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Home My WebLink About8248-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate O[ Occupancy No Z7576 Date t%r 21. lg 77 THIS CERTIFIES that the building located at ...NP~..8..m~..fP.~...L~..u.~. ...... Street Map No. ~ Block No. ~ .Lot No, ~ ~ew 8mffolk conforms substantially ~o the Application ~or Building Permit heretofore filed in this office dated ........... 0q~...~.?..., 19 ?~. pursuant to which Building Permit No.. dated ............. ~...~?.., 19.?~., was issued, ~d confor~ to ~1 of %he requ~ ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private one family dwelling with add~.tion (deck) The certificate is issued to Fra~ ~ Peggy MaJeski ~ers (owner, lessee or ten.t) of the aforesaid building. N.H. Suffolk County Department of Health Approval .................................... UNDERWRITERS CERTIFICATE No. ~?~ ....................................... HOUSE NUMBER ~20 Street New Suffolk Lane New Suffolk -- Bu{]ding Inspect(~r FORM NO. 2 TOWN OF SOUTHO£D BUILDING DEPARTMENT TOWN CLERK'S OFPI¢£ SOUTHOLD, N~. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8248 Z Building Inspector. STATE OF NEB' YORK : COUNTY OF SUFFOLK _ _ _ .J_ ~ _s_ .T_ .I_g..E_ ...... COURT ..... ~Qgla ............. 0 F-----SDL!~II~ c~T,r) ............................................ a~ainst Frank and Pe[[flfg. M._ajeski Defendant nf rrnalim .... 2ia~a~:d._Terry.~.._B__u_.i..~.4_i_.n_q....i..n_~.p.e.C.~c~r ........................... &.._~..., residing a Jock_e_y Creek Drive~ Southold~ New York .......... , by this information make written accusation as follows: That Frank and Peqqv Maj_eski ........................................ on d~v of Januar7 19 _7__7_ ....... at .a520 New Suffolk Lan~_ ........................................ -' ....................................................... in the Hamlet of New Suffolk · o.~ ak ,New York, di~ County ok__o.~_~_~_g_~_ .................................................................................... coromxt the offense of occ~u.p..yzD,q ad_d_!tJ-oD..o._n. a (mi.r. dam~xqaor--) (violation) in violation el Section .._~X_%_._...X._I_Y_~..-S--e-.g.,---L-QII=Z~LI--~--£I-)~f ~ Chapter 100 of the-Code of the TOwn of Southold ..._C.-_.-__-_n.-__tr_-__-?ba~r~ene~Sta~*~q~w-Y~rk, in that (s)he did, at the aforesaid time and place Count One: occupy addition built on,to existing dwelling located on the above mentioned premises without applying for or receiving a Certificate of Occupancy. The facts upon which this information is based are as follows: Frank and Peggy Majeski obtained Building Permit #8248Z on October 17, 1975, and built an addition onto an existing building. After due notice by mail, they have failed to apply for or obtain a Certificate of Occupancy. Wherefore, Complainant prays that---.-F--r. 9--n.-k---a--n--d----P--e-~tg~---M--a-j-¢-$3ii ............................. be dealt with pursuant to law. **Subscribed and Sworn to before me on .............................. , 19 ..... · Town Justice Title or Office / //; /,, , , / Complainant Howard Terry, Building Inspector *set forth statutory language constituting the offense **use only one Wherefore, Complainant prays tbat ............................................................................. be dealt with pursuant to law. *'Subscribed aod Sworn to before me on ........................................................ , 19 ....... Complainant Title or Office *set forth statutory language constituting the offense **Verification By Subscription and Notice Pursuant to CPL Section 100.30, subd. 1, par. d False statements made in the foregoing instrument are punishable as a Class A misdemeanor pursuant to sectloa 210.45 of the Penal Law. Accordingly and with notice of the foregoing, I hereby affirm that the foregoing statements of facts are true, under penalty of periury, this day of. 19 _. Complainant An appearance ticket has been issued herein on ................................................................... by ..................................................................................................... , directing the said to appear be[ore this court on the ................ day o[. .......................................................... , 19 ......... and ball in the amount of has been posted with Complete above only if appearance ticket has been issued) ACCUSAT~O RY INSTRUM£NT INFORMATION - GENERAL C.P.L. 100,15 FORM NO. 256 WILLIAMSON LAW J~OOK CO., ROCHESTER. N. Y. 14609 }nf rmatim ................................................... , by this information makes written accusation as follows: a (~iolation)in violation of Secuon ~: ~ Z.~ P.L/.~.~ ....~_.J....of the v of the State of New York, in that ~ did, at the aforesaid time and place* The facts upon which th{s informa[~on is based are as follows: The foregoing factual allegations are ba~ed upon personaJ knowledge of the complainant (and upon information and belief, the sources of ¢ompJaJnants information and belief being, $~herelore, Complainant prays that ............................................................................. be dealt with pursuant to law. **Subscribed and Sworn to before me on Complainant Title or Office *set forth statutory language constituting the offense *~Verilication By Subscription and Notice Pursuant to CPL Sectiou 100.30, subd. 1, par. tl False statements made in the foregoing instrument are puuishable as a Class A misdemeanor pursuant to section 210.45 of the Penal Law. Accordingly aud with notice of the foregoing, l hereby affirm that the foregoing statements of facts are true, under penalty of periury, this . day of. 19 Complainant An appearance ticket has been issued herein on ................................................................... by ..................................................................................................... , directing the said ...................................................................................... to appear before this court on the ................ day of ........................................................... , 19 ......... and bail in the amount of ...................................................................................................... has been posted with Complete above only if appearance ticket has been issued) TOWN OF $OUTHOLD i~t BUILDING DEPARTMENT ~/~~ ,~ TOWN CLERK'S OFFICE ~UTHOLD, N.Y. ~. ~is~pror~d ~/~ ........................... ].]......-...-.m~ .......................................... Date (~/- ~-. .. ., 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 or 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. e, No building shall be occupied 0r used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION I.S 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 ir~ buildings for necessary inspections. (Signature of applicant, c~rname, if. c~corpor~tj~on) ~.~ J State whether applicant is owner, lessee~,~xgent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of pr~~ . ~ ' (Name and title of corporate officer) Builder's License No ......... ~ .......................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... ?l~'/~, ~ I 2. State existing use and accupancy of premises ~nd intended use an~occuppncy of proposed construction: b. Intended use and occupancy .......... ~...''~..~~'...~~ ............ 3. Nature of work (check which applicable): New Building~· ................. Additio Iteration ................ Repair .................. Removal .................. Demolition .................... Other Work ................. ~....~ ......................... ~... ~ ~ ' (Description) 4. Estimated Cost ................... ~.,f~,.~,,~,~/ ......... .. ............ Fee .L..~. ................................................................................ (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, spec)f~_~.~rrjature end extent~,.~ ,,at eoch~tx,q,e)of use ...........~r' ,,-, ,,~"f ........... Dimensions of e~jsting structures, if any: Front ..... ..~.../.....X...~ Rear ...~."~..../........ Depth 7. / Height ......... .........Number of Stories ..... ~¢~......~......~.~.~..;~ ............................ ~_7.~.~.../. ....... Dimensions of same structure with alterations or additions:~-'''Front ....... .."7~....¢~... ................. Rear .......-~...../... .......... Depth .....~.,.7..~. ........ Height .......... :~. ............... Number of Stories ..... ~:¢~ ............. 8. Dimensions of entire new construction: Front .................................... Rear .................. Z ........ Depth ........................ Height ...~.:;;.....':'. ..... Number of Stories ........ .~.~...i....' ................................. z ...................................... ~-~....'/' .............. 9. Size of lot: Front .......... .~...~.'.' .~.... ............................. Rear .....~.~.i~.,~.....~.~....~7..~.....-S'. ..... Delpt~.~,n...'~... 10. Date of Purchase .......... .~..~..,~....~... ......................... Name of F~j'mer Owner'"'" "" ~' '" .T'~., ..,...... 11. Zone or use district in which premises are situated .................wt'Z~....: ........................................................................ 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ...... ~..~. ...................................... 13. Will lot be regraded .....w~.~,.) ............. Will 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 ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property fines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ~S.S COUNTY OF ..:~1~,{¢~.1.~. .......... f .......................................................... ,~ .................... being duly sworn, deposes end says that he is the applicom ¢1~ ~ individ~~tf) above named. He is the ~ ~for, 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 in the manner set fo~h Jn the application filed therewith. Sworn to before me this '""'t'~'**'"' day of ~....,. ............................, 19~ ...... ............................ .......................... ~'~ .... -(~,gnoture of ~licant) NOTARY ptIB~{;, ~te o~ ~:~ ..,,?/~ No. 52.8125850, Sufiolk Oo[mtv