HomeMy WebLinkAbout8392-zNO. 4
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. ZTP60 ..... Date ........... Ym-r'" 9 ....... , lg. ~2,~
THIS CERTIFIES that the building located at Gull Pomc~ t~ane ......... Street
Map No. -For'dham- AeBl°ck No. 'see' I' · ' Lot No.. 1 ..... G'~'aelap'o~t' · 'I~ ;Y'. ........
conforms substantially to the Application for Building Permit heretofore filed in this office
dated ... -Feb 27', 19.-76 pursuant to which Building Permit No. ~92Z., ·
dated .... Feb.. 2-? .... , 19.. '76 was issued, and conforms to all of the req~!ire-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . .. P~'iva~;e swl~,~ing- .peot- wi~h. ~ence' '& 'ac'eesso~ys ..............
The certificate is issued to . Harr.y. Fart. all ..... C~mer ...........................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval 'N ~tto .......................
UNDERWRITERS CERTIFICATE No. t%2~96~3' ....... Apr' '22" ~1'976 ..............
HOUSE NUMBER 190~ '" Street ' 'fiu~ 'P01~'cI 'L&h'~ '" G~/15oi~l; ........
FO~I~ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTH'OLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 8392 Z
Permission is hereby granted
~¢4~urs~ant B apphcahOn d~ed ......................... ~e~ ......... ~. .........19.~.., and ~ppmv~ by the
~7'~?,:. B~lding Inspector.
FORM NO. $
TOWN OF $OUTHOLD
~ Building Department
Town Clerks Office
Southo~d, N. Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This apphcation 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 buddings, 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 end similar buildings end
installations, a certificate of Code compliance from the Architect or Engineer responsible for
the building.
5. Submit Planning Board approval of completed s~te plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and 'pre-ex~sting"
land uses:
1 Accurate survey of property showing ell 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 cede or safety inspection of buildings or premises, or other pertinent
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 ................ Vacant Land ..............
Location Of Property .,~,.0.~...~.~X.L.....~P.,~.~.,.~,~..~..~.~'~.¢/~.~.~/. ,~....%~?~..~..~.P/~.~....~Z~&'J.z~'
~ner Or ~ners Of Prope~ ......... ~..~..~.~..,..~. ..... .~ ..... ~.~.~ ..................................
....... .......................... No ..... ...... Ho. e No ............
Permit No..~,~....~ Date pf Permit~.~/~....,~plicant ...... ~...~~....~ ..........................
Health Dept. Approval ...... ~~ .................... ~bor ~pt, Approval ..~~ .....................
Unde~riters Approval ..~.,..~.l.}.~.g.~ ................. Planning B~rd Approval .~~ .....................
Request For Tempora~ Ce~ificate ........................................ Final Certificate .~ ..................................
Fee ~bmitted $ ....................................
Construction on above described building and g~/rm~ meets~all~gppl,cable codes and regulations.
Sworn to before me this Applicant ~(~/~..~..,.~.~ .............................................
sea Z O
(stamp or ~/~~D'"~, [
202 ,Gul~ ~onG ,~ane," ~re~p0r~,
~T~S ' ~ ~RE APPLIANCE ~EDE~ S~ClALREC!FT TIM~CL~S J
B~cause: of unusual, eAV~onmen~s
ACCUSATORY INSTRUMENT
INFORMATION - GENERAL C.P.L. 100.15 FORM NO. 256 W~.Ln~MSON LAW BOOK CO , ROCHESTER.
STATE OF NEI~ YORK : C~OUNTY OF ...... ~ .........................................
_..~..._..__~_._._ COURT ........ ~._ 0 F. _. ~!~4.~ ............... ~ ...................
~l,~e ~lenple nf ll!e ~lale nf ~ew
A againstDefendant
............... r__k .................................... Jnfartnatim
..... -~--.~..'~..~_._~ ............ ~..~___'2_.'4c___~..,...-~.__~._ ...... residing at
........... ~.d~. .... .~.i_.k.~.i~! .......................................... , by this information makes
written accusation as follows:
That .... ~.~..~_....~..~._~.~ ..... ~ ........................................... , on the .... (5.__0~.__
day oL.~..~..,.~.... 19_.~_.~ .... , q.~_~--L ....... _c/~. .....
in the ...................... ~"&'""'2--~-'":~" .... of ............ ~'-1~'-~"' ...................................
County of ...... ~ ............................................................... ,New York, did
commit the offense~Jof?.._C~.....~_._..~..~.._~._...~7...~~....c...~..~,.~....~ ....
a (,.,;~2 ..... .'-:.:,0 (v~iolation)in violation of Section ~g~....d~...~../.~.o..~.~./Z~.~..._~...f. .... of the
~.~_.~.~.~.~Law of the State of New York, in that t;~he did, at the aforesaid time and place'
Count One:
The [acts upon which this information is based are as follows:
The foregoing factual allegations are based upon personal knowledge of the complainant (and upon snformat~on
and belief, the sources of complainants reformation and behef being,
TOWN OF soUTHoLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
.................................. AP~.Examined ~z./C?' '
Approved . .;'. ........ ...., ,97 Permit No .~..~ ~ .2..,7..,
i .....
APPLICATION FOR BUILDING PER~I1
Date ........................................................
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building ~4~
Inspector. Z
b. Plot plan showing location of. lot and of buildings on premises, relationship to od oining premises or public streets or L,
areas, and giving a detailed descriphon of layout of praperty must be drawn on the diagram which is part of this application. L7
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 r~
shall be kept on the premises available for inspection throughout the progress of the work.
e. No building sh~ll be occupied or used in whole or in port for any purpose whatever until a Certificate of Occupancy ~b
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
TR ~ge ual (;~ 1~ ~ Sa'n [ c Ltrheee sC ~ ~' ct L~mC ~il%n wCl ft hb ~illld io%%~ ~ c%~ id iet il%nwSs 7 ~ r~ [ne re~lt~ Ln, s 'b u° itl c[i~rg, r ce o% eov, a Ih o%rs #n~mc°(~ nc~ n~S rhe; ruliar~iodnesS~ribed'
( 14-- ............................. ...............................
Name of owner of premises ......... ,~.~..(~,...~-..~......~..~../~...~.~...~..~-. ............................
If applicant is a corporate, s~gnature of duly authorized officer. ' .....................................................
(Name and title'of co~orate officer)
1. L~ation of land on Which proposed wo~ will be done. Map No.: ...... ~.~Z..~ ..................... Lot No.: ..... ~ ................
Stre~ and Number ~o~ ~ ~o~ ~
MunicJ~li~
2. State existing u~ and ~cu~ncy of promises and intended use and occupancy of prop~ construction:
Existing use and occupancy ........... .~-....~..,~./..~..~....~?....~...~.. ..................
Intended use and occupanc,' ........ /.~..~..~...L. ....... l~..~...~...9...~.......~. ....... S.i,~.ZZ~.~¢?.!...~'....6-....~...s~......~' .....................
3. Nature of work (check which applicable): New Building ,.....'~ ......... Addition .................. ,~lteration ..................
Repair .................. Removal .................. Demolition ........... ~.~. ~Other Work (Describe) ....... }.~...~ ............... : ..........
4. E t oted Cost ................ ............................. Fee ................................... i .........................
(to be paid on fi~ing this application)
5. If dwefllng, number of dwelling units ............................ Number of dwelling units on each floor ............................
If garage, number of cars ....................................................................................................................................
6. If business, commercial or mixed occupancy~ spe.~fy nature and extent of each type of use ............................
7. D mens ons of ex st na structures f anv' Front
Height ~.r Number of Stories
Dimensions of same structure with olterations or additions: Front ....................................Rear ............................
Depth ................................ Height ............................ Number of Stories ................................
8. Dimensions pf entire new construction: Front ............. ./..?. ................. Rear ....../..~... ................. Depth ~..
Height ....~...!..~.?...~...~.. Number of Stories ...............................................................................................
9. Size of lot: Front ........... L.~.J .......Rear .......... .Z...q..~.. ............. Depth .......... ~...~......O......,~...~/(c~/~-6 ~_-
10. Date of Purchase ........................................................ Nome of Former Owner ........................................................
11. Zone or use district in which premises are situated .....................................................................................................
12. Does proposed construction violate any zoning law, ordinance or regulation;~ ........ 4~,Z.....~.. ....
]3. Name of Owner of premises ..~..~.......F.~.~...~..L:..~..Address ...~...~.~,....~...?....~...L....~.d'...~..~one No. ~..~..?..-...O.~'..~.~'
Name of Architect ...................................................... A~;~ress ............................................ Phone No.
, ~ ~i~ ,~, ~Cl~. ....................
Name of Contractor ~..~ .~...~..!~ ..........~..!..L.R..~..~....~.../~...Acldress ..... ~.~./.~...~. Phone No. ~.¥...~..T..~../...O..O
PLOT DIAGRAM
Locate clearly and distinctly oll buildings, whether existing or proposed, and indicate oil set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicat'e
whether interior or corner lot.
STATE OF NEW YORK, tS.s
COUNTY OF ...--,~'./.:,.,~:~.:~.Z ...(~.. ........ ~f ·
.................. . .~....~..~.~..~. ....... /~'.z/.,4.~,C~.[.~ ................................... being duly sy~r,n, depo~ses and says that he s the applicant
Z
above named He s the . . ..~..../~..~.':/.~...~..~ ~z,' ~4x~,///C/~']~
..................... ........ (Cont'" ;o;~';'~, ' (~ ~.~t' 1 ' ;; ~:;; ~-; [;'~'c~.'~, etc.'~"'~'~ ...............
of said owner or owners, and is duly authorized to perform or have performed the said work end to make and file
this application; that oil statements contained Jn 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 filecbtherewith.
Swam to before me this
19.;7..~,. ~ '
......... · '~ ........... day of ......... ..~..~'.~..~ ~. G .yl ........ ,
Notar'! Public, . ........ ~l~t~4~.~a~.~e~ ......... County (Signature of applicant)
ACCL'SATOEv INSq' RUMENT
STATE OF NE~ YORk COU.NTI OF_._._S__U.F_E.O_.L..K_ ..............................................
__J~JJg~ ....... COURT ........ JD_.wu_. .......... OF .......~D~gg~g .................................
_ ___H. _a_ _r_ _r_ _y__.~__ _a_ _r_ _r_ _e~_]._ ........................................... Defendant
3nfurmutiun
---J-9-c--k--e-~--~c--r--e--e--k----D-~--i-Y--e-~----~-9-u--t--h-~--~-~-~--~-~-K-~ ............... , by this information,
written accusation as follm~s:
That Harr Fa~rell
............ ~_ .......................................................................... , on the__k~
da) of_.__,.]'__a_g~_a_r~ 19_2_7_ ........ at ___L_o__L___l__L__e__a__s__L___.s_&_cl__e.___G_u__Z_.l____P__o_.n_0__.~R~_ ..............
outside of the (Location)
"'ilT '~h'~_.~ n~ c:, ¥'pcl'r' a'b,~ ~ _a ~o.a .... of .... ~X~9_n...Rg_ _~_~ .................................................
Count) of ......._.S__u_.f_f_o__l_k_ ........................................................................ ,Ne~ Yor
commit the offense ~f---9-9-9.g~-i~-n-~-.a~-c-q-e-s--s~9~r-~Y-~-s--t--r-u-c-t~-u--r.~-~i~-$~Bg~-E~k--
a (mi-s~m,m~e~-) (violation) in ~ iolation of Section _.A_.r..t_-__x__z_y_t__.S_.e_c__:___l._0..0_z.l_.4..4_b.__(.l_L
Chapter 100 of the Code of the Town of Southold
___.-__-._-_-__-__-_-_-__-__-_rhaw~d~-~e~e~-~x~b, in that (s)he did, at the aforesaid time and [_
C0unt0ne: occupy the accessory structure (swimming pool) locate~
on the above mentioned premises without applying for or receix
the necessary Certificate of Occupancy.
Thefactsupon ~hiehthisinformationis based areas ~llows:
Harry Farrell obtained Building Permit ~8392Z on February 27,
1976, and constructed the swimming pool. After due notice
by mail, he has failed to apply for or obtain a Certificate
of Occupancy.
%%erefore, Complainant pra) s that .... _I-I._a__r__r.y._.F_.a_r_.r__e_l__~ ...........................................
be dealt ~ith pursuant to law.
*~Subscribed and Sworn to before me on
Complamant
Howard Terry, Building Inspec
Town Justice
T~t]e or Office
*se[, foNh statutory language constituting the offense
The fo~ego,ng factual allegat,ons are based upon personal knowledge of the compla,nant (and upon ,nf
and behef, the sources of compJa,nants m{ormat~on and behef being,