HomeMy WebLinkAbout7192-zFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Off*~ of the Bulldin~ Impector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
Z10389
E®bruary 17~ 81
D~¢ ................................. ]9...
THIS CERTIFIES that the building ................................................
Location of Property .... .6.Q ~.
Hou~ No.
county Tax Map No. 1000 Section .... .1.0.~ .... Block ....1.4 .......... Lot ........ .~ .3 .......
Subdivision ............................... Filed Map No ......... Lot No ..............
conforms substantially to the Application for Building Permit heretofore filed in this office dated
....~.~ .r./~..~.9. ! ........ 19.7. 4. pursuant to which Building penuit No. 7~9~ ~-
dated ....... .A p?.J: ~..~.9. ........... 19.. 7. ,4 was issued, and conforms to an of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is .........
&ddit/on to D~elltn8
ltaz'old J. gob®~ & ~f.
The certificate is issued to ...... (owner,~&~t/" ................
of the afor~,aid building.
Suffolk County Department of Healtl~ Approval ....... r//~ ................................
UNDERWRITERS CERTIFICATE NO ..................................................
Buildin~ Inspector
,Roy. 1/~1
TOWN OF SOUTHOLD .
BUILDING DEPARTMENT '~,
TOWN CLERK'S OFFICE /
SOuTHOLD, N.Y. ~,~ ~' ~7~
.......... . ,,,,o,,o,.,,o.
prav, .......... .: ............ !.: ............. , Perm,t No.....................................?'/"'X ........................
Oisapprav a* c ,,. .................................................................
................................................................. · ............
........................'~"'"'"~~i'i~'~ ................................
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Date
o. This application must be completely filled in by typewrter or in ink and submitted in triplicate to the BuildL~lg~
Inspector, with 3 ~ets o? plans, accurate plot plan to scale Fee according to schedule. ~
b. Plot plan sJlc~win~ location of lot and of buildings on premises relationship to adjo n ng prem ses or public streets~r
areas, and giving:a detailed description of layout ofproperty must be drawn on the diagram which is part of this application
c. The work covered by this application may not be commenced before issuance of Bu Id ng Permit. ~1'
d. Upon approval 6f'this application, the Building Inspector will issue a Building Permit to the applicant. Such perrier
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 thee
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other appl cab · Laws, Ordinances or
Regulations,
for
the
construction
of
buildings, additions or alterat ons, or for removal or demolition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, bui .d ng code, housing code, and regulations, and to
admit outhorized inspectors on premises and in buildings for necessary inspections.
(Signature of applicant, or name, if a corporation) '.~j
(Address of applicant) ~' - "
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ......... ~...~..~.~.~...~....~/....~..o...~1'~....,~. ........ . ............
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 Trade's License No ................................................~......~ ~ .~.. ~..
1. Location of land on which proposed work will be done. M~p N · . Lot No ..................
Street and Number .................. ~'~[~.~...~....~..P..~.@....~.~.~ .....................................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy ........ .~.~.(...~/.,t?..ZT.~..~....~'...~..~'.@ .~:~.....c.~T.. ................
b.. Intended use and occupancy .....................~'~...~.~' ...............................................................................................
10.
12.
13.
'NatUre of work (check which applicable): New Building .................. Addition .................. Alta ration
Repair .................. Removal .................. Demolition. .................. Other Work .................... ii~.~.;i.L.i~_.~...r..il[.~,~ -J - ..... ~
Estimated Cost ..... ...~'....~...O....o. ...................................... Fee .........................................................................................
(to be paid on filing this appl cation)
If dwelling, number of dwelling units ......... .o...~....~. .......... Number of dwelling units on each flora ............................
If garage, number of cars ...... ~...Xx~... ...................................................................... : .....................................................
If business, commercial or mixed occupancy, specify nature and extent of each type of us~ ............................
Dimensions of existing structures, if any: Front ....... ,~..~....: ............ Rear .....a~..~..: .................. Del ,th ...~.~..~ ........
Height ....... ~....6...I. ....... Number of Stories ...... ~ ......................................................................................................
Dimensions of same structure with alterations or additions: Front ....... ~....o....~ .................. Rear .....~..O....~ .............
Depth ........ ~..~...~. .............. Height ....... ..~.....~...~ ........... Number of Stories ..........~;~ ...................
Dimensions of entire new construction: Front .............. ,7..O...~ .............. Rear ....... .~...O..~ ............ De ~th ..... .~..7. ...........
Height ....... .~...~.. ...... Number of Stories ................. ~ ................................................................................................
Size of lot: Front ................. .~....~. ................................ Rear ........... ~.....o....o.. ................... Depth ...... ~...o...~.. .............
Date of Purchase .................... ~'..~...~....o. ....................... Nomeof Former Owner ..................... ~ .~'..~'~ ..r~..... ........................
Zone or use district in which premises are situated ....................................................................................................
Does proposed construction violate any zoning law, ordinance or regulation: ....4~.... .............................................
Will lot be regraded ...... .~...~...~.. ............ Will excess fill be removed from premises: (v~' Yes
Name of Owner of premises ....~.~.~t,~..~.~)...~..~..°.~f.~...~... Address ~.~..~ .~..~.P...q~.....~....~. Phone
Name of Architect .............................................................. Address ................................ Phone
Name of Contractor ............................................................ Address ................................ Phon
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-b~
property lines. Give street and block number or description according to deed, and show street
whether interior or comer lot.
( )No
....
k dimensic~)s from
ames and indicate
/ --
STATE OF NEW "~DRI~,/ ,~ ,~ I c c
COUNTY OF
................................................................................................. being duly sworn, deposes and says that ~e is the applicant
(Name of individual signing controcf)
above named.
He is the .................................................................................................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to penCorm or have performed the said work and to make and file
this application; that oil statements contained in this application are true to the best of his knowle(ge and belief; and
thor the work will be performed in the manner set forth in the application filed therewith.
Swam to ~;~ge this
............. /...~......-~J:llay of .:.....,~....~....~....., 19...~.--
..............................
Notary PubJic~..,~~....~ty ........... ....¢ ...... ~'"'"'1 ..................
~ / (Signature/of applicant
JUDITH T, BOKEN
:¢[cry PuLric, ,State o~ New York
No. 52-03442,:3 SuffoJk Counh~ _
Commission Expire~ March 30, I~''~'~
FOB~ 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
COMPLETION OF THE WORK AUTHORIZED)
N? 7192 Z
Date ......................... '~pr:~'~' ....... te) ...... , 19jH,T"
Permission is hereby granted to:
~. ~n~2~L..~r. ...................................................
· 4.(~tteho~ue ......................................................
m ]~.B;L~d..~..a~d~t ~ _~.~z~..e&LstA~ff..~re:~t..~n~ .................................................................
at premises located at ...~,~l~....~--~....Eel.tv~od.-~ca~ele ............................................................
pursuant to ~ppli,'ation dat~l ....................... ~I~...~ ........ $~. ........ , 1~....., and ~ppro¥~t by th~
Building Inspector.
Fee $~'~.. j~..O.Q .............
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 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 any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. 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
February 17, 1981
Date ..........................
New Building ............. Old or Pre-existing Building .... x ....... Vacant Land .............
Location of Property ..... .6p.q.U.o.~.c[e..~. Av.e..~.u.e. ,. .......... q~..t .c.¥.~ .u .e.,..~....~.. .............
House No. Street Ham/et
Owner or Owners of Property Harold J. Kober & Wf.
County Tax Map No. 1000 Section 1 03 Block 1 z, Lot 1 3
Subdivision ................................. Filed Map No ........... Lot No ..............
7192 Z 4/19/74 Harold J. Kober
Permit No ........... Date of Permit .......... Applicant ..................................
Health Dept. Approval ........................ Labor Dept. Approval ........................
Underwriters Approval ........................ Planning Board Approval ......................
Request for Temporary Certificate ..................... Final Certificate x
Fee Submitted $ ....... ~;.. P.q .................
Construction on above described building and permit meets all applicable codes and regulations. /~
Applicant.' · ~d./2~ ..................... ~. _~.\.~
FO~M NO. 5
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
ORDER TO REMEDY VIOLATION
(owner or authorized agent of owner)
(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 ......... ..~...g:~..1..d.~..~.~...~.e....z3g....~.~...~...7..J..C)..~ ..............................
(state character of violation)
........... .....
new per. it.
in violation of .......... .S..e...0..'..!..0..9..~.1...4.'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 .... .s..~.~..b. ......................................................
day of ....~..~...B..~...tT~r. .................................. 19..8..1..,.
The premises to which this ORDER TO REMEDY VIOLATION refers are situated at
..~..4~.~...s~.t.F.`9~q.d.~.D.~;~'~.'x..~:~'~.g.~`~.'~'b:"~.~.~e.~unty 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 Inspectorz~c
T~ ~ *c' tqo. -TS - 0~3" Ol t,46
FOI~M NO. 5
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
ORDER TO REMEDY VIOLATION
(owner or authorized agent of owner)
~..4~. Eastwood Dr. Ext. ~ Cutcho e NY
(address of owner or authorized agent of owner)
]]93~
PLEASE TAKE NOTICE there exists a violation of:
Zoning Ordinance
ART. XIV
Other Applicable Laws, Ordinances'or Regulations ............................................
at premises hereinafter described in that ......... ..B...u..i...1..d..i...n.g....P..e....z~...$..t....~'....7..'l..c).~, ..............................
(state character of violation)
.J~?...e.~......4./. J.~/..7..4. ........... .h...a...s....e..x, ~...t.~.e..~........Z.o...u....a..r.e.... r.e...~.~, r.~. ~...~ .~... ~;p~.,. f.~ ..~ .....
new permit.
in violation of .......... .s..e...c..:.!.g.9..-.2..4].~ ................................................................................. i ...............
(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 .... .s..i...x..t...h. ......................................................
day of ..,..J...~?.....~...~,?.~'. ................................. , 19..8.~...
The premises to which this ORDER TO REMEDY VIOLATION refers are situated at
~..4~. Eastwood D~'. Ext.~ Cutch°gue,Count~ 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~-,wC