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Home My WebLink About7978-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy No.Z?.~. ....... Date ............. ~ep$;. RI~ .... , 19.?~5. THIS CERTIFIES that the building located at . ...ti®st;view. D.I~i~te ........ Street Map No..~4~ ........ Block No.. ~ ..... Lot No... xX.. Rai;t;ituek ............... conforms substantially to the Application for Building Permit heretofore filed in this office dated ., .......... liar.. 2~ 19..7~ pursuant to which Builai~g Permit No. ~9.~.8Z.. dated ....... ~me-3 , 19.7~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is .P.?.~:!.t.~..s.:.~.~...~..~..~.o.o..~. lit.~., r.~.n.?? .~..~.~..e.?ss.o.r~.$. ................ The certificate is issued to . .El..iz.a.b.e.t.h..~.,..Z.e.S.s.i~..a.. ...".~..e..1- .................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N.~tl, ........................... UNDERWRITERS CERTIFICATE No. ~el~di~ ................................... HOUSE NUMBER ...1680 .... Street . .lge~t;~rie~ .Dl"i.~e ....................... .......Iispe to / .... FO~ NO. ~ TO~VN OF SOUTHOLD BUILDII'4G DEPARTt~ENT TOWN CLERK'S OFFICE SOUTH*OLD, H. Y. BUILDING FER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7978 Z Date ............................. J.'aZ~ .....3 .......... , 19...~..~. Permission is hereby granted to: · C~-~:n~...~i.~-..~e.~ -..t.ne...A./~-. -gt.i ~a.b e.t h ............. 2.~.-C~..,La .......... ~t¢.hegu, ....... to..Y.ns.~a.l.~ .- ~ ~i-ve~ e-. s~ ~ it~ g...p c~e .1...w i .~.h.. ~ e e-e ~-s ~ ,~*-. ~,.. ~'~.n¢.im.g .................... a~-premises located at ...[~S.gVi~..~.~,~V~...(...%25.,...:~./...._..:.~.:-?.[....~.~,d.) .................................... .......................................................... ~a.~-i-~u,e~ -..- .~:- -, .~,- ~, .................................................................. pursuant to oppJicotion dated ....................... [.]~....~ ................ , 19.£p:,..., and approved by the Building Inspector. ~eed lmderwrite~'s c£rt±£Joate :~'or Fee $"~:itO0 .......... FORM NO. 6 TOWN OF SOUTHOLD , Building Department Town Clerks Office Southoid, bi. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This apphcation must be filled ~n typewriter OR ~nk, 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 hnes, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage d~sposal--(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 comphance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed s~te plan requirements where applicable. D. For existing buildings (prior to April 1957), Nan-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 cond,tion of buildings. 3. Date of any housing code or safety inspechon of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 1. Certificate of occup · 2. Certificate of occupanc?-orr pre-existing dwelling or land use $.5.00 [ / 3. Copy of certificate of occupancy $ ] .00 :-~ .~..(.2 .~..2..,~' Date ....................... New Building ................ Addition ......... Old or Pre-existing Building ................ Vacant Land .............. kocot~on Of Property ~:bn;;i:~:ners Of Property---- /~ ' // ' ..... ..,~....~L.:~:...~..,,~~...."~:., Health Dept. Approval ............................................ Labor Dept. Approval ............................................... Underwriters Approval .............................................. Planning Board Approval .~ .................... ~ ............. Request For Tempo~ficate ........................................ Find Certificate ..~/2.~ ....... ~ ................. :/ . Sworn to before me this Applicant ..~~.~~ .......... ~ ............................. .~'..~day of .... :~.~ ..................... ~ (s:~or7 TOWN OF SOUTNOLD , Building Deportment Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFIC~TE OF OCCUF~NCY Instructions A. This applicahon must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: I Final survey of property with accurate location of all buildings, property lines, streets, OhO unusual natural or topographic features. 2 Final approval of Health Dept. of water supply and sewerage disposa! (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 i957), Non-conforming uses, or buildings and "pre*exishng" land uses: I Accurate survey of property showing all property hnes, 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 hous,ng code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupan 2. Certificate of occupancy-~:~r~re-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 .............. Locat,on Of Property ............ ...Z~'..~.~......(~.~... ............ ..~..~/.~...~.. ................................................................. Owner Or Owners Of Property ........ ~...~..~,.~. ,~,, .......... ~,, ........-~.-.~.~'/~.~.,~ ........................................... Subdivision ................................................................ Lot No ............. Block No ............. House No ............ Permit No. Z.~.Z.[...~.. .... Date Of Permit ....~'.4/..,Y'..~..Applicant ........... '*'~¢'~"-~'~'7' ..... '~/~"* "~'~"~" '/' Health Dept. Approval ............................................ Labor Dept. Approval ............................................... Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Temporory_~.~Certificate ........................................ FmoJ Cerhficate ....................................... Fee Submitted $ .... ~ ................... Construction on above described building and permit meets all applicable codes and regulations. Sworn to before me this day of ................. (stamp or _ Notary Public ....... .~fl.,~.;t.-o.L ~.. ...... County ~"~~--'~ """7~'"""'"'~'"I~OT~,R¥ PUBLIC, St~t~ n~ T~r~ ~X~JS March 30 FOI{~ NO. 6 TOWN OF SOUTHOLD , Building Deportment 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 w~th the following; for new buddings or new use: 1. 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 supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of F,re 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 s~te plan requmrements where applicable. B For existing buddings (prior to April 1957), Non-conforming uses, or buddings 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 formation required to prepare a certificate. Fees: ~ 1. Certificate of occupa~.cy $5.00 j 2. Certificate of occupan~e-existing dwelling 3. Copy of certificate of occupancy $1.00 or land use $500 New Bqilding ................ Addition .~.~..Z .... Old or Pre-existing Building ................ Vacant Land .............. kocat,on Of Property .................z~-~...~...~...~.......~.~¢~'~'. ............ ~.,~:/.~....~'.. ....................................................... Owner Or Owners Of Property ........ ~./.~.~.~. ........... .~. ........ ..~...~..~.r~....~.~ ........................................ Subdivis,on ................................................................ Lot No ............. Block No ............. House No ............ Permit No ...~,,..~..~,.~ ....... Date Of Permit ,~.,~,~,.~.,.,..Applican, ........ Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval .............................................. Planning Board Approval ........................................ Request For Te~ficate ....................................... Fined Certificate .......................................... Fee Submitte~ ................... Construction on above described building and permit meets all applicable codes and regulations. ............. Sworn to before me this .~~ of I~.~ ~ ~_~ (stamp or seol) NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOL.ATION (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of Zomng Ordinance Other Apphcable Laws, Ordinances or Regulations ............................................ at premises hereinafter described in that ~..~....~ ' _~.- /_, (Ff~/~ch.aractez °f v,'°lot'°n) ,n .... ~,..~..Z.r~.....":~.....: ...... .C.C..,~ .... ~. ....................................................... YOU ARE THEREFORE DIRECTED AND ORDERED to comply w~th the law and to remedy the cond,t,ons above mentioned//forthwith on or before the .... day of ......... ~..~.~.~ ..................... ".7..~. The premises to which this ORDER TO REMEDY VIOLATION refers are sttuoted at /~.Q/..~....~.F~~:...~..'. ...... County of Suffolk, New York. Failure to remedy the conditions aforesaid and to comply w~th the apphcable provisions of law may constitute an offense punishable by fine or imprisonment or both. B~pector .... FORM NO. S TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLDr, N. Y. ORDER TO REMEDY VIOLATION TO'~.~ ..... ,.~'~. ~ ........ (ow~r or a_ut.hor,z~o~r~'of owner)~_ (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of. Zoning Ordinance Other Apphcable Laws, Ordinances or Regulat,ons ............................................ at premises hereinafter described ~n that ...~...~ (sta~ ~aracter of wolat~on) "-in v,ola ~on :f ....... ~.*.....,~.~.~...~.....~...~.....~... ...... ..'~..~.....~. ..................................................... (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply w~th the Iow and to remedy the conditions above mentioned forthwith on or before the ............... ~....~... ........................................ day of .......... ~,/~7~ ......................... ,I 9..Z~ The premises to which this ORDER TO REMEDY VIOLATION refers are s~tuoted at ..~,~,~..__~ .~,,__~..~__.~',~.... .; ............. C?nty of Suffolk, New York. Foilure to romedy the conditions ~foros~d ond to comply with the ~pphc~ble provisions o~ Iow may constitute an offense punishable by frae or imprisonment or both. Build~ng Inspector FORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a wolanon of. Zoning Ordinance .~.;7/.Z ............... Other Applicable Laws, Ordinances or Regulations ............................................ ........... in violation of .... ~..~c...~..~. ..... ~..~..L...-. ...... .C~..~ ..................................................... .~2. (State section or paragraph of apphcable law,-- ~'crr'd~nance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply, w~th the law and to remedy the cond,tions above ment,oned//forthw,th on or~/bef°re the ..... ~.~~...~..~......~..~t.. do~ of ......... ~./~.~ .................... , ~ The premises to which this ORDER, TO REMEDY VIOLATION refers are situated at /z~"..~....~.~~~,~.:...~...,. ...... County of Suffolk, New York Failure to remedy the conditions aforesaid and to comply with the applicable prows~ons of law may constitute an offense punishable by fine or imprisonment or both. · ~B~pectorl~~ .......... FORM NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION (ow~D~r or a_ut.hor,z/~a~of owner)..m~ (address et owner or authorized agent et owner) PLEASE TAKE NOTICE there exists a wolahon of. Tatung Ordinance Other Apphcable Laws, Ordinances or Regulahons ............................................ at premises hereinafter described in that ...~..~ (sta~ r.~aracter of violation) ~......-...~...~~--,~ :;~..~...~ .......... Z .... -in v,ob[n of ....... ~.,..-.Z~ ...... L~.~. ....... ~....Z ..................................................... (State section or paragraph of apphcable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above menhoned forthwith on or before the ................ ~....~... ........................................ .......... .......................... The premises to which this ORDER TO REMEDY VIOLATION refers are situated at Failure to remedy the conditions aforesaid and to comply w~th the applicable provisions of law may constitute an offense pumshable by fine or imprisonment or both. , J. Bumlding Inspector ~oa~ ~o. z ~.~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E ammed ..... .~ ..................... , Approved ,.~.... ............ :.! ....... ~ ....... , 19Zf Permit No ...... ...~.....~....~....~...~;... , ppro ed ....... ....... '~" ' ~ng Inspector) APPLICATION FOR BUILDING PERMIT Date ................. ~.:~..~ay. ................ , 19..7..~.... INSTRUCTIONS o. Th~s application must be completely filled in by typewriter or m 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 locahon of lot and of buddings on premmes, ~elationsh~p to adjo~mng premmes or public streets o areas, and giving a detailed description of layout ofproperty must be drawn on the dmgram which is part of this apphcation c. The work covered by thru apphcahon may not be commenced before ~ssuance of Building Permit. d Upon approval of this apphcotion, the Building Inspector wdl issue a Budding Permzt to the applicant. Such permi shall be kept on the premises available far 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 Occupanc, 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 th. Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of build~ngs, additions or alterations, or for removal or demolition, as herein describe, The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t. admit authorized inspectors on premises and in, buildings for necessary inspections. (Signature of applicant, or name, if o corporation) (Address of applicant) Cu. tchogue~ New ¥o~'k State whether applicant is owner, lessee, agent, architect, e~gmeer, general contractor, electncian, plumber or builde. Genez'al contractor Name of owner of premises ....................... ..~..%.~.~.b.~..~..I].....~. .... .Z..~g.z..ql.~ .......................... If applicant ~s a corporate, mgnature of duly authorized officer. (Name and title of corporate of/:icer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's kmense No ............................................. Other Trade's bcense No ....... .2..7...7....~...I. ......................... 1 kocohon of land on whmh proposed work wdl be done. Mop No .......................... Lot No .................... Street and Number ............ .~/e~.~.~.e.~..D~:L~.e.r..5.25..t..~..o.£..~:~we~...~o~ ................... Municipality 2 State exmting use and occupancy of premises and intended use and occupancy of proposed construction: a Ex,siting use and occupancy .............. ~.e.§.~..e.~.e...e. ................................................................................. b. Intended use and occupancy .............. ~.o..o..~ ..................................................................................................... 3. Nature of work (check which applicable) New Building .............. Addition ................ Alteration ........ Repair ................Removal ............... Demoht~or ............... Other Work ........ P.o...o. ~ ............................ (Description) 4. Estimated Cost ...... .~.~,..4..2..0.. ................................. Fee (to be pa~d on filing this application) 5 If dwelling, number of dwelhng umts ........... :~...; ...... Number of dwelhng umts on each floor .... ,.]. .................. If garage, number of cars ........ .1~,~, .................... 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use ............. .N...A, ........ 7. D~mens~ons of ex~stmg structures, if any Front .................... Rear ................................ Depth .................... Height ........................ Number of Stones .................. ~ .................................................................................... Dtmensions of same structure with alterations or additions Front ................................... Rear .......................... Depth ............................... Height ...................... Number of Stories ............................. 8 D~mensions of entire new construction: Front .................................. Rear ........................... Depth ................ Height .................Number of Stones ................................................................................................ 9 S~ze of lot Front ..................... .?.,5.! ......................... Rear ...........Z.5.: .................... Depth .....,1,.~ .................. 10. Date of Purchase ..... ;I,~...~'.e.~Z'u.~X',~....;I,~'j'.~. ...... Name of Former Owner .... ,~,~'.~11.t~,~....0~.~.~ ................... ! 1. Zone or use d~stnct in which premises are s~tuated ............. P,~e.s~, ............................................................... 12 Does proposed construction v~olate any zoning law, ordinance or regulation: ......... .~],O. ........................................ 13. Wdl lot be regraded ........................... Will excess fdl be removed fram premises' ( ) Yes ( ) No 1 4 Nome of Owner of premises .... l~,-1J.z~b~t, ll...S~, ..Z, ely,~.u~.aAddress .~/e,~.v.:L~,~...~7:.,... Phone No..2..~..~...,9...]...4.~.. Nome of Arch,tect ....................................... Address ..~.~..t;.~.~..t:.~..~.~.!.....,N~.. Phone No ...................... Nome of Contractor ..l!]~:[N~ ..DZ~...Z:K])OI',~ ............ Address .~,5.O..~a~..~.~,~.e... Phone No. ].~..4...~.0.:;L..0.. PLOT DIAGRAM Cutehogue ~ Locate clearly and d~stmctly all buildings, whether ex~st~ng or proposed, and md~cate all set-back dimensions fron property lines Gwe street and block number or description according to deed, and show street names and ind~cot.. whether interior or corner lot ..................... ~./('.~..-~.........C~..~.~ ..................being duly sworn, deposes and says that he IS the apphca (Ixl~rr~ of"mdivldual sigj?ing contract) ~ above nam~.4~' ~' ~/-)/) .. /]~,._. ~"'.,..~ .-~ ~" /- /-,>':. --~"~' He is the ............................. ~.~] ......... ..~ ...... ~.~..:/'/:...~..,,~.~..~ .................................................. (Contractor, agent, carporat4~'o~t'icer, etc) of said owner or owners, and ~s duly authorized to perform or have performed the sa~d work and to make and f this application, that all staternents contained in th~s apphcat~on are true to the best of h~s knowledge and behef, a thor the work wdl be pfi,,rfur~ed m the manner set forth in the application filed therewith Sworn to befor~ me th~'s. \ ~, =~day of ~ c----,-J----.~ ., 19.~. · ........ ...................................................................................... (._ .) //x~ (Signature of applicant)