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Home My WebLink About7364-zFOR31 NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupency THIS CERTIFIES that the building located at R,0,1g N, ~J. ew Road Street Map No. L. 9.o~a.~.~l..A.e. rl~ck No ........... Lot No, . ~. ~ ~. ~. $~.... 8PN~gg~.. conforms substantially to the Application for Building Permit heretofore filed in this office dated ............. ~. ¢0~, 1~71~. pursuant to which Building Permit No. dated Z~o 27 19.7~, was issued, and conforms to ~1 of the requke- ments of the applicable provisions of the law. The occupancy for which ~is certificate is issued is . ~,Y~9..~g. ~qq~..~. ~¢~ .~9. ~. 9~. ~ .q~P~) .... The certificate is issued to .~t)9¢~. 99g~ ..... ~ ............................. (owner, lessee or ten,t) of the aforesaid building. Suffolk County Department of Health Approval N ~2, ..... ........................... UNDERWRITERS CERTIFICATE No..N~O.:...~, .~.. ,~?~ .............. HOUSE NUMBEa ..... 79g0 .... Stree~ .. ~P.~g..~. aP~.. · ~9~ ..... ~0~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N:. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N9 7364 Z Permission is. hereby granted to: Date .............................. ~.UF~e...2~ ......... , 19-.~4.. Eess~na S erv:[e e...A/C ...ga.~... ~.o ~-s..... 4:/C...~.bos...Oen~'~ad- Box .368 ..................... ~o~...~.....~.e $~..g~ ...................... ~onkonkor~a ].]..?.~9. ................ ~p.~.u..~;.e. ......... . ..................... to J.z~ t,,],.~.. ~...~aa.$n. ta.~.'z..-p~,~v~ ~ ..~J~ .-~o ~ .-v~.t.h...~e~ ~ ..& .-aee~.r sot ~s .. of premises located ot .~.f,...~.(~t,.~.l.$..~...~...~.+,;...l~ ....... :[~&.~'4~-..~0.~0~ ................................. ..................................... ~/.,% ,.i~eZ~-~h..-~ a-3~¢t.e~. · ~o~ ................. 8e~,t~e.~l .................................. pursuont to opplicotion 'deted .................. Jl~:~....~O....; ....... ;;...., l~..., and epproved by the Building Inspector. Fee $.1,5, ~).(~ ............ FOItM NO. 6 TOWN OF SOUTHOLD 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 disp0sal--(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 alt 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 buiidings 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 ................ O~d or Pre-existing Building ................ Vacant Land .............. ........................... i ...... ........ .......... Owner Or Owners Of Property .'"~..']..~.~..~..-~'...,' .E..,. ........... .._~..~.~.~.~.,~ ..................................................... Subdivision ,..,(~.C..~...'...~. ~..~......~..(.r ....... ~ ................. LatONa./~.'~..J...~.~ Block No ............. House No.~....~..~.~...~ Permit No~..~.~...~..~.....~..... Date Of Permit .~...~..~/?..~.....Applicant' ..~../~..~....~..~..~.~........~..'....C.~....~'..~?.~. ..... Health Dept. Approval....~..~.~.. ............................... Labor Dept. Approval....../~.l..~.. ................................. Underwriters Approval ...~.! ..................................... Board Approval ~;~' Planning ..~ .,~..//~. ................ Request Fer Temporary Certificate ........................................ Final Certificate .....~ ................................ Fee Submitted' $ ~ .............................. Construction on above described building arjd~ermi~ meets all appli,c.~l~le Codes and regulations. ....... .......................... Sworn to before me this ,zz~,~ ,/,,,~,~ ...... (/..... day of ..... ~ ........................... ~ ~,'(stomp or sJ~; ~'7~~ >, auter r s euec, Residing in Suffolk County .~ ~/ ~ml~lon Expires ~arch 30, [~ ~ FORM TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATIObl (address of owner or c~thorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance ..~.....~ ......... Other Applicable Laws, Ordinances o~; Re, g, ulations .................... . .................... :.. at premises hereinafter described in that ~.,:.~...~...7,~..~.~ .~,,Z...~/~.~~,,~ n va at on of~,~../.~..~....~...~-...~../,... -K~.-/......~,...,~.- -/''-.~-...~'. --/~Z ,~...~...~../...: (State section or paragraph of applicable law, ordinance or regulation) conditions above mentioned forthwith on or before the ............. ~C ............... ~Z~ The premises to which~this ORDER TO REMEDY VIOLA~FION refers are situated at ~'"' '~'" ' "~'" ~ ~/~7~:(~/' '~"~ aunty of Suff~o k, New York Failure to remedy the conditions aforesaid and to comply with the applicable provisions of [aw may constitute on offense punishable by fine or imprisonment or both. Building Inspector ~G~VE~_ --K~w, RJ~NACE /~O~i~S FUTURE APPUA~C, FHOHS SPIClAL nEC'PT. ak BUREAU OF ELECTRIC~ ~j '~--- 85 JOHN STREET, NEW YORK, NEw YoRK THIS ~ffi~l~[~$ THaT '' ~ in the following ~ation; ~ exami~ on ~ ~ ~ ~1 ~ ~ ~ ~ and fou~ ~ ~ in complia~ ~th ~ ~ui~ments of thh ~ ~AC~ ~XTU~ (Swimming Pool) This certificate covers compliance at the date of Inspection onlY. Because of unusual environments it is advisable to haw~ frequent test and/or repairs made by a qualified person. Spuds Elec.Svce. Inc., Box 166 St. James, L.I. 11780 [ ] FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION (owner or authoriz~¢~t agent of owner) (address of owner or auth6rized agent of ow ) PLEASE TAKE NOTICE there exists a violation of: Other Applicable Laws, Ordinances or Regulations ............................................ at premises hereinafter described in that~~~..~6'~-......-.~..-.-. -- -~ /~dtate character of/v~jolation) ............ (State section or paragraph of applicable law, ordinance or regulation) conditions abov::;:~ned forthwith on or before the ................................. day of ........ The premises to which this ORDE,P, TO ~EMEDY VIOLATION refers are situated at ~':....~....,~.....~.r..~z~'~~ ....... Co~/pty 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. u~ d~ng nspec o THOMAS I~o CONRAD FORM NO. 6 TOWN OF $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ I~mma~am 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 Unde~vriters. 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: I. Accurate survey of property showing all property lines, streets, bui!dings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of bu ildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 1. Certificate of occupancy New Dwelling $25.(10, Accessory,S10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.updated c.c. ~ 5o .oo Date"~¢/J~.C.~.~./:~.~ j~..~. ....... New C on s t r uc t i on ...... OJd or Pre-existing Building ............ Vacant Land ............. 7o~ M ~.a' ~J'c~ ................. Location ofProperty ............ ~/, ...... .~0, ,~.~, ~.._..~.~. ~,T~.. kt-).~. ~" W,../. i ??/ . House No, Street Ham/et Owner or Owners of Property .~'~ .~.t.~..~. $."...~.,...~.~.~t~.~.~..f...~.. (.~..t.~ ...................... County Tax Map No. 1000 Section ............... Block ............... Lot '.~4~r~.~'. il 't- I ;7- Subdivisio, ~.E£tCRR~... l~..q.~.~..~ ......... Filed Map No. f .~. ?.?...Lot No.~.~r.~.. ?~. fl.( '.~j Permit No. IT~..~?/'.'~Z"... Date of Permit (-~/~.~'l~.'.Applicant ~',~ .O/~/~, .5,'. E.,...('.~..J~.'.t'~...~, .~. ..... Health Dept. Approval... ,~. ,~.~.'. ............... Labor Dept. Approval ..... ~//~ .............. Underwriters Approval .... 7,~,5.~ ............... Planning Board Approval..../~.7~. .............. Request for Temporary Certificate ..................... Final Certificate ,, ~,~, .................. Fee Submitted $ .~ ~, :77 .............. Construction on ~' .... ~-, ,~ "-~ --J ",, ..," - ..... · ~%' '-"-':~;,,~ ;~ ;7,es-.~all apphcable codes and regulations. :,,~ c~,~/,,~,~ o~-+~, ~..z~r~d's';',,t~.~,~: '~' '~-~.:~- &_~\~ Rev. 10-10-78 ~ ~ ~ - ~J ./ 00 , BUILDING DEP~RTMENT TOWN CLERK'S OFFICE ~roved ................................. , 19 ........ Permit No ./.. ~ · ..~...~ INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Buildings., Inspector. b Plot plan showing ocat on of lot and of bui d ngs on pram ses~ re otionship to adjolniog premises or pub lc streets ora areas, and g~ving a detaded description of layout of property must be drawn on the d~c~grom which is p~rt of this c. The work covered by this application may not be commence,cl, before issuance of Building Permit. d. Upon cq3proval of this application, the Building inspector wdl issue a Building Permit to the applicant. Such permi shall be kept on the premises available for inspection throughout the prOgress of the work. ' e. No building shall be occupied or used in whale or in part for any purpose whatever until a Certificate of OccupancyT-~ shall have been granted by the Building Inspector, APPLICATION IS H.EREBY M^DI: to the Building Department for the issuance Of a Building Permit pursuant to the~ Building Zone Ordinance of the Town of Southold, Suffolk County, ~ Yorlg~nd other applicable Lows, Ordinances orE Regulations, for the construction of buildings, additions or alterations~d'r for[re~hovol .e~demolition, os herein described,.*) The applicant agrees to comply with all applicable laws, ordinonc~~:ng code, orm~regulat,on,, (Signa~r~ ct[applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, orchltect, engineer, general contractor, electrician, plumber or builder. ........................... /. .~ ; . .~. .-. ~ . ~. . ~ .................................................................................................................................................. Name of owner of premises ..... .-/,,4~,~fi~,.% ........ ,~.,~xg./~..a..~ ............................................................................................... If applicant is a corporate, signature of duly authorized officer, (Name and title 'of corporate officer) 1. Location of land on which proposed work will be done. Map No,: ........................................ Lot No,: ........................ Street and Number ...... ~...a;~..o. ...... ~...,..~.~.Y.,v;,<,¢.~4.....~..~., ........... ............ ~,.e,.~J,.T.;~,.~A-,.~,.., ...................... · ~ Municll:mllty / 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a; Existing use and occupancy . ~.a~, .~ .~ ~ ~;.~.~. ................. ; ........................... b. Intended use and occupan:, , ........ ,/...~...[...5,.D...,z.~.~./,lw.~.eZ.,~..;,.,v;9,~,~,4~, ...... '-4 3. ' No?uie of work (check which applicable): New Building ...... k~,..~...~',.. Addition ................ 'Alterat'ion ............. Repair .................. Remova~ .................. Demolition .................. Other Work (Describe) .................................... 4, Estimated Cost ~' ~ ~ ~ (to be paid on filing this application) 5. if dwelling, number of dwelling umts ........................... 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 st'ructures, if any: Front, ......~.~.¢..~ ........ Rear ...~..~.%~. ................ Depth .... Height ........................ Number of Stories .......... ( ............................................................................................. D~mensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... ~.~ ................. Rear ...... .~.~ ....................................... D~th Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ...Z.~,~.r..,~Z .....~e~r / ~ ~' ~ ~ Depth / ~ ~ ~ 10. Date of Purchase ....................... ~. ............................... Nome of Former Owner ....................................................... 11. Zone or use district in ~hich premisas are situated ..................................................................................................... 12. Does proposed construction ~iolote any zoning law, ordinance or regulation? ............. ~..~ ......................................... 13. Name of Owner of premises ~,~ s ~4~ Address ~o~ ~'~Y~ ~b~ No. Name of Architect I~'~u ~~ , Address/~ ~ ~ ~ ,~h~n~ No. Name of Contractor ..~,~,~, ...... ~..~.~...~ .................. Address .(~..%~.....(.l...~.~.~:..~.ff.,Phone No. ,~[.R.[.~.[.~ PLOT DIAG~M Locate clearly and distinctly all buildings, whether existing or propOsed, and indicate all set-back dimensions from proper~ lines. Give street and block number or description according to deed, and show street names and indicate.:' whether interior or corner Jot. STATE OF NEW YORK, ! ~: c COUNTY OF ..~..v..~ ........ ~ ......... .J' ' .................... ~ ....................................................................... being duly, sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the /~P~'t ~'"' ' ' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perfomn or have performed the said w~rk and to make and file this application; that alt statements contained in this application are tr,0~'~to, tt)e~f his knowledge and belief; and thru the work will be performed in the manner set forth in the applicoti~ f~ecy~ferewith~ Swo.-n to before me this (1. ..... of ............................ , D/' ) .) s . ........... ................ Notart Public, ../.~..:....,~,...~ ......... ; ....... Counh - (Signature of applicant) NOTARY PLiFLIL gh'tr~ of Ftew Yolk ;~¢rm .Lxt)lres Iviarch 30, 19