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HomeMy WebLinkAbout9027-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Sou(hold, N.Y. Certificate Of Occupancy No....7,..~.02.~/3 ........ Date ...... D~oombe~..2, .............. 19~0. THIS CERTIFIES that the building ................................................ Location of Property .. T~.O. . .B.ay..V. ~..ey~..I~V,., ........... East. Marioll~. N~:~ .......... House No. Street Hamlet County Tax Map No. 1000 Section .... .~T. .....Block .... 5 .......... Lot .../~. & '5 ........ Subdivision..Ge(al&nets..Bay..Es~cetes .... Filed Map No ......... Lot No .... '~ 12 ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ·.. ~r~tgi~12.y.. 3 ....... , 19.7.7. pursuant to wtfich Building Permit No... 90~7. Z ............ dated ... Jgr~larff]..~ .............. 19..7.7, was issued, and conforms to alt of the requirements of the applicable provisions of the law. The occupancy for wlfich this certificate is issued is ......... .... AcldL~ion. o.f' .Dectt .to./DweiZ-l.ng .......................................... The certificate is issued to . . .~,. ~.o.. ~ ~S.8~ CrB. ....................................... (owner, ~ejJ~J~iX.X of the aforesaid building. Suffolk County Department of Health Approval .... N/R ................................... UNDERWRITERS CERTIFICATE NO... t~.~ ........................................... Rev 4/79 · ~d~./P ............ Building Inspector FORM ~0. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP. EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9087 z Permiss{on is hereby granted to: A..~..o.w~k.t,...¢...~.;...P.~..~,~..=...~..o.~......~/~.........~~S''' T-Ass f ~.~ ....... .E..~o...=. ..................................... build an addition (deck) on existin~ dweltinE pursuant to application dated .......................... ~.~.~..~.. ..... 19..?.,~..., and approved by the Building Inspector. Building inspector FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 Inspec- tor 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 natu raj or topographic featu res. 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 installa- tions, 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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 informa- tion required to prepare a certificate, Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $I.00 $5.O0 Date .~,,¢C,-../.../../~..~...~. ..... New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property,..'/..~. House No, (~$treet Ham/et Owner or Owners of Property .. ~.:.,. ,d~ ..... .~...~,~... ................................. County Tax Map No. 1000 Section ,...~..~. ........ Block .... ~.. ........ Lot., .~.¢. ,~;.~.: ..... Subdivision z:~ ................. Filed Map No ........... Lot No..//../. ~ .... Permit No..0..~.~. ~--Date of Perr~ .~...7.~.Applicant . ' ' -'~--~ Health Dept, Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and~ermit meets all applicable codes and regulations. Applicant . .~, .,, .~.. ~~~,,: .......... FORM NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Date November 26 19 80 (owner or authorized agent of owner) North Road ................. ~.t..~g~.,..~.,~ ........................ (address of owner or authorized agent of owner) Tessie~s PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance Other Applicable Laws, Ordinances'or Regulations ............................................ at premises hereinafter described in that ......... ..~.~.J=...1.~.~...~.g....2..e...~...~..i.~...~.,.e..O...2.Z~. ............................ (state character of violation) ..~..e.~ ...... ?./..3./..?.7. ............. ~..~....e...z.~..~..z:.e...a..:.......Z..o.M..~.~.e.....z:..e.~.~.~ ~...e.~....~.o...~.~Zg.. Z ~..~ ..... new permit. in violation of Sec. 100-1~1H (~:~;~;;.~;.;~ii~;;;..;/..~;~.~.~.~;.~...~.f..~;.~;~i~;~;~.~i~.~.~i~;..8.;%~i~ii~i ...................... YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the ......................... 1...2..'9..b: .................................... day of ......... .~..e..g..~.b..~.~ ......................... , 19...~.Q. The pre~/i_ses to which this ORDER TO REMEDY VIOLATION refers are situated at ~'-"~. ~/'-~.'~.y..~.'-'.)~..... County of Su f folk, New York. Failure to remedy th~ 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 $OUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be fil'led in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor 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. Fina~ 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 installa- tions, a certificate of Code compliance from the A, rchitect or Engineer responsible for the building. 5, Submit Planning Board approval of completed site plan requirements where applicable. For existing buildings {prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty 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 informa- lion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date . ~C,-. New Building ............. Old or Pre-existing Building ............ Vacant Land ............. Location of Property .. House No, (~lStreet Ham/et OwnerorOwnersofProperty ..~.:...,~ ..... -.~ ................................. County Tax Map No. 1000 Section .; ............. Block ............... Lot ................ Subdivision ~ ................. Filed Map No ........... Lot No.././.. ~ .... Permit No.~.. 0..~-. ~. ~--'Date of Perry,; .,~..7.,~.Applicant.. ~..~c~L:..~'2. ~. -'~-~ Health Dept. Approval ........................ Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ ............................. Construction on above described building and~ermit meets all applicable codes, and regulations. A licant ....... pp ............ !. ¥ TOWN OF'SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. k Examined .... 10.,2 ,~ Application No..,¢ ............ ,,,:,proved .................... ",rm't '"a. .... Disapproved a/c APPLICATION FOR BUILDING PERMIT ~.~,.~ Date ... .... ...~... .......... , 1 '.~....Z. .... INSTRUCTIONS '~ a. This application must be completely filled in by typewriter o~ in ink and submitted in triplicate to the Building Inspector, with 3 sets 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 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 permit shall be kept on the premises available for inspection throughout the work. N 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. 'g .......... ....... ........ (Address of applicont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (,Name and title.~,~ ~ ,~t/kal corporate officer) Builders License No..~,,,,..~.I.,..Z.........'?.~'...'~.. .................. Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... /~ f] .,'~ ,-., ,, - onoflan n h osed I ne Ma No ~b'r-k t o Locat, do w ich~,~r,~p~r.~ c"',.r~k'wil b?~3~ne. Map .: ...........................~. .......... o N ......................... Street and Number ...... .~C~..,.~..~...~....~~.~.....,~..~...~5/.4.{3...,-~.~,~__ __ ............................................... / Municipality State existing use and occupancy of pr,e~qises an~ intended use and occupancy of proposed construction: o. Exisiting use and occupancy .....~.~ ........... , ..................... ....... ...................................................... b. Intended use and occupancy ............... '../. ............ _._/~(~--~.~ ............ ---- /i __ ~...~! .J~.C. ..................................... 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ................ Repair .................. Removal .................. Demoiitior ..................... Other Work ................................................... '~ e /~ ~O (Description) 4. Estimated Cost ................~.....-r_..... .............................. F e ....... ~...... ........................................................................... (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 m~xed 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 ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... Z-.~.- ...................... Rear ...../'..~. ................... Depth ..../....~. ............... Neight .................... Number of Stories ~ ............................................. 9. Size of lot: Front ........................................................ P, enr. ......................................... Depth ................................ 10. Date of Purchase ........................................................ Name of,~Form~r Owner ........................................................ ] 1. Zone or use distric~r in which premises are situated ....~,.~ ......~r.~¢. ................................. .~ .................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .......... ~'...-....: ..................................... 13. Will lot be regraded . ......... ~ ......... Wil~ excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ........................... *~'"'~~~. Address .......~.<...~ ...... Phone No ....................... Name of Architect ....~....-~-.-.;/ .........~/,~ ................. Address ................................ Phone No ....................... Name of Contractor .~..'~.. ....... Address ....c~......~... ............... Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from propc~rty lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. / STATE OF NEW~-YE~:, COUNTY 0~1: -~',"~*~d'~L-~----[~'~ being daly sworn, de~oses and says that he is the applican~ (i~am~ ~f individual signing contract) above named. He is the ............................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; thd all statements contained in this application are true to the best of his knowledge and belief; and tho~ the work will be perforr~e,d in the manner set forth in the application filed therewith. Sworn to before me this .................. .>.. Notary Public, . ...................... County ...... ~ .............. ~.~7.~ -~'*' '- (~ (Signotureo appicant)