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Home My WebLink About7616-zNO. · TOWN OF $OUTHOLD BU~.nING DEPART~ffi~ .NT Town Clerk's Office $ou~hold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at . .TilLage. Lan~ ............ Street Map No.. :~ ........ Block No... lC~ ..... Lot No. xX .... 0~®nt.. N.~Y, ............ conforms substantially to the Application for Building Permit heretofore filed in this office dated ...........N.oy... $ .... , 19. ~.. pursuant to which Building Permit No...?.6.~..(~. dated ...........N.°~......~ .... , 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.r.~..v~.t~ .,~.~s~.o~j..bulldin&..($ho~ .&. ~tor&~e ) ................. The certificate is issued to .S.p.~..qqr. ..B.,. . T. .e.r.g,j'. .J.r. .... O~e.~, ....................... (owner, lessee or tenant ) of the aforesaid building. Suffolk County Department of Health Approval N ,..R: ................................ UNDERWRITERS CERTIFICATE No. N. :~.o ........................................ HOUSE NUMBER .... 1. ?.8.0 ..... Street ...VIii,is..I~ai ..... Qrlent ............. Building ln.~pector ~ TO~N OF $O~THOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N;. Y. BUILDING PERiV, IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7616 Z Permission is hereby granted to: S~ser~ee.~..~e~,¢~...,~, ......................................... ................. O~.~e~t~ ................................................ to ..~.-~lld..~n~.-~...~t'~t~...a~,~.ssn~'...b.~tlli~ ................................................................... at premises located at ..~..¢~11a~a..L~.ne. ............................................................................................. .......... [ ............................. ~ ........ .OX'.iex~....H ,Y., ................................................................................. pursuant to oppli¢gtion dated ..................... ]~(X~t .......... ~ ............... , 19.,,~., and approved by the Building Inspector. Fee SJ.O..O0. ........... TOWN OF $OUTHOLD 0 Building Department 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 disposals(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 complete(] 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 $5.00 3. Copy of certificate of occupancy $1.00 / D~te New B~lilding ................ Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ...... /...~...~.'..~..~....~..~.c?..~. ~..~.....,.....~..~..~....'.~... ....... ...~.....~..... ..... Owner OrOwnersOf Propert ~ ~. ~ ~-~-~ '~ /~// Subdivision .......................... ---~. ..................................... Lot No ......... i... Block No ............. House No.~..~...~...~ Permit No...~.~...I.(-~.~ Date Of Perm t/~!..~.~ ~j ~' ......................... 7; ...... 7 ........... Hea,th Dept. ^pprovo, ............ (( ........................ 'obor ~.pt. Approvo, .............. ~,.~. ...................... Underwr,ters Approva, ........... .,.~....,,~ ....................... P,ann,ng Bo, rd Appro¥o, ............. ,.~ ..................... Request For Tempor~ Ce~ific~te ........................................ Fee Submitted $ ......... ~, ......................... an~e~r codes and regulations. Construction on above described building mit meets oil--~°pp!icobl~e Sworn to before me this ........ ./.~... day of ............................... ~ ...... (stomp or seal) Notary Public ....... ~... County ACCUSATORY INSTRUMENT INFORMATION - GENER,,~L. C.P,L. 100.)5 FORM NO. 256 STATE OF NE~' YORK : COUNTY OF ...... ~g.~.~_9_~ _~.~_~ ........ COURT ........T_9.~& ........... O F...~9~_&g.~J 3nf rmalim $~ e 3~X_ _~___T.O~2.,_.~X_~ ................................... ........ Defendant --~E.~--e~--~-~.e--k-~-.D--r~Z-~-s-~-~9--u.-~.h-p-.~--d--~-~-E~.-Y--q~-~ ................. , by this information mak, written accusation as follows: That ........ S_ J2.e_ .n_ _c_ ~ * _ _.B..._ _ _~ _e_ _r~ _xY. ,_ _ _~JX ................................................. on t he__.J.__8. _'g~ da)' of__~t..n--u.-%x- 7.. 19__~__7_.7....., at ..... _l_7._8.O_.YZ_iJ. ls~ge__hart~ ............................................ (boeation) in t h e. _ _ _ _ _H.a_ _m. }.e_ ~ ........................ of ...... 0.~:~.~ ng ............................................................ County of ..... .S..u..f_~.o_.l__k._ ............................................................................... ,Ne~ York, d commit the offense of .......-f--a-i--l-~-n-g-~-%-~-~-~--~--t--a-~=-n---a-~-~-~-r-t--i--f-ig-~k¢~-~£~ggn~ac~ for accessory building. a ('rWi~d'e-m-e'allo't}' (violation) in violation of Section._~_r_~_..__.x__l._V_~___S_e.~_.___~_O_!k-_~k~t_~_..b._.£1lof-t~ Chapter 100..of t~h.e ~ode ,o~ 't.he ,TQW~ o~ ,~o~.t, hol~ ___-__~_-__~.~L_-_7__-.U_-_.'Lm'cr-o-l-ttm-~'a~e~rrl--l~-~m, m that {-~l~e om, at the aforesaid time and plac~ CountOne: The defendant is occupying the accessory building without the required Certificate of Occupancy. Thefaetsupon whlchthlslnformationisbasedareasfollows: B~ilding Permit 97616Z was issued on November 1, 1975, giving the defendant permission to erect an accessory building. He has failed to apply for or obtain a Certificate of Occupancy, even though several notices have been mailed to him by the Building Department. Wherefore, Complainant prays that.-----S--p--e-9?--e--r----B--'---~-e-K-r~.'--J-~:-'- ................................ be dealt with pursuant to law: ~Subscribed and Sworn to before me on Complainant Howard Terry, Building Inspector Name Town Justice ............. Title or Office *set forth statuLory language constituting the offense The foregolng factual allegations are based upon personal knowledge of the complainant (and upon inforrnat and belief, the somces of complainants information and belief being, 1 ACC U S~,'TO RY INSTRUMENT INFORMATION - GENERAL C.P.L. 100.15 FORM NO. 256 WIULIAM$ON LAW BOOK CO.. ROCHEST[R. N. Y. 14609 STAT~ OF NEW YORK : COUNTY OF ....... ~ ..... ,, ............................. ~v,.~c~.~ COURT ~ OF~_-.-~~ '"'-¥E""ZT;'""'--' ..... : .............. --- .................. lnf rmatian ....... .......... ...... /~.~-~'-(~)'- ..................... ~' ............................................. fi~"-~ ~._.~... res,dm§' ' at ................ ~.~....f_.~.~~_/....' ........................................ , by this information makes written accusation as follows: That ..... ~.~ ...... ..f~.= ...... --~-_~_..f~-. .................................. on t he_..../_ _.~.__ day of.~].. 19..2..~_._, at ..Z.Zk~-.......~...~ .~----..A.~,=----~7~--- ...................... , (.,/ , / . (Location) ia the ........ _/._~..~ ........ of ___.~.~ ........ ~ ............................................ County of ...... ~~ .................................................. ] ........... ,New York, did commit toe offe.s~ ofg/"~.._,''.--...'....''._.,....'--'.'.'.'~ a S c ' n k'h ~c~ flrO - /4 ( of the ~ (violation) in violation of e uo .~...~ ................. ff..c/~ ................... t~*~-of the State of New York, in that ~i~he did, at the aforesaid time and place~ The facts npon which this information is based are as follows: A,4w / I ? z / ~.C_ The foregoing factual allegations are based upon personal knowledge,of the complainant (and upon information and belief, the sources of complainants information and belief being, Disapproved a/c ............................................................................................ Application No. ...................... .. .. . ..... (Building Inspector] APPUGATION FOR BUILDING PERMIT INSTRUCTIONS o. This application must be completely filled in by typewriter ,~ in ink and submitted in triplicate to the Building'~ Inspector, wffh 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, re ationship to adjoining premises or public st.ree.~. areas, and giving a detailed description of. layout ofproperty must be drawn on the diagram which is pa?. of th s ppphcation.~t~ c. The work covered by this applicahon 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. i~ .A. PPLICATION IS HEREB. Y MADE to the Building Department for the issuance of a Building Permit pursuant to the ~ud;ar~tio~Zs,C~orO~nca(~r~:tmoL~hor~ oT~bui~d~ Sout_h?l.d.:. Suffolk ..Cou.n. ty, New .York, and other applicable Laws, Ordinanc..es ot~ The annlicant ~"~r ..... ,.. _:,r. _,,~_n~_~s..,__a~a~_~t~_.o~.._ or a~!terat~ons,, o.,r,~or re ,mov?l or demolition, as herein described oam,t outho,=ed o. p.m,ses in bu,ld,. n.e , i t,on;. '" --' --'" ..... ~gnature O~f ~'ican,, orpme. ~ co.rporation, (,~d~dress of applicant) //~:~:--~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · ~--~ /'~ ~ ~ ................ , .................................................. r~ame of owner of prem ses ~ .r/.~.~?--. g.~, ~/~.l'~u '-_t y' If applicant is a corporate, signature of duly authorized officer. (Nome and rifle of corporate officer) ~ ~~ Builder's liconse No ..................................................... ~1~'~-'- ~ Plumber's License No ................................................. ~ £1~ctrician's License No ............................................. Other Trade's license No ............................................... 1. Location o~ land on which proposed work will be done. ~ap No.: ........................................ lot No ......................... Street and Number ..l.~..,~......~..~.L~__~ .~1., . . Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ~. Exisifing use and occupancy ..... ~.../~....~ .................................. .. . . . b. Intended use and occupancy ...... ~ ....................................................................................................... 3. Nature of work (check which applicable): New Building· '~'/"' Addition .................. Alteration ................. Repair .................. Removal .................. Demolition, ............ [...'.... Other Work ........................... ~,...] .................... · ~ (Description) 4. £,timated cost ..... .......................... i ................. Cee .................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number af 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 ........ ./..~.i ............. Rear .....:/..~ .................. Depth ...ZzJ ........... Height........................1 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 ..;.~ ................ Number of Stories .../. ................................................................................................................. 9. Size of lot: Front .... /....~ ................................................ Rear .-4 ..................................... Depth ..../.~,~ ....................... 10~ Dote of Purchase ....................... :. .............................. marne of Former Owner ..;...,..:~./....~ ........1 ...... "~' ................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .C'.c,' ................................................. 13. Will lot be regraded ~ ~ .... ~..~ .................... Will excess fill be removed from premises: ( ) Yes (2%) No 14. Name of Owner of premises .,~.~:Z.,..£.~.:.....::......,~../......u..'.... Address ..~..(..~.'../Z~,7~...('~ ...... 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 indicate whether interior or corner lot. STATE OF COUN** .......... ~ ........ ~..~...~... ............................... being duly sworn, deposes'and says that he is the applicant (Na-~'r~of individual si~ c~troc~ He is the ................................... ~;~;;[~;;,~;.;;~;;~;-~;;;;.;~;{ ............................................................... of said owner or owners, and is duly aut~rized to perform or h~e performed the said work and to ~ke and file this application; t~t all sta~ments contained in this application are tree to the best of his knowledge and belief; and thor the work will be performed in the manner set fo~h in the application filed therewith. .o n,o .,orem. t,,. ~.. doy o{ ...........,.., 19. ~ot~, ~b~, .............. ~~.: .... C~ .............................. :~. ........ ........ ;. ....... :.....~....~ ........................ ~ ~i~notur~ or opp~i~t)