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HomeMy WebLinkAbout7417-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y.. Certificate Of Occupancy No ..... .2:. Date ..t ............................... 19. THIS CERTIFIES that the building ................................................ Locatioa of Property 2105 O'J.e ~Tu.I.® ],~ne~ N~ttl'bueks II,Y, Heu~ Ne. Strut Ham/et Couaty Tax Map No. 1000 Section .. 122 .Block 05 ..... Lot 00~ ,~d~division .............................. ,Filed Map No ......... Lot No .............. conforms subs{antlally to the Application for Building Permit heretofore Fried in this office dated . .~. ~..I .~ ...... ,19 .?.~pursuant to which Building Permit No. ?/~17 .Z a,ted .. ! .u!.~t..~.6. ~ ................ ~9 ?..~, was issued, aha conforms to ,n of the r,au~ements of the app!icable provisions of the law. The occupancy for which this certificate is issued is ......... Aooesse,.v7, Building The certificate is issued to Chal'q. ee .................... ~o'~.;~ '~ .................... 'of the aforesaid .building. Suffolk County Department of Health Approval .......................................... UNDERWRITERS CERTIFICATE NO .... .~I .~....; ........................ Building Inspector FO`nM NO. e, TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7417 Z Permission is hereby granted to: · -Ghe.~es..~ee c~b s ............................................ ~.P... J... ~.~ ...6.~ ~. ......... ..o.~..e....~.u. ~,.~...~.a.. ............ ......... .~.~.t:..i..t.~.~ ,k, .....~.... ~.... .................................. to ..... 1~.~ J.J.~... ~.~ ..~.c c.~ ~r~... ~;~. ~c...l~J. JAJ.ng ................................................................ at premises located at ..Ofl.e..,l~u3.e..~a,..&..~c.,K~&t[~e...~oa, d ......................................................... /t ....................................................... ~:t.t,~.~ck....I~.,.~., ....................................................................... pursuant to application dated ........................... ~T.I~. ......... .1.(~....., 19.~..., and approved by the Building Inspector. Fee $.1 ~ ,..O.C~ ........... ......... ~..~ ...... ; ...................................... ..~ ................ Building Inspector FORM NO, 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION (owner or authorized agent of owner) RFD .......... .3, Box 64A Ole Jule La.. Mattltuck; (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance .... .A..~...~..:....~..Z...V. ..................... Other Applicable Laws, Ordinances'or Regulations ............................................ at premises hereinafter described in that .......... .B.~$..~.~.L...~.[..~.e....z~...$.~...~.....?.~].~. ............................. (state character of violation) ........... ..... ne~ permit. in violation of .......... ~?..9..:.'1..~9..-.~..~.1...~. ................................................................................................. (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the .... .~$~.~. ..................................................... day of ....... ~D.!~,~.~. .............................. , 19..~.~,.. The premises to which this ORDER TO REMEDY VIOLATION refers are situated at 210~ Ole Jule ~ane, ~.~.t i uck Count ................................................... .~....~ ........ ~ ......... y 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. Building Inspector FORM NO. 6 TOWN OF SOUTHOLD 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 featu res. 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. 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 any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. 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 Date..Z, ,a_,~, ,u.~. ,z~',, .8.,...17.8.1, ...... New Building ..... ~ ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property ....... 2.1..0.~..0.~..e..~.~ .e..~.a.~..e, .............~.a..~.~.~..c.~..~ ..~.. ........ House No. Street Ham/et Owner or Owners of Property . . . g~.e..T'.~..~S..~T.ap.O.~. ......................................... County Tax Map No. 1000 Section ..... .1.2.2. ...... Block ...0~, .......... Lot ...... .0.0.~. ...... Subdivision ................................. Filed Map No ........... Lot No .............. Permit No. .z.. Date of Permit 7~'.1. ~../7~Applicant ..... ~.a_~_..c.~..~.a.c.o..b.s ............... Health Dept. Approval . .~/~ .................. Labor Dept. Approval ........................ Underwriters Approval ... ~/.R. ................. Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ..... ~.. ............... ~_~_~ Fee Submitted $..~','~., ........................ Construction on above described building ~'~'r~. it n);eets a.II ap~ Rev. 10-10-78 te codes~.d regu,~tions. '~ FORM NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date December 18 19 80 (owner or authorized agent of owner) ~...!..:...~.o..~...~.~A....o..z.~...~.z.~...~.~....,...~.~ ~..kt t ua k (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance ART. XIV Other Applicable Laws, Ordinances'or Regulations ............................................ at premises hereinafter described in that .......... .~.~.Z...~..'.a.,.~.~..~.e....z~...~.~...~.....~,.~,~.~ ............................. (state character of violation) ..~ ~..e. ~.......?/..z...6./..?..~ ........... ~.~..~....e...z.~..t.~.e..~..........z..o. ~ ....~.~.e.... ~..e..~.v,~,~.~.~._.~.~... ~.~lz,. Z ~ ~ ..~ ..... new permit. in violation of .......... ~e...a..'..?..O..9..'T?.,~...~. .................................................................................................. (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 .... ~.~.~.~.~ ..................................................... day of ....... ~.~,,~,~.~'. .............................. , 19..(~.~... The premises to which this ORDER TO REMEDY VIOLATION refers are situated at .~..'l...0.~......0..];...e....~..e....~..tg.~.,...~...e.~.~tz,..~..a.~, ......... 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. Building Inspector FO~M NO. ! TOWN OF SOUTHOLD ~r--~ BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT.OLD, N. Y. is~pproved ~/c .............................................................................. ................................................ Dote ................................................ , INSTRU~IONS o. This opplic~tion mu*t be compl~tel~ fill~ in b~ ~pewriter or in ink ~nd ~ubmitt~d in triplicate to th~ Inspector, with 3 sets of plans, accurate plot plan to ~ale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises relationship to adjoining premises or public street~ areas, and giving a detail~ description of layout ofproper~ must be drawn on the diagram which is pa~ of this applicati6~. 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 ~cupi~ or used in whole or in part for any pu~ose whatever until a Ce~ificate of ~cupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY ~DE to the Building Department for the issuance of a Building Permit pu~uant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the constru~ion of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building c~e, housi~ c~e, and regulations, and admit authorized inspecto~ on premises and in buildings for n~essa~ inactions. (Address of applicant) ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Zrade's License No ............................................... ~ ~. Location of land on which proposed work will be done. Map No.: .......................................Lot No ......................... Street and Number .............. ~..~....O...~ .......... ..O....L.._L..~....?...~..~..im...L_~ ......... .L....~...i~!.~ ............... ..r~/.....~....-~...i.../~-~..~......c~.. ...... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ~ N' E -~)L~/ J~ L L I/~ ~'~- b. Intended use and occupancy ............. . .~.....'~.. !.~..q...,/m~. ............ ..[~...!.._~...~.. .......... . ./~....C..~...~...~. ~.., .~.,..~.., .~. ....... ..'~...../~.... ..... 3. Nature of work (check which applicable): New Building'. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ................................................. ~) ~ (Description) 4. Estimated Cost .......................... ...~...~...O.....~.~.. .............. 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 entire new construction: Front ................ ~..,.~.. ............ Reor ............................ Depth ........................ Height ......L~.......Z~.. Number of Stories / 9. Size of lot: Front ...................... L...0.....0. ...................... Rear .......................................... Depth ..... (...~....~ ............... 10. Date of Purchase ......................... /....~. ........ ~ ........... Name of Former Owner...~....~.. ...... ..'~.....~....~....~../~..( 11. Zone or use district in which premises are situated r-~ ~-.~ I..~") ........... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..................................................... '"'-"7 13. Will lot be regraded . ........................... Will exces..s fi, II be removed from premises: ( ) Yes ( /~o 14. Name of Owner of prem,ses ....~.......~....~...C..~...~....'~.......~.~..~..l~..S~Address ................................ Pho~e'~l~o ...... ..~.....~....?Z. Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or prat property lines. Give street and block number or description accordir whether interior or corner lot. .used, and indicate all set-back dimensions from to deed, land show street names and indicate El-ATE OF NEW YORK, ~ c c COUNTY OF ................................ ~'~ ................................................................................................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ............ .0....W...!.x:/....~.~.'..~. ............................................................................................................................................... (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 thor the work will be performed in the manner set forth in the application filed therewith. to before me this ~j(JL~ "7~' .S..w..~.r.? ........ L~.. day of ................................... :~ ........ ,9....~.~.. (~_ (x~ z/~ Notary Public,. ............................................ ...... C6onty ............... '~.~.~~ ..................................