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Home My WebLink About7117-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Occupancy NoZ.l.0~?5 ........... Date ... t~e¢eiobe~. ;?~ ................ 1980. THIS CERTIFIES that the building ................................................ Location of Property .17~ ............ G2. e:~V:O. O0.. R~a~ .............. ~:Ut;¢~'~QgUe ...... House No. Street Hamlet Cotmty Tax Map No. 1000 Section . .1 ~0 ....... Block . .0~ ........... Lot 010 ............. Subdivision. ~C ........................... Filed Map No..X~ ..... Lot No.. ~C ......... conforms substantially to the Application for Building Permit heretofore Fried in this office dated · .Ivl~.cl2..q~ .......... 19.7.b, pursuant to which Building Permit No..7~ .t.7- ............... dated .... lvlarch~ .'[5 .............. 19 7./~, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... ..... a. ~ax:~.v~.te. orm-:£,.raJ.].y.d.wol].i-ng, wzC~ch, aclcl£ttxm. ...................... The certificate is issued to . .F, dga~ .Gt.l~os~'~; .... [o'vJn33r:t~'~t~) ...................... of the aforesaid building. Suffolk County Department of Health Approval . ~/.R ..................................... UNDERWRITERS CERTIFICATE NO.. I~ A78.6.7.2 .& N. ~78/475 ......................... Rev 4//9 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) 7117 Z Permission is hereby granted to: C. ~=Z~akJ.....~.~....~a~......Gtlbazt ......... at p/reVises located at ..~l.,-me~lll~..]~:l~.....~',l.~e.t,l.,]lll~.~ ....... ~td~ll~l~.[.[~.Ji.il ............... pursuant to application dated ........................~/~ .......... ~. ......... , 1°~,...~ and approved by the Building Inspector. / Fee $.l~.~f~ ........... Building Inspector FORM NO. 6 TOWN OF $OUTHOLD 0 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 New Building ................ Addition .....~. ......... Old or Pre-existing Building ................ ¥ocant Land .............. Location Of Property ....... ). .... ~'~ Owner Or Owners Of Property ................................................................ Subdivision ...................... ~w. ......................................... Lot No ........ ~-..... Block No ........ ~ House No........'..'~. .... Permit ~ ' ~ ' No~....~.../..L.~... Date Of Permit~l'.,'l?...?..App,,cant ............ Hearth Dept. Approval ..~;t.:..l~.:. ............................. Labor Dept. Approval ...~%/.,.../~....~ ................................. Underwriters Approval/.~.3...- .................................... Planning Board Approval ..~..:...~..! Request For Temporary Certificate .......'Z~... .............................. Fin(~l Certificate ...~ Fee Submitted $ ..-~.z......*~... ................... Construction on above described building an~d permit meets cd.I al~licable codes and regulations. pp ~cant ..................................................... Sworn to before me this ................ day of ............................................ Notary Public .................................... County (stamp or seal) FORM TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION TO .~?........C.~h...e..s...t..e..?.....~..r..~...~..~...s..k..~..~.....a.g..e..n.~....f...~.r Edgar Gilbert (owner or authorized agent of owner) .~.~. J.~....~.~m.~:..,.....c.~.~.o..s~.e.,....~..... J.!.9 3 ~ (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance ART. XIV Other Applicable Lows, Ordinances'or Regulations ............................................ at premises hereinafter described in that .......... .B.u:..i...1.~.i..~&..~.~..z~....i.~...~....?..'l.J..7. .............................. (state character of violation) ..~ ~..e. ~..... 5./. ]..5/. Z~ ............ .b..~..~....e. ~ ~...t..zZ..e...c!.:.....~.o. m ...~.~.e.....z:...e..~m~ me. ~...~ .o... ~.~.l.z.. ~ ~ ..~ ..... new permit. in violation of Sec. 100-1~1H (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 ~i×th day of ....~FJ'.~.~.~;f .................................. , 19...8..!. The premises to which this-ORDER TO REMEDY VIOLATION refers are situated at 175 Olenwood Rd., Cutcho ue ........................................................... ~.....z ............ 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~;~r ~' THE NEW YORK BOARD OF FIRE UNDERWRITERS '"UREAU O~ '=-ECTmCrrY THAT '' ~ I ~ ( C L.I. - fiXTURE ~A~.~BSI T E I FIXTURES I DRYERS IqJRflAC~ MOTORS FUTUI~ A~t~ANC~ FHO~RS ~T, K.W. ~L H.P. ~ H,P. ~T, ~, A.W,~ OVENS I mSHWAg~RS C EXHAUST FANS DIMMERS ?//?L. W.B. Ruland, Matt it uck, L.I. COPY IOR BUILDING DEPAIITMENT~fl"i~IIS COPY OF CERTIFICATE MUST~ BE ALTERm IN ANY MANNER. THE NEW YORK ~BOARD OF FIRE UNDERWRITERS ~ BUREAU OF ELECTRICITY ~- 85 JOHN STREET NEW YORK Ni~w~:YORK 10038 ,,.. A.,;..t 23. ].9~"~ ..,.,....o.,,o.o./.,. ~80~' : N 178473 THIS CE~IFIES THAT ~a~ ut~oe~ n/~tae u~enw~d R~,200, e/o req~h Ave. Cu~eho~ ~ b.~. TIME CLOC:KSt' .A~jT ~ BELL, ~UNIT HEATERS MULTI.OUI'I~SYSTrdAs · 7 TRANS. NO, OF FEET V I C EXHAUST FANE AMT. H. P, ~MMERS W.B. ~ulend, Matt it uek, L. l. COPY FOR BUILDING DEPARTMENT, ~1~ COPY OF CERTIFICATE ~ NOT Bi ALTERED IN ANY MANNER. t'~ 1~OzAlw NO. I ~~ TOWN OF SOUT,OLD 0~-~ ~ ~ ' ' BUILDING DEPARTMENT ~~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ........ ................. ~ra~ ................. ~.~ .......... :.'. ...... , ,~.~r~,~ ~7.{LZ..~...:. ...... Disapproved a/c .............................................. ~. ................. APPLICATION FOR BUILDING PERMIT Date ...... ~..~.::...~. ................. , I~Z..~.. INSTRUCTIONS ~ a. This application must be completely filled in by typewriter ot in ink and submitted ~r~mri~i:a~ ~btllce ~~ Inspector, with 3 set~ 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 s 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 Building Permit. ~ d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such I~errn'~ shall be kept on the premises available for inspection throughout the work. ~,- e. No building shall be occupied or used in whole or Jn part for any purpose whatever until a Certificate of OccupancY/ shall have been granted by the Building Inspector. APPLICATION IS HEREBY /V~ADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southotd, 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 heroin 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. (Signat~e of applicant, or name, ifa corporation) ......... ................. ~"-~'~£~;;;~;~;i ...................... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name °f owner °f premises ~:'Cn'a~i.i· .~ · · · - .~.. · * · · · · .~?.~.~-.~. · .' · .'~.. · .................................................................. If applicant is a corporate, 'g u e o du y authorized officer. ........................................................................................ (Name and title of corporate officer) Builder's License No. /~' ~' . ................................................... -~ Plumber's License No .... 2..0....~......L~... ..................... Electrician's License No ..... ' ......... ~'"'"'-" ................. other Trade's License No ............................................... 1. Location of land on which p!.~;~.d work w~ll be done. /~ap No.: ....~. ................................... Lot, N(~. ~ ..................... Street and Number ..~.. ~;~~'~.~...~.~.:...~..P~.~....~...~ .... { 7 ~-'~/ ~ // MunicipMity 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ..... ..~.......~J~.....C~......~...~.,,~Xl~. ' ......... -- Locate clearly and distinctly all buildings, whether existing or proposed, and property lines. Give street and block number or description according to deed 3. Nature of work (check which applicable): New Building .................. Addition .....~. .......Alteration ............... ~1~ Repair .................. Removal .................. Demolition .................... Other Work .................... i~'g;'~i~i;~'i"' ' ;";' ' ;" ' 4. Estimated Cost ./..~...~ .............. i. ....... ;...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, speci~ nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any:Front .......... '~./~. ........ Rear .......... .."'~.......'~.. ........... Depth .....~/./. .......... Height ......~..~)..~ ....... Number of Stories .......... ~......C~.. ................................................................................ Dimensions of same structure with alterations or additions: Front ............ ..)~....~. ................ Rear ....,~..~.. ............... Depth ........~.k,~7.. ................. Height ........ ~...~.' .......... Number of Stories ...... ~ .............. 8. Dimensions of entire new construction: Front'. ............... ~ ................ Rear ........... ~ ............. Depth ......~. ................. Height ........~.. .......... Number of Stories ........ ..-T ........................................... .~...,; ............................... '~"~.~Z'"'"? ......... 9. Size of lot' Front ........... .7..~~. ...................... Rear ............. .~....~.~ ................... Depth ...... ~.. ....................... 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,exc.ess fill be removed fr~om Rre~mises: ( ) Yes (/~ No · .. .. ... ........... 14. Name of Owner of premises ...~..~ ........... Address ........ ~.~':...~......../~.. I~none mo .......... Name of Architect .......................... ~3 .................. ~ ............. Address/Q n--/J~. ~ ,~Ph°ne No ....................... Name of Contractor ..~.~_,~-~:?~s~..~ .............. Address ~...~.;~ Phone N o.7.~ .~..'..6...~....~.... PLOT DIAGRAM indicate all set-back dimensions from and show street names and indicate whether interior or comer lot. STATE OF NEW S.S being duly sworn, deposes and soys ti,at he is the applicant (Name of individual signing contracf) above named. ~//~_ He is the .......................................... ~"~":(Contractor, ............................................ agent, corporate officer, e;~c.) ................................................................... 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 that the work will be performed in the manner set forth in the application filed therewith. Swam to bef_.~e this . ....... ..................... JUDITH T. 6OKEN Notary Public, State o{ New York NO. 52-0544963 Suffolk Coun~y~'~ Commission Expires Ma~ch 30,