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Home My WebLink About6685-zFOB,Bi NO. 4 TOWN OF SOUTHOLD BUn.F)ING DEPARTMi~IT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z6~8~ ...... Da%e ..............~I.~ZCh .... ~.., ~9.?~. THIS CERTIFIES that the building located at .tt&~oke..AYe .............. Street Map No. ~ ......... Block No.. ~ ...... Lot No, .x~.. 0rJ, ell~;e..1~ ~.o. ........... conforms substantially to the Application for Building Permit heretofore filed in thJa office dated .....6~..22/. '7~ ...... , 19 .... pursuant to which Building Permit No.. dated . .1~/]0/.67. ~ .6/2~.73., 19 .... , was issued, and conforms to all of the require- ments of the appUcable provisions of the law. The occupancy for which thi~ ~f/cate is issued is S. tud1.a .bu~Zc~$nZ .($~g.~ssO~.~)..~md..~d~:L.~lpl~..~;~. S~a~ ............. The certificate is issued to...I~QI~p~.~. ~.1~$ ....... .0.~. ~I' .......................... (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Heal/h Approval .NAR..* ............................... UNDERWRITERS CERTIFICATE No. p.~z~d.~pg ................................... HOUSE NUMBER ... 6.Q~ ....... Street ...~a~k~..Ave .......................... Building I~pector I ~O~ ~O. 2 TO~N OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Nr. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6685 Z Permission is hereby gronted to: Bobert Be~ks ............ ~.e.~.t. ...................................................... Btttld an addition on exlstin ..r. ff..s..~:2,e..n...t..i...a.,1....a..q.?..e...s..q..o...~...b.,,,~..1...d.~ ...... ~o .............................. ~ ......................................... .g. at premises located at ...... ZS.....~I~.G;C~..~.Ma.....(....~.~. ................................................................... Orient N.Y. pursuant to application dated .......................... .~.~-~.....~,~, .......... , 19~.;~ .... and approved by the Building Inspector. FOEM NO. ~ TOWN OF SOUTHOLD , Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions ^. 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 o certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existincj dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date ...,.~...~.~.......~....~........[..~..? New B~4ilding Location Of Property "~"~/~1-/'~/~ ........... ~ ................................................. Owner Or Owners Of Property ~' ~.. Subdv s on _ ~ ~ ...................... Lot No BlocI~No. House No '~ ~,'~ "///~1~7 ....... ~ ~ ................ Perm t No .G.~.~ ..Zm.. Date Of Perm t ..~.'~'.~...~....7.~.App cant ........ ~....~ ................................. Health Dept. Approval ..... ~..~..-~... ........................... Labor Dept. Approval ................................................ Underwriters Approval ..... .~....~..~..~..!...~....~.. ................. Planning Board Approval ...... /~/.:.~..~'.. ....................... Request For Temporary Certificate ........................................ Final Certificate ............ .~ ...................... Fee Submitted $ ...................... Construction on above described building and permit meets all applicable codes and regulations. App cant .(./..~... ? Sworn to before me this FOI~M NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION (owner or authorized agent of owner) (address of owner 6r authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance t/~/','~/~',,~;/~' /GO ../~.~J/ ......... Other Applicable Laws, Ordinances or Regulations .......................................... at premises hereinafter described in tha~....~.~..-.F. ~.../~.......~..~/~..~.~.~.--..~........~.~...~..../.~...~...~.~..~'..t.~/~//''~''' (state character of violation) / ~.c~.......¢.'...=.-...f.?~.z.o~..~.~......,~..f.......~..c.c ~.~.z.~r~:....../.~.~ ~___________________~.__ __ __,, ,,,,,_ ................. in violation of~--~......./.~2~/....'T../..~....~.......,~:':¢....:'..~'.....~ ............ ./..... ............................................. (State section or paragraph af applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy/fh"~ conditions above mentioned forthwith in or before the ..... / ~ doy of ............................ TheDremises to which this ORDER TO REMEDY VIOLATION refers are situated at - - ....... ..... ..~ ....... ' .County of Suffolk, New York.~' ~ ' Fa.ilure to remedy the conditions aforesaid and to comply with the applicable provisions of taw may constitute an offense punishable by fine or imprisonment or both. TOWN CLr~K'S OFFICE (' /-X~LJ2 ~ ~ ~ Ex.,~.~ ....... ~..~ ........ ,~4 , ~~.~.~.~.~. .............. ~~ ~ 19.~ ....... PermitNo. ~ ......... ...................... , .~.~..~.~..~ ..... ~ ~ ~proved ~se~rave~ .... ~ ............................................. 7~~~~~ ~ FOR BUILDING PE~IT ~ APP~I~TI~ ~te ............................ ,19 ............ .. r~is~ op,:~.t~o. ~.~ be ~o~,~,t.:y ~,~ i. ~y ~,.w,iter o~ i. i~ ..d ~i.~ i. t,i,,~te t~ n. ,.i:~' Ink,tar, with 3 ~ of plans, accuse pl~ plan to Kale. F~ acco~ing to ~h~ule. ~ b. Plot plan Showing I~ation of lot and of buildings on premiss relationship to adjoining premises or public struts o~ areas, and givi~ a detailed descripti~ of I~t ofpr~e~ must be drawn on the diagram which is ~ of this application. c. The work cover~ by this a~lication may n~ be commeK~ before i~uaKe of Building Pe~it. d. U~n approval of this a~licati~, the Building Insp~tor will issue a ~uilding Permit to the applicant. Such permit shall be kept on the premis~ ~ailable for ins~tion throughout the work. e. No building shall be ~cupi~ or u~d in whole or in pa~ for any pu~ose whatever until a Ce~ificate of ~cupancy shall have ~en grant~ by the Building In~or. APPLICATION IS HEREBY ~DE to t~e Buildi~ Depa~ment for ~e issuance of a Building Pe~it pu~ant to the Building Zone Ordinance of the Town of ~thold, Suffolk County, New York, and other applicable ~s, O~i~nc~ or ~ulations, for the construction of ~uildings, a~iti~s or a~terations, or for mm~al or demoliti~, as heroin d~rib~. ~e applicant agrees to comply with all applicable I~, ordinates, building c~, h~sing c~e, a~ ~ulati~s, and to ...... ) ~ ';~"gpp~,~ ~, i['~"~g&~;i;gi ........ State whether applicant is owner, lessee, agent, archit~nginee~ ,general contractor, electrician, plumber or bu der. Name of owner of premises ......... .~..L.~........g~...~.,...,~..~.~......' ..................................................................................... If applicant is a corporate, signature of duly authc~riz~d officer. ........... ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~.~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~(Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No .............. ~. ................................ ~:!~ · .ectricion's License ~o~ ....... ...¢...~........¢..i~ .......... Other Trade's License No ............................... · 1. Location of land on which~//~. ~prc~i~"'sed~~~~k~'~P Street and Number ...... /..~Z..~r.......,..... ~.:~............... ........ ~...". ............................................ '~ ' '~'"' '"~ 1~,~):~f~ ~ Municipality 2. State existing use and occupancy of premise~l~d intended use and occupancy of proposed construction: a Ex s tng use and occu anc ~"?_.~'~r~..~ · P Y ....... ""~'""~"'/ .................... J ......... ~ ................. · ............................................... 3. Nature of work (cheCk which applicable): New Building .................. -Addition .................. Alteration ...-. ~ . .. Repair .................. Removal .................. Demolition .................... Other Work ............................................... : .... ~ (Description) 4. Estimated Cost ........................................................... Fee ...~.. ............................................... ...... (to be paid on filing this application) 5~ If dwel(ir~h~number of dwelling units ............................ Number of dwelling units on each floor ..- .......................... If garage, number of cars ................................................................................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each ~/pe of use ~ ..... 7. Dimensions of existingstructures, if any: Front ............................ Reer ................................ Depth .................... Height: ....................... Number of Stories .................................................................................................... Dimensions Of s~me structure with olterafions or additions: F~ron~t .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ................................ ear ............................ Depth ....................... Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ..... i ..~...A ........... ]. Rear .......................................... Depth ................................ 10. Date of Purchase ..................................................... Name of Eormer,Owner ........................................................ 11. Zone or use. district in which premises are situated ...... ,~..._.~_..._....... ................................................ 12 Does proposed construction violate any zoning law, ordinance or regulation. t3. Will lot be.regraded ......................... ~.. Will excess fil be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ..... ~.~:....~ .................. 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 proposed, and indicate all set-back dimensic~ns fram property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF t~EW_~ORJ~, . t c c ........ ..L~.~..~ ................. : ............................... being 'duly sWorn, 'deposes and says that he is the applicam · ~ /(Name of/individ~al signing contract) ' above named.' 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, in this application are true to the best of his knowledge and belief; and thaz the workwill be performed in the manner set forth in the application filed therewith. Swam to. ~be~._~ me this ~ ~,~ ......... ~~ of ..,..:...~.~.~ ................... , ~.7~ 4,2 ~ / ~ ) / Notary Public, .~......'~,~em~ County ~..~..~.~..~:...~ ........................... . /(Signature of~pplicant) TEI~RI LEE F.~K ltO'[~ty PUBLIC, ~ of New York ,~'. ~/,No. 52,6]68295 '~Jfied in Suft~ County ~n Expires March 30. 19