HomeMy WebLinkAbout8049-zTOWN OF $OUTHOLD
BIJ~.nING DEPART~RNT
Town Clerk's Office
Southold, N. Y.
CertifiCate Of Occupancy
Date .............. 3~....2.., lg.
THIS CERTIFIES that the bui]dl-g located at . Lake. ~ri?e ............... Street
Map No.. xx ........ Block No..xx ....... Lot No~x... ~outh~ld.. I~,Y o ..........
conforms substantially to the Application for Building Permit heretofore filed in thi.~ office
dated ............. J.llly.. ~, 19.7~'. pursuant to which Building Permit No.
dated ............. July.. 3., 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
~sued is . Private..one. £amily. dwelling, w,tth, an.adtition ..................
The certificate is issued to .~t~.Q .Ceceh21i .... 0qlx,.,,e ...............................
(owner, lessee or tenant )
of the aforesaid building.
Suffolk County Department of Health Approval .E ,P,, ...................... ~ ........
LrNDERWRITERS CERTIFICATE No. N,R., ........................................
HOUSE NUMBER ..... .~07~ .... Street .. Lake. I~z,e; e ..... 3outho.l<t .............
! Building ln.~poctor
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building
Inspector.
b. Plot plan showing location of lot and of buildings on premises, relationship to od}oining premises or public streets or
areas, and giving a detailed description of layout of property 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 progress of 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, ordi nonces, building code, housing code, and regulations.
&
'" i~'i'~;'~'~';~";~c 't~'~ii'~;"~'r"r~'~'e, if a corporatio~'i ........
.................. ...................................
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises .....~...~.....~......~....~'.~ ....................................................................................
If applicant is a corporate,.signature of duly authorized officer. ~
.................. ......... , 'x . /
1. Location of [and on which proposed work w be done Map No - ./.......-'~.... Lot No l~.. .... '~
Street and Number ..~:.....~..¢~.,~".~:......~...~.'/.~./.((..~-.. ...... ,........~....~'~..~......~....~./~....~....2 .~_~ ~ ....... "~ ............
Municipality
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Exisiting use and occupancy ....... Z~.~x~'.,/~.~...¢.~¢~ .............................................................................
'~~'~, ' ~c ~t~' ~6~- ...................... ' ....
b. Intended use and occupancy ..... .x~ ........... .~.~..~. ........ .~. ........................................ . ..
-/
3. ~,,~qature of work (check which applicable): New 'Building .................. Addition ~ Alteration
, R~epair .................. RemOVal .................. Demolition .................. Other Work (Describe) ........................................
4. ~stimated Cost ............................. ~. ...... : ..................... 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, 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 ................................... ~ Rear ............................ Depth ........................
Height .................... Number of Stories ........................ i .............................................................................................
Size of lot: Front ..... ..~...~.:..g..&..~. ........ Rear ~. ~/' ~'
.................................. Depth ....~..~..~. ..................
Date of Purchase ......... ./...~..~.~.. ................................. Nome of Former Owner ........................................................
Zone or use district in which premises are situated .....................................................................................................
Does proposed construction violate any zo~ning law, ordinance or regu at on? ...............................
Name of Owner of premises ~.~R.....(~....c~...~./..~;. ............... Address ,¥/-Z~. //~ ~-E:. p~n~ee~'l~o~'.~..'~'''~'''~r' .....
Name of Architect ...................................................... Address ............................................ Phone No .....................
Name of Contractor. .............................. ; .................... Address ............................................ Phone No .....................
10.
11.
12.
13.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or pro~osed, and indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate
whether inteFior or comer lot.
STATE OF N~ ~" t,,,, '
COUNTY OF~~/, ~
..... , ...................................... ........... TI,.....ZL ............. being duly sworn, deposes and says that he is the applicant
(No~f individual signing applicati~]~;:;~_ . ~
above named. He is the .................................. ~...'~.......'~f:~. ................................................................................
(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; that all statements contained in this application are true to the best of his knowledge and belief; and
that the work will be performed/
Swam to befo~.~m, e this ~,
................... ~doy of ....~,
Notary Public,. ..........~
he manner set 'forth in the application filed therewith.
/9
.........................
FOI~M ]NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTH'OLD, N. Y.
BUILDING P. ERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N°. 8049 Z
Permission is hereby granted to:
Ken. Senotd ~/C Vito Ceaehini
Southold
w Build an addition & alteration on exi~t~n dwellin ~ Pool
at premises located at S/~ Lake Drive ( ~ Ert Pond) Southold N.Y.
pursuant to application dated ............................... ..~...~. ~. ....... ~....., 19~.~...., and approved by the
Building Inspector.
Fee $.~...~..~...~... ...........
Building Inspector
FOI~ NO. 6
TOWN OF SOUTHOLD
, Building Department
Town Credos 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:
]. 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 supRly 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-existir~j dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
Date ...~....~[.~ ....... ..~.....,... L ..~..12.~. ....
New Building ................ Addition .............. ,.. Old or Pre-existing Building .... '.~.'.. ...... Vacant Land ..............
Location Of Property .... : ............... .~. .................................... /. ..... f.. ' ..........
Owner Or Owners Of Property ............ : ................... .(~-z . ..~.! ..................................................................
Subdivision ................................................................ Lot No ............. Block No ............. House No .............
Permit No. (¢~.f~.~..~.~... Date Of Permit .~.
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 perrr~i-t meets all applicable codes and reg.ula, tions.
Applicant ....... ~,~,>f~'T" ............ <' ~'~*' ~'~' *~' · · *~* "'. .....................
Sworn ,o before me this
~. day of .-.~~..Z~Z. (stomp or ~ ~2
-- ~ ~ ~ ' -- NO~AI{Y PUbLiC, Sfafe of New Yore
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD~, N. Y.
ORDER TO REMEDY VIOLATION
To ..............................
(owner or author:d agent of owner)
PLEASE TAKE NOTICE there exists a violation al:
Zoning Ordinance
Other Applicable Laws, Ordinances or Regulations ............................................
at premises hereinafter described in that ............. te~'~v
// //~~"' ' ation of ~.......~.. ~..~..~.. ff..~...~, ff. '
in via ' . ......................... ~ .............. ~...: ............................... ~ .......................................
(State section or paragraph of applicable law, ordinance or regulation)
YOU ARE THEREFORE DIP~ECTED AND ORDERED to comply with the law and to remedy the
conditions above mentioned forthwith on or before the ..........................
19 .~....~..
The ,premises to which finis OI~DER TO RE/~EDY VIOLATION refers ore situated at
~. ..... 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.