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Home My WebLink About8898-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office South&d, N. Y. Certificate Of Occupancy No. Z?~3 ...... Date .......... 0~;. · THIS CERTIFIES that the building located at .. Map No...~ ........ Block No. ~ ........ Lot No, ,~.. -~atti-tuek. · 'N~Y', .......... conforms substantially to the Application for Building Permit heretofore filed in this office dated .............. Oct .... ~, 19. ~.~ pursuant to which Build~g Pemit No. 889~ · · dated .......... 0~2.. ~ ...., 19 ~6., was issued, ~d conforms to M1 of the requff~ ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .. mp~iVatO, zWl~.ing, pool. w&tb .fe~e~ .&. a~¢es~ys ................ The certificate is issued to . ~$¢er- .Peek.. · · ~er ................................ (owner, lessee or ten,t) of the aforesaid building. Suffolk County Department of Health Approval . ~..~, .............................. UNDERWRITERS CERTIFICATE No. ~g...~app~ie~. ~or. ~/2/F6) ......... HOUSE NUMBER ...... 780 ..... Street . .R,~, .~ .B~l~.B~oh' ~0ad ....... FORM NO. $ TO~ O~ $OUTHOLD , Building Department Town Clerks Office So.thold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructlons A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspectar with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, an6 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 P~anning Board approval of completed site plan requirements where oppllcable. 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 formation required ta 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 ./jr//(~/~ '~7 '~ Rte ...~'-4t-..~........'-.~... ................ New BL~ilding ................ Addition ................ Old or Pre-existing Building ...............Vacant Land .............. Locat,an of Property .......... .~.~.:'..~, ....... ~(~.L.~.~...~:~.',.~t..~:~.C~ ........... Owner Or O~ners Of P,operty .............. .~.~..,..:.(~ ........ ,.~=C...~.~'_.:.~..' ...................................... Subdivision ................................................................ Lot No ............ Block~N~o ............. Hous~ No ............. Permit No ..................... Date Of Permit .................... Applicant ..k~r..,., ...... 7 Health Dept. Approval .......... u ..... ..,.....:~ ............... Labor Dept. Approval ................................................ Underwriters Approval ....~,*.'~.~. ............... P arming Board Approval ........................................ Request For Temporary' Certificate ........................................ FinoJ Certificate .......~ ............................ Fee Submitted $ ..... ~ .............. Construction on above described building and regulations. Applicant Sworn t~efore me this ...... day of ..~.~.~.::.~'-~:'~ ~ ...... ~.? ~ 4,~ta~p o~ ~eo,, Notary Public .........;..~..~L~..'~.....~...C:. Cou~ v:~cr~', j<.~u~;~, ~ , . [ ) t ~ /~' Qualified in Suffolk County TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMED Dote ...'~.'. ............................................. (owner or ebthorize~ogent of owner) (address o~owner or authorized agent of owner) PLEASE TAKE NOTICE there exists e violation of: Zoning Ordinance Other Applicable Law~ Ordinances or Regulations ........................................... /~/(state character of violation)/; (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE D~RECTED AND ORDERED to comply_~!th the law and to remedy the conditions ~q~bove mentioned forthwith in or before the ........ .~..~,.?. ................................................. day of .~ .............................. 1 .~...~.. --" The premises t,o wh, ich t,~is ORD~ER TO REMEDY VIOLATION refers are situated at unty of Suffolk, New York. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of Iow may constitute an offense punishable by fine or imprisonment or both. ,.ii. ' ' Buildi~ Inspector TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ............ ~ ......... ~ ........ , 19... proved ................................. ...................................................................... : .. . .~:~ ....... ....................... .......................... ~ ' (Building Inspecto~ / APPLICATION FOR BULLDOG PERMIT . -- Date .... INSTRU~IONS a. This application must be completely filled in by typewriter o~ iff ink and submitted Inspector, with 3 sets of p{~ns, accurate plot plan to ~ale. Fee according to schedule. b. Plat plan showin9 location of Iot and of buildings on premises, relationship to adjoining premises or public streets areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is c. The work covered by this application may not be commenced before issuance of ~uildin9 Permit. d. Upon approval of this application, the ~uildJn9 I~spector 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 ~cupied or used in whole or in part for any purpose whatever until a Ce~ificate of ~cupanc~ shall have been granted by the Building ~nspector. "APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, Ne~6'Pk~ and other applicable Laws Ordinances or Regulations, for the construction of buildings, additions or alterations,~Sr for r,~moval or dem. elition, as herein described. The applicant agrees to comply with all applicai~le laws, ordinances/f~uilding,~ode, housing,~'.~de,,~nd regulations, and to admit authorized inspectors on premises and in buildings for \_(5~atu_re of~ app icant, or name, if a corporation) ( dress or applicant) State whether applicant is owner, lessee, agent, architect, engine~~_~, electrician, plumber or builder. If applica ora , si ture duly author' officer. '-~ame and title of corporate ~_o~icer) C~ Builder's License No .:' /9' Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No .................................... Ma o Location of land on which proposed work ,will be done. Jp~N .: ...... : ....... ~ ............ .~;. ...... Lot No ......................... Street and Number ............................. ...... ...... .... / Municipality State existing use and occupancy of pre~)es and in:ended use and occupancy of proposed construction: 3. Nature of work (check which applicable): New Building'. ................. Addition ...... ~ ........ Alte~ioj~..~.. ....... Repair .................. J~moval .................. Demolition .................. ~.. Other Work .~.)~¥,~-~,._~...~...~~. ~ ~'J/'/~//~~/~, . _.~4r'---' Fe ~/ ~ ~ (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units ...............f. ........... Number of dwelling units on each floor ..... , ...................... If garage, number of cars .......................................... --. ................................................................................................. 6. If business, commercial or mixed occupancy, sp~e and extent ~e of use ............................ ~ 7. Dimen§ions 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 ................................ B. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front .........~....~......~.. .......................... Rear ...... "-' --' ~..~..../. ................ ~De, pth ..... ' ~'" ~'..~......~(...~'.. ........... i0. Date of Purchase ,..~...~,~ · , ........ --'/"~'"'k~ ........ Name of~,,~, -,,~F~°rmer O~vner~, ..................... , 1 1. Zone or use district in which premises ore situated ............... .~.....~../...~-~/~.; ................................ ]2, Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ Will' lot be re raded 1.~.. ~ Will' excess fill' be removed from remmes' ( ) Yes 13. g · .......... : ........... _ p : (~',~ No 14. Nome of Owner of premises ...~....~..~ ............ Address ./~...~.~Z~..,~JC~J'~hone No. Name of Architect .............. '.L.' .................................... Address ................................ Phone No ....................... Nome of Contractor ............. Address ..~ ...... Phone ~1o .....x.~ ......... ¢ .... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frarn property lines. Give street and block number ar description according to deed, and show street names and indicate whether interior or corner lot. I //' ............................................. i~~.....~.,~being duly sworn, deposes and says that he is the applicam ' (Name of individ~al'signing contraclO ' d above named. He i, the .............................................. .............................. ................................................................ '(~ogent, co.rporote of.f~er, et~.) of said owner or owners, and is duly author,zed' to perform or hov/perforgn/e?l /~id/~work and to make and file this application; that oil statements contained in this opplication/6re rrue.,t'o the st,,/of//i~is knowledge and belief; and that the work will be performed in the manner set forth in the ap~icatio~/}iled the Swornt~o, before me this ~-~ ~.. ,~ __ / /_//.. ~ /[ .......... ~ .......... day of ....(,,).....(~.!,,:~1~ ............. , 199.,~.. / ~ ~// Natal, Pub,,c,. ................................................... Count, .................................... ' "'~L~'~''~ ~' ..... ~ ~_u,r.e of applicant) NOTA~.Y PU~3LIC, 5TATf~ OF NEW No, 030267600 QUALIFIED IN BRONX COUNT~ Co,nm, Expires M. prch 30; 1~<~'; LlOYd' S UNVE F ~'F'O R LICE N.Y. STAT E LICENSE