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Home My WebLink About9322-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTME~NT, . Town Clerk's Offide' Southold, N.Y. Certificate Of Occupancy Date ..... .J..an.u..a?f. fi..6: ............... 19...Sq THIS CERTIFIES that the budding ................................................ lbocation o f Property ../! !! .5..I.~.l..a .n.d..V. + .e.w..L.?.n.e., ............. q.r.e.e.n?, o..r.t.,...N., y... ..... House No. Street Hamlet 2 27 County Tax Map No. 1000 Section ...~.~ ....... Block .Lot Subdivision ............................... Filed Map No ......... Lot No .............. uonforms substantially to the Application for Building Permit heretofore filed in this office dated .... .J..u~.9..1.6.,. ....... ,19..'/.'/'pursuant to which Build,ns Permit No .... 9...~.2.~..Z. ........... dated .... .J.t~..e...2.1., ............... 19...77, 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 ......... Addition to Existing One Family Pvt. Dwelling The certtficate is ~ssued to . . .R. 9.bg?.~...S.w.~.n. t5 ...................................... (owner, of the aforesaid building. Suffolk County Department of Health Approval .... I}1../.R. .................................. l INDERWRITERS CERTIFICATE NO ..... I~../.f?. .......................................... Building Inspector R my 4/79 FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9322 Z Permission is hereby granted to: ................. ......................................... premises located at ..... ~J~,~I~,..~J~M..~-~J .................................... ~. ........................................... ................................................ , ~'~ ~ ...... ~ ................ , ............... t ........ , ...... ~ .................................................... pumuant to a~ncanon aar~ ................................ ;~ ......... ,.~ ......... , opprov~ the Btfilding Inspector. ., e~, ........................ - ' Building In~ector NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLATION (owner or author,zed agent of owner) Main Road ................. C;u~h~Bu~.~...N.,.Y..~ ............................ (address or owner or authorized agent of owner) PLEASE TAKE NOTICE there exists a violat,on of: Zoning Ordinance ART. XIV Other Applicable Laws, Ordinances'or Regulations ............................................ a~ premises hereinafter described in that ......... ..~..~.~..1..ct.~..~.g...?..e....z~...$.~...~...?.~.?:~.~.. ............................ (state character of violation) ...... .......... ..... ..... ...................................................................................................................................... in violat,on of .......... ................................................................................................ (State section or paragraph of apphcable law, ordinance ar regulation) YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the conditions above mentioned forthwith on or before the ............. 1...2. ?. ..~. ................................................ day of ............ .D...e. ~..e..~..b.. ,e. ?.. ....................... 19..~..0.. The premises to which this ORDER TO REMEDY VIOLATION refers are situated at . .~.~ .~....~.~~.Z/.~.~...~,7.)~'~'.~7.. County of Suffolk, New York. V --/ Failure to remedy the conditions aforesaid and to comply with the apphcable prowsions of law may constitute on offense punishable by fine or imprisonment or both. u, d,ng nspector FOENI NO. 6 TOWH OF $OUTHOLD Building Deportment Town Clef ks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY instructions A. This opphcotton must be filled m typewriter OR ink, and submitted m DUPLICATE to the Building Inspector with the following; for new buddings or new use: 1. Final survey of property with accurate location of all buddings, property lines, streets, OhO 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, Mulhple Residences and similar buildings and installations, a certificate of Code comphonce from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buddings (prior to April 1957), Non-conforming uses, or buildings and "pre-exmting" 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 inspect=on of buildings or premises, or other pertinent 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 .............. Sul)d,v,sion ................................................................ Lot No ............. BJ.ock No ........... ~, House No .~.~.~-~ Health Dept. Approval ..... ~::...~.,,. .......................... Labor Dept. Approval ...... ~/~./.,.~., ............................ Underwriters Approval ...... ~.~.r.../.('..: .......................... Planning Board Approval ../~..:~.'.~, ......................... Request For Temporary Certificate .../~4 .~.., .......................... Fincd Certificate ......~..~ ................... Fee Submitted $ .... .~.~'.,..{~.. ................ Construction on above described building g~ ge~mit meets ~ al~glicable codes and regulations. Sworn to before me this --t ,., ti ................ day of ............................................ (stamp or seal) Notary Public .................................... County ~[,~'t' , "P'¢t Examined Approved FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Permit No. d~.~ .~ ~_ ~ Disapproved o~ .............................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This apphcat,on must be completely f,lled in by typewriter o~ in ink and submitted in triplicate to the Buildin[ 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 streets o, areas, and glwng a detailed description of layout ofproperty must be drawn on the diagram which is part of this application c. The work covered by this apphcation 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 permi. 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 o Certificate of Occupanc~ shall hove been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to th, Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o, Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein described The applicant agrees to comply with oil applicable lows, 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 a corporation) / (Addle, is of opplicantg State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of If applicant is a corporate, signature of duly authorized officer. ~ (Name and title of corporate officer) Builder's License No ........ ..~...:Z....~.......-%.....~........-~... .... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proRosed w~rk will be done. AAap No: ................. --..... ................... Lot No......~ ................. Street and Number ..... ~....~, .~....~.(j,~......~...j.~..tZ,,:,t,¢~,.,,:~..l~:u.~,.,1/ ...... ~..,~...¢.~.... (~/ Municil~ality ' 2. Stale existing use and occupancy of premises and in?ende41 use and occupancy of proposed construction: o Exisiting use and occupancy .... ~ ..-~'~..'z .............. , ........................................................ 3. INature of work (check whmh applicable). New Building .............. Addition ..... ~ ...... Alteration .......... Repmr ................. Removal ............... Demohhor ................... Other Work ................................................ ,~ (Descriphon) 79-/-1] 4 Est,mated Cost ........ ./~....~... .................................. Fee ........... ~..~-r......L......-. ......................................................... (to be pa~d on filing th~s application) 5 If dwelling, number of dwelhng units .......... ~ ........... Number of dwelhng units on each floor ............ '"'. ............ If garage, number of cars ............................ ~ ........................................................................................................ 6. If business, commercial or m~xed occupancy, specify nature and extent of each type of use -- ... 7 D~mens~ons of ex,sting structures, ~f any' Front ..... ~ .............. Rear ................................Depth .................. Height -- Number of Stones ......... ~ ............................................................................................. D~rnens~ons of same structure with alterations or add~hons. Front ........ ..--2.. ........................ Rear ........................ Depth ....................... "--. ...... Height ............ '~. ...... Number of Stones ............................. 8 D~r~,ens~o~s of entire new construchon' Front ............. ~ ................... Rear ..... ~ ................... Depth ..................... He~!~ht ................. Number of Storms ........... "-. ........................................................................................ 9 S,ze of lot: Front ............ .............................. Rear ..............~....~..... ................. Depth..~;~.~. ................. 10 Date of Purchase ..................... ~ ........................ Name of Former Owne~ ........ ."........~....~:?..~.~. .............. 11. Zorle or u~e d,str,ct ,n wh,ch prem,ses are s,tuated ........ R.-J,¢~.~-,..~ ................ ............................ 12 Does proposed construction v~olate any zoning law, ordinance or regulation ...... ~....~. .................................... 13. W~II lot be regraded .................... ---. ...... W~II excess fill be removed from premises: ( ) Yes ( ) No 14. l'4arr,e of Owner of prem,ses ..~..,.-~..~n~,,~..~ ......... Address ..~..~.'.~.. Phone No ..................... Name of Architect ......................................... Address ................................Phone No ..................... Nome af Contractor . ~ ..(~.~"v-,'~'~.~ ........... Address ..C~..~..~..~Phone No.~.,~.~...-..~..~.?~. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether existing or proposed, and indicate all set-back dimensions fro~ property lines. Gwe street and block number or description according to deed, and show street names and indlcat whether ir,tenor or corner lot STATE C:'F NEW YORK, [c ¢ COUNTY OF ......................... f~"~ .................................................................................... being duly sworn, deposes and says that he is the apphca (Name of mdiwdual s~gning contracf) above no,med. He is th,': ................................................................................................................................................................ (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 f this opphcotion, that all stotements contained in thru applicat,on are true to the best of his knowledge and behef; a tha~ the 'work w~lt be performed in the manner set forth in the opphcation filed therewith Sworn to before me this ........................ day of ....................................... , 19 .... Notary I.'ubhc, . ................................................... County ................................... (Signature of applicant)