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Home My WebLink About7243-zFOYer NO. · TOWN OF $OUTHOLD BU~.r~ING DEPARTMENT Town ~erk's Office Southold, N. Y. Certificate Of Occupency THIS CERTIFIES that the building located at . .S.I~o.~#..~.~.$?.~. ............. Street Map No. (}pi;.,..~hl... Block No ........... Lot No.. 1.0 .&. p.i;1 ~ .... (}r#.e.~pg~.~ ...... confoms substantially to the Application for Building Permit heretofore filed in this office dated .............. Nay. · .~., 19..7~' pursuant to which Building Permit No...~ dated .......... Nal' ....9 ...., 19.~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. P~'$vata .&oe~ssoz~. ( sto~g® ). build~g ........................... The certificate is issued to . .J. tl,t.i,0. ~..I~R,~'~ ........ . .0~1#1~ ..................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval . .~ :.R.,. ............................. UNDERWRITERS CERTIFICATE No..~.~.R., ....................................... HOUSE NUMBER .... ~. ...... Street ...~.h.o.~..e..R.o.a..5 .... .6.z~..e.n.p.o.~.t. ............. Builrli~g Inspector I~OB~ NO. ~ 'rowH OF ~OUTNOLD BUIL~INg IglFAI~TMENT TOWN a~ERK~ OFFICE sou~u~, ~. Y. BUILDING PIRMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted at premises located at pursuant to application Building Inspector. 1.~.~ and approved by t~e FO~,M NO. S 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: I. 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 dispasal--(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 end "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. 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 ...~.e..~.. ................... .j..c).. ~..~ ........ New Building ....~.. ........ Addition ................ Old or Pre-existing Building ................ Vacant Land ' Location Of Property ~-~.~.~.~.'~...z.~.e.~.D'?'~.¥~e'~.G.?.~'e..e.~.~'~.~9..~.~t~ ................................ Owner Or Owners Of Property .....J...~.~.~..,~.~.~..~..~..¥,T.~.~ ............................................................................ Subdivision .~.e,~).Q~'.~..~q.~.O,7. t~,.% ......................... Lot No. J.~k-~ 'Block No ............. House No...cg~.... Permit No....~.~'.ff-.~7. ..... Date Of Permit ..~/.~Z?..¥....Applicant ....... ~'.,~.,...~.1~'.'1 ~. ................................ Health Dept. Approval ..~.t.l~.~ ................................. Labor Dept. Approval ...~..s~,.*. ................................... Underwriters Approval .... ~.:..~...* ................................. Planning Board Approval ........ .~..'..~.*. ....................... Request For Temporary Certificate ........................................ Fin~ Certificate ~ Fee Submitted $ ..~.:..0..0.. ........................ Construction on above described building and permit meets all applicable~codes and regulations. pp .. ......... ............ ............................................. 'x./ _ . Sworn fft~ before me this ~....~ day of ....~ /~: / z~n- ._ ,, ....... · .. ~ ~(stamp or seal) ....................... P~ER ~ Nota~ Public .................................... Coun~ ~. Pub~o ~0s'-~AS~L~ NeW y~ ~' ....... '.SSlon ~plr~ ~U~ ~/ FORM L )c"xO ~ ~/~TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date TO ........... (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists o violation of: Zoning Ordinance '2~....~~....~ ~ ~ Other Applicoble Laws, Ordinonces or Regulations .......................................... at premises hereinafter described in that....~...~.......~...~.~.....~..' ...~..'...' .......... (state charac~r of violation) ...... in violation of ................ ...~...¥.~...~...: ........ .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 in or before the /4~..~ ~ -71 day of .................................................. 19 ............ The premises to which this ORDER TO REM EDY VIOLATION refers are situated at ..................... ~'~ ......................... ~ ......................yo u~ o , New York. Fadure to remedy the conditions aforesaid ~nd to com~[y with the app ice--provisions of law may constitute an offense punishable by fine or imprisonment or both. Building Inspector ~i~,ppraved a/c ...... , ............................... ~'7' .............. ""~ .................... ............................................................ ....... ................... ,f ~_ ........ ~..~;~:~,. ........ ~~ ........... ~ ,~ APPLICATION FOR BUILDING PERMIT .,. .......... ..................... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted Jn triplicate to the Building Inspector, with 3 sete of plans, accurate plot plan to scale. Fee according to schedule. b. Plot 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 ofpraperty 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 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 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 the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ant, or ~e~e, if a corporation) (Addre, ss_o_f applicant). /~/ ~/d~-~' . .,a ~ y ilar / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buJlcler. Name of owner of premises ................................................................................................................................................... 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. ,~-~. ~ / ~ *H~-// Location of land on which proposed work will be done. Mop No.: ../.. ...............................,~ ~t N~ ..........;...r~ ....... Street and Number ...... ~.~ ....... ~.~...~~...~~~, ~,~~ -- -- ........ ~ U Munid~i~ State existing use and occu~ncy of premises and intended, use and ~cupancy of pr~d c~stmction: ~u.on~ '"~"~"'~'7~~_._ ............... ' ............. ~ ~'~"' .... ~isiting use b. Intended use and ~cu~ncy ............. ~.~.,...~.~....~...~ - j 10. 11. 12. 13. '14. 3. Nature of work (check which applicable): New Building ~:! .............. ,~ldition .................. Alteration .......... .-..,~... Repair .................. Removal .................. Demolition ........ ......... i.. Other work~.~.....~...' : ~..~ (Descriptior~ 4. Estimated Cost ............ (...~.....O..:..~... ......... i ......... "...."...Fee ...-~...~...~..~... ................... ;...;.......:7.~..~ .................................... · ' (to be paid on filing th~s application) 5. If .al. welling, number of dwell!ng units ......... ~ ...... Number of dwelling units on each floor ............................ If garage, number of cars ..................... '. ....................................................................................................................... 6. If business, commercial or mixed occupancy, specify %ature 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 .............. I.~-~ ................ Rear ....... /.....o.. ............. Depth ....... ..~..-~. ........... Height .................... Number of Stories ................................................. .? ................................................................... Size of lot: Front ..................... .7...~.~...I ......................... Rear ......... ?....~.'. .......................... Depth ....../...C?....O...../. ........... Date of Purchase ................ ./.,~,K...~.....: .................... Name of Former Owner,~f~...c~...~..fi.~.~,~' Zone or use district in which premises are situated ....... ~ ....................................................................................... Does proposed construction violate any zoning law, ordinance or regulation: .... ~ ......................................... W. ill lot be regraded, .....~ ............ Will excess fill be removed from Rre, n3ise~ _( ) Y¢-~ ( ) No Name of Owner of premises ,.~...~. ~- / ~' /_.,,9~,/~z/9- A"re . . "--'" .................................................. aa sS.,.. ...... u.....~.,4..),~,.._.... I,'noD~ I~0 .................. Nqme of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... ..... ~ .... ,,- PLOT -DfA~RAtvt Locot.e c,ear,x and d,.t,nct~y a" bu~'~'~r-.x,st,~"~r~ed, a~d ,nd,cat. a,. set~ p.ropert~ hnes. Gwe strut and block n~er or description ~co~g to de~, and sh~ ~reet iT~eri°r whether or corner lot. / ~ Lk dimensions from names and indicate tool STATE OF NEW....YORK, .. COUNTY OF ..~q,,l~..~.: ......... ................................................................................................. ~emg duly sworn, d~oses and says t~t he is the applic~nt~ (Mame of i~ividual signing contrac~ above name. He is the ............................................................................................... ~ ................................................................................. (Contractor, agent, co,orate officer, etc.) of said owner or owners, and is duly authorized to p~orm or have performed the said work and to ~ke and file this application; that all statements contained in this applicotion are true to the best of his knowledge and belief; and t~az the wor~ will ~ performed in the manner set fo~ in the application filed therewith. Swom to be~m me this ............. ~. ........ ~ o~ .~ ...... ~...., .......... , ~Z~ ~ ,. ~ ~ · ....... ........................ ~ ' fi/ (Signa~re of ~plicant)