HomeMy WebLinkAbout6514-zNO. &
TOWN OF SOUTHOLD
BUH.~ING DEPARTMENT
Town Clerk's Office
$outhold, N. Y.
Certificete Of Occupency
No.ZT..2~-- ·~ ....... Date .............. .~...R.~....2.0. .... , 19.~.6.
THIS CERTIFIES that the building located at .. F~al~&~.0.%k$. ~Q~tl ......... Street
~lattituek
Map No. ~X ......... Block No. X,X ....... Lot No, .. l~X l~][~[l~l[....N.:.I[: .......
conforms substantially to the Application for Building Permit heretofore ~ed in thi.~ office
dated ............. A.p.r...~.R., 197.~. pursuant to which BUilding Fermit No...6.~.~ .~.Z.
dated ........... .A.9.r.. ?.~..., 19.?], 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 P. ri.v~te..olle, fi~.~,~y..clW~l.~n, g .V~[.t. tl .a.d.dJ,$~[.o~.. (g.a~l.~g~) ............
The certificate is issued to . .F.~Dk .~.. }la~le. ~l~Yer. .... 0wD.e.r $ ....................
(ovrner, lessee or ~nant )
of the aforesaid building.
Suffolk County Department of Health Approval .N...R... ...............................
UNDERWRITERS CERTIFICATE No. ~2~763 .... .~.Uly...10...197~. .............
HOUSE i~ER ..... ~ ? 80 .... Street .. Mar, t® ok,a. Road .......................
..... '..~. ,..,., \. ........
Buirding inspec r I
FOKM NO. 2
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)
65~Z] Z Date ......~......~-L~" P ........................... ~ , 19..~
Permission is hereby granted to,~---- ~q /
.... ~...~...~~.....Z..~-
~o ..... ~..~ ....... ~....~......~.~?~...~.~..~.~.~.,,/
at premises located at ..... ~,~...~_ .~.~.~.?.~;~.....~:....~ ..........................
pursuant to application dated .............. ~l....~C...~...~..:..~ ....... , 19.....~.-~..., and approved by the
Building Inspector.
Building Inspector /
l~OBM NO. $
TOWN OF SOUTHOLD
Building Department
Town Clerk~ 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 os 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
$5.00
New Building ~ Old or Pre-existing Building Vacant Land
Location Of Property ........................................... .O.~.~'~/~.~.~.. ......... /...'7...~.. .................................
Owner Or Owners Of Property .......................................................... ~ ................................
Subdivision ................................................................ Lot No ............. Block No ............. House No .............
Permit No ~..~'.../.{/' 2. Date ^f PermP .~.'~'0"~'7,-'=' '
.................. u .................... ^pphcant ..................................................................
Health Dept. Approval ............................................ Labor Dept. Approval ................................................
Underwriters Approval ...~.....-T...~.....-....~.....'~....'.. ................ Planning Board Approval ........................................
Request For Temporary Certificate ........................................ Final Certificate% ..................................
Fee Submitted $ ....................................
Construction on above described building and permit meets all applicable co~es and regulations.
Applicant ~~ ~ ................................
Sworn to before me this ~"~- 7,~-'/'/:~
......... · c; "~"... day x.~~ .......... (stamp or~) ~r~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK's OFFICE
SouTHOLD, N. Y.
ORDER TO REMEDY VIOLATION
(owner or author'~d agent of owner)
taaaress aT owner or authorizea agent at owner) .
PLEASE TAKE NOTICE there exists a violation of: ~'~
Zoning Ordinance ~/~ ~
Other Applicable Laws, Ordinances or Regulations ............................................
at premises hereinafter described ~' x;' ........ i~:t~'~'~:'~'~'~ ~i~ ~i ..................
...
~n wolatlon of (~tate 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 ....... .~. .................................................
The p~mises to which this ORDER TO REMEDY VIOLATION refers are situated at
......................................................................... 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.
EW YORK BOARD OF FIRE UNDERWRITERS
: BUREAU OI= ELECTRICITY
;ti h; ;iii ' Il "il/BStJOHN STREET. NEW yORK. NEW ,
YORK
10038
'~ .'~. ~;y~a~:NeYe~,':Ma~ratooka Rd Suffolk Ave ~ Park D~., Southold, L.I.
[] 2nd Fl.~ I , c~a~, o Section, Block
and found to be n compliance with the requtrement# of th s Board,
RANGES KING DECKS DISH WASHERS
Lot
FANS
FUTURE Af~LIANCE FEEDERS
TIME CLOCKS
MULTI.OUTLET
SYSTEMS
NO, OF FEET
DIMMERS
S~RVK~' OL~iONHE~I' '
S E
R VI I
C
A.w G
OF NEUTRAl
OTHER APPARATUS:
Panelboar/d$: = .~-2cir. 30amp
Frank ,Meye~ . -'
Marratooka. Rd.'
/'Mattltuck, L.I'. 11952
This certificate must nat be altered in any manner; return to the office of the Board if incorrect, inspectors may be identified ay their credentials.
TOWN CL~K'$ omc~ "/ '-'7' _""2~..~ '
~OUTHOLD, N.Y. ,,e/"~//.~ -
· 0~ NO. I ~ ~
· TOWN OF SOUTHOLD ' *' ,gx/
APPLICATION FOR ZUILDING~ PERMIT
..... ...... ,,,.7....g.....
INSTRUCTIONS
e. This appliCation must be completely filled Jn by typewriter or in ink and submitted in triplicate to the Building Inspector, with~,
3 sets of plans; aeeur~e plot plan to sCale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on promises, relationship to adjoining premises or public streets or areas, and~
giving a detailed description of layout of property must be drawn on diagram which is part of this appliCation.
c. The work Covered by this appliCation may not be commenced before issuance of Building Permit.
d. Upon approval of' this at~liCation the Building Inspector will issue a BUilding Permit to the applicant. Such permit shall be kept
the premises available for insl~Jctlon throughout the work. '
a. No building shall be __~_.m~_~iad or use~ in whole or in part for any purpose whatever until a Ce,rtificate of Occupancy shall have bee~
grentmJ by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone
,~.~.inanm of the Town of 8outhold, Suffolk County, New York, and other appliCable Laws, Ordinances or Regulations, for the construction of~
;~bulldin~, additions or alterations, or for reme~ld or demolition, as herein described. The appliCant a~rees to comply with all applicable laws,
ordinances, building code, housing code, and mgulati0ns, and to admit authorized inspectors on premises and in buildin~ for necessary inspections.
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
........... ~.~ ....................................................................................................
.F.. cv..e
Name of owner of premises ~.l~l...~..l.~ ....... .~'~J....~.l..~..., .................................................................................
/
If applicant is a corpora,, signature of duly authorized officer. ' .~
(Name and title of corporate officer)
Builder's License No ........................................... ', ............
Plumber's License No
Electrician's License No ..................
Other Trede's License No ...................................................
1. Location of land on which proposed work will be done. Map No .............................................. Lot No .........................
r . ++ , .... ; ....................
Street and Number .~1~.~ ...Ca .~..~.O...~....~d........~.....OI.. ......... J[ ....... ,..~[ .1~ ..... '.":', . . ......
· / Mumc,pahty
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
I
=~,.~ ....... ~ ....... I '/'.~ s~o~v ~o~-~- ...........
Intended use and occupancy ...~.....~-....~....W....:I..~....~.. :.~....q..~....~..~..../~.....~ ff ......................................
3. Nature of work (check which applicable): New Buildin~ ................. Addition ..................... Alteration ........ ..~....
Repair ......................... Removal ......................... Demolition ........................ Other Work ....................................
st-~...~ ~ (Description)
4. Estimated Co ..~t..~ J~....~ .......... 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 ....m~-- .................................................................................................................................
~. If business, commercial or mixed occupancy, specify nature and extent of each type of usa., ...................................
7. D,mensmns of existing structures, ,f any: Front~......~. ......... Rea~.,~ ................. Depth,,~.l~,.:...~.... ...................
Height ...~...~....'. ............................................ Number 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 ....JJ~JJ~.........,~,.~,.~. ............... Number of Stories .........................................................................................
9. S ze of lot: Front ...~.O.~:..~....~. ................. Rear ....J..~...~.~,...~..~ .................... Depth ~.~...~....~.:.....~...~.. ~i
10. Date of Purchase ..~,~/,,,~..J.:~..~. ............ Name of Former Owner#....~..-~:.-../.~..-- - --" °- '""..~.........,~.....CI...~..I..~....~t...'~J'""""'"'"'"'""""'"'"'"'
11. Zone or usa district in which premises are situated .....................................................................................................
12. Does proPOsed con~tr,..ction ~iolate any zoning law, ordinance or regulation: ~.1~. ....................................................
.13. Willlot beregraded--~Lg3;:~ ....................... Will excass fill be removed from premises: [ ] Yes 'vet] NO_~
14. Name~f~wner~fpremi~.~K~FJ[~.~3`f;`~U~j~.~.j~('~`~j~i~£;Q~e~-~t~L~;~f~k~[~L~`~
{Address) (Phone No.)
Name of Architect .....................................................................................................................................................
(Address) (Phone No.)
Name of Contractor ...................................................................................................................................................
(Address) (Phone No.)
propertY lines. Give street and block number or description
er interior or corner lot.
* ~ PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proPOsed, and indicate all satJoack dimensions from
and show street names and indicate wheth-
(Name o£indivld, ual~i~n~ngcontrac(); { ; ~ . .. being duly sworn, deposes and says that he is the applicant above named.
· ...........................................................
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 a~d belief; and that the work will be performed in the manner
set forth in the application filed therewith,
.............. ~5 .......... .............. day of ~tater'~ _ 'TE~IIILEE ELAKof New'~V~l~'7~i !~ I I :1 , ! . ..
......... ~'"~'~:'~.n~i~§y ............
Notary Public '-,~-~ ...~~.,L,,.i.,'~A..M..a.r.c~ ~U~"'t ~. ....... ./....~..~....~'~'~ .................................