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Home My WebLink About9403-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Zl1339 Date December 13 19.8.2. THIS CERTIFIES that tl%e ~ti~,. p.o.o.], .......................................... Location o f Property .... 7.6. 9..L.q n. g..C?, e..e .k..D.v..5. y.e.,...S 9.u.~.h..o .1.d. ....................... House No. b~reer Ham/et County Tax Map No. 1000 Section . .5 .5 ......... Block .4. ............. Lot ...8 .............. Subdivision...~.e.n.n.e..c .o~.~. ~.a?.~ ............ Filed Map No..5.1.8..7...Lot No..2.0. .......... conforms substantially to the Application for Building Permit heretofore fried in t~s office dated · 3.qg.u.s.~...1.5. ........ ,197.'/. pursuant to w~ieh Building Permit No..9.4..0.3. g. ............... dated .... g. u. g.u.s.~.. ~.6 .............. 197.7.., was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... .n.e.~. p.v.iya..t.e. ?..,q.t.m.m.t.n. ~. p.o. 9..3. ~t..t:.~..t'.e..n.cp .............................. The certificate isissued to Charles M. Hall (owner, ~e~eee.ee-ee~) of the aforesaid building. Suffolk County Department of Health Approval ....N./.~ ................................... UNDERWRITERS CERTIFICATE NO...~4. 97.~.8. ? ....................................... Building Inspector BU!~DING ~ER~IT (THIS PERMIT MUST BE KEPT ON THE PP, EMISE$ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9~03 Z Date .......................... ~lg ............ $6....., 19...~/.~. Permission is hereby granted to: 26.~....(;.clr.~ .....3.Z'..(L. ~1 e,,s..,,[~L ..................... .......... ~.~:~c ..36.8 ....... ~nkoakoma.....ll.X. ....... at premises located at ....¥,o.t;..,g.O.....~l~c~ecx~, ~.J~ · ..................................... ..L.9~¢ C~.~ ~.~.~X.e .... ~.~.~ho~,d ............................................. pursuant to application dated ........................... ~U~,,,,,,1.~ ............ , 19..,~,~,, and approved by the Building Inspector. Fee $.!~.°..9. ........... FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall 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 Inspec- tor with the following; for new buildings 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-iS-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 installa- tions, 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: I. Accurate survey of peoperty 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 informa- tion required to prepare a certificate, Fees: 1. Certificate of occupancy $5.00 2, Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5,00 Date ..... New Building ............. Old or Pre-existing Building(Z) .. ....... =/Vacant Land ............ Location of Property ?..,.~.O~,~...~?,~...~., . .¢..~-~.,, .~.,, , , ~. ~ ............ ,~, '~' ."~.~.~,=. .......... House No, Srreef~ Hamlet Owner or Owners of Property . .~-~.~. ~ ~ .%~, ,~t~.~.~....~.., .... ~. I.t ..... County Tax Map No. 1000 Section ..... .~.-7.~, ..... Block ..... .~. ........ Lot ..... .~, ......... Subdivision .Y~I~, ,t¢.~.~.~. ~-~.....~..I~..~. ........ Filed Map No ............ Lot No. Health Dept. Approval ........................ Labor Dept. Approval ......................... Underwriters Approval. ~J../¢. ?..~./..~. ':~. ......... Planning Board Approval .................. Request for Temporary Certificate Final Certificat~ ~ Fee Submitted $ Construction on above described building and perf"ir mee~ all appl~,cable~c~d,~s and regu lations. ....... .................. THE NEW YORK BOARD OF FIRE UNDERWRITERS ~m BUREAU OF ELECl'RICITY ~- October24. . jo.. ST.EET..EW VO. ,ooaB ~.,, ~..,~.,,o..o.o.~,. N 407182 THIS CE~IFIES THAT in the following IocationA .[]. B~s_emfq~ E~ i. [] 2nd FI. Section Block Lot was examln~d on t) CTO o e r ]~, 9~ and found to be in compliance with the requirements of this Board. SERVICE DISCC)NNECT NO. O~ S R V I ~ ~' ~W t ~' ~W 3 ~' 3w 3 ~ 4w NO. ~CR~,COHD. OF cc. CO~D. : I C E I-G.F.C.I. (Swlmmln~ Pool) This certificate covers compliance Bt *he date o~ Inspee~lon only. Because of unusual environments It Is advisable *o have frequent test end/or repalrs made by e quellflad person. EXHAUST FANS DIMMERS Hall Eleco 760 Long Creek Dr. Southold, L.t. 11971 LIc.657 E II This certificate must not be altered in any manner;, return to the office of the Board ~f incorrect. Inspectors may be identified by their credentials. COL~P¥_FOR .BUILDI~TW!. I~!!s..cc~?Y OF CERT..IFI LC~TE~ST NOT. M.ALT. KRID IN~M~Y ~ANpr~. __ "~ L TOWN OF S U OLD ',: sOUrHOLD, N..y 11971. , , cng Creek D ":, , : " i.'Southold New York -" 11971 ': .... ..., ,, ....: < ...:,pea~ ,i~. Hail, , ,:. - :., :. ,, .: . ,.,,_.,.,<,,:.,.,... Your pool.has been app.~oved for e.,Certxf~cate ....:.... '...--: <. , -.,:.~Ocoup~cy:'you need. to apply ior the Certificate ..... ':. .-.. ".w~th the flee of $5,00~ . We havea copy of.the Unde~rJters. TOW. O~ SOU~.O~.O ~.~ ~,;~. ~.~ $OUTHOLD, No Y. ORDER TO REMEDY ¥10LATIO~ ~owner 9t/authorized a~ ~ [address o~ owe/er or author Tea agent or owner1 PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance .... escribed in that ~.4Z~.~-~ at premises nereinatter a ~,~ ......................... ~ ~ ~ ~tio~ ot ~st~t~ ~e~io~ o~ p~p~~"-'~"~f'"':pp~'i:::::~%"~: ~:%~:~"ZT~b:,blo:~ .................... YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions ~ mentioned forthwith on or before the ..................... ~..~ ................................ The,,~,, .l::xCmises~>t: wh;,h, this10RDE~TO REMEDY VIOLATION refers are situated at ~,~..~.X~.,7~..~./__~¢?~..o~...~. '~..'...~,..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. IUILDIN DIBArtFMBIT / Disapproved ale ..., ................................................... I ' a. This application rnu~t be completely filled in by .typ~_writer o~. in ink and submitted in trip ioate to the Building Inspector, with3 sds of pinto, occu ~r~te p&cdr plan to scab. Fee Gajx~ding to schedulL . b; Plot p. la.n showing Iocati°n of tot and of buildinge on ~ses, relationship t.o. adjoining premises or ..l~b. lic streets m ~ areas, and giving a detoibd description of layout ofpralIty.must be drawn on the dmgram which is prat of th~ al~lication. d. Upan aPproVal of thil~ bpplication, the I~uilding Impector will issue a Building Permit to the al~licant. Such parmit e. No building shall be occupied or used in whole or in part for any puq~se whatever until a Certificate of Oocupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADi~ to the Building Department for the issuance of a Building Pem~it pumuant to the Building Zone Ordinance of the Town of Southo~d, Suffolk Crawly, New York, and other al~icable Laq~ ~ or Regulations, for the construction of buildings, additiom4~ o1~, or/4~ _mmovat' or dm~lition, m heroin d~ctibecl. The applicant agrees to comply with all applicable lows, ordina~__~, bu/lding ~:odg~'~ml~ade~ and raguloflam, and to admit authorized inq~ctors off premises and in buildings for new, oilI in~;~fctMJ~ 'c~ ' ] , // ......... ............... (Signature of applicont, or name, if a corix)ration) (, ldrbss of applicant) r .... 7"" State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................... : ....................... ...................................................... ........................................................................ Name of owner of premises ......... ~'~.~.~..~...~...~.....~..'.....~.,~:)../m.....~'... ............................................................................ If applicant is a corporate, signature of duly authorized officer. (Nome and title of corpprate officer) Builder's Liceflse No ................. Plumber's License No. .............................. : ................. Electrician's License No ....... ~7~....~ ........ Other Trode's License No ............................................... Location of land on which prq:x:m~l work will be done. MaP No.: ,.....~.../..~...~. ..................Lot No ........ ..~:.....O.. ........ Street and Number ............................. ~ .............. ' '. ....... : .................... State existing use and occupancy of premises and intended use and occupancy of praposed comtruction: a. Exisiting use and occupancy ............ ..'~.....~....~.,..: ...................................................................................................... b. In~nded use and cacupancy .......... ,~.~../.~?~.~./../~.....~......."~....~..~....~...~ ........ ' ..................................................... 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration' .....: ......... j~. 0-O~. (Description) (to be paid on filing this application) 5. If dwelling, number of clwell!ng ·units ............................ Number of dwelling units on each floor ............................ If garage, number of cars .............................................................................................. 6. If business, commemial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ....... .~....~. .............. Rear ........ .~...~. .................. Depth ......~..'7. ......... Height ....... /..~'.. ........... Number of Stories ....... ,.../ ................................................................................................... Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stori.e~ ................................. , 8. t~lmens,ons o1' entire new cOnstruction: 'front ..~./~..~...-~h ............... Rear ............................ Depth ......... Height .................... Number of Stories ...................................................................................................................... 10. Date of Purchase ........................................................ Name of Former Owner ....................................................... 1 1. Zone or use district in which premises ore situated ...... ~..~....' ........................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ~ O 13. Will lot be regraded ............. ..~.....?.. ...... Will excess fill be removed from premises: (~) Yes ( ) No Nome of Architect .............................................................. Address ................................ Phone No. ...................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, 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 interior or corner lot. STATE OF NEW YORK, ~ c c COUNTY OF ................................ t'~'~ ................................ · ,~..~.,/~J...~......~.~'~.~.~../~..~/~. ............. being duly sworn, deposes and says that he is the applicon, (Name of individual signing contrecf) - above named. He is the .................................................................... ./,~.,,~,,.,.~,...,.A~.....T... .................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to I~erform or have performed the said work and to make and file this application; that all statements contained in this applicoHon gr~..t.rue to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the app){cation') filed Swam to before me this ~ [ ~ ~ / / ..... ............ // ~ // FRANCES HESSIN/I ~ ~ ~ (Sig~l~re oTapplicant) NOTARY PUBLIC, Slate el Ney, Yor~ Ne. 52-4i4899~ ~~Commlsflon Ex~Jres~,~~~leKh 30, t~ 7~ L t