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Home My WebLink About9465-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No. Z1028'~ Date December 2 ., 19 ..8.0 THIS CERTIFIES that the building ................................................ I.~80 Sandy Beach Road, O~e~o~, N,Y, ~fion of ~op~y ~ ~o[ ....................... ~i ....................... Co~W T~ Map No. 1000 ~ction ~ . .Block ~ .Lot q q Sub~ion ............................... Filed Map No ......... Lot No .............. confo~s subst~t~y to ~e AppOrtion for B~g Pe~it heretofore ~ded ~ ~ offi~ dat~ Sept~ber Z dated S ~t ~b er 2 3, 19 .~, w~ ~ued, ~d confoms ~o ~ of the requ~men~s of ~e applicable prov~o~ of ~he ~w. ~e occup~cy for w~ch ~s ce~e ~ ~ued ~ ......... Richard Fie~ er ~e ce~cate ~ ~ued ~o ........................................................... of ~e afo~e~d b~d~g. Suffo~ Co~W Dep~en~ of HeM~h Appro~ ...~ .................................... ~BRWRITERS CERTIF~CATE NO. N~ Re~ TOWN OF SOUTHOLD BUILDIN~ DEPARTMENT 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? 9~65 Z Permission is hereby granted to: .~.~.~...~ ~.~.e...r. ........................................... ....... ~..~.~ .......... ~.~1~.~.~. ..................... to .~ ,u..~,~!...~.~,.~...~...r..~.v.,~ ~....e..~ ~..e..~:..~.?. ?. ~....~.t..9.r.,~ g,e...~..u. ~.~.~.n. g ................................................. at premises located at ...L~.~.~ ....... ~.,,.~,~}~..~.~,~ ................................................................................ ..................................................... ~: ~.~.~ ~.~ ..................................................................................... pursuant to application dated .............................. ~.p.~..~.~ ......... , 19.~.~..., and approved by the Building Inzpector. Fee $,.1.~.,.0~). .......... fl_ Building I n~'t~ FORM NO. 6 TOWN OF $OUTHOLD 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 featu res. 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 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. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of peoperty showing all property lines, streets, buildings and unusual natural or topographic featu res. 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. 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 Date .... ~, ~: . , ,/ .... / ~..~. · · · New Building ...... ~ ..... Old or Pre-existing Building ............ Vacant Land ............. Location of Property /~O ~'/~C~L ~, ~P~-.~__/~..~./~ House No, Street Hamlet Owner or Owners of Property ..... .~. ~/~.~ ....... ~.L~./~,'~/~ ...................... County Tax Map No. 1000 Section ............... Block ~ '~ Lot - -- l Subdivision /: . .Filed Map No. .Lot No, Permit No. ~. ;~.~.~..~. Date of Permit .7.Applicant.... /.d,' ? ..... Health Dept. Approval ......................... Labor Dept. Approval ........................ Underwriters Approval ........................ Planning Board Approval ...................... Request for Temporary Certifica~? .~/ ................. Final Certificate ~/ FeeSubm,,te $ ..... ..... Construction on above described building and permj~r~eets all applicab~e~code~and regulations. FORM NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION (owner ~r authorized agent of owner) , 13~0 Sandy Beach Road ................. ~r~enpom~.,...~.~ ............................. (address of owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violation of: Zoning Ordinance ART. XIV Other Applicable Laws, Ordinances'or Regulations ............................................ at premises hereinafter described in that .......... ,B...u..i..~..,d..i...n.g....P..e,,..z~...,i.$...~...~.~,~. ............................ (state charQcter of violation) ,..d.~..e..d.. ...... .9.../.~.3.../. Z.y' .......... .h...a...8... ?...z, p.$.C.e..~..........y.g..u.....~.~.e.... ~..e..q.u..$.~?.9..8.....t; 9... ~.p. gly,. ~ ~ ~ ..~ ..... ne.w., permit. , . , . in violation of .......... ,~.?...O..:.?.,O.,0.'TJ..]g:.~...~. ................................................................................................. (Stgte section ~r paragraph of applicable Iow,. ordinance or regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the .................... ]..2.~..h. ......................................... day of ............ .D...e..o...e..~..b...e.?,. ...................... , 19...8..,0.. es to which this ORD,~;~ TO REMEDY VIOLATION refers ore situated at Failure to remedy thq conditions aforesaid and to comply with the applicable provisions of law may constitute an offense punishable by fine or imprisonment or both. u~ dmg Inspector FO~ NO. ! TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .... ~ ...................... , 19..Z.~ ........................................ , 19 ........ Permit No .................................... Disapproved e/c ..... ~ .......................................................................... ..................... ......... APPLICATION FOR BUILDING PERMIT ~ INSTRUCTION$ 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 ~ale. Fee according ~o schedule, b. Plat plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout ofproper~ must be drawn on the diagram which is pa~ of ~his application. c. The work covered by this application may not be commenced before issuance o~ 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 port for any purpose whatever until a Certificate of Occupancy shall hove 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 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 in buildings for n~essa~ inspections. ~Signature of appl~ant, or name, it a corporation) ......... .......... (Address of applicant) x~ State whether applicant is owner, lessee, agent, architect, engh~eer, general contractor, electrician, plumber or builder. ........................ ....................................................................................................................................................... of owner of .................. ........ .............................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. Plumber's License No .................. .~.1 ............................ Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Map No.: .......... 2('.,,k~. ...................... Lot No...,~.~.~. .......... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: 3. Nature of work (check which applicable): New Building ....... k~, ......Addition .................. Alteration .............. Repair .................. Removal oE..f)/.O. ..... Demolitior- .................... Other Work ................................................... ~el6j~ Il(JO, (Description) 4. Estimated Cost ............................................................ Fee /b ~ (to be paid on filing this application) 5. If dwelling, number oi dwelling units ........................... Number oF dwelling units on each floor ..... , ...................... If garage, number et cars ................................................................................................................... 6. If business, coJnrnerciol or m~xed occupancy, sparely ~an~re and extent of ea~ch type of use ........... ~..; ........... 7. Dimensions of existing shuctures, ii any: F*unt .......... ~....' ........... Rear .......... ~.. ................... Depth .................... Heighl .......... ~ ........... Number of Stories I Dimensions of same stna,,tore with altmatious or ~cl~ ;lions; mord' ................................... Rear ............................ Depth ............................... Height ................ Iqu,'al cr of Stories ................................ 8. Dimensions of entire new construction: Fronl ......... /.~ .......... Rear ..............]~.. ......... Depth Height .~.[~.~,o,?.~...~. NLiml)er of Stories ......... ( .................................................................................... 9. Size of lot: Front ............. /ad ................................ iL,,,, .................. ~ ....................Doth ../.~0 .......... /..0...~..,..~... 10. Date of Pmchase ......................................... b,lnme of kormer Owner .... /~¢.~.j~.~......~-.J,~/~.~.,G.~.~ ............. 1 1. Zone or use district in which premises are situuted ................... .~.O.-.-L/..~.L~/f~/-D.....~:~).~D-/2¢ ....................................... 12. Does proposed construction violate any zoning law, ordinance or regulatioa: ........................................................ 13, Will lot be regraded .......... ..~..O. ........... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ..~(C.'.L'g~..~D ....... .~.I.E.,~..~,~.")~ ........ Address J~.~..O....~./~..f.-/... ,~,D.... Phone No. Name of Architect ....~, ............................ ~ ........... Address ................. ~ .......... Phone No ....................... IX!ama of Contractor ....... .~,rJdress .~ .................. ,~./..:.. enone I'~O .................... PL(.)I DI/\(~,RAM (-¢~/~' ¢/1)/ 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, end show street names and indicate whether interior or comer Io% CTA'TE OF NEW YOI~.I(, I ~- ~. ....... : ...... . ...... -.:.,, is ~ -- ~~--(Name o~ inUividLmol signing contmcf) aboF ~med. ........... .......................................................................................................... (Contractor, agent, corporute officer, etc.) of said owner or owners, end is duly authorized to perform or have performed the said work and to make and file th s,app cat on; that all statements contained in~t~s application are true to ~he best of his knowledge and belief; and that the work will be performed in the manner s~fff~ the apphcotion filed therewith. 4 Sworn to before me this ~ ~ , ~ -- '~ v - ~J~ ¢ ~ ~ ~ ~ jzl(Signture~licanf)