HomeMy WebLinkAbout7218-zFORM NO. S
TOWN OF SOUTHOLD
BUH.DING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No..Z.?.~0.?. ..... Date Apr~ ]i~ 19.7~
THIS CERTIFIES that ~e b~ld~g locat~ at N~e~ Bi~ S~t
Map No. ~ Block No. ~ .Lot No, ~ 8~thold
confo~s substanti~y to the Application for B~lding Permit heretofore ffl~ in ~ office
dated .......... April.. 1 ~, 19.. ~ p~suant to which Bufl~g Pemit No...~} ~
dated ............ ~..2 .... , 19. ~., was issued, ~d co~o~ to ~ of ~e r~
ments of the applicable pro~sio~ of the law. The occup~cy for whi& ~ ce~ificate ~
~ssu~ ~s .~,..~?~.~?~..~t?r~. ~ ...............................
The certificate is ~sued to . .~$~en. ~gq~.. 9~ ............................
(owner, lessee or ten,t)
of ~e aforesaid building.
S~olk County Department of Health Approval N ,R.
U~ERWRITERS CERTIFICA~ No..N?]? .......................................
HOUSE ~U~BER ..... ~7~ .... Strut ... ~.~*~. ~.~ .......................
Building Inspec}or
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N~ Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 7~18 Z
Permission is hereby granted to:
~a g~...g.9.p..o.~......A/.g...~:~. ~..e.p....~.~.o. ~.e. lLo.~. .........
.......... Jtml.tJao'l d.....: .............................................
~ .o~.....Z.~..~.e.~..s.~.~.e., ~.~.~'.Z....(.B ~.~.:~g~,.)... ~ ~,r,. ..................................................................
at premises located at ..~J~I]31~.~I~I~L ..........................................................................................
......................................................... ~o~ko.~4 ...................................................................................
pursuant to opplication doted ........................&]~.~,.....$.~. ......... , 19.~..~..., and opproved by the
Building Inspector,
Fee l.~..~.(~ ..............
Building Inflictor ~
-- , BUILDING DEPARTMENT ~~~
~_ ~'~ C~-,~._ TOWN OF SOUTHOLD
'' TOWN CLERK'S OFFICE
~ SOUTHOLD, N.Y. ~~ ~ ~. %~
Exomined ........ ~.~...~ ...... 19~.~ Applicotion No. ~ ~ / C---- ~
.................. ...... ' ..............................
.......................... : .......................
B
1~STR~CIIO~S~ ~
a. T's application must be com~10tel~ filled in ~g tgpewrimr or in ink and submitted in triplicate to the Buildin~ Inspeetor~ wit~
3 set~ of ~lans, accuram plot ~[an to *cale. Fee accordin~ to schodul*. ~
b. Plot plan showin~ location of lot and of buildings on pmmisos~ r01ationship to adjoinin~ promises or public stre0ts or areas, an~
~Nin~ a detai~ed description of lagout of pro~rW mu~t b~ drawn on diagram ~hich is part of this a~plication.
e. The work co~ered b~ this application mag not be comm~nc*d b~fom issuance of Buildin~ Permit. ~
d. ~on a~ro~al of thi~ a~lication~ the ~uildin~ Inspector will issu~ a ~uildin~ Permit to the a~plicant. Such ~rmit *hall B~ k~pI o
the ~remises a~ailable for inspection throughout th~ work.
e. ~o buildin~ shall be occupied or u~d in whole or in ~art for any ~ur~o*e whatever unti~ a Certificate of Occupanc~ ~h~ll ha~e been
~r*nt*d b~ th~ Buildin~ Ins~ctor. ~
~PPklC~TIO~ IS H[~fiBY M~ff to the Buildin~ Department for the issuance of a ~uildin~ P*rmit pursuant to th~ Buildin~ Zo~
OrdinanCe of th~ lown of ~uthold, Suffo[~ CounW, ~ew York~ and other a~plieablo kaws~ Ordinances or ~e~u~at[on*, for th~ construction of
buildings, additions or alterations~ or for remoual or d~molition, a~ h~r*in described. The a~pticant a~r~s to complg with all a~plicable la~,
ordinance*, buildin~ code, housin~ code~ and m~ulations, and to admit authorized in~ctor* on ~mmises and in buildings ~or neeos~ar~ inspections.
(Signat..ure of applicant, or name, if~o~rporation)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder,
................................................. .........................................................................................................................
Name of owner of premises .... .~..~....~...~....~....~....~.. ...... ../..~..?:.....~..../..~.......~....,~_..~..~.~.~. .......................................................
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 N9.: .................... Lot No .............. ~ ............................
/ Municipality
2. State existing use and occupancy of premises and. intended use and occqpancy of proposed construction:
3. =Nature of work (check which applicable): New Building L4;~.......~'...../~....-~.. Addition ..................... Alteration ...............
Repair ......................... Removal Demolition ...; .................... Other Work ....................................
......................... ( Description}
(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 .......... ..-;T.; .......................... Number of Stories ........................................
~o f Depth
8. Dimensions of entire new construction: Front .......... ..~../. .......... Rear .............................................................
Height ................................................. Number of Stories ........................................................................
Height .................................................... Number of Stories ·
10. Date of Purchase ............/..~..~...~'.. ............ Name of Former Owner ................. ?': .........................................................
11. Zone or use district in which premises are situated .....................................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation:
13. Will lot be regraded ....... {..~....~. ................. Will excess fill be removed from premises: [ ] Yes [/XJ' No
(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 st. ree~t names and indicate wheth-
er interior or corner lot ...............
(Contractor, agen t, corporate officer, etc.}
of said owner or owners, and is duly authorized to ~rform 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 that the work will be ~ormed in the ~nner
set forth in the application filed therewith.
....................... ...................
ACCUSATORY INSTRUMENT
INFORMATION - GENERAL C.P.L. 100.15 FORM NO. 256 w~Lo^~asos LAW BOOK CO., ROCHESTER, N. Y. 14609
STA~I~E OF NEI~ YORK : C?~UNTY OF ...... ~r~----. .....................................
......... ...................................
"~l~r ~r~pl~ ~f tier ~tatr ~f ~rm
a~ainst 3nfnrmatian
......... ~ ........ ._~___}_~_t. ............................................. , by this information makes
written accusation as follows:
V hat _ ___..~....C.~.~......~x~ ...... .~.~..~~ ................... ,on !he.__/...~.._.
day o[~ .... 19_.2.2 .....at ...~~.1.,.o,.~-~ ....~ ..-~-.- ............................ ,
in the~.~..~... ............ of ...~~.~. ....................................................,
County of...~~ .................................................................... ,New York, did
commit the offenL/s~e~///~--of ...~._..~..'...~_.....~......~_....G'~'z........~.....~...~....~.~....~-
a x{mi~lsm~amO (violation)in violation of Section ~ gl tJ .~_..~.~//2)2.-.Z./-t'.~.._.../(L...[.of the
State of New York, in that (~Ohe did, at the aforesaid time and place*
The facts upon which this information is based are as folldws:
The foregoing factual allegations ore based upon personal knowledge of the complainant (and upon information
and belief, the sources of complainanSs informotion and belief being,
$¥herefore, Complainant prays that .............................................................................
be dealt with pursuant to law.
**Subscribed and Sworn to before me on
........................................................ , 19 .......
Compl~nant
Title or Office
*set fo~h statutory language constituting the offense
**use only one
**Verification By Subscription and Notice
Pursuant to CPL Section 100.30, subd. 1, par. d
False statements made in the foregoing instrument are punishable as a Class A misdemeanor
pursuant to section 210.45 of the Penal Law. Accordingly and with notice of the foregoing, l
hereby affirm that the foregoing statements of facts are true, under penalty of periury, this
day of _19
Complainant
An appearance ticket has been issued herein on ...................................................................
by ..................................................................................................... , directing the said
...................................................................................... to appear before this court on the
................ day of ........................................................... , 19 ......... and bail in the amount of
...................................................................................................... has been posted with
Complete above only if appearance ticket has been issued)
STATE OF NE~¥YORK : COUNTY 0F____~EEgh~ ...................................................
~l,~r people of ll~r ~tatr of .~rul
against
' -E'a-E'r' 'e' 'n' - 'M'o-~-r-e-'q -°-E ........................................... Defendant
JJnfarmalian
..... .~._9_W.a_r_ g_ ~ _e_r_ry_ ,_ ..g.g. _i_1.c].i. n cL _z..ri_s1:,..e..q ~. .......................... :_.___]. .... residing
--J--9.g-k--e-X~--C~.r---e--~-k---D-.r-~Y--e-~---~-~-u-tZh--q-~-¢-~--~.~-V--~E~ ................... by this information mak~
written accusation as follows:
That Warren McGragor ........... on ,he 19th
day offf__a.n_~_a__r.~___ 1 g_Z_'7_ ........ at .___M_.Jz.n__n_.e__h__a_.h__a____B._°_-~..1.e--Y-a-r.~ ..........................................
(Location)
in the Hamlet of Southold .
County of ......$.kk~2~J.k ............................................................................... , New York, d;
commit the offense of ..... -~-q~E~-.1--n-q-~-a-g-~-e--~--s~.~--~-v-~-s--L-Kg-g-L--g.r--~-~-~h9~-~-~- ..............
required Certificate of OccuEanc~ ...........
a (,m/sdemsaaao~) (violation) in violation of Section___&r..~,__Z~.~__fiac~.._L0.0..-_L4A._A-_L1Jof4!
Chapter 100 of the Code of the Town of Southold
.__.-._-__-_.-._-__-__-.-._-.=.i_T=e,-~-t&-~,~e-~-Neq~Y-~d~, in that (-s)he did, at the aforesaid time and plac~
CountOne: occupy accessory building located on the above captioned
premises without applying for or receiving the necessary Certi-
ficate of Occupancy.
Thefactsupon whichthisinformationisbasedareas ~llows:
Warren McGregor obtained Building Permit #7218Z on May 2,
1974, and constructed the accessory building. He has
failed to apply for or obtain a Certificate of Occupancy
for this structure, although he has been notified by
mail to do so.
lYherefore, Complainant prays that ....... ~-a--r--r--e--n---~-q-G--r--e-g-9--r .........................................
be dealt with pursuant to law.
**Subscribed, and Sv, orn to before me on
Complainant/
Howard Terry, Building Inspector
Town Justice ............
Title or Office
*set forth statutory language constituting the offense
**use only one
The foregoing factual allegations ore based upon persona) knowledge of the complainant (and upon intorrnat
and belief, the sources of comp)ainants information and belief being,
Wherefore, Complainant prays that. ............................................................................
be dealt with pursuant to law.
**Subscribed and Sworn to before me on
........................................................ , 19 .......
Gompl~nant
Name
Title or Office
*set fo~h statutory language constituting the offense
**Verification By Subscription and Notice
Pursuant to CPL Section 100.30, subd. 1, par. d
False statements made in the foregoing instrument are punishable as a Class A misdemeanor
pursuant to section 210.45 of the Penal Law. Accordingly and with notice of the foregoing, l
hereby affirm that the foregoing statements of facts are true, under penalty of perjury, this
day of 19
Complainant
An appearance ticket has been issued herein on ...................................................................
by ..................................................................................................... , directing the said
...................................................................................... to appear before this court on the
................ day of ........................................................... , 19 ......... and bail in the amount of
has been posted with
Complete above only if appearance ticket has been issued)