 1, par. d False statements made in the foregoing instrument are punishable as a Class A misdemeanor pursuant to section 210.45 of the Penal Law. Accordingly and with notice of the foregoing, ! hereby affirm that the foregoing statements of facts are true, under penalty of perjury, this day of 19 Complainant An appearance ticket has been issued herein on ................................................................... by .................................................................................................. , directing the said ...................................................................................... to appear before this court on the ............... day of ........................................................... , 19 ......... and ball in the amount of has been posted with Complete above only if appearance ticket has been issued) ACCusAToR~/ INSTRUMENT INFORMATION - GENERAL C.P.L. 100.15 FORM NO. 256 WILL~AMSON LAW BOOK CO., ROCHESTER, N. Y* 14609 STAT~ OF NEW YORK : COUNTY 0~_.._.~ ......................................... ................... co~.~ ........ ~..o~ ...... ~~~ ................................. ~l~e ~e~pl~ of tl~e ~late ~f ~ew ~.~t 3nformalim~ ..... ................................. Defendant c,., ~_~.._ ~ , les,din at ..... .......................... ........ written accusation as follows: Th~ ..... ~....~; ...................................... , on ,ne_.~.~...... day of~ .... 19.~..~. ...... at ...... ...~.... / .9.'. ;g.~. ...... ~a~~ ...... "~"~'"'~ in the~.~ ........... of .... ~Z ......... i .................................... , ........... ~..~._~._~. ............ : .................................................................. a ~ (violation) in violation of Section...~...~..~...qZ'....tq..~../_~'....~__~ ....... of the State of New York, in that (s)he did, at the aforesaid time and place* CountOne: ~ f~,.~,,~, .~ The facts upon which this information is based are as follows: The foregoing fa(tua~ allegations are baled upon personal knowledge of the complainant (and upon information and belief, the sources of complainants information and belief being, ~TH~D, N.Y. ~/~ ~ ~ ~ /~ ~ i i ..~..~.~ ~amin~ ......................... ,. ............. , 19 ........ /~ ~pl~t~ ~ ................. ~p~ ........................................ , 19 ........ P~it ~ ....... ~...~...~..~ ............ ~ ~ , ~ . /-- · ~ ./~ ~ .................... ~ ................................................ : ....... ~~/~ .................... ~~.....~ ~ (Building Ins~torl ~ ~.~.~ O~l~Tl~ ~R l~l~l~ ~[~lT ~ ~t, .~.....~. ...................... ~¢2&. ..... INTRUSIONS ~. This ~lic~tim must be completely filled in by ~pewriter or in ink and ~ubmi~ i~ ~li~tt Insofar. b. Plot plan shying I~ation of lot and of buildings ~ p~mises, relationship to adjoining pr~mis~ or ~ubli~ ar~, and givin~ a d~tail~ d~ription of layo~ ofpr~e~ mu~ be drawn ~ the diagram *hich i~ ~ ~ thi~ ~li~fim. c. ~ work ~r~ bY this a~lication may not be comm~n~ed befor~ i~ua~e of Building P~rmit. d. Upon appeal of ~i~ application~ ~e Buildin~ Insp~r *ill issue a Building P~rmit ~ ~l~t. ~h shall b~ kept ~ ~ pr~mi~ ~ailabl~ tar in~ctim thr~h~t th~ pr~r~ of ~ ~rk. · . No buildi~ ~h~ll ~ ~cupied or u~d in whole or in pa~ for:any pu~os~ whatev~r until a ~lfi~tl shall have ~en gr~nted ~ th~ Building Ink,tar. APPLICATION IS HEREBY ~DE to the Building ~par~ment for the issuance of ~ Bui~i~ P~it pu~nt Building Zon~ ~in~nc~ of th~ To,n of ~ld, Suffolk .Count, N~w ~ork, and ~th~r.~l]~l~ ~, O~in~ of .~. R~ulations, ~r thJ ~on~tr~ti~ of buildings, a~itim~ or ~lt~rations, or tar ~m~a~ or d~mohti~, ~ hi,in d~rib~. Th~ applicant auras to comply with all applicable I~s, ordinances, buildi~ c~e, housing c~e, ~ ~ul~i~ ¥""~g~;;i';';g';['g~i'~i;';7'~'&;;"ii"g'~g~;i;~i ........ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .....g...~.~f,~ ............................. ~ ...................................................................................... .. .............. ,,.~ ....... ,.,,..,.,: ........... , ........ Name of owner of premises ....(=...~..~.~.~J~ .... : ....................................................... :~ .................... '.L ....... s ............. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Map No.: .~.~..i ................................ Lot ~o. L~...+..I~, ... ~' 0 I~'~s ~ I'~J:~ i~'- Street and Number (~1~......~....,.~I~..¥.~.!...~..,..~.~..~.~. ............... ..~.LI~,J~.J-~ ............................................. ~ ~ ~ Muni~li~ - ~te ~isting ~e and ~ncy of pr~ ~ intended use and ~u~ncy of p~ c~ti~: ~.~.~a ~ ~ =~=y ..~.~.~. .................................................................................................. ,.t.naed ~. and =~ ~[e~ ........................................................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration-.~......-~......., Repair .................. RemovaJ .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost .~..~.. ................ ............................. i.Fee ...~..J..~... ............................................................................... (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. Jf business, commercial or mixed occupancy,' specify nature and extent of each type of use -- .. 7. DimenSions of existing structures, if any: Front ..~.~a! .................. Rear ...~.,~ ...................... Depth .~,.~..~ ......... Height ...~.~.! .............. Number of Stories ..~ .......................................................................................... I Dimensions of same structure with alterations or additions: Front....................................."~1 Rear ....~....~... ................. / Depth .-~../. ...................... Height ...~....~. ................... Number of Stories . .~... .......................... $. Dimensions of entire new construction: Front ...-~.....~..! ......................... / Rear ...~.~ ............... :', Depth Height .--~...~../. ........... Number of Stories ..---~ ................................................................................................................ / i , 9. Size of lot: Front ..... ~.J. .................. Rear ....J.'~.~. ........................ Depth ....~,l.~.. ................ 10. Date of Purchase ..~.~/ ~'~, .~..~.~.,{. Nome of Former Owner ~...~....L~..~.~....~...C...~. .................... 1 I. Zone or use district in which premises are situated ....~....~.J.~'~]).~. ...................................................................... 12. Does proposed construction violate any zoning law, ordinance or regu at on? ~.~ ............................................... 13. Name of Owner of premises ~-.{).)~L<',~..~:.~..~.~.....~...(.....Address ~0.~..E....~..I~J.~)..~..,,.~...~.~....~ne No.~.~.~...-.~.~..~.~.. %OU'r~OL~> , ~,~, 1 lqql '" Name of Architect ...................................................... Address .................................. ~ ......... Phone No ..................... Name of Contractor ..~,t~.~..~.~......~..~.~...~.~.~.l~....~..Address [.~.~.0...~...c~..~.~.~...~..{{ ..E~..J~.~ Phone No.~,.~. PLOT DIAGRAM 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 dee~, and shOW Street names and indicate whether Interior or comer lot. ~)taw/ Public, S~te of New Yad~ No. 60-0678330 Qualified in Wes~chester Cou~dy C. gm~l~lafl E~oirel March 30, i~/3 STATE OF NEW yORK,--,. ~ j .l S.S COUNTY OF ~,...~...~....~...(..~/)=~..... $ ................. ~. ~)..LJ.I ~ .. ~.-..'~ ~ ~;~J~ ~ ...................................... being (Name of individual signing application) duly sworn, deposes and says th~tshe is the applicant above named. SHe is the ....~fl~J~ ...................................................................................................................................... (Contractor, agent, corporate officer, etc.) ~of said owner or .owners,)and is duly authorized to perform or have 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 ~hwaotmtht~)~l:~kor~i]ml el:~thq~rfL~ rr ed in l~e rrcrner set forth in the application filed ~herewith. ........... . ........... ............................