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Home My WebLink About8303-zTOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. g.?~,~ ...... Date ............ .lV!~f?...9 ........, 19.7.7, THIS CERTIFIES that the building located at . .}ta;y~a~;el'.s .]aoarl ......... Street Map No~.s. 5 ,. P~ ... Block No ........... Lot No, 306 ...... ~ichog~e,. E,Y, ..... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Oe.g .. ~7..., 197~.. pursuant to which Building Pemit No..8~03Z. dated ....... ~.qV. ] ~. ........ , 19~/[., was issued, ~d conforms to fll of the requke- ments of the applicable provisions of the law. The occup~cy for which ~is certificate is issued is . P~-Y~..9~..~.~,~. ~!~i~g. ~ith..s,~. ~-~ditl.o.n .................. The certificate is issued to . Ca ~.her ir~e. Eumc~an ..... O~a~er ...................... (owner, lessee or ten,t) of the aforesaid building. Suffolk County Department of Health Approval }[,~l., ................................ UNDERWRITERS CERTIFICATE No. ~',i~. ........................................ HOUSE NUMBER ..... J.1.7~ .... Street .. Iia~¢a.ters. ~oad ..... C~tcho6~e ....... TOWN OF SOOTHOLD BUILDIHG DEPARTM~:NT TOWN CLERK'S OFFICE SOUTHOLD, N~. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8303 Z Permission is hereby granted to: ................... .~.~.e.a.o.~e..: ....................... : ............. ~o..~.z.¢.....a.m...a...a..a. ~.$..o.~....o.~ ...e.~.~..¢v..e..z..Z..~ .............................................................. at premises located at .,~l~t~..~....~j~..~;,~..~.~..~..~ .................................................. ............................................... ~..y~.~.e..~ ~...~o..~ ......... ~..e...~.~ ................................................ pursuant to application dated .........................~...~...;.....~:.~.'~..' ......... , 197,.~..., and approved by the Building Inspector. Fee $.1.~.~,..(~... ........... Building I~spector { . FORM NO. $ TOWIq OF SOUTHOLD, Building Department Town Clerks 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: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusua~ natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disp0sal--(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, o 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 ~3nd 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-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., .......................... '7 ........................... ~ ......................... ~ ................................................. Owner Or Owners Of Property Permit No, ..~.,~...~.~...~... Date Of Permit ./. ~ ...... Applicant . .4~./.~.~...K~f;..~......~./..~...~..~...¥.. ....................... Health Dept. Approval ............................................ Labor Dept. Approval .......................................... ~ ..... Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporary Certificate ........................................ FinoJ Certificate ....~T..~. ................................. Fee Submitted $ ..~..:.:.~b.O ...................... Swor:~/q/before.~... me this ¥ ..... ....... day of Nota~ Public ...... ~ Coun~ MARIAN HEHER ~ · / // ,;'3?A~Y PUBLIC, State of New ~ , No, ~'0-4516410 //~ y~-~ ~Ug, lifled in Nassau Coun~ ~ ~ ~pJres March 30, Construction on above described building and permit meets all applicable codes and regulations. Applicant .............. ~. ,~r.,....../, ~,~ ~ .~, ,~, ,<'.~,~.: ....................... 7ss FOI~I NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION (owner ~' authorized agent of owner) ....... - (address of owner or authorized agent of owner) / / PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance Other Applicable Laws, Ordinances or Regulations ............................................ at premises hereinafter described in that ~/J.~.~.-~..~~ (state character of violation) ~ v ..... ~ [.~.~z Z . ~. ~o~o. ~....~ .~z_.~..z, Y...~..:. ....................................... (State section or paragraph of apphcable law, ordinance or regular*on) YOU ARE THEREFORE DIRECTED AND ORDERED to comply_...~.~/~~ith the I~ to rem~ the conditions ~ve mentioned forthwith on or before the ...... .~~...~~...~.. The premises to whi~ this ORD[R IO~M[~VIOkAIIO~ refers ~re situated ot . . ~y of Suf{olk, Mew York. Failure to remedy the conditions o ply with the applicable provisions of Iow may constitute an offense punishable by fine or imprisonment or both. / Buildin¢ I~spector TOWN OF SOUTHOLD ;~ TOWN CLERKS OFFICE ~UTHOLD, N. Y. APPLICATION FOR BUILDING PERMIT Date ....0..q.~,~.~..e.~',..~.~. .................... , 19...~.5 ..... INSTRUCTIONS e. This application must be completely filled in by typewriter ox 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. Pl~t 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 s]oall be kept on the premises available for inspection throughout 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 far 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, buildii~g code, housing code, and regulations, and to admit authorized inspectors on premises and ir~ buildings for necessary inSpections. ....... ap- .................................................... (Signature of applicant, or name, if a corporation) ............... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber ar builder. ........ ............................................................................................................................................. Name of owner of premises ..... G~.+~.i.~e...~L~e.~g,~J~. .......................................... ; ....................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ....... ~, .......................................... Plumber's License No ................................................. Electrician's License No ............................................. /o~~- II1--~/'-I/ Other Trade's License No ............................................... Location of land on which proposed work will be done. Mop No.~-.,~..*.~e..~l~Lt...~.~..,... Lot No....~)i~ ............... Street and Number ,...~...~.~..~.,~...~.?..~....'~,..O..8*...~.x....~,.~...O..O..~..~.~. ................. i ........................................................................ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ..... .O,~.~..,.~..a:...~.~.]r.~...~..w.~,.~..~...~..~.l~ .............................................................................. b. Intended ese and occupancy .............................................. -7.- 3. Nature of work (check which applicable): New Building'. ................. Addition .......][. ........ Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) 4. Estimated Cost~...L~.,2~f~.g.,D.¢~ ................................... Fee .............. .. ....... m..O ................. ......................................... '~' (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 ......... ~&t ..... Height ..... ~&t ............. Number of Stories ...........Q~ ............................................................................................... Dimensions of same structure with alterations or additions: Front ....... ~ ....................... Rear Depth ........... ~8.t ............... Height ......~4.t ................ Number of Stories ....... ~, ........ ......... 8. Dimensions of entire new construction: Front .................... · ............... Rear ................... . ......... Depth ....... ~ ................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ....... ~.t ........................................ Rear ........ 2~* ......................... Depth ..~.~} ..................... 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ........ '~"~O~ .............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ..~ ................................................. 13. Will lot be regraded . ........ ~ .............. Will excess fill be removed fr~&p~n)R~s (Z) No 14. Name of Owner of premisesg~.~s~ ........ Addre~ ~[~..~e~ Phone No. Name of Architect .............................................................. Address ................................ Phone No. 7.~;6B.65... Name of Contractor ~4.~[e~..~...~e~¢e~ ..................... Address ~e~g~.~e .......... Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil set-~ck d~mension~ from properly lines. Give street and block number or description according to deed, and show street name~a~ whether interior or corner lot. STATE OF NEW Y~K.~//~ COUNTY OF ~'~ ................................................................................................. being duly sworn, deposes and seys that he is the appficam (Nome of individual signing contract) above named. He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform ar have performed the said work and to make end file thls applicatian~ 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 forth in the application filed therewith. Sworn to ~efor~/jq~e this ......... (Signature of applicant)