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Home My WebLink About7586-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z10370 Date...January.29.,.A98.1 ........... 19... THIS CERTIFIES that the building ................................................ Location of Property . .~ ~ 8.ZC~. ~1/~.5..~..g.o.a.d., ....... .~.u[~. ~..hp.g.u' ? ~. New York House No. Street Ham/et County Tax Map No. 1000 Section ... 109 ...... Block .... .0 .1 .........Lot 003 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated ·...O.q~.9.~9.v...~ .~ ...... ,19..7.~ursuant to which Building Permit No.. 7586 Z dated October 11 lO 74 ............................ ~..., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... .................. 97.y...%uy.z. ........................................ The certificate is issued to ... g.vg.:..B.e?.~. J: ?..Pti.? .e ..................................... of the aforesaid building. Suffolk County Department of Health Approval .... .g/.~. .................................. UNDERWRITERS CERTIFICATE NO ....... .~./. ~- ....................................... l~di~fding Inspector .... Rev. 1/81 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N:. ¥. N°. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ?ss~ z Dote .................................... /......~/...., Permission is hereby granted to: ............. ~....: ........ .-..~.~.~.. ........ : ................. ~o ........ ~..&:...~...~ ........... ~. ....... ..~Lc..~....L~....~.~.~..Z ........ .T.~.~.L.L.-.?-.!..~.,~.. ................. at premises loaoted at ........................ ~J..O..~.~. ........... T~.~..~..~ ............................... : .................... pursuant to application dated ........................................................ 19 . and opproved by the Building Inspector. F~e *.../..~L~..~.... ...... ............ :.:~ .................. .../:.~ ................... Building Inspector FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall 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 Inspec- tor 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 installa- tions, 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 peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of an,/ housing code or safeW inspection of buildings or premises, Or other pertinent informa- tion required to prepare a certificate. C. ~Eees: ,,1.. Certificate of occupancy $5.00,~' 2. Certificate of occupancy 0~ p~e:~xisting dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 Date . ~.-~Y,~.,..,~ '~I · ;~; · ';' .'''Y ,7 .... New Building .~, ~¢('.. :/~... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . .~:2.). ,~ :/.4~. ............. Hamlet Street Owner or Ownersof Property .~..)J. ,~,.../~ ~.'~.~. , /./,,~. ~.(.-.~ ........ County Tax Map No. 1000 Section ~"~'~ Block . ........... Lot.. ,-.... ~- ........ Subdivision .... ~. ~ ......................... Filed Map No...~ ...... Lot No. ~ ........... Permit No. ,. ~ ..~ ...... Date of Permit .~. (. /:~Applicant .. Z~ ~:'.n/~ ~-., .~.~ ~.~ ............... Health Dept. Approval .. ,~ ................ Labor Dept. Approval .. ~/~ ................ Unde~riters Approval ..... ~ ............... Planning Board Approval ................. Request for Temporary Certificate ..................... Final Certificate ., .,~ ................. Fee Submitted~~ cn ed nd meets II h d regul s '~0~' ~gk , Constructiono abovedes 'b buildinga e~mit a app'cab~codesan ation, tu Applicant TOWN OF SOUTHOLD BUILDIHG DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Dote December 19 19 80 (owner or authorized agent of owner) (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: ' Zoning Ordinance Ai~.~. ~TV ,; ~ Other Applicable Laws, Ordinances'or J~eguJations ............................................ at prekrnises hereinafter described in that .......... .B.,.'9:..:i:...1..d..i...n.g....P..~...z~...$.~...~.,,.~.~.6. .............................. (state character of violation) dated 10/11/~.4 has e~ired. You are ~.~Gu.~ed tp ~PlY. ~. ~ new permit. in violation of Sec. 100-1~1.1H (State 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 .... ~..i..x..t.,l'3. ...................................................... The premises to which this ORDER TO REMEDY VIOLATION refers are situated at ..~.l..~.~.Q..]]~.8..,~,.~,..]~.~.,.~,...g.~.~;.g.~g.g,,1A.~.~ ................. County of Suffolk, New York. Failure to remedy th~ conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment ar both. Building Inspector TOWN OF BUILDING TOWN CLERK'S ~UTHOLD, N. Y. Examined // /~ / /'/ ........................................ , 19 ........ ~proved ..................................... ~74 19..::..~ Permit No. Disapproved a/c .............. L:::~ 7;'.~-.-.~. ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sere 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 adjoining premises or public streets oF areas, and giving a detailed description of layout ofproperty must be drown on the 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 application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall 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 a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, 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 all applicable laws, ordinances, building code, housing cede, and regulations, and to admit authorized inspectors on premises and ir~ buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Address of applidant) State whether applicant is owe?r, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nome of owner of premises .................... ~. ' "· ~ If applicant is o corporate, signature of duly outhorized officer. (Name and title of corporate officer) Builder's License No ................................. .................... Plumber's License No ........................... ~ ..................... Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: .................... :.~:.:.; ............ Lot No. Street and Number ......................... ': ...... ;......: .......... ~;..!...f'....;.%~ ..................... .:.,../. ....... .~:...~:..~' / '/ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy / ~ ' ' " ' b. Intended use and occupancy ' ' - ' 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work .................................................. 4. Estimated Cast .......................... .~....~?C) ~- Fee /C) ~ (Description) (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 or mixed occupancy, specify nature and extent of each type of use ............................ 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 ............................ N um~:~.of Stories ................................ 8. Dimensions of,~entire new construction: Front ................ ./. ................. Rear ............................ Depth ........................ Height .......... '-~./. ....... Number of Stories ............................................................................... ! : ...................................... 9. Size of lot: Front '~ ~'- Rear Depth 10L Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ~' ~- ~ ) ~-~ · 12. Does proposed cor~truction violate any zoning law, ordinance or regulation: ........................................................ 13. VV~ill lot be regraded ............................ Will exces~ fill be removed from premises: ( ) Yes ( 14. Name of Owner of premises .................................................... Addre~ /'~/7~'/~r',¢,,J ~N~ Name of Architect .............................................................. Addres~ ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from property lines. Give street and black number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW _Y~R.I~,/~// !¢¢ COUNTY Of ................................................................................................. being duly sworn, deposes and says that he is the applicanl (Name of indivJclual signing contract) above named. He is the .~) ~ ,4! ..~.~ ~ ............... ................... . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform o! have performed the said .work and to make and file this application; that oil statemm~ contained in thL'; application are true t° the best of his knowledge and belief; and that the work will be performed' I~ the manner set forth in the application flied therewith. Sworn to before, me this m. ...........of ....,.. ...... ....... -- ,oto ..................................................... ................................ ~" (Signature of applicant) JUDITH T. BOI~EN '~-]t~-y Pu~li~_, State of New York/ :~ 52-~.4963 Suffolk Cc, mrni~ion Expires March 30, (Building InspectOr) lUll. liNg I~FARTMINT ~-7 ~' ~ ~ Application No...~.~ ................ APPLICATION FOR BUILDING FERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter o~.in ink and submitted in triplicate to the Building~ Inspector, with 3 sets of plans, accurate plot plan to scal~ Fee occord,ng to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or ..p~. lic streets o~ areas, and giving a detailed description of layout ofpraperty must be drawn on the diagram which is part of th~s application. c. The work covered by this application may not be commenced before issuance of Building Permit. shalld' beUp°nkeptappr°valon the premises°f this application,available fortheinspectionBuilding throughoutlnspect°r willtheiSSUewo~k.a Building Permit to the applicant. Such permit _._~j~/ e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy~f shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bull,ding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ~egulati..ans, for the construction of buildings, additions or a!terations, or for remava ' or demolition, as herein described. , ne app,icant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulatior-,, and to admit authorized inspectors an premises and in buildings for necessary inspactJons. (Sig~'*atu~e of,~pllcant, or name, if a corporation) ....................... · ........................... (Address of applicant) State whether applicant is~:wmer, lessee, agentLamhitect, engineer, general contractor, electrician, plumber or builder. ............................................................. 7.~., ........... ~,,~..,~.r...F ................................................................................................. Name of owner of premi ................. ........ .................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate offic_._er) Builder's License No .......................... ~...__,_ ..................... Plumber's License No ........................ ,~ ........................ Electrician's License No ............. ;...~, ................... Other Trade's License No ............................................... 1. Location of land on which proposecYv~, will be done ~ap No.: .................. <..y ........ ,~..~,.,..,Lot No ......................... · [ Street and Number ........... ~r~;..A~.....,J~Z~. ....... ~. ............ ~...~...~.~/~.~.~..0~. ........................................... Municipality State existing use and occupancy of prem/is~s and intended use an,el occupancy. : of proposed construction: a. Exisiting use and occupancy ........... ..G.../~..~... ....... ~L~)~_.~.~.~.6~.~_~ ................................................... b. Intended use and occupancy ........................................................... F' ............................................................... 3. Nature of work (check which applicable): New Building.. ...... .~.... Addition .................. Alteration .....~. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... . *.~.,./.~ ~ ~ /, f (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 or mixed occupancy, specify nature and extent of each type of use ............................ 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 e~tire new construction: Front ................. [ ................. Rear ............................ Depth ..... ~ .................. Height .................... Number of Stor~s ........................................................................................... '-":-'7"~ ................. 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10~ Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ............................................ ~ ........................................................ 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ........................................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes ( 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 dimensions from property lines. Give street and block number or description according,to deed, and show street names and JndJcate whether interior or corner lot. STATE OF NEW YORK · !SS COUNTY OF .;..'...:.;..:'..:'~..~.~t?;.~...~ ' ................................................................................................. being duly sworn, deposes and says that he is the opplicanl (Name of individual signing contracf) 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; end thar the work will be performed in the manner set forth in the application filed therewith. Swam to belam me this ,'[ ........................ day of ............................................ , 19 ........ Notary Public, ~ · (Signature of applicant) JUDITH T. ~OKEN i~.0~ p~t_!:, State of Ne~* York ~' N0,52-0~44963 Suffc. k Ccun~D