HomeMy WebLinkAbout7207-z/ I~OBM NO. ~
TO~VN OF SOUTHOLD
BUll.r~INC. DEPARTMENT
Town Clerk's Office
$outhold, N. Y.
Certificate Of Occupancy
No...Z. 9.~3.~. .... Date .... February .... .~./*. ........ ,19 7:3.
THIS CERTIFIES that the building located at . '~725' ' 'Dee~ 'Ho~.w ']~r; .... ~
Map No ............. Block No ........... Lot No ..................................
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . .A~.r.~L1 ....9 ......... , lg.7.~, pursuant to which Building Permit No. 7~07~ ·
dated .. ~pril' · '~5 .......... , 19.,f/~., was issued, and confoms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is ........ F~ily. Roo~a Addition ........................................
The certificate is issued to ....... Hurls'on ' &' Emr~r 'HSgglu~ ........ . ..... .', .........
[ owner, x~~.~
of the aforesaid building.
Suffolk County Department of Health Approval .............. N;tR. ..................
UNDERWRITERS CERTIFICATE No ...... N.5270.~8 ..............................
HOUSE NUMBER ...~.7.2.5 ....... Street ... Dee~. Ho~e. D~, .......................
......................................... l~a~;'c~,uok,. ~Ie~. YoFk ................
Building Inspector
County Tax Number
1000-115-1h-19
I~OEM NO. 2
TOWN OF SOUTNOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N~ Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
No. 7207 Z
Permission is hereby granted to:
q.~,~.~x..~,~A~...6:...~ ~,~e ............................
........ ~]tz~..,,;~.t ....,B~ ..86 .....................................
............. ~;~tt~k ....... 5..:Z. ............................
ro~.~...~...~.~!.t.~..o........o.~.......z..~.s...t.~....L~..].~.~ .................................................................
at premises located at ...J.~.~ ....... D.ee.p..Jto'te..D~.t:~e ....................................................................
................................................. Ne~.t,$~ak .........................................................................................
pursuant to application dated ......................... Ap.I~:L1. ....... ~......, 19;1~...., and approved by the
Building Inspector.
FO~M NO. 5
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
o~E~ TO RmED* VIO~TION
~te ..... ~.J~...J...~.. ...........................
[owner or authorized agen~o~F owner)
(address of owner~or authorized agent"of owner)
PLEASE TAKE NOTICE there exists o violation of:
Zoning Ordinance
Other Applicable Laws, Ordinances or Regulations ..........................................
at premises hereinafter described in that ................................................................................................
(state character of violation)
.......... ........................................................... : .....
i~"~i~;'~;'i~"~; ........... ~ ~iiiiiiiiiiii-'.~~iiii~''~ii~iiiii?~i~'''i~';~i 'III'I''III''I''''IIII''
i~tate section or paragraph of applicable Iow, ordinance or regula;;i;n) ............
YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the
conditions above mentioned forthwith in or before the .............. '.~..~-.. ............................................
day of ...J~.~.~... ................. ~..~'
T,h~e premises, f~~to which this ORDER TO REMEDY vIOLATION refers are situated at
~,...~..,~......~,,,,,~--~.,.~c'~....~,...."~..~'~ounty 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 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 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
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 all 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 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
Date ................................................
New Building ................ 6d~dition ..... ..X. ........ Old or Pre-existing Building ................ Vacant Land ..............
Locat on Of Property ~.~..~?~?:[:..//:.~t/.f'.~...~..~..~.~:~.~.~.~:~.~...~../.?:'4...~.~.~..~..?....~...~.~...~;~ ......... '../.~.'~.~..~....
Owner Or Owners Of Property
Subdivision ................................................................ Lot No...I...~ ..... Block No. ............... I HL House No...!.~f:~
Permit No. 1.7..~..C:.7...i.2Z..... Date Of Per,nit Z~..:::.~.i..!~:A~pplicant ...~..: ...... /.f..,.~....~..~...~.~...~.'..~?. ........................
Health Dept. Approval ..... ~,..7~ ............... Labor Dept. Approval ................................................
unaerwr ters ,~pprova !.r......: .................................... Planning Board Approval ........................................
Request For Temporary ?e[tificate ........................................ Final Certificate ..........................................
Fee Submitted $..~.'...~ ~/~--~ ............................
Construction on above described building and ~ermit meets. Jail opplifable codes and regulations.
Applicant ........ _.c-r~.. ~..~ ........ ,~ .............................
Sworn to before me this
................ day of ............................................ (stamp or seal)
Notary Public .................................... County ~/,.LI~/~
TOWN Of SotrrHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Disol~rcved a/c ................ __ ~.
APPLICATIOH FOR BUILDING PERMIT -~
Dote April ~, 19....??......~,j,I
INSTRUCTIONS
a. This egplication must be completely filled in by typewriter or in ink and submitted in-triplicate to the Building Inspector, withf~i
3 mrs of plum, eccurate plot plen to scale. Fee according to schedule.
b. P~ot plan showing location of lot and of buildings on premises, relationship to adjoining-premises or public streets or areas, and
giving a detailed description of layout of property must be drawn on diagram which is pert of this application.
c. The work coeered by this epfllication may not be commenced before issu~nca of Building Permit.
d. Upon epprovel of this application, the Building. Ir~pector will issue a Building Permit to the applicant. Such permit.shall be kept
the premise~ ivaitMde f~ inspection throughout the work.
e. No building shall be occupied or used in whole or in pert for any purpose whatever until a Certificate of Occupancy shall have bee~
Irlnted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Z~
Ordinance of the To~m of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction
buildings, edditions or alterations, or for removal or demolition, as. herein described. The applicant agrees to comply with ~lll al~)licable taws,;
ordinancal, building code. housing code. and regulations, and to admit authorized inspectors on premises and in buildings for necessary in~oections.
(Signature of applicant, or name, if a corporation}
1~55 Deephole ~ve
~%tX%~}~, lew.Zork 11~52
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, Plumber~of builder.
owno~
Name of owner of premises Wud~on
If applicant is a corporate, signature of duly authorized officer.
lit
(Name and title of corporate officer)
Builder's License No ..........................................................
Plumber's License No .........................................................
, 2_
Electrician's License No .................. ~ ................................
Other Trede's License No .........................
I. Location of land on which pr, opoeed work will be done. Map No .................................. ~..~ ......... Lot No .........................
r~t--~ ,,.-~-- '~5' Deep~ole Drtv® s lat%~%uok, To~ of Southold, New ZOrk
St.--. o,.~ ,.u,,,,~....,,~1..~.,~,c ..................................................................... , .................. ' ............................................. Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ....~....ff..a..~.,,t.]:~....h..o..,,i~,. .............................................................................................
so. me - OhO fo, rally hOBO -
b. Intended use and occupancy .................................................................................................................................
: 3~b Nature of worl
Repair ...........
Se
13.
14.
Estimated Cos
If dwelling, nu
If garage, num
If business, co~
Dimensions of
.sight .....
Dimensions of
Depth ...... .2..4.,
Dimensions of
Height ..... .1..,~.,
Size of lot:
Date of Purcl
Zone or use d~
Does propose~
Will lot be re~
Name of 0w~
Name of Arc~
Name of Con1
'
: (check which applicable): New Building ....................... Addition ..................... Alteration ...............
.............. Removal ......................... Demolition ........................ Other Work ...................................
/ ~..,. ~.,~ (Description)
: ...... .~,[~,,2.,0,,0,,,.. ........................ Fee
· (to be paid on filing this application)
~ber of dwelling units .....~.. .......... Number of dwelling units on each floor ........ '.= ..............................
er of cars ..... ,.......~.-. ............................................................................................................................
tmercial or mixed occuoancy,'specify nature and extent of each type of use ..'..'~ ................................
existing structures, if any: Front ...... ..4~.....~..~..... Rear ....ll~......~..%..;. ......... Depth ..2..~..,.~.t~...~....~ ...........
ft,. Number of Stories oa, e
same structure with alterations or additions: Front ..... ..~..0....~..~.... ....... Rear ..... ..6..0.....:[..~..., ......................
..~..~....8....[..~ ............... Height ...)~.~..~'.~ ........................ Number of Stories ......o..~..e.. ............................
entire new construction: Front .1.,~. ~. Rear 15
:~'t · - o~e
......... Number of Storms ........................................................................................
:on;'.:: ::~.~.~.::~.~.;:~:::: Rear ...... ],~.~ ;~.~#~ ................. Depth .1. ,,~.., feet
..... Name of Former
strict in which premises are situated .....r...e..e.~..d:.e...~..~..[..&.~ ....................................................................... az.
·construction violate any zoning law, ordinance . .
or regulation .............................................................
(Address) (Phone No.)
itect ............. :'...'. ................................................................................................................ ; ..................
._ (Address) (Phone No.)
rector ..~. ..................................... ~ ........................................................................................................
(Address) (Phone No.)
PLOT DIAGRAM
ly and diatinatly all buildings, whether existing or proposed, and indicate all set-back dimensions from
street and bi~ek number or description according to deed, and show street names and indicate wheth,
lot. 1655 ~eephole Drive, Natt~tuok, lev York - taterior lot
Led sheet
Locate clee~
interior or oornel
See artsci
STATE OF NEW_YORK
eOUN'rv
............................
o~r~e ~
He is the ........................
of said owner or ownen
statements contained in
set forth in the appticati,
Notary Public~
................................................................. being duly sworn, deposes and says ~hat he is the applicant above named.
individual signing contract) ~
(Contractor, agent, corporate officer, etc.)
, and is duly authorized to perform or have performed the said work and to make and file this application; that all
his application are true to the best of his:~o9W ~dgtbl~Lal~ belief; and that the work will be performed in the manner
~n filed therewith. Notary Public, Stale of New York
s A rt[ -- No. 52e59~L44963 SufEolk Coun%...--
y. O~ · .~7...,..,~-'-~........~.., ~R.m,m~eign-rExEires March 30, 19/.~
, :,. ............
~...'~....~...0.~.: ................... County ............ ..~...; ........ ~ ...............
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