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HomeMy WebLinkAbout9460-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No..z.~?.395 .......... Date .... ~13~5.&i~¥. 2.9. ................ 195.6. THIS CERTIFIES that the building ...P~ C C ~3.S 0 ~ 7 ................................... Location of Property . .295.0.. C/~FI.E .~l~[~.g0L& .I~I~ .............. ?{/i?T2.TtJCK ............ House No. Street Hamle~ ~ounty 'Tax Map ]No. ]000 Section . . ] 2,3 ....... Block ..... ~5 ......... Lot .... 5 ............ Subdivision ............................... Filed Map [No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated .S~ .E?.T.E.H...B ~.R.. ] 9 ....... 19.7.'/. pursuant to which Building Permit No .... .9.4.~ 9.Z ............ dated .S.E. ?.T.E.~. B..~..2. 9 ............. 19 7.7., 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 ......... The certificate is issued to ...J. g~I.E.~..KB.E.H. ...... [o~n'e),'l~'~e'~r't~,3a'n'tI ...................... of the aforesaid building. Suffolk County Department of Health Approval ...~J ./b .................................... UNDERWRITERS CERTIFICATE NO .................................................. Building Inspector BUILDING DEI~ARTMENT~: : SOUTHOLD, N~ Y. BUILDING ~ERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9 60 Z Permission is hereby granted to: ..... ~:~ ~:~c: ~.....i.~c ~..h ................................................ ............ .~::~. ~.~ :;-,. L~.~.c.:J; .............................................. to ...... ;):>L L;J,.~...,~L':~.~.',L..~.q.?. ~ .:'~ '.Lg.~ .~L · · Z;~.~: ~.~ f L · .~ .~.~.~ =.~ ~.~. .................................................................. at premises located at ..... ~;::.~...~'..~D.9.~-'~...;~,r.;;~-'~ .............................................................................. .................................................. j..~.~.'~ L~.'!~:~..q .k:'..... ~:~ ;%... .......................................................................... pursuant to application dated .......................~.~L....2£! .............. , 19.~..., and (~pproved by the Building Inspector. Fee $..!..0..'.~!? ........... Building Inspector FOBM NO. 6 TOWN 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 triplicate 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 supply 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 ]957), 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~existing dwelling or land use $5.00 / 3. Copy of certificate of occupancy $1.00 ~/// Da,e ........ New Building ....... ~. ......... Old or Pre-existing Building ............................ Vacant Land ........... ................ Owner Or ~ners Of Property~ ~- ' ~~ ~~ Subd,v,sion ...................................................... :.... Lot No....~.. Block ~...~.-;~ouse No ............. Permit No....~.~.~.~.. Date O~rmit ...~..~.Z~pplicant ...... ~.~ Health Dept. Approval ............................................ Labor Dept. Approval~ ........ ~J ................................... Underwriters Approval .............~ ........................... Planning Board Approval .............~'~ ................... Request For Tempora~ Ce~ificate ........ :~ ...................... Final Certificate ..................................... ...4..V.... Fee Submitted $ .......~ ........................ / Construction on above described building and ~it meets all applicab~ c~e~nd regulati~s. ................ day of ............................................ (stamp or seal) Notary Public .................................... County JUL. FOI~M NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION Dote ................ .: .................... (owner or authorized agent of owner) (address o~ owner ~)r authorizeo agent aT owner} PLEASE TAKE NOTICE there exists a violation of: Other Applicable Laws, Ordinances'or Regulations ............................................ (State section or paragraph of applicable law, ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions obove mentioned forthwith on or be{ore the .................... ~..~. .................................. The premises to which this ORDER TO REMEDY VIOLATION refers are situated at '~C?~-~(~)...~.Zt~.~ ...,:~/./~/~ ~..~.../'~./~.:...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. r-y' ~A T T/TU~K TOWN OF BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~UTHOLD, N. Y. ........................................ ,~ ~ .................................... ~ved ~I~ ................. ~~....~~~~~~~ ................................................ ..................... Application No ................................ APPLICATION FOR BUILDING PERMIT INSTRUCTION$ a. This application must be completely filled in by typewriter or~ in ink and submitted in triplicate to the Building-~ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedu e b. Plot plan showing location of lot and of buildings on premises relationship to adjo n ng premises or public streets oE areas, and giving a detailed descr pt on 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 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 applicab e Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolit on, as herein described. The applicant agrees to comply with all app icable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ress o applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractbr, electrician, plumber or builder. z ................................................................................. (Name and title of corporate officer) Bui,der's , ic se No ......... ............. /: . Plumber's License No ...... ,m~'..~ .................... Electrician's License No ..... ,,<:~Z~.~ ................. Other Trade's License No ......... ~.~;.~ ................ Location of land on which proposed work will be done. ~ap No.: ......... . ............. Lot No ....... Street and Number ......... .~..~.'~...C?. ........... ~-"¢~.~:L~..'-.~~4'/.-~.~.. .j/~-.~ ~.~..' · ........ iiiiiiiiiiiiiiiiii Municipality State existing use and occupancy of premises and in~ended use and occupancy of proposed construction: a. I:xisiting use and occupancy ...... j~..~ck.&~.: ................................................................................................ b. Intended use and occupancy ......... ~.~.~(. . ................ 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work ..........,~...6~.~..~ .............. (Description) 4. Estimated Cost .....~7..~.~..~].,.O..J~..~,~ ............................. Fee .L0.. ................................................................................... (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 ...... ~,'~.u .................................................................................................................. 6. If business, commercial ar 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 ................................ / SJ ....... ........... o~.~. ........ Depth ..... o~.. ........ 8. Dimensions of entire new construction: Front .......... oQ.~' ................... Rear Height ....... .~.~.(. .... Number of Stories .............~ .................................................................................................... Cj ~ 9. size of lot: Front .............. z3J..'.. ............................... Rear ........ 6 ............................... Depth ..... o~..~... ............... I0. Dote of porch°se ............. /P.d.7.. ............................... Name of 6ormer owner ....P...~..~z~.~.....I.-...~.~..~..~...,...d~... I I. Zone or use district in which premises are situated .......... ~.~.¢0..., ............................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... ~..O ........................................... 13. Will lot be regraded . ................ //Z'..~... Will excess f, jll be removed from premises: ( ) Yes 14. Name of Owner of premises .....~.~1.¢¢~,...../~,.~...~.~ ......... Address .,,P~ ................ Phon~ No, ~.~.r~'..~....~.. Name of Architect .............................................................. Address ................................ Phone No ....................... Nome 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 lines. Give street and block number or description accordin9 to deed, and show street names and indicate whether interior or corner Iol. ~TATE OF NEW~ ~RI~ ~'Z'/ COUN'F¥ ©F .... ' .................................. ba n~ duly sworn, doposes ond s~ys that he is the (~ame of individual si~nin~ contr~cf) ~bove n~med. He is the ................................................................................................................................................................................. (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 tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn to b~e me this , ~ ~..~ ~ ~ , / - , , applicant} JUDITH T. T~RR? ~ ' ~Jo. 52 L3~';DZ3 ~':~,03( Coml~ ,~ gommi~sion Expiros ~v, arch 30, 7 · ', FORiVi NO. 1 TCWN O? SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ................ , 19... Approved ................ , 19...Permit No ............ Disapproved a/c ....... '. ............................ '. Application No ............... (Building Inspector).; APPLICATION FOR BUILDING PERMIT Date ................... t9 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Build 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 ~trc or areas, and giving a detaile~l description of layout of property must be drawn on the dia~am which is part ot~this ap' cation. c. Tile work covered by this application may not be commenced before issuance of Building Permit. d. Upon apprc.'al of this application, the Building Inspector will issue a Building Permit to thc applicant. Such per. shall be kept on the premises available for inspection .throughout the work. e. No buildi:~g shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Oecupar shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for th~ issuance of a Building Permit pursuant to Building Zone Ordinance of the Town bf Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, a~ herein describ TEe applicant agrees to comply with all applicable laws, ordinances, building code, .housing code, and regulations, and admit authorized inspectors on premises and in buildin~ for necessary inspections. · (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State wbeth.¢~, ~' " rio app.~cant ~s owner, lessee, agent, architect, engineer, genera}./cont tor, electrician, plumber or bulk! (as on the tax roll or latest deed) If applicant is a corporation, signature of duly attthorized officer. (Name and title of corporate officer) Bt, lder's L cerise No X ,-. . f)o ...... ..... Plmnber's Licens". No ......... V ........... E1 .... ~ ' actr,c,an s L,cense No ...... ./Z....NX. ........ Other Trade's License No..../ ................. Location of land on which proposed work will be done.. ~.'r~ ~ ~'~, ~"~../~ . Rd.. ~.~. ~'.$'.O. ). ....... ........... .sr2/ TJ .J ....... House Number Hamlet County Tax Map No. 1000 Section .................. Block .................. Lot ................. Subdivision ..................................... Filed Map No ............... Lot ............. (Name) 2. State existing use and occupancy of premises and intended us~,.and occupancy of proposed construction: a. Existing use and occupancy .... i~....~.ei/'. ~' ./~ ,; .,~.. 5'.~. ,~:E ~..~. ........... ~0. 12. 14. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ... ;~ .... Repair Rezno:'al D:molit~on Other Work ,.~,./.~.(~. ~t~ ~ ~ (Description) Estimated Cost ........................... Fee .............. :...'7~ ........ .~...._._~.. (to be paid on filing this application) If dwelling, number of dwelling onits ............... Number of dwelling units on each floor .............. If garage number of cars If business, commercial or mixed occupancy, specify ~,ature and extent of each type of use ................... Dimensions of existing structures if any: Front ' Rear Depth Height Ntu ~ber of Stones Dimensions of same structure with alterations or additions: Front ................. Rear ............... Depth ...................... I-Iciest ...................... Number of Stories ............... Dimensions of entire new construction: Front Rear Depth Height Number of Stories ' Size of lot: Front ' Rear Depth Date df Purchase ............................. Name of Former Owner ...................... Zone di th in hict p ~ises resit ated ' or us~ s ct w 1 ren a u ........................... "~. Does proposed construction violate any zoning law, ordinance or regulation: ......................... Will lot be regraded .......... · .................. Will excess fill be removed from premises: Yes lq Name of Owner of premises .................... Address ................... Phone No ............... Name o," Architect · Address Phone No Name of Contractor .......................... Address ................... Phone No ............... PLOT DIAGRAM ~" Locate clearly and distinctly fil bui!din~, whether existing or proposed, and, indicate a]l set-back dimensions fror p~operty lines. Give street and block number or description according to deed, and show street names and indicate whethe ',aterior or corner lot; f'----'~ Top Yloo,'- ~'FATE OF NE%V Y6ORK.ff ~, ~ C_OUNTY OF:~ S.S ~ - (NaMe oCi~vidual signing contract) named. ..... being duly sworn, deposes and says that he is the applicon [4e is the ' (Contractor, agent, corporate officer, etc.) o-f said Owner or own'ers, m~d is duly authorized to perform or have performed the said work and to make and file thi: cti~plication; fl~at all statements contained in this application are true to thc best of his knowledge and belief; and that th, Work will be performed in the manner set forth hi the application filed fi~erewith. ~orn to before me~