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HomeMy WebLinkAbout7024-zNO. 4 TOWN OF $OUTHOLD BUll.nlNG DEPARTMI~IT Town Clerk'e Office Southold, N. Y. Certificate Of Occupancy No. Z ?0L~I+ Date liay 2~ 19.76 THIS CERTIFIES that the building located at . S/,~ .,: ~,~T~..20~d. Street Map No...x~. ......... Block No. ~ ....... Lot No.. ~....L.a.~..e..3....}! :.Y., ............. conforms substantially to the Application for Building Permit heretofore ~ed in this office dated ...........l~ec.. 2.. 7,319 .... pursuant to which Building Permit No. ~[.0.2..~... dated ...............Dec .2.., 19.7.3., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which thi~ certificate is issued is .F. ara .bl,tllcll~.g ....................................................... The certificate is issued to Itenry..Bo~anovski ..... ov~e~, .......................... (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval . .I~ ~1~.: ............................. UNDERWRITERS CERTIFICATE No..p.e.,ri.cl..~.g ................................... HOUSE NUMBER Street }Lain lqoad Laurel ..... ......... Building ln,pector~ FOF, M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N; Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 702 Z Date ........................ ~ee ....... ~ ............... , 19~.~... Permission is hereby granted to: ....~.~.~'...,,T..,... ~,zm.~rk/, ........................ ; ..... .................... ~,e~tee.1. ......... ~;,.~., .................... ~. ..... ~o ~...u../.~.1.~/.~.t../.~.°.~.°.~e.~r"~*~.~'~g~.ar~a~R~b~/1~J~C~"~~ ere) at premises located at ..... .8.../..~......~.....:~....~....0~...~. ......... .Ot.~/~.~.~.e.t%.e~.,.). ................................................. ........................................... ~.~..e~ ......... ~.~., ................................................................................... pursuant to application dated ........................~Qe,~ .......... ~ ............ , 19.~..~.., and approved by the Building Inspector. Fee $..~s~ ........... FORM NO. ~ TOWN OF $OUTHOLD ~ Building Deper~ment 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: 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 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 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. 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 $5.00 3. Copy of certificate of occupancy $1.00 New Building ................ Addition ......~ ..... Old or Pre-existi,~;~g Building ..,~ ............ Vacant Land .............. · .of Pr p ty ............ ........ ......... O n 'Or O nCe/s roperty ....... ................................... Subdivision .................................................. 7"]_ ...... Lot No....X.....~.7,ock No...~.~. House No.~.~..). .... Permit No....~....~....~...~.. Date Of Permit ./~/]/~,,~...Applicant /~.~./~,~,,,~......../~.~.~l~..#..~/.,/~/t:'(~¢../..° Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Fin~zl Certificate .......................................... Fee Submitted $ .....~.'...~...~. ................... Construction on above described building a~.d permit meets all opplj~z~ble codes and regulations. Applicant . ~...~...~.. ......... g.~,... ~J~/~.~...l!~.(~..~ ~ 1~. Sworn ,o before me this ~'~ ...:~.~.... day of .............. J.~.?..C .... (stomp or seal) Noto~ Public ...... ~..~..~ ..~ ~o,*,~ ~.S~  PUBLIC, Sts~e Coun~ ~He'~r~62'39~92~ l~l J~ 7 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date (owner of authorized agent of owner) '"~"~¢'"'~"~. '~, '"'-"'" '~'~- taddress aT owner or authorizea 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) ~ ~.~..z~.x.<...z......~...~..:..-......~,,~....~ ...... (State section or paragraph of applicable law, ordinance ar regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the .......... ~ ....................................... day of .......... .~.~. ......................... , lC)7~. The premises to which this ORDER TO REMEDY VIOLATION refers are situated at ,~../~- ~z County ....................... of Suffolk, New York. Failure to remedy the conditions aforesaid and to comply with the ~:pplicable provisions of law may constitute an offense ~unishable by fine or imprisonment or both. Approved '( "-~ TOWN OF SOUT,OLD BUILDING DEPARTMENT ~.~.~, TOWN CLERK'S OFFICE / ~)UTHOLD, N. Y. /' Applicotion No ............... ..(.. ......... :..., 19.2.?. Permit No..?....~.....'~....~...~ .......... Disapproved a/c .................................................. ~. ......................................... APPLICATION FOR BUILDING PERMIT ..~ Date December 7 19..7...3. ~ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building~ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises relationship to ad Dining premises or public streets o~-I areas, and giving a deta led description of layout ofproperty must be drawn on the diagram which is part of this application./V 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 shaft be kept on the premises available for inspection throughout 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 oil applicable laws, ordinances, building code, housing cede, and regulations, and to admit authorized inspectors on premises and ir~ buildings for necessary inspections. Henry J. Romanowski (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. ............................................ Qw~r....-...hu~l~ar ....................................... Name of owner of premises ...~,e..n..r..~.....R.9.m. an°wski ........ If applicant is a corporate, signature of duly authorized officer, (Nome and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: ..... ~ ........................... Lot No....,,x~.. ............... Street and Number $./.~ ~'i~J.l~. ~.9.~1, .... ~.~,~.~, ...~j'.,.~., ................................................................ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy Farm Storage building same with an addition b. Intended use and occupancy ................................................................................................................................ 3. Nature of work (check which applicable): New Building ...~ .............. Addition ......~ .... Alteration .................. Repair .................. Removal ' Demolition... ................. Other Work ......................................... ..~...:....~ (Description) 4. Estimated Cost .................... ~..0..~.,0..0.0.....,~+ ...... ;i .......... Fee ..1.~Q0 ............................................................................. (to be paid on filing this application) ,5. If dwelling, number of dwelling units ..... .0.. .................... Number of dwelling units on each floor If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify nafure and extent of each type of use ...~..[~.~...e...t~...~...'g~...e. 7. 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 ................................ 8. Dimensions of enfire new construction: Front ................. 5..©. .............. Rear ........ .~..0. ............... Depth ..... 9..~. .............. Height .................... Number of Stories ...................................................................................................................... 9. Size of lot: Front ..... ~c~a,~e .................................. Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises ore situated ............ ]]~,!~...d;:L~.~ ...................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ..... .~.O.. ............................................. 13. Will lot be regraded' .....~.Q .................. Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of preFnises ...~.O.T~.~..~D~.B,~C~,S}',~ .......... Address LaUrel Phone No. Name of Architect .............................................................. Address ................................ Phone No ....................... · Name of Contractor ........ ..~,.~..~..e. .......................................... Address ................................ 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 deed, and show street names and indicate whether interior or comer lot. STATE OF NEW YORK, ~ S S couNtY Of ....... .~]~.;~.Q2 .......~ ' ............................... .H. 9..~.?.~....'-T..:.....~..°.~..~..~...o.¥~'~..~.~- .................... being duly sworn, deposes and says that he is the'applicam (Name of individual signing cohtracf) above named. owner -b~idler He is the ................................................................................................................................................................................. (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 Jn this application are true to the best of his knowledge and belief; and tha~'the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ................... 7.... day of ............ ............ , /')/ , - Notary Public,. ................................................... County ... f~7~ .~..~,;.~~ ................. · " ~,/ ~-/(Signature of applicant) '